癌痛病患的疼痛信念、疼痛感覺特質及其相關因素之探討

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 中文摘要

 論文摘要

 論文名稱：癌痛病患的疼痛信念、疼痛感覺特質及其相關因素之探討

 研究所名稱：台北醫學大學護理研究所

 研究生姓名：李淑貞

 畢業時間：九十一學年度第二學期

 指導教授：賴裕和台北醫學大學副教授

 本研究之目的是在探討癌痛病患的疼痛信念、疼痛感覺特質及其相關因素之關係。研究採橫斷式相關性研究，於北

部某教學醫院腫瘤科病房選取符合之個案 94 人，研究資料以簡明疼痛量表、疼痛態度量表（ SOPA-35 ）、疼痛及麻醉性止痛藥物量表 - 癌症版（ POABS-Ca ）及疼痛因應策略 - 厄運次量表 (CSQ-C) 收集資料，利用 SPSS 統計軟體進行描述性統計、獨立 t 檢定、單因子變異數分析。

 研究結果發現： (1) 個案有較低的疼痛控制信念及較高的疼痛殘障信念，在止痛藥負向作用及忍耐疼痛的擔心較高

，雖然研究對象之厄運感普遍較低，但仍有些個案有較高的厄運感想法。 (2) 女性的厄運感信念比男性高，年齡與疼痛殘障信念呈負相關；接受教育愈多年者其疼痛控制信念愈好，且疼痛強度 ( 最劇烈疼痛強度及平均疼痛強度 ) 愈低。 (3) 身體功能愈差者，其疼痛強度愈強，整體疼痛干擾愈大；身體功能與疼痛控制信念、忍耐疼痛信念呈正相關，與疼痛殘障信念、厄運感及疼痛本質呈負相關。 (4) 整體疼痛干擾與疼痛控制信念、忍耐疼痛信念呈負相關

，與疼痛殘障信念、厄運感呈正相關。 (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 ) 與疼痛殘障信念、厄運感呈正相關，與疼痛控制信念、忍耐疼痛信念呈負相關。 (6) 平均疼痛強度對疼痛控制信念及忍耐疼痛信念有較大預測力，而整體疼痛干擾對疼痛殘障信念及厄運感信念則有較大預測力。本研究結果顯示整體疼痛干擾及平均疼痛強度在疼痛信念方面扮演一個很重要的角色，整體疼痛干擾愈大者及疼痛強度愈強者，有愈負向的疼痛信念，且愈沒有疼痛控制能力，使疼痛處理更加複雜；在麻醉性止痛藥方面，病人有較負向的疼痛信念，尤其擔心藥物負向作用，而忍耐疼痛。因此臨床照護上，應強化病人的疼痛控制信念及正確的用藥信念。，以有效改善疼痛控制，讓病人獲得更佳的生活品質。

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An Exploratory Study of the Pain Beliefs, Pain Sensory Characters, and Related Factors in Cancer Pain Patients

 英文摘要

 In order to investigate the pain beliefs, pain sensory characters and related factor in cancer pain patients, we conducted a study in an oncology ward using cross-section correlation design. Respondents in this study were obtained from 94 patients sufferin g from cancer pain who were hospitalized in an oncology ward of a teaching hospital of northern Taiwan. The Belief Pain Inv entory (Short From), Survey of Pain Attitude (SOPA-35), Pain Opioid Analgesics Belief Scale-Cancer (POABS-CA) and Cop ing Strategies Questionnaire-Catastrophizing (CSQ-C) were used for data collection. For statistical analysis, clinical data was managed by the Scientific Package of Social Sciences software version 10.0, and student t-test, one-way ANOVA and stepwis e regression were adapted for descriptive statistics.

After data completion and statistical analysis, the results were as follows: (1) The clients with lower pain control beliefs and h igher pain disability beliefs were worried about the side effect and endurance of pain, although they had a lower catastrophic t hinking. (2) Female respondents were associated with a higher probability of catastrophic thinking than male, whereas the eld er were with a lower belief of pain disability. In addition, better pain control beliefs and lower pain intensity were noted in par ticipants with a higher education level. (3) The diminution of physical function was associated with a higher pain intensity an d total pain interference. In other words, patients with a better physical condition whose pain control beliefs and beliefs of pai n endurance were better as well, and they showed a lower correlation to the pain disability, catastrophic thinking and the essen ce of painful. (4) There was a negative correlation between the total pain interference, the belief of pain control and the beliefs of endurance. However, a positive correlation was noted for the beliefs of pain disability and catastrophic thinking. (5) The nu mber of sites of pain and the duration of pain were insignificant to previous factors, whereas the intensity of pain (the worst pa in intensity and average pain intensity) revealed a positive correlation with the beliefs of pain disability and catastrophic think ing. However, the intensity of pain showed a negative correlation to the belief of pain control and belief of pain endurance. (6) The average intensity is a predictor of pain belief control and beliefs of pain endurance, and total pain interference is an indica tor of beliefs of pain disability and catastrophic thinking. In this study, it revealed that the pain beliefs were playing a very im portant role in total pain interference and the average intensity of pain. In other words, increasing in the total pain interference and pain intensity could lead to a worse pain control in patients. Regarding the narcotic analgesics, respondents who used the m were associated with a lower pain belief, especially for the narcotic side effect and intention to pain endurance. Therefore, r einforcement of the pain control beliefs and medication beliefs may improve the efficacy of pain control and provide a better quality of life.

Key words: Cancer pain, Pain beliefs, Pain control belief, Disability belief,

endurance pain belief, Pain negative belief, Catastrophic thinking, Interference of pain, Pain sensory characters