病人對癌痛麻醉性止痛藥之信念探討—量表發展與現況

Beliefs about Cancer Pain and Opiold Analgesics: Scale Development and Current Status

10.7081/NR.200010.0557

賴裕和(Yeur-Hur Lai)

癌症疼痛 ； 疼痛信念 ； 麻醉性止痛藥 ； 疼痛及麻醉性止痛藥信念量表 ； cancer pain ； pain beliefs ； opioid analgesics ； pain and opioid analgesics beliefs scale-cancer (POABS-CA)

護理研究

8卷5期（2000 / 10 / 01）

557 - 567

繁體中文

麻醉性止痛藥在疼痛控制中扮演極重要的角色，然而對該類藥物種種不合適或不正確的看法，可能影響病人接受該類藥物治療的意願，本研究目的即在發展“疼痛及麻醉性止痛藥信念量表—癌痛版”量表與測試其信效度，並以此量表初步探討病人該方面信念。研究者以第一階段質性研究方式訪談10位病人，分析其內容並參考該方面文獻後，發展出12題以0-4分Likert記分方式的“疼痛及麻醉性止痛藥信念量表—癌痛版”，得分愈高表對疼痛有越負向或不正確之信念，並以7位專家效度分析達內容效度指標.86上，再以此量表測試於144位癌痛病人，結果發現該量表之內在一致性信度Cronbach's α值達.72，以主軸因素分析斜交轉軸測試建構效度，呈現3個因素結構，其固有值皆大於1，此3因素分別爲“忍耐疼痛”、“止痛藥負向作用”及“疼痛與止痛藥本質”；而病人對癌痛與麻醉性止痛藥確實有十分負向的信念，如其普遍認爲麻醉性止痛藥對身體不好、有許多負向作用與成年人不應經常使用麻醉性止痛藥等。本量表具良好之信效度且填答簡易，建議普遍使用於臨床疼痛評估及研究。

Opioid analgesics play a very important role in clinical pain control. However, inappropriate beliefs regarding pain and opioid analgesics might influence patients’ willingness to use these drugs. The purpose of this study was to develop and test a “Pain and Opioid Analgesics Beliefs Scale-Cancer Version (POABS-CA)” which can be used to assess the related patient beliefs. The POABS-CA was developed based on the results analyzed from a qualitative interview of 10 cancer patients with pain and a related literature review. The 12- item POABS-CA was a 0 to 4 Likert’s type scale with 0 mean “completely disagree” and 4 meaning “completely agree”. The higher the scores, the more negative pain beliefs the patient has. The POABS-CA then was applied to 144 hospitalized cancer pain patients at four medical centers in Taipei. The principal axis factor analysis with promax rotation tested the construct validity. The results showed that the POABS-CA has a clear factor structure with 3 factors, which were named “endure pain”, “analgesics adverse effects”, and “nature of pain and analgesics”. The internal consistency reliability was accepted as the Cronbach’s alpha values of the above three subscales and overall scale were .79, .69, .61 and .72, respectively. The results showed that the POAB S-CA is a valid and easily used scale that should be used in clinical pain assessment and research to facilitate effective pain management.

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