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Severe pain at the end of life: a population-level observational study.
BMC Palliative Care ( IF 2.5 ) Pub Date : 2020-04-30 , DOI: 10.1186/s12904-020-00569-2
A Meaghen Hagarty 1 , Shirley H Bush 1, 2, 3 , Robert Talarico 3, 4 , Julie Lapenskie 2, 3 , Peter Tanuseputro 1, 2, 3, 4
Affiliation  

BACKGROUND Pain is a prevalent symptom at the end of life and negatively impacts quality of life. Despite this, little population level data exist that describe pain frequency and associated factors at the end of life. The purpose of this study was to explore the prevalence of clinically significant pain at the end of life and identify predictors of increased pain. METHODS Retrospective population-level cohort study of all decedents in Ontario, Canada, from April 1, 2011 to March 31, 2015 who received a home care assessment in the last 30 days of life (n = 20,349). Severe daily pain in the last 30 days of life using linked Ontario health administrative databases. Severe pain is defined using a validated pain scale combining pain frequency and intensity: daily pain of severe intensity. RESULTS Severe daily pain was reported in 17.2% of 20,349 decedents. Increased risk of severe daily pain was observed in decedents who were female, younger and functionally impaired. Those who were cognitively impaired had a lower risk of reporting pain. Disease trajectory impacted pain; those who died of a terminal illness (i.e. cancer) were more likely to experience pain than those with frailty (odds ratio 1.66). CONCLUSION Pain is a common fear of those contemplating end of life, but severe pain is reported in less than 1 in 5 of our population in the last month of life. Certain subpopulations may be more likely to report severe pain at the end of life and may benefit from earlier palliative care referral and intervention.

中文翻译:

生命终结时的剧烈疼痛:一项针对人群的观察性研究。

背景技术疼痛是生命终止时的普遍症状,并且对生活质量产生负面影响。尽管如此,很少有人口水平的数据能够描述生命终结时的疼痛频率和相关因素。这项研究的目的是探讨临终时临床上明显疼痛的患病率,并确定疼痛增加的预测因素。方法对加拿大安大略省2011年4月1日至2015年3月31日在生命中最后30天(n = 20,349)接受家庭护理评估的所有后代进行的人群水平队列研究。使用链接的安大略省卫生管理数据库,您在生命的最后30天中每天都会出现剧烈疼痛。严重疼痛的定义是使用经过验证的疼痛量表,结合疼痛频率和强度:每日重度疼痛。结果据报告,每天剧烈疼痛的比例为20%的17.2%,349名死者 在女性,年轻和功能受损的后代中观察到严重每日疼痛的风险增加。那些有认知障碍的人报告疼痛的风险较低。疾病轨迹影响疼痛;那些死于绝症(即癌症)的人比那些虚弱的人(1.66)更容易遭受痛苦。结论疼痛是那些打算临终的人们的普遍恐惧,但是据报道,在生命的最后一个月中,只有不到五分之一的人感到剧烈疼痛。某些亚人群更有可能在生命终结时报告严重疼痛,并且可能会从早期的姑息治疗转诊和干预中受益。那些有认知障碍的人报告疼痛的风险较低。疾病轨迹影响疼痛;那些死于绝症(即癌症)的人比那些虚弱的人(1.66)更容易遭受痛苦。结论疼痛是那些打算临终的人们的普遍恐惧,但是据报道,在生命的最后一个月中,不到五分之一的人感到剧烈疼痛。某些亚群更有可能在生命终结时报告严重疼痛,并且可能会从早期的姑息治疗转诊和干预中受益。那些有认知障碍的人报告疼痛的风险较低。疾病轨迹影响疼痛;那些死于绝症(即癌症)的人比那些虚弱的人(1.66)更容易遭受痛苦。结论疼痛是那些打算临终的人们的普遍恐惧,但是据报道,在生命的最后一个月中,不到五分之一的人感到剧烈疼痛。某些亚群更有可能在生命终结时报告严重疼痛,并且可能会从早期的姑息治疗转诊和干预中受益。但是据报道,在生命的最后一个月中,只有不到五分之一的人感到剧烈疼痛。某些亚群更有可能在生命终结时报告严重疼痛,并且可能会从早期的姑息治疗转诊和干预中受益。但是据报道,在生命的最后一个月中,只有不到五分之一的人感到剧烈疼痛。某些亚群更有可能在生命终结时报告严重疼痛,并且可能会从早期的姑息治疗转诊和干预中受益。
更新日期:2020-04-30
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