Ger Luo-Ping, Chang Ching-Ying, Ho Shung-Tai, Lee Ming-Chien, Chiang Hsien-Hsien, Chao Co-Shi, Lai Kwok-Hung, Huang Jui-Mei, Wang Shih-Chun
Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
J Pain Symptom Manage. 2004 Jan;27(1):61-71. doi: 10.1016/j.jpainsymman.2003.05.006.
A hospital-based quasi-experimental (pretest and post-test) study was conducted in Kaohsiung Veteran General Hospital, Taiwan. This study was to evaluate a continuing education program (CEP) on nurses' practices of cancer pain assessment and their acceptance of patients' pain reports with respect to four types of misconceptions. A questionnaire was sent to on-duty nurses or head nurses with patient care responsibilities before the implementation of CEP (n=645) and six months after the program (n=630). The response rates were 92.6% and 91.3% for pretest and post-test surveys, respectively. The CEP was implemented in 8 weeks with four-repeated sessions of 4-hour lectures. A one-day workshop focused on cancer pain assessment and treatment was held 3 months after the four-repeated sessions. Several educational strategies and teaching materials were used in the CEP. The results showed that CEP made statistically significant yet moderate improvement in nurses' practices of pain assessment using pain rating scales (pretest 3.29+/-0.76 vs. post-test 3.48+/-0.75, P<0.001) and acceptance of patient's pain reports without misconceptions on addiction (3.12+/-0.80 vs. 3.39+/-0.90, P<0.001), phantom pain (3.91+/-0.96 vs. 4.07+/-0.92, P=0.005), and placebo testing (3.63+/-0.72 vs. 3.81+/-0.73, P<0.001), except on patient gender-age-related doubts (3.60+/-0.72 vs. 3.67+/-0.77, P=0.109). In order to achieve further improvement, additional follow-up CEP combined with a hospital-wide institutionalization of pain assessment should be promoted and implemented in the future.
台湾高雄荣民总医院开展了一项基于医院的准实验性（前后测）研究。本研究旨在评估一项继续教育项目（CEP）对护士癌症疼痛评估实践的影响，以及护士针对四种误解类型对患者疼痛报告的接受情况。在CEP实施前（n = 645）和项目实施六个月后（n = 630），向负责患者护理的值班护士或护士长发放了问卷。前后测调查的回复率分别为92.6%和91.3%。CEP在8周内实施，共进行了4次时长为4小时的讲座。在4次讲座后的3个月举办了为期一天的专注于癌症疼痛评估和治疗的研讨会。CEP中使用了多种教育策略和教材。结果显示，CEP在护士使用疼痛评分量表进行疼痛评估的实践方面（前测3.29±0.76 vs. 后测3.48±0.75，P<0.001）以及在对患者疼痛报告的接受情况方面取得了具有统计学意义的适度改善，具体表现为在成瘾误解（3.12±0.80 vs. 3.39±0.90，P<0.001）、幻痛（3.91±0.96 vs. 4.07±0.92，P = 0.005）和安慰剂测试（3.63±0.72 vs. 3.81±0.73，P<0.001）方面，除了在患者性别 - 年龄相关疑虑方面（3.60±0.72 vs. 3.67±0.77，P = 0.109）。为了实现进一步改善，未来应推广并实施额外的后续CEP，并将疼痛评估在全院制度化。
