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评估住院儿童急性疼痛管理方面住院医师的知识:一项试点研究。

Assessing resident knowledge of acute pain management in hospitalized children: a pilot study.

作者信息

Saroyan John M, Schechter William S, Tresgallo Mary E, Sun Lena, Naqvi Zoon, Graham Mark J

机构信息

Division of Pediatric Anesthesia, Department of Anesthesiology, College of Physicians and Surgeons, Columbia University, New York, New York 10032, USA.

出版信息

J Pain Symptom Manage. 2008 Dec;36(6):628-38. doi: 10.1016/j.jpainsymman.2007.12.006. Epub 2008 Apr 8.

Abstract

This pilot study was undertaken to evaluate the hypotheses that there are differences in pediatric pain management (PPM) knowledge across resident specialties, that questions in the form of multiple-choice items could detect such differences, and that resident knowledge of analgesic-related adverse drug events (ADEs) would be greater than knowledge of PPM. Questions were based on two general categories of knowledge within acute pain management in hospitalized children: pediatric pain assessment and treatment, and identification of analgesic-related ADEs. As part of the pilot nature of this study, a convenience sample of 60 residents completed a 10-item PPM knowledge assessment prior to a PPM lecture. Twenty-six were pediatric residents (43%), 19 were orthopedic residents (32%), and 15 were anesthesiology residents (25%). All items had content validity. When controlling for resident year, performance by resident specialty was significantly different between anesthesia and orthopedics (P=0.006) and between anesthesia and pediatrics (P<0.001). Resident knowledge of analgesic-related ADEs was not greater than knowledge of PPM. The most difficult topics were opioid equianalgesia, assessment of the cognitively impaired child, and maximal acetaminophen doses. Repeated administration of the PPM knowledge assessment at multiple institutions will allow further evaluation of our initial findings, and with directed educational interventions, provide opportunity for measurement of improvement.

摘要

本试点研究旨在评估以下假设

不同住院医师专业在儿科疼痛管理(PPM)知识方面存在差异;多项选择题形式的问题能够检测出这些差异;住院医师对镇痛相关药物不良事件(ADEs)的了解会多于对PPM的了解。问题基于住院儿童急性疼痛管理中的两类一般知识:儿科疼痛评估与治疗,以及镇痛相关ADEs的识别。作为本研究试点性质的一部分,60名住院医师的便利样本在PPM讲座前完成了一项10项的PPM知识评估。其中26名是儿科住院医师(43%),19名是骨科住院医师(32%),15名是麻醉科住院医师(25%)。所有项目均具有内容效度。在控制住院医师年级后,麻醉科与骨科之间(P = 0.006)以及麻醉科与儿科之间(P < 0.001)的住院医师专业表现存在显著差异。住院医师对镇痛相关ADEs的了解并不多于对PPM的了解。最难的主题是阿片类等效镇痛、认知受损儿童的评估以及对乙酰氨基酚最大剂量。在多个机构重复进行PPM知识评估将有助于进一步评估我们的初步发现,并通过有针对性的教育干预,为衡量改进情况提供机会。

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