26 1 : 35 45 2017 1 2 2 2 2 2 2 2 2 1 1 2 Self - reported Practices of Cancer Pain Management among Nurses in Tohoku University Hospital Hideyuki Hirayama 1, Yoko Nakajo 2, Akemi Saito 2, Rie Hatakeyama 2, Yukie Iinuma 2, Noriko Ogiri 2, Tomoko Shida 2, Yumi Syoji 2, Noriko Monma 2 and Mitsunori Miyashita 1 1 Division of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine 2 Division of Nursing, Tohoku University Hospital Key words : Practice, Cancer Pain, Nurse, Palliative Care The aims of this study were to describe self - reported practices of cancer pain management among nurses in Tohoku University Hospital and to explore related factors. Anonymous questionnaires were distributed to 524 nurses who are engaged in cancer and 331 63% were analyzed. As for self - reported practice, only 3 of 34 items, such as assessment of site of pain, assessment of efficacy of analgesics, and nursing - care plan for pain, were performed enough over 80% of participants. On the other hand, assessment about cause of pain, assessment of total pain, communication about pain with patient and family, and discussion about medical treatment with medical staff except for the doctor were especially low response less than 50%. Self - reported practice of cancer pain management was higher as experience of terminally ill cancer care ever or in the last year was more. Although knowledge about cancer pain was significantly affected self - reported practice, the correlation coefficients were low. 1 3 1 1 30% 60 70% 75% 2,3 WHO 70 80% 4 QOL 2 5,7 WHO 35
QOL 8 24 5 8 Hirooka 9 Sato 10 Sasahara 11 2010 71% 12 1. 524 2. 2016 1 2016 3 2 3. 1 4 13 5 34 1. 2. 3. 4. 5. 5 2 6 24 1. 2. 3. 4. 5. 6. 6 3 Nakazawa Palliative Care Knowledge Test 14 ELNEC - J CQ 15 2 10 36
24 3 4 1 1 4. α ±SD ; P 15 1 5 2 JMP Pro 12 0.05 r<0.2 0.2<r<0.4 5. 1. 524 332 63% 1 331 1 30 51.5% 10 61.9% 9.9% 10 93.3% 100 57.1% 2. 1 5 80% 93% NSAIDs 80% 80% 3 37
1. N=331 N=331 n % n % 24 25 29 30 34 35 39 40 89 82 48 28 75 26.8% 24.7% 14.5% 8.4% 22.6% 100 14 51 69 189 4.2% 15.4% 20.8% 57.1% AOBA 4 5 9 10 14 15 19 20 4 5 10 34 8 4 7 142 63 29 28 60 290 23 11 3.00% 10.30% 2.40% 1.20% 2.10% 42.90% 19.00% 8.80% 8.50% 18.10% 87.60% 6.90% 3.30% 100 100 1 100 6 27 117 89 77 2 89 127 41 66 18 178 85 19 21 1.80% 8.20% 35.30% 26.90% 23.30% 0.60% 26.90% 38.40% 12.40% 19.90% 5.40% 53.80% 25.70% 5.70% 6.30% ±SD 4.48±0.95 4.23±0.98 3.76±1.25 3.83±1.14 3.69±1.17 3.00±1.17 3.94±1.01 4.36±0.96 14.87±5.04 100% 38
1. 2. 50% 44% 39
3. 4. 5. 39% 38% 36% 30% 24% 46% 23% 16% 15% 40% 36% 40
35% 25% 23% 50% ±SD 41.4±7.0 12 60 33.5±5.4 10 50 10.4± 2.2 3 15 11.9±3.1 4 20 18.6±3.6 5 25 α 0.77 0.72 0.82 0.80 0.77 0.82 3. 2 1 1 3 p= 0.01 p=0.01 1 p=0.04 p=0.008 4. 4 0.2<r<0.4 2 1 80% 3 2 1 80% 3 41
