Psychological predictors effective on Persist pain after mastectomy

سال انتشار: 1394
نوع سند: مقاله کنفرانسی
زبان: انگلیسی
مشاهده: 318

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شناسه ملی سند علمی:

ICBCMED12_031

تاریخ نمایه سازی: 2 تیر 1397

چکیده مقاله:

Introduction & Aim: Persistent pain following breast cancer treatments remains a significant clinical problem despite improved treatment strategies. To study examined the prevalence and severity of and the factors associated with chronic pain after breast cancer surgery and adjuvant treatments.Methods: Participants consist 287 Eligible women who were younger than 65 years with unilateral nonmetastasized breast cancer recruited in this study 12 months after surgery. Preoperatively, medical history,demographic data, Beck Depression Inventory, and Spielberger State-Trait Anxiety Inventory Pain Catastrophizing Scale and the Brief Pain Inventory were obtained. Preoperative pain in the operative area (breast, axilla, and arm) during the previous week was assessed with a numerical rating scale of 0 to 10. The worst pain in any area was used for statistical analysis, in which pain was considered an ordinal variable. SPSS Statistics version 20 software was used. Results: At 12 months after surgery, 34.5% (95% CI, 31.4%-37.8%) of the patients reported no pain, 49.7% (95% CI, 46.3%-53.0%) mild pain, 12.1% (95% CI, 10.0%-14.5%) moderate pain, and 3.7% (95% CI, 2.6%-5.3%) severe pain. The factors significantly associated with pain at 12 months after mastectomy were anxiety, depression, catastrophizing, low age, chronic preoperative pain, preoperative pain in the area to be operated, preoperative depression, axillary lymph node dissection, chemotherapy, and radiotherapy. Discussion: This prospective study found that 50% of patients had mild pain and 16% had moderate to severe pain 1 year after breast cancer surgery and identified psychological factors and intraoperative clinical factors associated with persistent pain. Psychological factors such as Anxiety, depression, catastrophizing worse perceived pain and dispositional optimism, high positive affect, and low emotional distress, younger age was protective have been associated with persistent pain in previous, mainly retrospective studies, which have been inconclusive regarding the effect of preoperative psychological factors. Intraoperative clinical factors like area to be operated, preoperative depression, axillary lymph node dissection,chemotherapy, and radiotherapy were important to severity of persist pain. These findings may be useful in developing strategies for preventing persistent pain following breast cancer treatment. To identify patients who would benefit from preventive interventions, a risk assessment tool is needed

نویسندگان

Manijeh Firoozi

Ph.D, University of Tehran, Tehran, Iran