Zhang Chun-Hua, Hsu Lily, Zou Bi-Rong, Li Jian-Fang, Wang Hong-Ying, Huang Jue
Zhongnan Hospital of Wuhan University, Wuhan.
J Pain Symptom Manage. 2008 Dec;36(6):616-27. doi: 10.1016/j.jpainsymman.2007.12.020. Epub 2008 Jul 2.
The purpose of this study was to develop, implement, and evaluate the impact of a Pain Education Program (PEP) for nurses in China. The effects of PEP were measured in a quasi-experimental design. A total of 196 nurses who met the inclusion criteria from five nursing units in two teaching hospitals participated in the study. Randomization took place at the hospital level to select experimental and control groups. The research intervention was the PEP, which had two components: (1) to educate nurses about pain management and (2) to implement daily pain assessment by using the Changhai Pain Scale. The duration of PEP was five weeks and intervention methods included focused education, group activity, and individual instruction. After the baseline data were collected, PEP was implemented in the experimental group. The control group (n=90) received no intervention, and the experimental group (n = 106) received six hours of focused education training. During the fourth and fifth weeks of the training program, the researcher and the faculty instructed nurses in five nursing units on how to use the Changhai Pain Scale to assess patients' pain levels and demonstrated how to document pain condition in the nursing records. Nurses in both groups filled out a set of questionnaires, which included a background information form and the Nurses' Knowledge and Attitude Survey form, before the PEP (T1), at one month after the PEP (T2), and at three months after the PEP (T3). Nurses in the experimental group who received the PEP had a significant improvement in their pain knowledge and attitudes. Their scores on the Nurses' Knowledge and Attitude Survey increased from 15.67 at T1 to 26.13 at T2 and 35.14 at T3. The scores of nurses in the control group were unchanged (from 15.20 at T1 to 14.29 at T2 and 14.93 at T3, P>0.05). In addition, experimental group nurses had an improvement in pain assessment. The percentage of nurses who correctly used the Changhai Pain Scale to assess patients' pain intensity increased significantly after the PEP, and the increased usage of the assessment tool between experimental and control groups also shows a statistical difference in trend (chi(2)=93.281, P<0.001). The PEP has been demonstrated to be effective in improving nurses' pain knowledge, attitudes, and assessment.
本研究旨在为中国护士开发、实施并评估疼痛教育项目（PEP）的影响。PEP的效果采用准实验设计进行测量。来自两家教学医院五个护理单元的196名符合纳入标准的护士参与了该研究。在医院层面进行随机分组以选择实验组和对照组。研究干预措施为PEP，它有两个组成部分：（1）对护士进行疼痛管理教育；（2）使用长海痛尺实施每日疼痛评估。PEP为期五周，干预方法包括集中教育、小组活动和个别指导。收集基线数据后，在实验组实施PEP。对照组（n = 90）未接受干预，实验组（n = 106）接受了六小时的集中教育培训。在培训项目的第四周和第五周，研究人员和教员指导五个护理单元的护士如何使用长海痛尺评估患者的疼痛程度，并演示如何在护理记录中记录疼痛情况。两组护士在PEP前（T1）、PEP后一个月（T2）和PEP后三个月（T3）填写了一组问卷，其中包括背景信息表和护士知识与态度调查问卷。接受PEP的实验组护士在疼痛知识和态度方面有显著改善。他们在护士知识与态度调查问卷上的得分从T1时的15.67分提高到T2时的26.13分和T3时的35.14分。对照组护士的得分没有变化（从T1时的15.20分变为T2时的14.29分和T3时的14.93分，P>0.05）。此外，实验组护士在疼痛评估方面也有改善。PEP后，正确使用长海痛尺评估患者疼痛强度的护士比例显著增加，实验组和对照组之间评估工具使用情况的增加趋势也显示出统计学差异（χ² = 93.281，P<0.001）。PEP已被证明在提高护士的疼痛知识、态度和评估方面是有效的。
