A cross-sectional survey of pain in palliative care in Portugal

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• 作者：Ferraz Gon?alves (1) (11)
  Ana Almeida (1)
  Catarina Antunes (2)
  Maria Cardoso (3)
  Margarida Carvalho (4)
  Maria Claro (5)
  Francisca Coimbra (6)
  Inês Diniz (2)
  Bruno Fonseca (5)
  Emília Fradique (7)
  Edna Gon?alves (8)
  Florbela Gon?alves (9)
  Maria Gon?alves (4)
  Américo Magalh?es (10)
  Paulo Pina (6)
  Concei??o Pires (8)
  Paula Silva (1)
  Ricardo Silva (3)
  Rui Silva (9)
  Filipa Tavares (7)
  Laura Teixeira (10)
  
• 关键词：Palliative care ; Portugal ; Pain ; Pain control ; Pain Management Index
• 刊名：Supportive Care in Cancer
• 出版年：2013
• 出版时间：July 2013
• 年：2013
• 卷：21
• 期：7
• 页码：2033-2039
• 全文大小：140KB
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• 作者单位：Ferraz Gon?alves (1) (11)
  Ana Almeida (1)
  Catarina Antunes (2)
  Maria Cardoso (3)
  Margarida Carvalho (4)
  Maria Claro (5)
  Francisca Coimbra (6)
  Inês Diniz (2)
  Bruno Fonseca (5)
  Emília Fradique (7)
  Edna Gon?alves (8)
  Florbela Gon?alves (9)
  Maria Gon?alves (4)
  Américo Magalh?es (10)
  Paulo Pina (6)
  Concei??o Pires (8)
  Paula Silva (1)
  Ricardo Silva (3)
  Rui Silva (9)
  Filipa Tavares (7)
  Laura Teixeira (10)
  
  1. Instituto Português de Oncologia, Porto, Portugal
  11. Unidade de Cuidados Paliativos, Instituto Português de Oncologia, 4200-072, Porto, Portugal
  2. Hospital do Mar, Lisbon, Portugal
  3. Centro Hospitalar Lisboa Central, Lisbon, Portugal
  4. Hospital do Litoral Alentejano, Santiago do Cacém, Portugal
  5. Unidade Local de Saúde de Matosinhos, Matosinhos, Portugal
  6. Instituto Português de Oncologia, Lisbon, Portugal
  7. Hospital de St. Maria, Lisbon, Portugal
  8. Centro Hospitalar de S. Jo?o, Porto, Portugal
  9. Instituto Português de Oncologia, Coimbra, Portugal
  10. Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, Portugal
  
• ISSN：1433-7339

文摘

Objective The purpose of this work is to study the prevalence, intensity, and treatment of pain in Portuguese palliative care teams. Methods Twenty-one palliative care teams were invited to participate in a cross-sectional survey. Ten of these accepted and were included in the study. Data of all patients observed on the 18th week of 2011 were collected. The data collected concerning pain were: demographic data, pain intensity, drugs prescribed, and invasive techniques. The intensity of pain was rated using a five-point verbal rating scale from none to maximum. The Pain Management Index (PMI) was used to calculate the adequacy of the analgesia. Results A total of 164 patients were included in this study. One hundred fifty-one (92?%) had cancer. The median age was 71?years (16 to 95). Eighty-four (51?%) were females. Pain was directly assessed in 136 (83?%) of the patients, whereas 27 patients could not report pain because of cognitive failure. Of those directly assessed, 77 (57?%) had pain when they were assessed: 42 (55?%) mild, 25 (32?%) moderate, 9 (12?%) severe, and 1 (1?%) maximum. Non-opioid analgesics were used: paracetamol in 61 (37?%) and NSAID in 20 (12?%). Tramadol was the only opioid for mild to moderate pain used in 25 (15?%) patients. The opioids most used for moderate to intense pain were: morphine 74 (45?%), transdermal (TD) fentanyl 32 (20?%), and buprenorphine TD 28 (17?%). The adjuvants most used were: corticosteroids 38 (23?%), gabapentin 37 (23?%), and amitriptyline 15 (9?%). Only five (4?%) patients had a negative PMI, meaning an inadequate analgesia. Conclusion The general prevalence of pain is similar to that reported by other. The prevalence of moderate to severe pain is also similar to that reported in other studies, although severe pain is somewhat lower than indicated in most reports. According to the PMI, pain control was acceptable to good.