PHYSICIAN ATTITUDES AND BELIEFS ABOUT USE OF MORPHINE FOR CANCER PAIN

被引:80
作者
ELLIOTT, TE
ELLIOTT, BA
机构
[1] Section of Medical Oncology and Hematology, Duluth Clinic, Ltd., Duluth, Minnesto
[2] The Duluth Family Practice Center, Duluth, Minnesota
[3] University of Minnesota School of Medicine, Duluth, Minnesota
关键词
CANCER PAIN; NARCOTIC ANALGESICS; ATTITUDES; ANALGESIA; PAIN CONTROL; MORPHINE; PHYSICIAN EDUCATION;
D O I
10.1016/S0885-3924(06)80005-9
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
The recent literature asserts that mistaken physician beliefs and attitudes are critical barriers to adequate cancerpain relief. To determine the prevalence of 12 proposed myths or misconceptions about morphine use in cancerpain management (CPM), we surveyed all physicians engaged in direct patient care in Duluth, Minnesota (N = 243). A 62% response was obtained. Many physicians misunderstood concepts of morphine tolerance, both to analgesia (51%) and to side effects (39%). Many were unaware of the use of adjuvant analgesics (29%), efficacy of oral morphine (27%), and nonexistent risk of addiction in CPM (20%). Analysis of result by physician age and specialty groups confirmed significant levels of misunderstanding in all subsets. Strategies to change physician attitudes and beliefs regarding morphine in CPM should focus on tolerance concepts, dosing schemes, safety, efficacy, lack of addictive risk, use of drug combinations, and the fact that cancer pain can be relieved.
引用
收藏
页码:141 / 148
页数:8
相关论文
共 22 条
[1]  
Silverberg E., Boring CC, Squires TS, Cancer statistics, 1990, CA, 40, pp. 9-26, (1990)
[2]  
Bonica JJ, Cancer pain: a major national health problem, Cancer Nurs, 1, pp. 313-316, (1978)
[3]  
Twycross RB, Lack SA, Symptom control in far advanced cancer: pain relief, (1983)
[4]  
Angell M, The quality of mercy, N Engl J Med, 306, pp. 98-99, (1982)
[5]  
Marks RM, Sachar EJ, Undertreatment of medical inpatients with narcotic analgesics, Ann Intern Med, 78, pp. 173-181, (1973)
[6]  
Twycross RG, Ethical and clinical aspects of pain treatment in cancer patients, Acta Anaesthesiol Scand, 74, pp. 83-90, (1982)
[7]  
Walsh TD, Common misunderstandings about the use of morphine for chronic pain in advanced cancer, CA, 35, pp. 164-169, (1985)
[8]  
Dahl JL, Joranson DE, Engber D, Dosch J, A report on the Wisconsin Cancer Pain Initiative, J Pain Symptom manage, 3, pp. 52-55, (1988)
[9]  
Stjernsward J, Cancer pain relief: an important global public health issue, Clin J Pain, 1, pp. 95-97, (1985)
[10]  
National Institutes of Health Consensus Development Conference, The integrated approach to the management of pain, J Pain Symptom Manage, 2, pp. 35-44, (1987)