肿瘤外科医生对癌痛治疗和吗啡临床应用的认知调查

发布时间：2018-09-10 07:42

【摘要】：目的了解肿瘤外科医生对癌痛治疗和吗啡临床应用的认知情况,并探讨制约吗啡临床应用的消极因素。方法鉴于天津医科大学肿瘤医院是我国大型肿瘤专科医院,本研究于2014年1月选取天津医科大学肿瘤医院肿瘤外科医生85例进行问卷调查,问卷内容除一般情况外,主要分为3部分:(1)对WHO"癌症三阶梯止痛指导原则"的了解程度、用药习惯及对镇痛药物成瘾性的认知情况;(2)有关癌痛治疗和吗啡临床应用的基本知识;(3)影响吗啡临床应用的因素及其影响程度。共发放问卷85份,回收有效问卷72份,有效回收率为84.7%。结果 59.7%(43/72)的肿瘤外科医生表示很明确WHO"癌症三阶梯止痛指导原则"。28.9%(33/72)的肿瘤外科医生首选吗啡控释片治疗重度癌痛,22.8%(26/72)首选哌替啶治疗重度癌痛。58.3%(42/72)的肿瘤外科医生认为哌替啶的成瘾性最大,34.7%(25/72)认为吗啡针的成瘾性最大。有关癌痛治疗和吗啡临床应用基本知识的总体正确答题率为59.2%(341/576),其中"吗啡应用的目的"的得分率为36.1%(468/1 296)。不同职称肿瘤外科医生有关癌痛治疗和吗啡临床应用的基本知识得分间差异无统计学意义(P0.05);而是否接受过相关培训的肿瘤外科医生有关癌痛治疗和吗啡临床应用的基本知识得分间差异有统计学意义(P0.05)。38.9%(28/72)的肿瘤外科医生认为"医务人员是否接受镇痛治疗的专业培训"对吗啡的临床应用影响很大,其中"医务人员是否接受镇痛治疗的专业培训""对药物成瘾性的顾虑""担心药物不良反应""医疗卫生管理部门对吗啡的使用限制"的影响得分分别为3.1、2.9、2.9、2.9分。结论肿瘤外科医生在癌痛治疗和吗啡临床应用方面存在认知不足,亟须开展相关专业培训来改善癌痛治疗和医用吗啡现况。
[Abstract]:Objective to investigate the cognition of tumor surgeons on cancer pain treatment and clinical application of morphine and to explore the negative factors restricting the clinical application of morphine. Methods in view of the fact that Tianjin Medical University Oncology Hospital is a large tumor hospital in China, this study selected 85 tumor surgeons from Tianjin Medical University Oncology Hospital in January 2014. It is mainly divided into three parts: (1) the degree of understanding of WHO's "cancer three ladder pain relief guidelines", (2) basic knowledge about cancer pain treatment and clinical application of morphine; (3) factors affecting clinical use of morphine and their influence degree. A total of 85 questionnaires were sent out, 72 valid questionnaires were collected, and the effective recovery rate was 84.7. Results 59.7% (43 / 72) of tumor surgeons said they were clear about WHO's "Three-Stage pain Relief guidelines for Cancer." 28.9% (33 / 72) of cancer surgeons preferred morphine controlled-release tablets to treat severe cancer pain. 22.8% (26 / 72) of cancer surgeons preferred pethidine to treat severe cancer pain. 58.3% (42 / 72) of cancer surgeons recognized it as the first choice. The drug addiction of pethidine was 34.7% (25 / 72) that morphine needles were the most addictive. The overall correct answer rate of the basic knowledge of cancer pain therapy and morphine clinical application was 59.2% (341 / 576), and the score of "the purpose of morphine application" was 36.1% (468 / 1 296). There was no significant difference in the basic knowledge of cancer pain therapy and morphine clinical application among tumor surgeons with different titles (P0.05), but there was no significant difference among tumor surgeons who had received relevant training on cancer pain treatment and morphine clinical application (P0.05). There were statistically significant differences in the scores of basic knowledge between the two groups (P0.05). 38.9% (28 / 72) of the tumor surgeons thought that whether or not medical personnel received specialized training in analgesic treatment had a great impact on the clinical use of morphine. The scores of "whether the medical personnel receive the professional training of analgesia treatment", "concern about drug addiction", "worry about adverse drug reactions" and "medical and health management department's restriction on the use of morphine" were respectively 3.1m2.92.92.92.9 points. Conclusion Cancer surgeons have insufficient cognition in cancer pain treatment and morphine clinical application. It is urgent to develop relevant professional training to improve cancer pain treatment and medical morphine status.
【作者单位】：天津医科大学肿瘤医院国家肿瘤临床医学研究中心天津市"肿瘤防治"重点实验室天津市恶性肿瘤临床医学研究中心;中南大学湘雅医院;中南大学湘雅医学院;天津医科大学;
【分类号】：R730.5

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