Abstract: Objective To evaluate the severity of cancer-related pain and the adequacy of pain management in home-based advanced cancer patients with pain, and to examine whether the awareness of cancer diagnosis affected their pain severity. Methods A cross-sectional study was completed with a sample of 98 home-based advanced cancer patients with pain who first visited the Hospice of the First Affiliated Hospital of Chongqing Medical University from December, 2009 to June, 2010. Pain severity was measured by using the Brief Pain Inventory (BPI). Descriptive analysis was conducted for demographic and clinical data, t-test was performed to compare pain severity between 2 groups, those who knew their cancer diagnosis and those did not. Results Of 98 patients, 56.12% (55/98) were male and the mean age of patients was (61.08 ± 11.67) years old, 79.59% (78/98) of the patients reported moderate to severe pain during the past 24 h. 11.22% (11/98) of the patients were not receiving any analgesics at the time of the survey. There were 19.39% (19/98) patients receiving non-steroid anti-inflammatory drug (NSAID), 35.71% (35/98) receiving weak opioids and 33.67% (33/98) receiving strong opioids, and 39.80% (39/98) had a negative Pain Management Index (PMI). There were 46.94% (46/98) patients did not know their cancer diagnosis. No statistically significant differences in cancer pain severity were seen between 2 groups, those who knew their cancer diagnosis and those did not (P > 0.05, for all). Conclusion This study provides a representative view of pain status of home-based advanced cancer patients in China. The findings suggest that cancer pain management is insufficient in home-based advanced cancer with pain. Intensive analgesia should be given to these patients. Many factors may influence the pain severity and reduction, but honest disclosure of the cancer diagnosis to patients does not affect their severity of cancer pain.

Key words: Pain, Analgesics, opioid, Drug therapy, Neoplasms, Cross-sectional studies

摘要： 目的   通过分析家居晚期癌性疼痛患者的疼痛一般情况、镇痛药物使用情况及疼痛控制情况，研究知情与否对家居晚期癌性疼痛患者疼痛程度的影响。方法   以2009 年12 月-2010 年6 月在重庆医科大学附属第一医院宁养院初次就诊的家居晚期癌性疼痛患者作为对象进行横断面研究。采用一般社会人口学资料调查表和中文版简明疼痛调查表进行调查，疼痛治疗指数（PMI）评价患者疼痛控制情况；描述性统计方法分析患者疼痛的一般情况、镇痛药物使用情况和疼痛控制情况，t 检验比较知情组与不知情组患者在过去24 h 内疼痛程度的差异性。结果   共纳入98 例家居晚期癌性疼痛患者，平均年龄（61.08 ± 11.67）岁，男性55 例（56.12%）。其中79.59%（78/98）为中至重度疼痛，未曾服用镇痛药者占11.22%（11/98），服用非阿片类镇痛药19.39%（19/98）、弱阿片类镇痛药35.71%（35/98）、强效阿片类镇痛药33.67%（33/98）；提示39.80%（39/98）患者疼痛治疗不足（PMI < 0）。约46.94%（46/98）患者不知情，但与知情患者疼痛程度之间差异并无统计学意义（均P > 0.05）。结论   疼痛是晚期癌症患者的主要症状之一，部分家居晚期癌性疼痛患者疼痛治疗不足，应该加强对此类患者的镇痛治疗。疼痛程度和疼痛缓解效果受多种因素的影响，患者对病情知情与否并不影响其疼痛程度。

关键词: 疼痛, 镇痛药, 阿片类, 药物疗法, 肿瘤, 横断面研究