Törnkvist Lena, Gardulf Ann, Strender Lars-Erik
Karolinska Institutet, Family Medicine Stockholm, Huddinge, Sweden.
Scand J Caring Sci. 2003 Dec;17(4):332-8. doi: 10.1046/j.0283-9318.2003.00237.x.
This study investigated whether district nurses' opinions changed after the education and introduction of district nurses as 'pain-advisers' at primary health care centres (PHCCs) regarding working conditions and satisfaction with pain control management at their PHCCs, their own knowledge of pain control and satisfaction with their own pain control management, pain assessment and nursing documentation of patients with chronic pain conditions. A study area (SA) with five PHCCs and a control area (CA) with seven PHCCs were selected. In the SA, 28 and in the CA, 25 district nurses answered a questionnaire both before and after the introduction of the 'pain-advisers' into the SA. The district nurses in both areas in 1996 and 1998 considered many aspects of pain management to be unsatisfactory. According to the district nurses in the SA, several statistically significant improvements were achieved after the introduction of the 'pain-advisers'; more district nurses reported that pain policies or other written information were now available at their PHCCs, that they were more satisfied with present overall routines at their PHCCs, that a better pain control was applied at their PHCCs regarding patients with leg ulcers, that they themselves to a greater extent performed individual pain assessments of the patients and that they more often used pain visual analogue scales to assess the patients' pain and to evaluate the results of the pain treatment. They also reported an increased satisfaction with their own nursing documentation. Although much remains to be done, it must be acknowledged that the 'pain-advisers', with relatively small resources, managed to make significant improvements.
本研究调查了在初级卫生保健中心（PHCC）将社区护士引入作为“疼痛顾问”并开展相关教育后，社区护士对于其所在PHCC的工作条件、疼痛控制管理满意度、自身疼痛控制知识及对自身疼痛控制管理的满意度、慢性疼痛患者的疼痛评估和护理记录等方面的看法是否发生了变化。选取了一个拥有5个PHCC的研究区域（SA）和一个拥有7个PHCC的对照区域（CA）。在SA，28名社区护士在向该区域引入“疼痛顾问”之前和之后都回答了一份问卷；在CA，25名社区护士也进行了同样的操作。1996年和1998年，两个区域的社区护士都认为疼痛管理的许多方面不尽人意。根据SA的社区护士反馈，引入“疼痛顾问”后取得了一些具有统计学意义的显著改善；更多社区护士报告称，他们所在的PHCC现在有了疼痛政策或其他书面信息，他们对所在PHCC目前的整体工作流程更满意了，在处理腿部溃疡患者时所在PHCC采用了更好的疼痛控制方法，他们自己对患者进行个体疼痛评估的程度更高了，并且他们更频繁地使用疼痛视觉模拟量表来评估患者的疼痛以及评估疼痛治疗的效果。他们还表示对自己的护理记录更满意了。尽管仍有许多工作要做，但必须承认，“疼痛顾问”凭借相对较少的资源，成功取得了显著的改善。
