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母亲们关于儿童免疫接种期间镇痛的看法。

Mothers' beliefs about analgesia during childhood immunization.

作者信息

Parvez Elena, Stinson Jennifer, Boon Heather, Goldman Joanne, Shah Vibhuti, Taddio Anna

机构信息

Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario.

出版信息

Paediatr Child Health. 2010 May;15(5):289-93. doi: 10.1093/pch/15.5.289.

DOI:10.1093/pch/15.5.289
PMID:21532793
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2912630/
Abstract

BACKGROUND

Immunization injections are the most common painful medical procedures experienced during childhood, yet there is a discrepancy between recommendations for the effective use of topical anesthetics to reduce vaccine injection pain and actual practice.

OBJECTIVE

To improve our understanding of mothers' experiences and practices regarding their children's routine immunizations.

METHOD

Adopting an interpretive, naturalistic paradigm, semi-structured interviews were conducted with 15 mothers to examine their perceptions and experiences of their children's immunization pain and pain management.

RESULTS

The findings demonstrated three main themes: attitudes toward immunization pain, immunization pain management and physicians as sources of information. Participants described feeling distressed while their children were being immunized, but most managed these difficulties by focusing on the benefits of immunization and by minimizing or justifying the pain. All of the participants used non-pharmacological techniques to manage immunization injection pain. Few mothers were aware of the availability of topical anesthetics. When participants did use pharmacological analgesic approaches, oral analgesics were most likely to be used for prophylaxis and treatment of fever, and participants were unaware of evidence-based approaches to managing pain. Participants viewed their physicians as trusted sources of information, and the majority said that they would likely use a topical anesthetic in the future if recommended or approved by their physician.

CONCLUSION

The present findings provide direction for future knowledge translation activities to enhance the knowledge of mothers and clinicians regarding pain during immunization injections and its effective management.

摘要

背景

免疫接种注射是儿童时期最常见的引起疼痛的医疗程序,然而在有效使用局部麻醉剂以减轻疫苗注射疼痛的建议与实际做法之间存在差异。

目的

增进我们对母亲们在孩子常规免疫接种方面的经历和做法的了解。

方法

采用解释性、自然主义范式,对15位母亲进行了半结构化访谈,以考察她们对孩子免疫接种疼痛及疼痛管理的认知和经历。

结果

研究结果显示出三个主要主题:对免疫接种疼痛的态度、免疫接种疼痛管理以及作为信息来源的医生。参与者描述了在孩子接受免疫接种时感到苦恼,但大多数人通过关注免疫接种的益处以及尽量减少或为疼痛找借口来应对这些困难。所有参与者都使用非药物技术来管理免疫接种注射疼痛。很少有母亲知道有局部麻醉剂可用。当参与者确实使用药物镇痛方法时,口服镇痛药最有可能用于预防和治疗发热,而且参与者并不了解基于证据的疼痛管理方法。参与者将她们的医生视为可信赖的信息来源,并且大多数人表示,如果医生推荐或批准,她们将来可能会使用局部麻醉剂。

结论

目前的研究结果为未来的知识转化活动提供了方向,以增进母亲和临床医生对免疫接种注射期间疼痛及其有效管理的了解。

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Paediatr Child Health. 2010 May;15(5):289-93. doi: 10.1093/pch/15.5.289.
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本文引用的文献

1
Effectiveness and tolerability of pharmacologic and combined interventions for reducing injection pain during routine childhood immunizations: systematic review and meta-analyses.药物及联合干预措施在减轻儿童常规免疫接种时注射疼痛方面的有效性和耐受性:系统评价与荟萃分析
Clin Ther. 2009;31 Suppl 2:S104-51. doi: 10.1016/j.clinthera.2009.08.001.
2
Routine immunization practices: use of topical anesthetics and oral analgesics.常规免疫接种操作:局部麻醉剂和口服镇痛药的使用。
Pediatrics. 2007 Sep;120(3):e637-43. doi: 10.1542/peds.2006-3351.
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Pain management: a fundamental human right.疼痛管理:一项基本人权。
Anesth Analg. 2007 Jul;105(1):205-21. doi: 10.1213/01.ane.0000268145.52345.55.
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Psychological interventions for needle-related procedural pain and distress in children and adolescents.针对儿童和青少年与针头相关的程序性疼痛和痛苦的心理干预措施。
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Do too many shots due lead to missed vaccination opportunities? Does it matter?过多的疫苗接种针次会导致错过接种机会吗?这有关系吗?
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