任金妹 项蔚 谢宁 沈毅

摘 要 目的：了解社区卫生服务中心医务人员对癌痛控制知识掌握情况，以加强社區对癌痛患者诊疗的规范管理。方法：利用金数据平台对上海市青浦区11家社区卫生服务中心的1 237名在职医师、护士、药师进行手机线上问卷调查，共采集776份有效数据，分析癌痛评估和处理、阿片类药物使用、药物不良反应的认知情况。结果：对于癌痛评估和处理、阿片类药物使用和药物不良反应的知晓率分别为58.2%、50.8%和43.6%，差异有统计学意义（P<0.05）。医师和护士对阿片类药物使用回答准确率的差异有统计学意义（54.9%比51.0%，P<0.05）。医师和药师与护士对药物不良反应回答准确率的差异均有统计学意义（45.7%比38.0%，P<0.05；50.8%比38.0%，P<0.05）。结论：社区医务人员社对疼痛控制的相关知识掌握较少，需加强培训，提高对癌痛的认知和实践水平，更好地为社区癌痛患者的延续性治疗提供服务。

关键词 癌症疼痛控制；认知；社区卫生服务中心医务人员；横断面调查

中图分类号：R730.6 文献标志码：A 文章编号：1006-1533（2021）04-0050-04

*基金项目：青浦区卫生健康系统第四轮特色项目（WX2019-08）

A cross-sectional survey of cognition of cancer pain control in the community medical staff

REN Jinmei1， XIANG Wei2， XIE Ning1， SHEN Yi1

（1. Pharmacy Department of Qingpu Branch of Zhongshan Hospital affiliated to Fudan University， Shanghai 201700， China 2. Medical Department of Qingpu Branch of Zhongshan Hospital affiliated to Fudan University， Shanghai 201700， China）

ABSTRACT Objective： To understand the knowledge of cancer pain control among medical staff in the community health service center， so as to strengthen the standardized management of cancer pain diagnosis and treatment in the community. Methods： Using the golden data platform， 1 237 in-service doctors， nurses and pharmacists from 11 community health service centers in Qingpu District of Shanghai were investigated by mobile phone online questionnaire， a total of 776 valid data were collected to analyze the cognition of cancer pain assessment and treatment， opioid use and adverse drug reactions. Results： The awareness rates of cancer pain assessment and treatment， opioid use and adverse drug reactions were 58.2%， 50.8% and 43.6%， respectively， and the differences were statistically significant（P<0.05）. There was significant difference between doctors and nurses in the accuracy rate of opioid use（54.9% vs 51.0%， P<0.05）. There was a statistically significant difference in the accuracy of physicians， pharmacists and nurses in answering adverse drug reactions（45.7% vs. 38.0%， P<0.05； 50.8% vs. 38.0%， P<0.05）. Conclusion： Community medical staff have less knowledge about pain control， and need to strengthen training to improve the awareness and practice of cancer pain， to better provide services for the continuous treatment of patients with cancer pain in the community.

KEY WORDS cancer pain control； cognition； medical staff of the community health service center； cross-sectional study

疼痛是癌症患者的常见并发症，尤其是中晚期癌症患者。一项关于慢性癌症疼痛（以下简称“癌痛”）的患者调查报告显示，约50%的癌症患者伴发疼痛，疼痛会给患者造成极大的身心痛苦，是导致抑郁和死亡等不良结局的高风险因素；如果接受合适的治疗能减轻80%～90%癌痛患者的疼痛，提高他们的生活质量[1]。因此，对癌症疼痛患者进行有效的疼痛管理尤为重要[2]。社区卫生服务中心是为社区居民提供公共卫生服务和慢性疼痛等服务的重要场所，在减轻患者慢性疼痛方面起到重要的作用。目前社区卫生服务中心在癌痛患者的疼痛诊疗、评估等过程中还存在一些问题，如疼痛专科医师人数少，医务人员业务水平参差不齐，缺乏诊疗和服务操作规范等[3]。……