Leegaard Marit, Rustøen Tone, Fagermoen May Solveig
Faculty of Nursing, Oslo University College, Oslo, Norway.
Pain Manag Nurs. 2010 Jun;11(2):99-107. doi: 10.1016/j.pmn.2009.04.001. Epub 2009 Sep 9.
Women report more postoperative pain and problems performing domestic activities than men in the first month of recovery after cardiac surgery. The purpose of this article is to describe how women rate and describe pain interference with daily life after early discharge from cardiac surgery. A qualitative study was conducted in 2004-2005 with ten women recruited from a large Norwegian university hospital before discharge from their first elective cardiac surgery. Various aspects of the women's postoperative experiences were collected with qualitative interviews in the women's homes 8-14 days after discharge: a self-developed pain diary measuring pain intensity, types and amount of pain medication taken every day after returning home from hospital; and the Brief Pain Inventory-Short Form immediately before the interview. Qualitative content analysis was used to identify recurring themes from the interviews. Data from the questionnaires provided more nuances to the experiences of pain, pain management, and interference of postoperative pain. Postoperative pain interfered most with sleep, general activity, and the ability to perform housework during the first 2 weeks after discharge. Despite being advised at the hospital to take pain medication regularly, few women consumed the maximum amount of analgesics. Early hospital discharge after open cardiac surgery implies increased patient participation in pain management. Women undergoing this surgery need more information in hospital on why postoperative pain management beyond simple pain relief is important.
在心脏手术后恢复的第一个月,女性报告的术后疼痛及进行家务活动时遇到的问题比男性更多。本文旨在描述女性如何评估以及描述心脏手术后早期出院后疼痛对日常生活的干扰。2004年至2005年进行了一项定性研究,从挪威一家大型大学医院招募了10名女性,她们即将接受首次择期心脏手术且尚未出院。在出院8至14天后,通过在女性家中进行定性访谈,收集了她们术后经历的各个方面:一份自行设计的疼痛日记,记录疼痛强度、回家后每天服用的止痛药类型和剂量;以及在访谈前即刻填写的简明疼痛问卷简表。采用定性内容分析法从访谈中识别反复出现的主题。问卷数据为疼痛经历、疼痛管理及术后疼痛干扰情况提供了更多细微差别。出院后的前两周,术后疼痛对睡眠、日常活动及做家务能力的干扰最大。尽管医院建议定期服用止痛药,但很少有女性服用最大剂量的镇痛药。心脏直视手术后早期出院意味着患者在疼痛管理方面的参与度增加。接受这种手术的女性在医院需要更多关于术后疼痛管理为何超出单纯缓解疼痛范畴而如此重要的信息。