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住院患者自我报告的疼痛管理:过程与结果之间的联系。

Self-reported management of pain in hospitalized patients: link between process and outcome.

作者信息

Bovier Patrick A, Charvet Agathe, Cleopas Agatta, Vogt Nicole, Perneger Thomas V

机构信息

Quality of Care Unit, Geneva University Hospitals, Switzerland.

出版信息

Am J Med. 2004 Oct 15;117(8):569-74. doi: 10.1016/j.amjmed.2004.05.020.

Abstract

PURPOSE

Hospitalized patients commonly experience pain. We investigated the association between patients' reported use of recommended pain management practices and overall pain relief.

METHODS

All adult patients discharged during a 1-month period from a Swiss teaching hospital were invited to complete a mailed survey that included the Picker patient experience questionnaire, questions on pain relief during hospitalization, and questions on various procedures that are recommended as standards of pain management.

RESULTS

Of 2156 eligible patients, 1518 (70%) participated. Sixty-nine percent (n = 1050) had experienced pain during their hospital stay, of whom 71% (n = 697/978) reported complete pain relief. After adjustment for sex, age, general health, and hospital department, pain relief was associated independently with availability of physicians (odds ratio [OR] = 11; 95% confidence interval [CI]: 3.3 to 36 for excellent vs. poor availability), having received information about pain and its management (OR = 2.8; 95% CI: 1.8 to 4.2), regular pain assessment (OR = 1.8; 95% CI: 1.2 to 2.8), modification of pain treatment when ineffective (OR = 3.0; 95% CI: 1.6 to 5.6), and waiting less than 10 minutes for pain medications (OR = 3.5; 95% CI: 1.9 to 6.6).

CONCLUSION

Patient reports that recommended pain management procedures had been used were associated with better self-reported pain relief among hospitalized patients.

摘要

目的

住院患者通常会经历疼痛。我们调查了患者报告的推荐疼痛管理措施的使用情况与总体疼痛缓解之间的关联。

方法

邀请一家瑞士教学医院在1个月内出院的所有成年患者完成一份邮寄调查问卷,其中包括Picker患者体验问卷、关于住院期间疼痛缓解的问题以及关于作为疼痛管理标准推荐的各种程序的问题。

结果

在2156名符合条件的患者中,1518名(70%)参与了调查。69%(n = 1050)的患者在住院期间经历过疼痛,其中71%(n = 697/978)报告疼痛完全缓解。在对性别、年龄、总体健康状况和医院科室进行调整后,疼痛缓解与医生的可及性独立相关(优势比[OR] = 11;95%置信区间[CI]:优秀可及性与差可及性相比为3.3至36)、接受过关于疼痛及其管理的信息(OR = 2.8;95% CI:1.8至4.2)、定期疼痛评估(OR = 1.8;95% CI:1.2至2.8)、疼痛治疗无效时进行调整(OR = 3.0;95% CI:1.6至5.6)以及等待疼痛药物的时间少于10分钟(OR = 3.5;95% CI:1.9至6.6)。

结论

患者报告使用了推荐的疼痛管理程序与住院患者自我报告的更好的疼痛缓解相关。

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