Abstract:Cancer has a high incidence in the elderly, and pain is one of the main symptoms that plague elderly cancer patients. Cancerous pain management is a standardized process of pain control and has important clinical significance. This article summarizes the common problems in the pain management process of elderly cancer patients, the deviation of elderly patients’ perception of pain and the degradation of their physiological levels, insufficient attention of medical staff and insufficient knowledge reserves, imperfect hospital regulations and lagging social cognition, etc. All have negative impacts on the management of elderly cancerous pain. With the stepping into an aging society, the cancerous pain problem of elderly patients urgently needs to be solved by mature clinical management solutions. This article puts forward suggestions for the pain management and evaluation process. The training of medical workers should be increased, the importance of medical staff should be emphasized, the communication and guidance of patients’ medication should be strengthened, and comprehensive and effective personalized pain assessment should be provided. Doing a good job in the assessment and management of elderly cancerous pain can effectively improve patients’ attitudes towards cancer treatment and their quality of life, and at the same time play an important and positive role in cancer treatment.
潘岑 王庆兰▲ 伍龙 邓杨清 王迪. 老年癌症疼痛管理过程中的问题及建议[J]. 中国医药导报, 2021, 18(2): 176-178,186.
PAN Cen WANG Qinglan▲ WU Long DENG Yangqing WANG Di. Problems and suggestions in the management of elderly cancerous pain. 中国医药导报, 2021, 18(2): 176-178,186.
[1] van den Beukin-van Everdingen MHJ,Hochstenbach LMJ,Joosten EAJ,et al. Update on Prevalence of Pain in Patients With Cancer:Systematic Review and Meta-Analysis [J]. J Pain Symptom Manage,2016,51(6):1070-1090.
[2] Rucinski K,Cook JL. Effects of preoperative opioid education on postoperative opioid use and pain management in orthopaedics:A systematic review [J]. J Ortho,2020, 20:154-159.
[3] van den Beukin-van Everdingen MHJ,de Rijke JM,Kessels AG,et al. Prevalence of pain in patients with cancer:a systematic review of the past 40 years [J]. Ann Oncol,2007,18(9):1437-1449.
[4] Zylla D,Steele G,Gupta PA. Systematic review of the impact of pain on overall survival in patients with cancer [J]. Support Care Cancer,2017,25(5):1687-1698.
[5] Islami F,Sauer AG,Miller KD,et al. Proportion and number of cancer cases and deaths attributable to potentially modifiable risk factors in the United States [J]. CA Cancer J Clin,2018,68(1):31-54.
[6] Lin J,Hsieh RK,Chen JS,et al. Satisfaction with pain management and impact of pain on quality of life in cancer patients [J]. Asia Pac J Clin Oncol,2020,16(2):e91-e98.
[7] 王伟,吴清霞.临床疼痛管理研究进展[J].护理学杂志,2016,31(4):101-103.
[8] Magrum BA,Brower K,Eiferman D,et al. Combating the Opioid Epidemic in Acute General Surgery:Reframing Inpatient Acute Pain Management [J]. J Surg Res,2020, 251:6-15.
[9] You E. Nontraditional and Home-Based Self-management Interventions in Cancer Patients With Pain:A Mixed-Method Systematic Review [J]. Holist Nurs Pract,2020,34(3):138-149.
[10] Smith BD,Smith GL,Hurria A,et al. Future of cancer incidence in the United States:burdens upon an aging,changing nation [J]. J Clin Oncol,2009,27(17):2758-2765.
[11] Lemaire A,George B,Maindet C,et al. Opening up disruptive ways of management in cancer pain:the concept of multimorphic pain [J]. Support Care Cancer,2019,27(8):3159-3170.
[12] 赵婷鹭,马旭梅,邓玉珊.术后疼痛管理影响因素的研究分析[J].护理管理杂志,2015,15(6):411-413.
[13] Yoshikawa K,Brady B,Perry MA,et al. Sociocultural factors influencing physiotherapy management in culturally and linguistically diverse people with persistent pain:a scoping review [J]. Physiotherapy,2020,107:292-305.
[14] Taylor S,Bishop A. Patient and public beliefs about the role of imaging in the management of non-specific low back pain:a scoping review [J]. Physiotherapy,2020, 107:224-233.
[15] 谢辉兰,曾令清,顾连兵,等.老年癌症疼痛治疗的研究进展[J].实用老年医学,2017,31(1):20-23.
