Sandie C L, Heindel L J
Naval Medical Center, San Diego, Calif., USA.
AANA J. 1999 Oct;67(5):455-60.
The provision of epidural analgesia for postoperative pain control offers many patient benefits and has become commonplace on many nursing units. Since nurses are responsible for the day-to-day management of patients receiving epidural analgesia, their knowledge, attitudes, and practices regarding this technique are pivotal to its success. Therefore, the purpose of the present descriptive study was to examine the knowledge base, attitudes, and clinical practice of registered nurses (N = 85) regarding postoperative epidural analgesia as managed by an acute pain service (APS). Information was obtained from a survey distributed via a convenience sample to all nurses working on 6 units in a large military teaching facility. We developed the "Epidural Knowledge and Attitude Survey" using the nursing literature on epidural analgesia. The survey consisted of a demographics section, true/false (T/F) questions, multiple choice (M/C) questions, an attitude section, and a comment section. These sections addressed the nurses' knowledge, attitudes, and practices in regard to epidural pharmacology, management, and adverse effects, as well as their general satisfaction with the APS of their facility. Data were analyzed statistically using means, standard deviations, percentages, forward step-wise linear regression, the Fisher-Irwin (exact) test, the chi 2 test, and analysis of variance with Bonferroni multiple comparisons. A P value of < .05 was considered statistically significant. Results of the study demonstrated that the respondents attained a 78% overall correct score on T/F questions and 38% on M/C questions. The attitude section illustrated that 73% of nurses had "positive" attitudes toward epidural analgesia. Correct management of patients receiving epidural analgesia was being practiced by 77% of nurses. The satisfaction with the APS at this facility was 32% "very satisfied" and 62% "somewhat satisfied." The demographic characteristics that best predicted a higher score on the knowledge portion of the survey were greater years of practice as a nurse and receipt of pain education in nursing training. Nurses who had received inservice education about epidural analgesia rated a "good" self-knowledge of epidurals more often (40%) than those who did not (10%) and scored significantly higher on the knowledge portion of the survey.
提供硬膜外镇痛以控制术后疼痛对患者有诸多益处，并且在许多护理单元已成为常规操作。由于护士负责接受硬膜外镇痛患者的日常管理，他们对该技术的知识、态度和实践对其成功至关重要。因此，本描述性研究的目的是调查注册护士（N = 85）在急性疼痛服务（APS）管理下对术后硬膜外镇痛的知识基础、态度和临床实践。信息通过便利抽样向一家大型军事教学机构6个科室的所有护士发放的调查问卷获取。我们依据关于硬膜外镇痛的护理文献编制了“硬膜外知识与态度调查问卷”。该问卷包括人口统计学部分、正误（T/F）问题、多项选择（M/C）问题、态度部分和评论部分。这些部分涉及护士在硬膜外药理学、管理和不良反应方面的知识、态度和实践，以及他们对所在机构APS的总体满意度。数据采用均值、标准差、百分比、向前逐步线性回归、Fisher-Irwin（精确）检验、卡方检验以及带有Bonferroni多重比较的方差分析进行统计学分析。P值 <.05被视为具有统计学意义。研究结果表明，受访者在正误问题上的总体正确得分率为78%，在多项选择问题上为38%。态度部分显示，73%的护士对硬膜外镇痛持“积极”态度。77%的护士对接受硬膜外镇痛的患者进行了正确管理。对该机构APS的满意度为32%“非常满意”和62%“有些满意”。在调查问卷知识部分得分较高的最佳预测人口统计学特征是护士工作年限更长以及在护理培训中接受过疼痛教育。接受过硬膜外镇痛在职教育的护士比未接受过的护士更常（40%）认为自己对硬膜外知识“掌握良好”，并且在调查问卷的知识部分得分显著更高。
