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癌症病人經定期評估及治療後的疼痛改善:某醫學中 心的一項前瞻性研究
Pain Improvement of Cancer Patients After Regular Assessments and Treatments: A Prospective Study in a Medical Center


台灣疼痛醫學雜誌第26卷第1期(2020-03-01)
 黃明輝(Ming-Huei Huang)、黃詩毓( Shih-Yu Huang)、許婷茹(Ting-Ju Hsu)、袁志綸(Chih-Lun Yuan)、樊君儀(Chun-I Fan)
摘要

Abstract
Background: Clinical practice data about good pain management (GPM) implementation is still lacking in Taiwan. The purpose of this study is to investigate the effectiveness and feasibility of GPM.
Methods: From June 1, 2018 to December 31, 2018, a total of 48 patients with moderate to severe pain were included in the analyses prospectively. Pain intensity was evaluated by using the numerical rating scale (NRS). Presence of neuropathic pain was evaluated by using the Douleur Neuropathique 4 questionnaire. The Revised American Pain Society Patient Outcome Questionnaire, including six core quality indicators, was filled out during initial admission, 24±4 hours, 48±4 hours, and 72±4 hours after admission.
Results: There were 26 males and 22 females. The types of cancer were mainly pancreatic cancer (37.5%), head and neck cancer (16.6%) and gastric cancer (16.6%). Our patients experienced a significant pain improvement after regular assessments and pain medication adjustment (p< 0.05; Table 3, Figure 1). Six patients failed to reach the 333 index of cancer pain control [1]. After completion of the study, our patients were divided into two groups: well-controlled group (NRS<4, n=42) and poorly-controlled group (NRS≥4, n=6). The average age was 55.0 in well-controlled group and 53.5 in poorly-controlled group. Only one patient was eligible for neuropathic pain. In the poorly-controlled group, the emotional impact severity scores were slightly higher than those of the well-controlled group at the four survey time points (Figure 4). The impacts of disease severity and drug side effects on pain were unremarkable (Figure 3, Figure 5).
Conclusion: Our study suggest GPM implementation is effective and feasible for moderate to severe cancer pain. If the patient's pain is not well controlled, psychological counseling and necessary interventions might be considered.

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