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音乐与麻醉后护理单元环境

Music and the PACU environment.

作者信息

Shertzer K E, Keck J F

机构信息

Richard L. Roudebush Veterans Administration Hospital, Indianapolis, IN, USA.

出版信息

J Perianesth Nurs. 2001 Apr;16(2):90-102. doi: 10.1053/jpan.2001.22594.

Abstract

Pain is a common problem in the PACU, resulting in negative respiratory, cardiovascular, gastrointestinal, renal, neuroendocrine, and autonomic nervous system consequences for patients. Pain relief contributes to improved patient outcomes and is also an important component of patient satisfaction, particularly in light of today's environment of high competition among hospitals for patients. Music and quiet conversation by staff, contributing to low noise levels in the PACU environment, have the potential to provide pain relief and improve patient satisfaction with the PACU experience. This study investigated the effect of soothing music and lowering noise levels on the pain experience of patients during their PACU stay. A quasiexperimental study was conducted with 2 groups of patients, one who listened to music on a day when staff kept extraneous noise at a minimum in the PACU (the experimental group) and one who experienced the typical PACU day (the control group). The study was conducted at a large Veterans Administration hospital in the Midwest. The sample consisted of 97 individuals undergoing same-day surgery from all surgery services except open heart. Pain was measured by using the 11-point Numerical Rating Scale (NRS). The experimental group experienced a significant reduction in pain from admission to the PACU until discharge. There was no significant decrease for the control group. Approximately 65% of both groups reported no pain on admission to PACU. The percentage of those in the experimental group with no pain increased to 74% at time of discharge. The percentage of those in the control group who reported no pain on discharge had decreased to 58%. A total of 99% of the participants remembered their PACU stay. When asked to remember aspects of comfort during the PACU stay, the experimental group reported (1) significantly less noise caused by staff voices and equipment, (2) greater perception of availability of nurses, and (3) significantly more positive perception of their PACU stay. The study findings support the potential for music played throughout the PACU stay to positively affect the pain experience and improve comfort among patients having surgery.

摘要

疼痛是麻醉后护理单元(PACU)中的常见问题,会给患者的呼吸、心血管、胃肠道、肾脏、神经内分泌和自主神经系统带来不良后果。缓解疼痛有助于改善患者的预后,也是患者满意度的重要组成部分,尤其是在当今医院为争夺患者而竞争激烈的环境下。工作人员播放的音乐和轻声交谈有助于降低PACU环境中的噪音水平,有可能缓解疼痛并提高患者对PACU体验的满意度。本研究调查了舒缓音乐和降低噪音水平对患者在PACU停留期间疼痛体验的影响。对两组患者进行了一项准实验研究,一组患者在工作人员将PACU中的外部噪音降至最低的那天听音乐(实验组),另一组患者经历典型的PACU一天(对照组)。该研究在中西部的一家大型退伍军人管理局医院进行。样本包括97名接受当日手术的患者,这些患者来自除心脏直视手术外的所有手术科室。使用11点数字评分量表(NRS)测量疼痛程度。实验组从进入PACU到出院期间疼痛明显减轻。对照组则没有明显下降。两组中约65%的患者在进入PACU时报告无疼痛。实验组中无疼痛的患者在出院时比例增至74%。对照组中出院时报告无疼痛的患者比例降至58%。共有99%的参与者记得他们在PACU的停留经历。当被要求回忆在PACU停留期间的舒适方面时,实验组报告(1)工作人员声音和设备产生的噪音明显减少,(2)对护士可及性的感知更强,(3)对其PACU停留的积极感知明显更多。研究结果支持了在整个PACU停留期间播放音乐对手术患者的疼痛体验产生积极影响并提高舒适度的可能性。

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