在退伍军人中自我报告和代理报告的疼痛之间存在一致性,这些退伍军人患有高级心力衰竭
Kathleen M Akgün1,2, Ling Han1,2,3, Yan Zhan4
1VA Connecticut Healthcare System, West Haven, CT, USA.
The American journal of hospice & palliative care
|July 31, 2025
概括
晚期心力衰竭 (aHF) 患者的疼痛代理报告显示,与患者对严重疼痛的自我报告中适度一致. 对于轻度疼痛和较短时间的疼痛,共识较弱,这表明使用家庭报告的疼痛评分的局限性.
科学领域:
- 抚慰性护理是一种缓解性护理.
- 老年医学 老年医学
- 疼痛管理 疼痛管理
背景情况:
- 自我报告的疼痛在晚期心力衰竭 (aHF) 中很常见.
- 关于患者和代理疼痛评估之间的一致性,存在不一致的结果.
- 了解这一协议对于终身护理质量至关重要.
研究的目的:
- 为了检查患者自我报告的疼痛和家庭报告的疼痛在退伍军人与近EOL的aHF之间的协议.
- 在这个人群中评估代理疼痛报告的可靠性.
主要方法:
- 在2018-2020年间死亡的1045名aHF患者的回顾性队列研究.
- 患者数值评分表 (NRS) 疼痛评分 (过去30天和7天) 与来自Beavered家庭调查 (BFS) 的家庭报告的疼痛进行了比较.
- 使用科恩的卡帕系数来评估分类疼痛水平之间的一致性 (没有,轻度,中度,严重).
主要成果:
- 在30天NRS严重疼痛和BFS"永远疼痛"之间发现了适度的协议.
- 过去7天的公平协议;轻微的疼痛显示无到轻微的协议.
- 与生命的最后7天相比,过去30天的同意力更强.
结论:
- 患者和家人之间达成协议,在aHF中报告疼痛仅适度严重疼痛.
- 当考虑较长的报告期 (30天而不是7天) 时,协议更为强烈.
- 这些发现突显了在高级心力衰竭患者中使用代理报告的疼痛评分的局限性.
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