痛みのある癌患者の日常生活の安寧感と痛みのコントロール

A Study of Well-Being and Pain Control in Cancer Patients

要約

　本研究の目的は痛みのある癌患者の日常生活の安寧感と痛みのコントロールついて明らかにすることである．一般総合病院に入院中の痛みをもつ癌患者49名を対象に質問紙を用いた面接調査を行った．

　その結果，対象者の約15％の者が痛みのコントロールに対して「やや～とても不満」と評価しており，痛みの強さは，コントロールに対する不満や，医療者に何もしてもらえないので痛みを訴えても無駄という怒りとの間に有意な相関がみられた．対象者のうち半数以上が痛みの増強は病気の悪化を意味するものであると捉えていた．鎮痛薬の使用に関しては，半数以上が鎮痛薬への依存性や，鎮痛薬耐性が生じることを懸念しており，懸念の強さと日常生活の安寧感との間に有意な負の相関がみられた．また，痛みの強さの増強と，疲れやすさ，体力・気力の低下，心理的な苦痛の増強との間には有意な相関が示された．

Abstract

　This study set out to clarify the situation with regard to pain control among cancer patients and the links between this and their sense of well-being in their daily lives. The study was carried out by means of a questionnaire distributed to 49 patients with cancer pain admitted to a general hospital.

　The survey showed that about 15% of the subjects were somewhat or very dissatisfied with the pain control. It also revealed that pain intensity correlated significantly with dissatisfaction with regard to pain control as well as with anger resulting from a feeling that there was no point in reporting the pain because the doctors and nurses did nothing. Over half the subjects assumed that an increase in pain signified progression of the disease. With regard to the use of pain medication, over half the subjects were worried about resulting tolerance of or addiction to analgesics, and the strength of their concerns showed a significant negative correlation with the score assigned to their sense of well-being. The intensity of pain also correlated significantly with a tendency to become easily fatigued, a lowering of vitality and physical strength, and an increase in psychological and emotional distress.