Martin-Herz S P, Thurber C A, Patterson D R
University of Washington School of Medicine, Seattle, USA.
J Burn Care Rehabil. 2000 Sep-Oct;21(5):458-72; discussion 457.
The pain involved in acute burn care can be excruciating and intractable. Even the best pharmacologic pain control efforts often fail to adequately control pain, especially procedure-related pain, in pediatric patients with burn injuries. Nonpharmacologic interventions have been found to be effective in reducing pain in both children and adults and can be extremely important adjuvants to standard pharmacologic analgesia in the burn care setting. In the first article in this series, we outlined psychological factors that influence the emotions, cognitions, and behaviors of children during wound care. Building on this theoretical framework, we now present a detailed discussion of the implementation of nonpharmacologic intervention strategies in the burn care setting. Because accurate measurement of discomfort is imperative for the development of interventions and for the evaluation of their efficacy, we begin with a brief review of pain measurement techniques. We follow this with suggestions for tailoring interventions to meet specific patient needs and conclude with a detailed and practical discussion of specific intervention techniques and the implementation of those techniques.
急性烧伤护理中的疼痛可能极其剧烈且难以控制。即便采用最佳的药物止痛措施，对于烧伤患儿，往往仍无法充分控制疼痛，尤其是与操作相关的疼痛。已发现非药物干预在减轻儿童和成人的疼痛方面有效，并且在烧伤护理环境中，它可以成为标准药物镇痛极为重要的辅助手段。在本系列的第一篇文章中，我们概述了影响儿童在伤口护理期间的情绪、认知和行为的心理因素。基于这一理论框架，我们现在详细讨论在烧伤护理环境中实施非药物干预策略。由于准确测量不适对于干预措施的制定及其疗效评估至关重要，我们首先简要回顾疼痛测量技术。接着，我们给出针对特定患者需求调整干预措施的建议，最后详细且切实地讨论具体干预技术及其实施。
