Analysis of characteristics and influencing factors of breakthrough cancer pain in advanced cancer patients

Objective To study the characteristics of breakthrough cancer pain(BTCP)and the related factors leading to BTCP in patients with advanced cancer, and to analyze the influence of BTCP on quality of life of patients. Methods A total of 160 patients with advanced cancer were selected by convenience sampling method and then were investigated to complete a series of questionnaires, including a general information questionnaires, Hospital Anxiety and Depression Scale(HADS), Social support Rating Scale(SSRS), Eastern Cooperative Oncology Group(ECOG), the Nutrition risk screening 2002(NRS2002)and Quality-of-Life Concerns in the End-of-Life Questionnaire(QOLC-E). Binary Logistic regression model was used to analyze the related factors of BTCP in patients with advanced cancer. The influence of BTCP on the quality of life of patients was analyzed based on propensity score matching(PSM)method to balance the confounding factors. Results A total of 160 valid questionnaires were collected, with an effective response rate of 97. 56%. Statistics found that 87 cases(54. 38%)of the 160 investigated in patients with advanced cancer experienced BTCP during hospitalization. BTCP occurred within 24 hours, but it was mostly concentrated in 19: 00—22: 00, and 56. 32% of BTCP was unpredictable. BTCP attacked rapidly and reached the peak of pain within 3 minutes. The NRS score of pain intensity ranged from 4 to 9 points, with an average of (6. 43 ± 1. 43)points. The daily attack frequency was 1 to 7 times, with an average of (4. 46±1. 07)times per day. Multivariate regression analysis suggested that female, misunderstanding of analgesic drugs, abdominal distension, anxiety and anxiety with depression were risk factors for BTCP in patients with advanced cancer, and standardized use of analgesic drugs was a protective factor for BTCP. After propensity score matching balanced confounding factors, QOLC-E score of patients in BTCP group was lower than that in NBTCP group (P＜0. 05). Conclusion The incidence rate of BTCP is high in patients with advanced cancer during hospitalization, healthcare professionals should focus on assessing influencing factors and taking preventive management measures to improve the quality of life of patients with advanced cancer during hospitalization. (目的 研究晚期癌症患者癌性爆发痛(BTCP)发作特点及引起BTCP的相关因素, 并分析BTCP对患者生活质量的影响。方法 便利抽样法选取160例晚期癌症患者作为研究对象, 采用一般资料调查表、医院焦虑抑郁量表(HADS)、社会支持评定量表(SSRS)、美国东部肿瘤协作组活动状态评分(ECOG)、营养风险筛查2002(NRS2002)、患者生存质量量表(QOLC-E)进行调查, 采用二元Logistic回归模型分析引起癌症晚期患者BTCP的相关因素, 基于倾向性评分匹配法(PSM)均衡混杂因素后分析BTCP发生对患者生活质量的影响。结果 共回收有效问卷160份, 有效回收率为97. 56%。据统计有87(54. 38%)例住院患者经历过BTCP, BTCP 24 h内均有发作, 但其多集于19: 00~22: 00时间段, 有56. 32%的BTCP不可预测。BTCP发作迅速, 多数在3 min内达到疼痛顶峰; 疼痛强度NRS评分4～9分, 平均(6. 43 ± 1. 43)分; 日发作频率1～7次; 平均每日(4. 46±1. 07)次。多因素logistic回归分析提示, 女性、对镇痛药物的认识错误、腹胀、合并焦虑以及同时合并焦虑抑郁是影响晚期癌症患者BTCP的危险因素, 而规范使用镇痛药物是BTCP的保护因素。倾向性评分匹配均衡混杂因素后, BTCP组患者晚期患者生存质量量表(QOLC-E)得分低于NBTCP组, 差异有统计学意义(P＜0. 05)。结论 癌症晚期患者住院期间BTCP发生率高, 医务人员应对影响因素进行重点评估并采取预防管理措施, 提高晚期癌症患者住院期间的生活质量。)