疼痛教育及放鬆訓練對改善癌痛之立即與中程效果比較
中文摘要
疼痛是與癌症相關的常見症狀，疼痛所造成的身體不舒服，可能間接降低生活品質及生 存的意義，而疼痛是一個多層面的經驗，且焦慮、憂鬱等情緒困擾也會強化疼痛的感受，因此疼痛可藉由不同的方式來處理及控制，故本研究目的在於比較接受病房常規照護
、給與疼痛教育及給與疼痛教育加上放鬆訓練對癌痛經驗改善之探討。
本研究採類實驗法，於北部五所教學醫院之腫瘤相關病房選取符合條件之癌痛病患，以隨機方式將病患分為對照組 (15 人 ) 、實驗組 I- 疼痛教育組 (13 人 ) 及實驗組 I I- 疼痛教育加放鬆訓練組 (12 人 ) ，進行連續五天之介入性措施，共進行 14 天之觀察
，研究資料以描述性統計、成對 t 檢定、單因子變異數分析及重複測量變異數分析來評 值措施之成效。
研究結果發現： (1) 疼痛教育組之最重疼痛強度及平均疼痛強度有顯著改善 (2) 疼痛教育組之疼痛干擾整體量表具有顯著改善 (3) 疼痛教育放鬆訓練組之疼痛干擾整 體量表具有顯著改善 (4) 疼痛教育組之疼痛及麻醉性止痛藥信念有顯著改善 (5) 疼痛 教育加放鬆訓練組之疼痛及麻醉性止痛藥信念有顯著改善 (6) 疼痛教育加放鬆訓練組 之憂鬱情緒困擾有顯著改善 (7) 疼痛教育放鬆訓練組之放鬆訓練對於改善疼痛、焦慮 及憂鬱之情緒狀態有立即性效果。研究顯示給與正確之疼痛教育可以改善癌症病患疼痛 強度、疼痛干擾、憂鬱情緒及疼痛與麻醉性止痛藥信念，而增加放鬆訓練能減緩憂鬱情 緒困擾且對於疼痛、焦慮及憂鬱之情緒狀態有立即性效果。Comparison of the Immediate and Mediate Effects of Pain Education and Relaxation Training on Cancer Pain Experiences
英文摘要
Pain is a common manifestation related to cancer and pain induced discomfort over the body, possibly and indirectly reduced life quality and the meaning of survival. Pain is also a multi-modalities experienced, anxiety and depression of emotional dist urbance also emphasize the feeling of pain. Therefore, pain can be treated and controlled by different methods. So the purpose of this study is to discuss an experience in comparison with accepting regular care of ordinary ward, giving pain education an d pain education with relaxation training to improve cancer pain.
The study is a quasi-experimental design, choosing appropriate cancer pain patients from the related oncology wards among fi ve northern teaching hospitals, performing interventional procedures for continues 5days and total 14 days observation. Eligib le cancer patients with pain (N=40), were randomly assigned to three groups, including (1) control group which receive 15 mi nutes care as usual ward routine (n=15), (2) pain education group which receive 15 minutes education (Experimental group I, n=13), and (3) pain education plus relaxation training group which receive 15 minutes education and 12 minutes relaxation tra ining (Experimental group II, n=12). To evaluate the effect of these interventions on pain intensity, pain interferences, beliefs about pain and narcotic analgesics, and mood status were used with the Brief Pain Inventory Short Form (BPI-S), Pain and Op ioid Analgesic Beliefs Scale-Cancer (POABS-CA), and Profile of Mood State Short From for anxiety and depression (POMS- anxiety and depression). Studying the above information by descriptive statistics, paired t-test, one-way ANOVA and repeate d measures ANOVA.
The results showed that (1) the most and average painful intensity had significant improvement in Experimental group I, (2) t he total measured scales of painful disturbance had significant improvement in Experimental group I, (3) the total measured sc ales of painful disturbance had significant improvement in Experimental group II, (4) the negative effect of pain belief had sig nificant improvement in two Experimental group, (5) the depressively emotional disturbance had significant improvement in Experimental group II, (6) relaxation training had immediate effects on improving pain, anxiety and depression. The study ex pressed giving correct pain education could improve the pain intensity, pain disturbance, depression emotion and negative eff ect of pain belief of cancer patients, and addition relaxation training could ameliorate depressively emotional disturbance and could have improving immediate effects on pain, anxiety and depression.
