de Jong Alette E E, Gamel Claudia
Burn Unit, Rode Kruis Ziekenhuis, Beverwijk, The Netherlands.
J Adv Nurs. 2006 Jun;54(6):710-21. doi: 10.1111/j.1365-2648.2006.03858.x.
This paper presents a literature review examining the implications of previous research in order to make evidence-based decisions about the possible use of breathing exercises with adult patients with burns for pain management during wound care.
Adult patients with burns experience pain during wound care despite pharmacological interventions. Additional interventions are needed to improve the effectiveness of pain management. Relaxation techniques can be considered, for example breathing exercises, music and distraction. A simple breathing relaxation technique is especially relevant because it involves no risk, is easy and quick to learn, equipment does not need to be purchased and it can be employed immediately by the often exhausted and ill patient. However, the effect of breathing exercises on procedural pain during burn wound care has not been investigated.
The CINAHL, PubMed and Cochrane databases were searched in 2004 in order to answer two questions: are breathing exercises effective in the management of procedural pain in adult burn patients, and what are the implications of previous investigations for future research concerning pain reduction in adult patients with burns during wound care? Eleven papers were included in the review.
The effect of breathing exercises for pain management in patients with burns has not been investigated. Prior to undertaking an effect study, additional basic research is needed. The number of sessions necessary to learn to use the technique should be clarified. A valid and reliable instrument to assess relaxation must be developed. The adequacy of the proposed data collection procedure needs to be assessed.
It is not possible at this time to base decisions about the use of breathing exercises during wound care in adult patients with burns on research specific to the procedure and patient group. The most suitable relaxation technique for future investigation is concentration on breathing, in combination with jaw relaxation.
本文进行文献综述，审视既往研究的影响，以便就是否可能对成年烧伤患者在伤口护理期间使用呼吸练习进行疼痛管理做出循证决策。
成年烧伤患者尽管接受了药物干预，但在伤口护理期间仍会经历疼痛。需要额外的干预措施来提高疼痛管理的效果。可以考虑采用放松技巧，例如呼吸练习、音乐和分散注意力。一种简单的呼吸放松技巧尤为适用，因为它没有风险，易于快速学会，无需购买设备，而且疲惫且患病的患者可立即采用。然而，呼吸练习对烧伤伤口护理期间程序性疼痛的影响尚未得到研究。
2004年检索了CINAHL、PubMed和Cochrane数据库，以回答两个问题：呼吸练习对成年烧伤患者程序性疼痛的管理是否有效，以及既往研究对未来关于成年烧伤患者伤口护理期间减轻疼痛的研究有何影响？该综述纳入了11篇论文。
尚未研究呼吸练习对烧伤患者疼痛管理的效果。在进行效果研究之前，需要进行更多的基础研究。需要明确学会使用该技巧所需的疗程数量。必须开发一种有效且可靠的评估放松程度的工具。需要评估所提议的数据收集程序是否充分。
目前无法基于针对该程序和患者群体的研究，就成年烧伤患者伤口护理期间使用呼吸练习做出决策。未来研究最合适的放松技巧是专注于呼吸，并结合下颌放松。
