Department of Nursing Studies, The University of Hong Kong, China.
J Adv Nurs. 2010 May;66(5):1120-31. doi: 10.1111/j.1365-2648.2010.05273.x. Epub 2010 Mar 22.
This paper is a report of a study of the effectiveness of a pain management educational intervention on level of pain, anxiety and self-efficacy among patients with musculoskeletal trauma and consequent orthopaedic surgery.
Substantial evidence supports the use of preoperative education to improve patient outcomes. Educational interventions are common in preparing patients for orthopaedic surgery.
A pre- and post-test design (quasi-experimental) was employed in 2006 with patients assigned either to a control (usual care) or an experimental group (usual care plus educational intervention). The 30-minute educational intervention consisted of information about pain, coping strategies and breathing relaxation exercises. The outcome measures were scores for pain, anxiety, self-efficacy, analgesic use and length of hospital stay and these were measured before surgery and on day 2, day 4, day 7, 1 month and 3 months after surgery.
A total of 125 patients completed the study (control, n = 63; experimental = 62). The experimental group reported statistically significantly lower levels of pain, less anxiety and better self-efficacy during hospitalization (before surgery to day 7), as compared to the control group. The experimental group had more requests for analgesics at day 2 only. There were no statistically significant effects on length of stay. At the 3-month evaluation, a statistically significant effect on anxiety level was found in favour of the experimental group.
Patients may benefit from this educational intervention in terms of relieving pain, anxiety and improving self-efficacy, and the educational intervention could be incorporated as part of routine care to prepare musculoskeletal trauma patients for surgery.
本文是一项关于疼痛管理教育干预对肌肉骨骼创伤和随后骨科手术患者疼痛水平、焦虑和自我效能影响的研究报告。
大量证据支持使用术前教育来改善患者的预后。教育干预在为骨科手术做准备时很常见。
2006 年采用了预-后测试设计(准实验),将患者分为对照组(常规护理)或实验组(常规护理加教育干预)。30 分钟的教育干预包括有关疼痛、应对策略和呼吸放松练习的信息。结局测量指标为疼痛、焦虑、自我效能、镇痛药物使用和住院时间,分别在手术前、术后第 2 天、第 4 天、第 7 天、1 个月和 3 个月进行测量。
共有 125 名患者完成了研究(对照组 n=63;实验组 n=62)。与对照组相比,实验组在住院期间(手术前至第 7 天)报告的疼痛水平更低、焦虑程度更低、自我效能感更好。实验组仅在第 2 天对镇痛药物的需求更多。住院时间无统计学显著影响。在 3 个月评估时,实验组在焦虑水平上有统计学显著的优势。
患者可能会从这种教育干预中受益,缓解疼痛、焦虑和提高自我效能感,教育干预可以作为常规护理的一部分,为肌肉骨骼创伤患者手术做好准备。