癌痛病患疼痛控制信念、殘障信念、感覺特質及其相關性之探討

An Exploratory Study of Pain Control Beliefs, Pain Disability Beliefs, PainSensory Characteristics and Their Relationships in Cancer Patients

本研究之目的在探討癌痛病患的疼痛控制信念、疼痛殘障信念與疼痛感覺特質及其相關性。採橫斷式相關性研究，於北部某醫學中心腫瘤科病房之住院病人為收案對象，共選取94位癌痛病患，以簡明疼痛量表及疼痛態度量表(SOPA-35)收集資料，研究發現：1.個案疼痛強度在中度至重度間，疼痛緩解程度僅達68.3%，對病患的日常生活活動之干擾程度屬中度干擾。2.個案有較低的疼痛控制信念及較高的疼痛殘障信念。3.身體功能愈差者，其疼痛強度愈強，整體疼痛干擾愈大。4.整體疼痛干擾愈大者，其認為有能力控制疼痛之信念愈低，病患愈會覺得疼痛使其如殘障般失能。5.疼痛部位數及疼痛時間與疼痛信念無關；疼痛強度(最劇烈疼痛強度及平均疼痛強度)愈強其疼痛控制信念愈低，疼痛殘障信念則愈高。研究結果顯示病患的疼痛強度及整體疼痛干擾在疼痛信念方面扮演著重要的角色，因此臨床照護上，應強化病患疼痛控制技巧，以矯正其對疼痛之負向看法，將有助於腫瘤病患改善疼痛問題及其生活品質。

The purpose of this study was to investigate pain control belief, pain disability belief, pain sensory characters, and their relationships in cancer patients. The cross sectional study involved 94 cancer patients in the oncology ward of a teaching hospital in northern Taiwan. The Belief Pain Inventory (Short form) , and Survey of Pain Attitude (SOPA-35) were used for collecting data. According to our results: (1) The clients' pain intensity ranged from moderate to severe, and the pain relief was only 68.3%. Pain interference to clients' daily activities presented it with moderate interference. (2) The participating patients had lower pain control beliefs and higher pain disability beliefs; (3) Diminution of physical function was associated with a higher pain intensity and total pain interference. (4) A higher total pain interference was associated with a lower pain control beliefs, and more severe total pain interference was associated with a higher probability of belief in pain disability; (5) The number of sites of pain and the duration of pain did not correlate with pain beliefs, whereas the increased intensity of pain (the worst pain intensity and average pain intensity) was associated with a lower pain control beliefs and higher beliefs of pain disability. Our study revealed that the pain beliefs played a very important role in total pain interference and pain intensity. Therefore, the reinforcement of pain control skills may improve the efficacy of negative pain belief and provide a better pain control and quality of life.