[16] Russo MM,Sundaramurthi T. An Overview of Cancer Pain:Epidemiology and Pathophysiology [J]. Semin Oncol Nurs,2019,35(3):223-228.
[17] Prostran M,Vujovi■ KS,Vu■kovi■ S,et al. Pharmacotherapy of Pain in the Older Population:The Place of Opioids [J]. Front Aging Neurosci,2016,8(16):144.
[18] Brant JM. Assessment and Management of Cancer Pain in Older Adults:Strategies for Success [J]. Asia Pac J Oncol Nurs,2018,5(3):248-253.
[19] Sera L,Uritsky T. Pharmacokinetic and pharmacodynamic changes in older adults and implications for palliative care [J]. Prog Palliat Care,2016,24(5):255-261.
[20] Borsheski R,Johnson QL. Pain management in the geriatric population [J]. Mo Med,2014,111(6):508-511.
[21] Zhang JQ,Zhu SS,Tan QL,et al. Combination therapy with ropivacaine-loaded liposomes and nutrient deprivation for simultaneous cancer therapy and cancer pain relief [J]. Theranostics,2020,10(11):4885-4899.
[22] Ng R,Allore HG,Trentalange M,et al. Increasing negativity of age stereotypes across 200 years:evidence from a database of 400 million words [J]. PLoS One,2015,10(2):e0117086.
[23] Schroyen S,Missotten P,Jerusalem G,et al. Ageism and caring attitudes among nurses in oncology [J]. Int Psychogeriatr,2016,28(5):749-757.
[24] Eymard AS,Douglas DH. Ageism among health care prov-iders and interventions to improve their attitudes toward older adults:an integrative review [J]. J Gerontol Nurs,2012,38(5):26-35.
[25] 周倩.个体化护理干预对老年癌症疼痛患者使用阿片类药物镇痛的效果观察[J].中国医药指南,2017,15(20):256.
[26] Raoul D,Jean P,Lynne M,et al. Recent opioid use and fall-related injury among older patients with trauma [J]. CMAJ,2018,190(16):E500.
[27] Qian Y,Haider A,Lu ZN,et al. Factors Associated with Improvement in Uncontrolled Cancer Pain without Increasing the Opioid Daily Dose among Patients Seen by an Inpatient Palliative Care Team [J]. J Palliat Med,2020, 23(4):483-488.
[28] 林碧薇,林红英.癌症疼痛的护理问题及对策[J].中国实用医药,2013,8(5):267-268.
[29] Rigdon AS. Development of patient education for older adults receiving chemotherapy [J]. Clin J Oncol Nurs,2010, 14(4):433-441.
[30] 张凤,张静.癌症疼痛的非药物干预方法研究进展[J].护士进修杂志,2020,35(8):723-726.
[31] Tse MMY,Ng SSM,Bai X,et al. Lesson Learned from Peer Volunteers in a Peer-Led Pain Management Program among Nursing Home Residents [J]. Int J Environ Res Public Health,2019,16(17):3097.
[32] Balducci L,Dolan D. Palliative Care of Cancer in the Older Patient [J]. Curr Oncol Re,2016,18(12):70.
[33] Minello C,Beorge B,Allano G,et al. Assessing cancer pain-the first step toward improving patients’ quality of life [J]. Support Care Cancer,2019,27(8):3095-3104.
[34] Guerard EJ,Cleary JF. Managing Cancer Pain in Older Adults [J]. Cancer J,2017,23(4):242-245.
[35] Williams S,Keogh S,Douglas C. Improving paediatric pain management in the emergency department:An integrative literature review [J]. Int J Nurs Stud,2019,94:9-20.
[36] Lichtner V,Dowding D,Esterhuizen P,et al. Pain assessment for people with dementia:a systematic review of systematic reviews of pain assessment tools [J]. BMC Geriatr,2014,14(1):138.
[37] Klaess CC,Urton M,Whitehead P,et al. Pain Management Pillars for the Clinical Nurse Specialist:Summary of National Association of Clinical Nurse Specialists Opioid Pain Management Task Force [J]. Clin Nurse Spec,2019,33(3):136-145.
[38] 郑彦,姜涛.老年癌症疼痛患者治疗与护理进展[J].现代中西医结合杂志,2012,21(18):2048-2050.
[39] Asman O,Slutsker E,Melnikov S. Nurses’ perceptions of pain management adequacy in mechanically ventilated patients [J]. J Clin Nurs,2019,28(15/16):2946-2952.