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术后疼痛体验:基于麦吉尔疼痛问卷的描述

The postoperative pain experience: a description based on the McGill Pain Questionnaire.

作者信息

Fortin J D, Schwartz-Barcott D, Rossi S

出版信息

Clin Nurs Res. 1992 Aug;1(3):292-304. doi: 10.1177/105477389200100308.

Abstract

In surgical nursing practice, postoperative pain is of particular concern because of its documented effect on recovery and behaviors associated with recovery. Yet, little is known about the nature of this pain, other than its intensity. In this study, a description of the nature of the postoperative pain experience was generated from analysis of patient responses to the McGill Pain Questionnaire in four nursing intervention studies. The combined sample included 246 adult cholecystectomy patients. Patient descriptions of pain on the third postoperative day suggest a circumscribed sensory experience of moderate intensity. Sensory descriptors selected reflect two levels of noxious stimulation, one at the deeper somatic level (e.g., throbbing, stabbing, cramping, pulling, and burning) and one at a more superficial level (e.g., pricking, sharp, pinching, itching, sore, and tender). Descriptors of deeper pain tended to reflect greater intensity. The overall experience was characterized by 16 descriptors, selected by more than 30% of the sample and reflecting sensory, affective, and evaluative dimensions of the pain experience. Comparison of the findings from this combined sample drawn from hospitals in the northeastern United States were remarkably similar to those reported by Taenzer in Canada. The descriptors selected support, extend, and validate the kind of "sensation information" needed in preoperative instruction used in nursing practice and for abdominal surgery and can be useful in the assessment and management of postoperative pain.

摘要

在外科护理实践中,术后疼痛备受关注,因为已有文献证明它会影响恢复以及与恢复相关的行为。然而,除了疼痛强度外,对于这种疼痛的本质知之甚少。在本研究中,通过分析四项护理干预研究中患者对麦吉尔疼痛问卷的回答,得出了术后疼痛体验本质的描述。合并样本包括246名成年胆囊切除术患者。患者对术后第三天疼痛的描述表明是一种强度适中的局限性感觉体验。所选择的感觉描述词反映了两种有害刺激水平,一种在较深的躯体层面(如搏动性、刺痛性、痉挛性、牵拉性和灼痛性),另一种在较浅的层面(如刺痛、尖锐、挤压、瘙痒、酸痛和压痛)。较深疼痛的描述词往往反映出更强的强度。总体体验由16个描述词表征,超过30%的样本选择了这些描述词,它们反映了疼痛体验的感觉、情感和评价维度。从美国东北部医院抽取的这个合并样本的研究结果与加拿大的Taenzer报告的结果非常相似。所选择的描述词支持、扩展并验证了护理实践及腹部手术术前指导所需的那种“感觉信息”,并且可用于术后疼痛的评估和管理。

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