Analysis Of The Questionnaire Of Distress Assessment And Response System In 497 Patients With Cancer Pain

Background and Objective:Cancer pain is one of the most common symptoms of cancer patients.At present,30%-50% of cancer patients worldwide have different degrees of pain.The incidence of pain in advanced cancer patients is about 60%-80%,of which 1/3 of patients are severe pain.It seriously affects the quality of life of.The patients with cancer pain have many other physical problems besides pain,psychological problems,and social support,which not only reduce the quality of life o,but also affect the prognosis.Assessing the physical symptoms,psychological and social factors of patients with cancer pain,and analyzing their relationship with pain and the impact on prognosis,have a positive effect on the development of scientific and effective intervention measures.In this study,the distress assessment and response tool(DART)was used to screen and assess the physical symptoms,psychological problems and social support of patients with cancer pain,explore the relationship between pain and other physical symptoms,psychological and social support,and analyse the factors that affect the prognosis of patients with cancer pain,which aim to provide comprehensive care for patients with cancer pain,improve the quality of life of patients.Methods:This study used a distress assessment and response system(DART)to conduct a questionnaire survey on 497 cancer pain patients who visited the First Hospital of Jilin University Hospital from April 2016 to January 2017.All cases were diagnosed as malignant by clinical,radiological or cytological examinations,and accompanied by tumor-related pain.The study started from the date of completing the questionnaire and recorded the patient's somatic symptoms,psychological problems and social support in detail.The follow-up period was 3 months.The follow-up content was the patient's survival status.The follow-up deadline was February 28,2018.After the data were collected,SPSS 21.0 software was used for statistical analysis.All statistical analyses were P<0.05 as significant test levels.Count data are expressed in terms of frequency and percentage(%).Chi-square test was used for comparison between groups.Kaplan-Meier method was used to draw the survival curves between different groups.Log-rank test was used to compare survival differences of different groups.The Cox proportional hazards regression models were used to analyse the significant variables for multivariate analysis to find independent factors that affected the prognosis of patients with cancer pain.Results:1.Compared with other somatic symptoms of mild pain group and moderate-severe pain group,the incidence rate of symptoms from high to low was: fatigue(59.4%),appetite(56.4%),shortness of breath(38.1%),nausea(37.2%)and sleep disturbance(36.3%).In the moderate-severe cancer pain group,the incidence of symptoms from high to low was: fatigue(83.8%),appetite(80.6%),sleep disturbance(59.6%),shortness of breath(58.1%),nausea(54.6%),the difference in the incidence of symptoms between the two groups was statistically significant.In the survey of self-perceived health problems,64.6% of the patients in the mild cancer pain group had poor health status,and 79.0% in the moderate-severe cancer pain group.There was a statistically significant difference between the two groups.2.The incidence of anxiety and depression in the mild pain group was 13.1% and 21.6%,respectively.The incidence of anxiety and depression in the moderate-severe pain group was 30.6% and 37.1%,respectively.There was a statistically significant difference in the incidence of anxiety and depression between the two groups.3.Comparison of social support in the two groups of patients.34.5% of the patients in the mild pain group received substantial support per day,52.3% in the moderate-severe pain group.48.7% of the patients in the mild pain group had work and economic concerns,62.8%in the moderate-severe pain group.20.2% of the patients with mild pain had concerns about family life and social activities,and 30.2% in the moderate-severe group.The difference in social support between the two groups was statistically significant.4.Analysis of the factors affecting the prognosis of patients with cancer pain: the 1-year survival rate of patients with mild pain was 80.0%,and that of moderate-severe pain group was 56.5%.The survival rate of patients with different pain groups was statistically significant at P<0.05.Log-Rank was used to test the prognostic factors of single factor analysis.The results suggested that age,education level,primary tumor,tumor stage,pain,fatigue,health status,depression were related to the prognosis of patients(P<0.05).The above factors with univariate analysis were included in the Cox proportional hazards regression model for multivariate analysis.The results suggest that education level,depression,pain,tumor stage,and primary tumor are independent factors for the prognosis of cancer patients(P<0.05).Conclusion:1.Patients with moderate to severe cancer pain are more likely to suffer from fatigue,nausea,poor appetite,shortness of breath,and physical symptoms of sleep disorders,and are prone to conscious health conditions.Anxiety and depression are more likely to occur on them.2.In terms of social support,patients with moderate-severe cancer pain need to receive substantial support.There are job and economic concerns as well as difficulties in family life and social activities.3.The tumor stage,primary tumor,pain degree and depression are independent risk factors affecting the prognosis of patients with cancer pain.The late stage,hepatobiliary and pancreatic system tumors,moderate-severe pain and depression cancer pain patients have a poor prognosis.Education level is an independent protective factors of prognosis,the higher the degree of education,the better the prognosis.