2. ±SD ±SD ±SD ±SD ±SD ±SD 41.4±7.0 12 60 33.5±5.4 10 50 10.4±2.2 3 15 11.9±3.1 4 20 18.6±3.6 5 25 115.8±17.5 34 170 24 39.0±6.7 r=0.17 32.3±5.8 r=0.07 10.2±2.2 r=0.14 11.6±3.0 r=0.05 18.3±3.3 r=0.04 111.1±17.5 r=0.11 25 29 42.4±6.6 p=0.003 34.6±5.2 p=0.23 10.1±2.1 p=0.01 12.4±3.0 p=0.40 18.8±3.5 p=0.47 118.4±16.9 p=0.04 30 34 41.7±6.7 33.7±5.3 10.0±2.5 11.6±3.1 18.4±3.7 115.2±17.0 35 39 43.1±7.0 32.5±4.2 10.0±2.0 11.0±2.4 18.3±3.7 115.1±15.1 40 42.6±7.6 34.0±5.3 11.1±2.1 12.4±3.4 18.9±3.9 118.9±18.8 4 39.7±6.6 r=0.17 32.6±5.5 r=0.08 10.0±2.2 r=0.19 11.7±2.9 r=0.07 18.3±3.5 r=0.05 112.1±17.0 r=0.14 5 9 43.4±7.3 p=0.002 35.3±5.4 p=0.14 10.3±2.4 12.3±3.1 p=0.21 18.9±3.5 p=0.36 120.0±17.8 p=0.02 10 14 42.2±6.4 33.1±4.7 10.1±1.9 11.6±3.1 18.6±3.7 115.8±15.0 15 19 42.3±6.4 33.3±4.6 10.4±2.3 11.1±2.8 18.3±4.0 115.3±15.8 20 42.9±7.3 34.1±5.3 11.2±2.1 12.6±3.4 19.0±3.8 119.7±18.6 41.0±6.7 r=0.17 33.3±5.3 r=0.08 10.2±2.2 r=0.14 11.9±3.0 r= - 0.01 18.4±3.5 r=0.16 114.7±17.0 r=0.14 4 46.2±8.8 p=0.002 35.7±5.7 p=0.16 11.3±3.1 p=0.01 11.8±3.9 p=0.94 20.9±3.5 p=0.005 125.7±20.9 p=0.009 5 9 44.2±6.3 34.0±4.9 11.4±1.7 11.9±2.6 19.9±4.0 121.3±14.4 36.5±9.3 r=0.19 29.5±7.5 r=0.22 9.6±2.4 r=0.19 10.2±3.7 r=0.19 16.1±5.8 r=0.14 100.1±24.4 r=0.23 39.6±6.9 31.9±5.3 9.5±2.3 11.3±2.6 18.1±3.7 p=0.01 110.3±17.4 41.4±6.7 33.2±5.7 10.2±2.0 11.4±3.1 18.6±3.2 114.9±17.0 100 42.3±6.8 34.3±4.9 10.7±2.2 12.4±3.1 18.9±3.4 118.4±16.3 1 100 100 1 100 43.7±11.0 37.0±8.2 41.3±6.6 41.5±6.4 42.9±7.1 35.5±6.4 38.6±6.6 41.8±6.4 42.9±6.5 43.8±7.6 42.2±9.3 40.2±6.1 42.1±7.5 44.2±5.8 45.2±8.6 r=0.14 p=0.01 r=0.26 r=0.19 35.7±8.3 29.5±5.9 33.1±5.1 33.6±5.4 35.0±4.8 26.0±7.1 31.4±5.7 34.2±4.9 34.0±5.2 34.6±5.2 34.4±7.0 32.9±5.1 33.7±5.6 35.5±3.8 35.6±5.7 r=0.18 r=0.20 r=0.13 p=0.02 11.3±2.1 9.5±2.6 9.9±2.2 10.4±1.9 11.2±2.3 9.0±4.2 9.7±2.4 10.2±1.9 10.6±1.9 11.3±2.4 9.2±2.5 10.1±2.2 10.2±1.8 12.1±1.6 11.6±2.9 r=0.21 r=0.24 r=0.24 12.3±3.9 10.7±3.4 11.4±3.1 12.0±2.7 12.7±3.2 11.0±2.8 10.9±2.8 12.1±2.9 12.6±3.2 12.5±3.3 10.8±3.0 11.7±3.0 12.0±2.8 13.8±3.0 12.1±3.8 r=0.18 p=0.002 r=0.19 r=0.13 p=0.02 19.3±7.3 16.2±4.7 18.7±3.4 18.3±3.2 19.3±3.4 14.0±5.7 17.9±4.0 18.6±3.2 19.3±2.9 19.1±4.1 18.1±4.5 18.2±3.6 18.7±3.1 20.0±3.8 20.0±4.1 r=0.13 p=0.02 r=0.13 p=0.02 r=0.16 p=0.005 ±SD ±SD ±SD ±SD ±SD 122.3±27.4 102.0±22.0 114.4±16.5 115.6±15.6 121.1±16.4 95.5±26.1 108.6±17.4 116.7±15.5 119.3±16.1 121.2±18.8 113.3±22.6 113.0±16.2 116.8±17.2 125.5±14.8 124.4±20.7 38.0±9.9 p=0.002 31.4±7.3 p=0.51 10.1±3.3 p=0.40 12.5±4.4 p=0.15 16.1±6.9 p=0.07 107.9±30.6 p=0.20 42.9±6.1 34.0±3.9 11.1±1.8 12.4±2.8 19.3±2.6 119.6±13.6 AOBA 45.2±7.1 34.3±3.9 9.9±2.3 10.6±2.7 19.9±3.6 120.0±14.0 51.5±7.2 37.0±7.8 10.7±2.0 14.0±3.3 20.0±5.6 132.6±20.9 41.6±8.1 34.0±3.4 10.6±2.6 13.3±2.9 18.4±3.2 119.6±20.1 r=0.20 r=0.25 r=0.20 rp 42
3. β SE β SE β SE β SE β SE 0.13 0.29 0.67 0.16 0.23 0.49 0.14 0.09 0.13 0.13 0.13 0.34 0.03 0.16 0.84 1.46 0.56 0.01 1.14 0.44 0.01 0.20 0.18 0.26 0.67 0.25 0.01 0.14 0.30 0.65 1 0.24 0.56 0.66 0.05 0.44 0.92 0.36 0.18 0.04 0.06 0.25 0.82 0.50 0.29 0.09 R2 Adj - R2 R2 Adj - R2 R2 Adj - R2 R2 Adj - R2 R2 0.07 0.06 0.04 0.03 0.08 0.07 0.04 0.03 0.02 Adj - R2 0.02 4. 0.31 0.26 0.20 0.18 0.11 0.34 0.27 0.25 0.19 0.13 0.24 0.25 0.19 0.14 0.16 0.26 0.20 0.19 0.10 0.18 0.33 0.28 0.25 0.20 0.21 0.25 0.25 0.18 0.08 0.17 0.05 0.02 0.07 0.07 0.08 0.04 0.03 0.03 0.02 0.04 0.21 0.22 0.15 0.13 0.21 <0.05 <0.01 <0.001 4 6,16 43
6 17 4,6,7,16 18 Nakazawa 7 Sato 10 1 1 1 1 44
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