| Summary: | 碩士 === 長庚大學 === 護理學系 === 99 === This prospective longitudinal study was designed to explore pain intensity and interference and appropriateness of pharmacological management in newly diagnosed HCC patients with pain. A total of 75 patients met the inclusion criteria, among them four rejected to join the study due to physical tiredness or consideration of age. Pain intensity, interference, and satisfaction with pain management were measured by the American Pain Society Patient Outcome Questionnaire at enrollment and weekly for 8 weeks. Information regarding use of pain medications were collected at the same time schedule by reviewing medical records.
Data from 71 patients were analyzed using Hierarchical Liner Model. Both pain intensity and interference decreased linealy over time. Patients were most interfered with their dialy life (M = 2.03, SD = 2.44) and mood (M = 1.71，SD = 2.21).
Sixty-four (90%) patients were prescribed with analgesics at enrollment, among them most received sigle analgesic with only 12.3% received a combination of narcotic and non- narcotic analgesics. During the data collection period, 36 (55%) patients were continuously treated with analgesics and 21 (29.6%) patients were initially prescribed with analgesics but then the analgesics were discontinued mainly due to decreased pain intensity.
The most frequent inappropriate use of analgesics were『not combining non-narcotics, such as NSAIDs, when using narcotics』and 『administering analgesics through intramuscle injection』(29/71). When rescue pain medications were needed, 『inappropriate selection of rescue drugs』（20/29） was found to be a common problem. In addition, more than half of Fentanyl use (9/16) did not meet the indication criteria. Overall speaking, patients were satisfied with their pain management provided by physicians and nurses, and the satisfaction to nurses (M = 3.26) was slightly higher than that to physicians (M = 3.14). Furthermore, the satisfaction to physicians decreased over time.
When further examining the relationship between the appropriateness of analgesic use and patients’ pain outcomes, it was found that patients’ pain intensity and pain interference with daily life and mood would significantly higher when the use of analgesics was inappropriate. Howerer, the appropriateness of analgesic use was not associated with patients’ satisfaction with pain management.
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