| Titre : | Understanding the experience of pain in terminally ill patients. Commentary. (2001) |
| Auteurs : | SAM HJELMELAND AHMEDZAI . (.) ; Linda-L EMANUEL ; Ezekiel-J EMANUEL ; Diane-L FAIRCLOUGH ; Stefan-C Weiss ; Department of Clinical Bioethics. Warren G Magnuson Clinical Center. National Institutes of Health. Bethesda. MD. USA |
| Type de document : | Article |
| Dans : | Lancet (The) (vol. 357, n° 9265, 2001) |
| Pagination : | 1304-1315 (7p.) |
| Langues: | Anglais |
| Mots-clés : | Douleur ; Médicament analgésique ; Thérapeutique ; Thérapeutique médicamenteuse ; Médecin ; Soins santé primaire ; Spécialité médicale ; Soins palliatifs ; Tolérance ; Etats Unis ; Amérique ; Homme ; Amérique du Nord |
| Résumé : | [BDSP. Notice produite par INIST R0xU0EQ2. Diffusion soumise à autorisation]. Background Terminally ill patients commonly experience substantial pain. Unresolved pain has been cited as evidence that end-of-life care is of poor quality. However, the data on which that conclusion is based are limited. We aimed to provide additional data on the experience of pain in such patients. Methods We interviewed 988 terminally ill patients from six randomly selected US sites. We asked them who had treated their pain in the previous 4 weeks (primary-care physician, pain specialist, or both), and whether they wanted more pain medication than they were receiving, or why they did not want more. Findings 496 (50%) terminally ill patients reported moderate or severe pain. 514 (52%) individuals had seen a primary-care physician for treatment of pain in the previous 4 weeks and 198 (20%) saw a pain specialist. Of those who had been treated by their primary-care physician, 287 (29%) wanted more therapy, 613 (62%) wanted their pain therapy to remain the same, and 89 (9%) wanted to reduce or stop their pain therapy. Several reasons for not wanting additional therapy were offered-fear of addiction, dislike of mental or physical side-effects, and not wanting to take more pills or injections. We saw no association between disease and amount of pain between disease and the desire for more treatment. Black patients were more likely to seek additional pain therapy, see a pain specialist, and refuse additional medication because of fear of addiction than other populations. (...) |
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