|
| 四川省成都市肿瘤内科医护人员对癌痛规范化管理认知现状的调查 |
| Survey on the Current Status of Standardized Management of Cancer Pain Among Medical Staff in the Oncology Department of Chengdu, Sichuan Province |
| 投稿时间：2025-02-14 修订日期：2025-02-14 |
| DOI： |
| 中文关键词: 医护人员 肿瘤内科 癌痛管理 认知 调查 |
| 英文关键词: Medical staff Oncology departments Cancer pain management Cognition Investigation |
| 基金项目:新乡市科技攻关项目（GG2019044） |
|
| 摘要点击次数: 0 |
| 全文下载次数: 0 |
| 中文摘要: |
| 目的：调查四川省成都市各级医院肿瘤内科医护人员对癌痛的认知情况及管理现状，为推进癌痛规范化管理提供依据。方法：选取2024年6月-2024年10月四川省成都市19所医院的190名肿瘤内科医护人员作为研究对象。收集190名肿瘤内科医护人员的基本资料、癌痛相关知识知晓情况、癌痛治疗现状及癌痛管理中存在的相关障碍因素等信息。结果：肿瘤内科医生与护士在癌痛治疗和管理现状、世界卫生组织（WHO）三阶梯止痛疗法和癌痛治疗五项基本原则运用熟练程度、掌握NCCN、ESMO指南内容及应用熟练程度、在药物的使用、不良反应的处理、药物剂量的换算、职称对治疗差异比较具有统计学意义（P<0.05）。护士的认知率显著低于医生（P<0.05）。开展情况以及相关培训结果显示，80%的医护人员所在单位有开展癌痛规范化诊疗，但不到40%的医护人员所在单位未开展癌痛规范化诊疗相关培训。患教管理和出院随访情况显示，90%以上的医护人员在为患者使用止痛药前会常规告知患者所用止痛药物的副作用。25%以上的患者遵照医嘱用药情况较好，约70%的患者遵照医嘱用药情况一般，另有约4%的患者遵照医嘱用药情况较差。约90%的医护人员认为为患者及家属提供了较好的癌痛健康指导与咨询，80%以上的医护人员会指导患者进行疼痛日记的记录。统计结果显示：医生选择的排名在前三位的障碍因素依次为：医生对患者的疼痛评估不到位（58.2%）、医生及患者对止痛药成瘾性和依赖性的担心（58.2%）和医生对癌痛重视程度不足（56.2%）；患者选择的排名在前三位的障碍因素依次为：患者离院后随访不到位（54.9%）、患者及其家属不愿意主动或真实的报告疼痛（48.4%）和患者及其家属对止痛药的接受度和依从性差（48.4%）。在癌痛管理提升方面，医护人员认为需要多维度进行提升和改进以促进癌痛患者的治疗。在解决癌痛管理问题的关键所在方面，81.70%的医护人员认为需要按照生物-心理-社会医学模式治疗癌痛、76.47%的医护人员认为需要推进癌痛规范化病房的落实、71.90%和71.24%的医护人员认为有必要改变传统观念和开展多学科协作治疗（MDT）模式、62.09%的医护人员认为需要加大医护人员的培训力度、52.94%的医护人员认为加强患者教育也同样重要。结论：四川省成都市19所肿瘤内科医护人员对癌痛的认知、评估、治疗和管理上都有待加强。建议在癌痛管理过程中强化医护人员教育，转变患者认知、增强癌痛自我管理能力、加强患者心理疏导、提供情感支持以及完善相关制度，以改善癌痛患者的生活质量。 |
| 英文摘要: |
| Objective:To investigate the awareness and management status of cancer pain among medical staff in oncology departments at all levels of hospitals in Chengdu, Sichuan Province, and provide a basis for promoting standardized management of cancer pain.Method:190 oncology medical staff from 19 hospitals in Chengdu, Sichuan Province from June 2024 to October 2024 were selected as the research subjects. The basic information, knowledge of cancer pain, current status of cancer pain treatment and related obstacles and factors in cancer pain management from 190 medical staff in the oncology department were collected.Result:There were statistically significant in the current status of treatment and management of cancer pain, proficiency in the application of the World Health Organization (WHO) three-step pain management therapy and the five basic principles of cancer pain treatment, mastery of NCCN and ESMO guidelines and their application proficiency, use of drugs, management of adverse reactions, conversion of drug doses, and differences in treatment based on professional titles between oncology medical staff and nurses (P<0.05).The cognitive rate of nurses was significantly lower than that of doctors (P<0.05). The implementation status and related training results show that 80% of medical staff work in units that carry out standardized diagnosis and treatment of cancer pain, but less than 40% of medical staff in their units have not received carry out standardized diagnosis and treatment of cancer pain. According to patient education management and discharge follow-up, more than 90% of medical staff routinely inform patients of the side effects of painkillers before using them. More than 25% of patients had good medication adherence to medical advice, about 70% of patients had average medication adherence to medical advice, and about 4% of patients had poor medication adherence to medical advice. About 90% of medical staff believed that good cancer pain health guidance and counseling were provided to patients and their families, and more than 80% of medical staff will guide patients to keep pain diaries. The statistical results show that the top three obstacle factors selected by doctors were: inadequate pain assessment of patients by doctors (58.2%), Concerns among doctors and patients about addiction and dependence on painkillers (58.2%) and insufficient attention to cancer pain by doctors (56.2%); The top three obstacles selected by patients were: inadequate follow-up after discharge (54.9%), unwillingness of patients and their families to actively or truthfully report pain (48.4%) and poor acceptance and compliance of painkillers by patients and their families (48.4%). In terms of improving cancer pain management, medical staff believed that multidimensional improvements and enhancements were needed to promote the treatment of cancer pain patients. In terms of solving the key issues of cancer pain management, 81.70% of medical staff believed that it was necessary to treat cancer pain according to the biopsychosocial medical model, 76.47% of medical staff believe that it was necessary to promote the implementation of standardized cancer pain wards, 71.90% and 71.24% of medical staff believed that it was necessary to change traditional concepts and carry out multidisciplinary collaborative treatment (MDT) models, 62.09% of medical staff believed that it was necessary to increase training for medical staff, and 52.94% of medical staff believed that strengthening patient education was equally important. Conclusion:Medical staff in 19 oncology departments in Chengdu, Sichuan Province need to strengthen their understanding, evaluation, treatment, and management of cancer pain. It is recommended to strengthen the education of medical staff in the process of cancer pain management, transform patient cognition, enhance cancer pain self-management ability, strengthen patient psychological counseling, provide emotional support, and improve relevant systems to improve the quality of life of cancer pain patients. |
|
View Fulltext
查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
