Ross R S, Bush J P, Crummette B D
Department of Psychology, Virginia Commonwealth University, Richmond 23284-2018.
J Pediatr Psychol. 1991 Apr;16(2):151-67. doi: 10.1093/jpepsy/16.2.151.
Investigated postoperative PRN analgesic medication decisions regarding children in 113 hospital nurses, using analog stimuli. Nurses with greater narcotics knowledge and comfort indicated they would provide significantly more medication. Nurses provided more analgesics to children showing higher pain, and on the first than on the third postoperative day. Seriousness of child's condition also affected medication decisions. On the first day, nurses gave less medication to the child with than without permanent sequelae, whereas on the third postoperative day nurses provided more analgesics to the child with than without sequelae. These findings were consistent across high and low pain conditions. Nurses' ratings of children's pain were also affected by seriousness and time since surgery. Findings are discussed with reference to problems of undermanagement of children's pain.
使用模拟刺激研究了113名医院护士关于儿童术后按需镇痛药物的决策。对麻醉药品知识掌握更好且更自信的护士表示，他们会提供显著更多的药物。护士会给疼痛程度更高的儿童提供更多镇痛药，且术后第一天比第三天提供得更多。儿童病情的严重程度也会影响药物决策。第一天，护士给有永久性后遗症的儿童的用药比没有后遗症的儿童少，而在术后第三天，护士给有后遗症的儿童提供的镇痛药比没有后遗症的儿童多。这些发现在高疼痛和低疼痛情况下都是一致的。护士对儿童疼痛的评分也受到病情严重程度和术后时间的影响。文中结合儿童疼痛管理不足的问题对研究结果进行了讨论。
