Kaasalainen Sharon, DiCenso Alba, Donald Faith C, Staples Eric
School of Nursing, McMaster University, Hamilton, Ontario, Canada.
Can J Nurs Res. 2007 Jun;39(2):14-31.
The purpose of this study was to examine the role of the nurse practitioner (NP) within an interdisciplinary model of pain management in long-term care (LTC). In a cross-sectional survey, 16 NPs in the Canadian province of Ontario (89%) indicated whether they currently performed and whether they should be performing 33 activities related to pain management and identified barriers to the fulfilment of their pain-management role. Most NPs (81.3%) reported use of pain-assessment tools, but less than half reported use of pain-management clinical practice guidelines. NPs were less involved in activities related to (a) prescribing and adjusting pain medications, (b) providing leadership in pain management, and (c) engaging in pain-related research initiatives. However, most felt that they should be more involved in these activities. Barriers to NP management of pain included time constraints; prescribing restrictions; lack of knowledge; difficulties with assessing pain; MD, staff, resident, and family reservations about use of opioids; and poor collaboration with physicians. The results indicate that NPs are not being used to their full potential in managing pain among elderly LTC residents.
本研究的目的是探讨执业护士（NP）在长期护理（LTC）疼痛管理跨学科模式中的作用。在一项横断面调查中，加拿大安大略省的16名执业护士（89%）指出了他们目前是否开展以及是否应该开展与疼痛管理相关的33项活动，并确定了履行其疼痛管理职责的障碍。大多数执业护士（81.3%）报告使用了疼痛评估工具，但报告使用疼痛管理临床实践指南的不到一半。执业护士较少参与以下活动：（a）开具和调整止痛药物；（b）在疼痛管理方面发挥领导作用；（c）参与与疼痛相关的研究项目。然而，大多数人认为他们应该更多地参与这些活动。执业护士进行疼痛管理的障碍包括时间限制、处方限制、知识缺乏、疼痛评估困难、医生、工作人员、居民和家属对使用阿片类药物的保留意见以及与医生的协作不佳。结果表明，在管理老年长期护理居民的疼痛方面，执业护士的潜力尚未得到充分发挥。
