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父母术后疼痛管理:态度、评估和管理。

Parental postoperative pain management: attitudes, assessment, and management.

机构信息

Department of Family Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA.

出版信息

Pediatrics. 2010 Jun;125(6):e1372-8. doi: 10.1542/peds.2009-2632. Epub 2010 May 24.

Abstract

OBJECTIVES

Previous studies suggested that parents frequently do not adequately treat postoperative pain that is experienced at home. Reasons for these parental practices have not been extensively studied. Aims of this study were to examine parental postoperative pain assessment and management practices at home as well potential attitudinal barriers to such pain practices.

METHODS

This was a longitudinal study involving 132 parents of children who were aged 2 to 12 years and undergoing elective outpatient surgery. Parental attitudes about pain assessment and management were assessed preoperatively, and children's pain severity and analgesic administration were assessed postoperatively for the first 48 hours after discharge.

RESULTS

Although postoperative parental ratings indicated significant pain, parents provided a median of only 1 dose of analgesics (range: 0-3) during the first 48 hours after surgery. In the attitudinal survey, parents' responses have indicated significant barriers. For example, 52% of parents indicated that analgesics are addictive, and 73% reported worries concerning adverse effects. Also, 37% of parents thought that "the less often children receive analgesics, the better they work." Regression analysis demonstrated that, overall, more preoperative attitudinal barriers to pain management were significantly associated with provision of fewer doses of analgesics by parents (P < .05).

CONCLUSIONS

Parents detected pain in their children yet provided few doses of analgesics. Parents may benefit from interventions that provide them with information that addresses individual barriers regarding assessing and treating pain.

摘要

目的

先前的研究表明,父母在家中经常不能充分治疗术后疼痛。这些父母行为的原因尚未得到广泛研究。本研究的目的是检查父母在家中术后疼痛评估和管理的实践情况,以及对这些疼痛实践的潜在态度障碍。

方法

这是一项纵向研究,涉及 132 名年龄在 2 至 12 岁之间、接受择期门诊手术的儿童的父母。在术前评估父母对疼痛评估和管理的态度,在术后出院后的头 48 小时内评估儿童的疼痛严重程度和镇痛剂的使用情况。

结果

尽管术后父母的评估表明疼痛明显,但在术后的头 48 小时内,父母仅提供了中位数为 1 剂的镇痛药(范围:0-3)。在态度调查中,父母的反应表明存在重大障碍。例如,52%的父母表示镇痛药会上瘾,73%的父母表示担心不良反应。此外,37%的父母认为“儿童越不经常接受镇痛药,它们的效果就越好”。回归分析表明,总体而言,父母对疼痛管理的态度障碍越多,父母提供的镇痛药剂量就越少(P<.05)。

结论

父母察觉到孩子的疼痛,但只提供了少量的镇痛药。父母可能受益于干预措施,这些措施为他们提供了有关评估和治疗疼痛的个人障碍的信息。

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