期刊
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT
卷 28, 期 5, 页码 474-487出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jpainsymman.2004.02.022
关键词
pain assessment; symptom-free day; chronic pain; patient goals; quality of life
Although the construct of a symptom-free day has been widely applied in asthma and gastric reflux disease, there is no analogous concept in the field of pain management. This study represents the initial development of a day of acceptable or manageable pain control, a construct which reflects patients' daily strategic use of pain medication in order to allow the accomplishment of desired activities while minimizing side effects. Focus group methodology was used to extract patient-generated themes of an acceptable day of pain control. Fifty-three outpatients with Persistent moderate to severe average pain intensity due to osteoarthritis (n = 18), metastatic cancer (n = 15), and low back pain (n = 20) participated. Participants preferred the term manageable or tolerable to acceptable. Thematic analysis revealed components of a manageable/tolerable day of pain control as including: 1) taking the edge off the pain, 2) performing valued activities; 3) relief from dysphoria and irritability; 4) reduced medication side effects; 5) feeling well enough to socialize. Additional cancer-specific themes included relief from fatigue and ability to have a positive day when one's future days were perceived as being limited. The set of themes is presented and their relevance for developing a measure of a manageable day of pain control discussed. Study findings identify a novel construct that can inform development of an outcome for evaluating the effectiveness of different pharmacotherapies for pain management.
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