Tengvall Oili, Wickman Marie, Wengström Yvonne
Department of Molecular Medicine and Surgery, Section of Reconstructive Plastic Surgery, Karolinska Institutet, Stockholm, Sweden.
J Burn Care Res. 2010 Mar-Apr;31(2):319-27. doi: 10.1097/BCR.0b013e3181d0f5dd.
Pain after burns is a major clinical problem and researchers continue to report that burn pain remains undertreated. Adequate pain management could contribute to the prevention of posttraumatic stress disorder and can give a growing sense of patients' self-confidence and strength. Freedom from pain might be unrealistic, but the objective should be to reduce pain as much as possible. The purpose of this study was to describe burn patients' experiences and memories of pain during burn care and to acquire a deeper understanding of how patients cope with the experience. The study method was qualitative and interviews were conducted with 12 adult burn patients (eight men and four women) 6 to 12 months postburn (mean = 7 months). The mean burn size for the group was 10.6% mean of TBSA and the mean stay in hospital was 16 days. The interviews were analyzed using Kvales' method for structuring analysis. The patients' experiences and memories of pain during the trajectory of care were clearly described by the informants during the interviews. Four themes were identified for pain: becoming aware of pain, allowing oneself to feel pain, different pain experiences, and fragile body surface. Four themes were identified for coping: pragmatic coping, allowing someone to care for you, carrying the pain, and perspectives on the trauma. Both good and bad memories were recorded during the care trajectory, and it is evident that the patient has to carry the pain experience by themselves to a large extent.
烧伤后的疼痛是一个主要的临床问题,研究人员不断报告称烧伤疼痛仍未得到充分治疗。充分的疼痛管理有助于预防创伤后应激障碍,并能增强患者的自信心和力量感。完全摆脱疼痛可能不太现实,但目标应该是尽可能减轻疼痛。本研究的目的是描述烧伤患者在烧伤护理期间的疼痛经历和记忆,并更深入地了解患者如何应对这种经历。研究方法是定性的,对12名成年烧伤患者(8名男性和4名女性)在烧伤后6至12个月(平均 = 7个月)进行了访谈。该组患者的平均烧伤面积为总体表面积的10.6%,平均住院时间为16天。访谈采用克瓦尔的结构化分析方法进行分析。在访谈中,受访者清楚地描述了患者在护理过程中的疼痛经历和记忆。确定了疼痛的四个主题:意识到疼痛、允许自己感受疼痛、不同的疼痛经历以及脆弱的体表。确定了应对的四个主题:务实应对、允许他人照顾自己、承受疼痛以及对创伤的看法。在护理过程中记录了好的和不好的记忆,很明显患者在很大程度上必须自己承受疼痛经历。