Lee Anna, Gin Tony, Lau Angel S C, Ng Floria F
Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, China.
Anesth Analg. 2005 Jan;100(1):87-93. doi: 10.1213/01.ANE.0000140782.04973.D9.
In this study we sought to examine the differences in patients' and health care professionals' preferences for symptoms during immediate postoperative recovery and the management of postoperative nausea and vomiting (PONV). The key differences between symptoms during immediate postoperative recovery (PONV, sedation, and pain) and management of PONV (prophylaxis, efficacy of antiemetic, and extra cost) were used to develop 14 scenarios in a questionnaire. Fifty-two health care professionals (anesthesiologists and recovery room nurses) and 200 women undergoing elective gynecological surgery were recruited (overall response rate, 97%). From patients' and health care professionals' perspectives, conjoint analysis showed that the most important attribute for immediate postoperative recovery was a reduction in the risk of PONV. Health care professionals placed more importance on postoperative sedation than patients did. They were more concerned about the cost of the antiemetic to the patient than the patients were themselves. There was no preference for a policy of effective treatment versus routine prophylaxis. This study shows that there were small differences in the importance of pain, sedation, efficacy of the antiemetic, and extra cost of treatment between patients and health care professionals.
在本研究中,我们试图探讨患者与医疗保健专业人员对术后即刻恢复期间症状以及术后恶心呕吐(PONV)管理的偏好差异。利用术后即刻恢复期间的症状(PONV、镇静和疼痛)与PONV管理(预防、止吐药疗效和额外费用)之间的关键差异,在一份问卷中设计了14种情景。招募了52名医疗保健专业人员(麻醉医生和恢复室护士)以及200名接受择期妇科手术的女性(总体回复率为97%)。从患者和医疗保健专业人员的角度来看,联合分析表明,术后即刻恢复最重要的属性是降低PONV风险。医疗保健专业人员比患者更重视术后镇静。他们比患者自己更关心止吐药对患者的费用。对于有效治疗策略与常规预防策略并无偏好。本研究表明,患者与医疗保健专业人员在疼痛、镇静、止吐药疗效以及治疗额外费用的重要性方面存在细微差异。