Niemi-Murola Leila, Pöyhiä Reino, Onkinen Kaarina, Rhen Birthe, Mäkelä Arja, Niemi Tomi T
Department of Anesthesiology and Intensive Care Medicine, Helsinki University Hospital, Helsinki, Finland.
Pain Manag Nurs. 2007 Sep;8(3):122-9. doi: 10.1016/j.pmn.2007.05.003.
Patients often suffer from inadequate treatment of postoperative pain. The purpose of this study was to survey the factors affecting patient satisfaction with postoperative pain management. A questionnaire with 41 items was given on the third postoperative day to 102 patients undergoing major orthopedic or vascular surgery. Intensity of pain was assessed using a 10-cm visual analogue scale (VAS) and given analgesics were recorded. Nurses (n = 74) working on the wards received a questionnaire concerning attitudes toward management of pain. The questionnaires were returned by 75.5% of the patients and 86.3 % of the nurses. Mean VAS on all wards was 2 (scale 0-10). Twenty-eight percent of the patients agreed having hard pain during the day of the operation and 39.3% during the first postoperative night. Eighty percent of the patients were satisfied with pain management, and their satisfaction correlated significantly with received preoperative information (p < .01) and preoperative well-being (p < .01). There is discrepancy between the amount of experienced pain and values of the frequent VAS recordings, which does not seem to be due to the nurses' attitudes toward pain. Preoperative interview is important tool to receive and give information concerning postoperative pain management.
患者术后疼痛常常得不到充分治疗。本研究的目的是调查影响患者对术后疼痛管理满意度的因素。在术后第三天，对102例接受大型骨科或血管外科手术的患者发放了一份包含41个条目的问卷。使用10厘米视觉模拟量表（VAS）评估疼痛强度，并记录所给予的镇痛药。在病房工作的74名护士收到了一份关于疼痛管理态度的问卷。患者问卷的回收率为75.5%，护士问卷的回收率为86.3%。所有病房的平均VAS评分为2分（0 - 10分制）。28%的患者表示手术当天疼痛剧烈，39.3%的患者表示术后第一个晚上疼痛剧烈。80%的患者对疼痛管理感到满意，他们的满意度与术前获得的信息（p < 0.01）和术前的健康状况（p < 0.01）显著相关。患者实际经历的疼痛程度与频繁的VAS记录值之间存在差异，这似乎并非由于护士对疼痛的态度所致。术前访谈是获取和提供有关术后疼痛管理信息的重要工具。
