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冠状动脉手术患者疼痛感知相关的社会心理因素

Psychosocial aspects associated with pain perception in individuals undergoing coronary surgery.

作者信息

Leal Elisabete Nave, Ribeiro José Luís Pais, Oliveira Mário Martins, Roquette José

机构信息

Escola Superior de Tecnologia de Saúde de Lisboa, Lisboa, Portugal.

出版信息

Rev Port Cardiol. 2005 Oct;24(10):1221-31.

Abstract

OBJECTIVE

To identify the psychological factors that influence post-surgery pain perception in patients undergoing coronary artery bypass graft surgery (CABG).

METHODS

This was an exploratory correlational study of 91 patients (71 men and 20 women) who underwent CABG (aortocoronary anastomosis) by sternotomy. Mean age was 63.8 + 9.6 years (between 39 and 84). The following instruments were used: visual analogical scales at 24, 48 and 96 hours of post-surgery; demographic characteristics survey; pain expectations scale; perceived support scale; self-efficacy scale, Mental Inventory (5 items); health perception scale; and satisfaction with treatment, doctors and nurses (American Pain Society questionnaire) at 96 hours after surgery.

RESULTS

Patients who had presented high expectations of pain, perceived more support, presented high levels of self-efficacy to deal with pain or were male, felt less pain. Furthermore, patients who presented better mental health, perceived their general health as being good, or expressed greater satisfaction with treatment, felt less pain. Pain was not influenced by age, level of education or satisfaction with doctors and nurses.

CONCLUSION

After the first 48 hours following surgery, the pain experience is influenced by psychosocial factors, in particular by expectation of pain and of self-efficacy, perceived support, perception of general and mental health, and satisfaction with pain treatment. The results confirm the need to bring together different kinds of knowledge for a broad, multidisciplinary approach to postoperative CABG pain treatment, focusing, along with other aspects, on management of patients' expectations.

摘要

目的

确定影响冠状动脉旁路移植术(CABG)患者术后疼痛感知的心理因素。

方法

这是一项对91例患者(71例男性和20例女性)进行的探索性相关性研究,这些患者通过胸骨切开术接受了CABG(主动脉冠状动脉吻合术)。平均年龄为63.8±9.6岁(39至84岁之间)。使用了以下工具:术后24、48和96小时的视觉模拟量表;人口统计学特征调查;疼痛期望量表;感知支持量表;自我效能量表、心理量表(5项);健康感知量表;以及术后96小时对治疗、医生和护士的满意度(美国疼痛协会问卷)。

结果

对疼痛期望高、感知到更多支持、应对疼痛的自我效能水平高或为男性的患者,疼痛较轻。此外,心理健康状况较好、认为自己总体健康状况良好或对治疗表达更高满意度的患者,疼痛较轻。疼痛不受年龄、教育程度或对医生和护士的满意度影响。

结论

术后最初48小时后,疼痛体验受社会心理因素影响,特别是疼痛期望和自我效能、感知支持、总体和心理健康感知以及对疼痛治疗的满意度。结果证实,需要整合不同类型的知识,采用广泛的多学科方法来治疗CABG术后疼痛,除其他方面外,重点关注患者期望的管理。

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