Tsay Shiow-Luan, Chen Hsiao-Ling, Chen Su-Chiu, Lin Hung-Ru, Lin Kuan-Chia
Graduate Institute of Nursing, National Taipei College of Nursing, Taipei, Taiwan.
Cancer Nurs. 2008 Mar-Apr;31(2):109-15. doi: 10.1097/01.NCC.0000305694.74754.7b.
Even after receiving analgesia, patients with gastric and liver cancer still report moderate levels of postoperative pain. The purpose of the study was to investigate the efficacy of foot reflexotherapy as adjuvant therapy in relieving pain and anxiety in postoperative patients with gastric cancer and hepatocellular cancer. The study design was a randomized controlled trial. Data were collected from 4 surgical wards of a medical center in 2005 in Taipei, Taiwan. Sixty-one patients who had received surgery for gastric cancer or hepatocellular carcinoma were randomly allocated to an intervention (n = 30) or control (n = 31) group. Patients in the intervention group received the usual pain management plus 20 minutes of foot reflexotherapy during postoperative days 2, 3, and 4. Patients in the control group received usual pain management. Outcome measures included the short-form McGill Pain Questionnaire, visual analog scale for pain, summary of the pain medications consumed, and the Hospital Anxiety and Depression Scale. Results demonstrated that studied patients reported moderately high levels of pain and anxiety postoperatively while patients were managed with patient-controlled analgesia. Using generalized estimation equations and controlling for confounding variables, less pain (P < .05) and anxiety (P < .05) over time were reported by the intervention group compared with the control group. In addition, patients in the intervention group received significantly less opioid analgesics than the control group (P < .05). Findings from this study provide nurses with an additional treatment to offer postoperative digestive cancer patients.
即使接受了镇痛治疗,胃癌和肝癌患者术后仍报告有中度疼痛。本研究的目的是探讨足部反射疗法作为辅助治疗对缓解胃癌和肝细胞癌术后患者疼痛及焦虑的疗效。研究设计为随机对照试验。2005年在台湾台北的一家医疗中心的4个外科病房收集数据。61例接受了胃癌或肝细胞癌手术的患者被随机分配到干预组(n = 30)或对照组(n = 31)。干预组患者在术后第2、3和4天接受常规疼痛管理加20分钟足部反射疗法。对照组患者接受常规疼痛管理。观察指标包括简短McGill疼痛问卷、疼痛视觉模拟量表、所消耗止痛药物的总结以及医院焦虑抑郁量表。结果表明,在患者接受自控镇痛治疗时,研究对象术后报告有中度高水平的疼痛和焦虑。通过广义估计方程并控制混杂变量,与对照组相比,干预组随时间推移报告的疼痛(P <.05)和焦虑(P <.05)更少。此外,干预组患者接受的阿片类镇痛药明显少于对照组(P <.05)。本研究结果为护士提供了一种额外的治疗方法,可用于术后消化道癌症患者。