癌症病人及家屬之疼痛教育對改善病人服藥遵從性及疼痛控制之成效 The Effectiveness of a Pain Educational Program for Cancer Patients and Their Family Caregivers
中文摘要
本研究目的為探討疼痛教育是否能長期降低癌症病人及家屬的障礙因子、增進病 人服用止痛藥物之遵從性、降低疼痛強度及疼痛對生活的干擾程度。研究對象為 診斷為癌症，目前使用口服止痛藥物治療之病人及家屬，定期於門診追蹤者，
而研究地點為台北市某醫學中心及某區域醫院之腫瘤科門診。
本研究以中文版簡明疼痛量表、止痛藥障礙因子問卷、服藥遵從性測量問卷、及
口服藥物劑量比率換算表進行資料收集。採類實驗研究法，共收集實驗組31 對
病人及家屬，對照組30 對病人及家屬（N＝122）。實驗組給予疼痛教育手冊及 進行系統性疼痛教育措施，對照組僅接受常規性的門診追蹤照護，並未提供衛 教手冊，而兩組均進行前測一次的資料收集，及於第二週及第四週進行後測追 蹤。研究結果以SAS 8.0 版套裝軟體進行 GEEs(Generalized Estimating Equations) 統計分析來測試兩組在疼痛教育介入成效之差異。
本研究為第一個使用GEEs(Generalized Estimating Equations)統計方式進行疼痛 教育對改善病人及家屬之服藥遵從性及疼痛控制長期成效之研究，其能有效控 制介入型研究中兩組的不對等狀態、對照組的成長效應及混淆因素的干擾中，來 檢定疼痛介入的成效為何。而本研究證實了疼痛教育在改善病人及家屬的障礙因 子、病人的服藥遵從性、最劇烈疼痛強度、疼痛對生活干擾程度的顯著成效，也 說明家屬因同時獲得疼痛教育的諮詢增進他們於疼痛處置上的知識，而能在病 人的疼痛控制中發揮相輔相成的結果。同時本研究也支持多次給予病人及家屬面 對面疼痛教育、及長期追蹤評值病人疼痛強度的在癌痛處置中的重要貢獻。
英文摘要
The purpose of this study was to explorer the pain educational program for cancer patient and their family caregivers could reduce the barriers to taking analgesics, improve the analgesic compliance, decrease the degree of pain and lower the impacts on daily life. The sample who had been diagnosed as cancer and their family
caregivers, and had been taking pain medications.
The Barriers Questionnaire-Taiwan Form (BQT), Brief Pain Inventory-Short Form (BPI), compliance Self-report assessment tool and oral analgesics prescriptions ratio were used in this study. This study include experiment group of 31 pair patient and their family caregivers, and control group of 30 pair of another patient and their family caregivers. (N=122). The outcomes of pain education were measured at two times after the intervention. Data were analyzed by descriptive analysis and
GEE(Generalized Estimating Equations).
Results showed a significant increase in pain knowledge and analgesics compliance in patients who received the pain education program and a significant decrease in severe pain intensity. This research project is the first pain education and counseling program for both cancer patient and families by GEE(Generalized Estimating Equations).The finding of this research contribute to the literature on cancer pain management and improve of quality of cancer pain management.
