Idvall E, Hamrin E, Sjöström B, Unosson M
Department of Medicine and Care, Faculty of Health Sciences, Linköping University, Linköping, Sweden.
Qual Saf Health Care. 2002 Dec;11(4):327-34. doi: 10.1136/qhc.11.4.327.
To describe and compare patient and nurse assessments of the quality of care in postoperative pain management, to investigate differences between subgroups of patients, and to compare patient assessments in different departments.
Patient and nurse questionnaires.
Five surgical wards in general surgery, orthopaedics, and gynaecology in a central county hospital in Sweden.
Two hundred and nine inpatients and 64 registered nurses. The response rates were 96% for the patients and 99% for the nurses; there were 196 paired patient-nurse assessments.
The Strategic and Clinical Quality Indicators in Postoperative Pain Management patient questionnaire was used which comprises 14 items in four subscales (communication, action, trust, and environment). The items were scored on a 5 point scale with higher values indicating a higher quality of care. Five complementary questions on levels of pain intensity and overall satisfaction with pain relief were scored on an 11 point scale. Twelve of the 14 items in the patient questionnaire and two of the complementary questions were adjusted for use in the nurse questionnaire.
The patients' mean (SD) score on the total scale (scale range 14-70) was 58.6 (8.9) and the nurses' mean (SD) score (scale range 12-60) was 48.1 (6.2). The percentage of patients who scored 1 or 2 for an individual item (disagreement) ranged from 0.5% to 52.0%, while for nurses the percentage ranged from 0.0% to 34.8%. Forty two patients (24%) reported more pain than they expected; these patients assessed the quality of care lower. There were differences between patient and nurse assessments concerning the environment subscale, the question on overall satisfaction, and patients' experience of worst possible pain intensity.
The results provided valuable baseline data and identified important areas for quality improvement in postoperative pain management.
描述并比较患者和护士对术后疼痛管理中护理质量的评估，调查患者亚组之间的差异，并比较不同科室患者的评估结果。
患者和护士问卷调查。
瑞典中部一家县级医院的普通外科、骨科和妇科的五个外科病房。
209名住院患者和64名注册护士。患者的回复率为96%，护士的回复率为99%；共有196对患者-护士评估。
使用术后疼痛管理患者问卷中的战略和临床质量指标，该问卷包括四个子量表（沟通、行动、信任和环境）中的14个项目。这些项目采用5分制评分，分数越高表明护理质量越高。关于疼痛强度水平和对疼痛缓解总体满意度的五个补充问题采用11分制评分。患者问卷中的14个项目中的12个以及两个补充问题经过调整后用于护士问卷。
患者在总量表（量表范围14 - 70）上的平均（标准差）得分为58.6（8.9），护士在总量表（量表范围12 - 60）上的平均（标准差）得分为48.1（6.2）。单个项目得分为1或2（表示不同意）的患者百分比在0.5%至52.0%之间，而护士的这一百分比在0.0%至34.8%之间。42名患者（24%）报告的疼痛比预期更严重；这些患者对护理质量的评估较低。在环境子量表、总体满意度问题以及患者对最严重疼痛强度的体验方面，患者和护士的评估存在差异。
研究结果提供了有价值的基线数据，并确定了术后疼痛管理中质量改进的重要领域。
