Pain management for cancer patients in hospice wards of community health centers
10.3760/cma.j.cn114798-20211116-00852
- VernacularTitle:社区卫生服务中心舒缓疗护病房肿瘤患者癌痛治疗情况及镇痛效果影响因素分析
- Author:
Ying YU
1
;
Lin ZHANG
;
Danxia CHEN
;
Yuezhong TANG
;
Haiying GAO
;
Donghao XU
;
Zheng WANG
;
Qiong ZHU
;
Sunfang JIANG
Author Information
1. 复旦大学附属中山医院全科医学科，上海 200032
- Keywords:
Community health service;
Pain;
Carcinoma;
Palliative care
- From:
Chinese Journal of General Practitioners
2022;21(3):225-230
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the status quo of pain management for cancer patients in hospice care wards of community health service centers.Methods:The electronic medical records of 373 cancer patients admitted in hospice wards of Kangjian Community Health Center of Xuhui District and Jinshanwei Town Community Health Center of Jinshan District from January 2015 to July 2021 were collected. The characteristics of cancer pain, the use of analgesic drugs, the effects of analgesic drugs and its influencing factors were analyzed.Results:The incidence of cancer pain in 373 patients was 93.0% (347/373), and the proportion of moderate to severe cancer pain was 55.6% (193/347). Analgesics were used in 304 patients, among whom 233 (76.6%) patients used oral analgesics, 297 (97.7%) used on time, 97.6%(285/292) used sustained-release opioids, and 94 (30.9%) used combinedly. Breakout pain occurred in 100 cases (32.9%), all of which was controlled with immediate-release morphine. Cancer pain was not relieved in 132 cases (43.42%), and multivariate logistic regression analysis showed that the pain degree on admission (moderate: OR=3.69, 95 %CI:2.09-6.49; severe: OR=5.52, 95 %CI:2.43-12.53), the presence of burst pain ( OR=3.28, 95 %CI:1.77-6.06), the type of analgesics used (non-steroidal+weak opioids: OR=0.39, 95 %CI:0.20-0.76; nonsteroidal+strong opioids: OR=0.20, 95 %CI:0.08-0.51) and the adverse reactions ( OR=1.92, 95 %CI:1.03-3.60) were the influencing factors of pain relief in cancer pain patients (all P<0.05). Conclusion:The pain of cancer patients admitted to community palliative care wards cannot be ignored. Although most cancer pain patients use analgesic drugs in a standard way, there are still a high proportion of patients whose pain is not controlled. Various factors affect the effect of analgesic treatment.
