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以色列癌症患者的疼痛严重程度、对疼痛管理的满意度以及与患者相关的疼痛管理障碍。

Pain severity, satisfaction with pain management, and patient-related barriers to pain management in patients with cancer in Israel.

作者信息

Naveh Pnina, Leshem Rinati, Dror Yossi Freier, Musgrave Catherine F

机构信息

Oncology Nursing Service of Hadassah Medical Organization, Jerusalem, Israel.

出版信息

Oncol Nurs Forum. 2011 Jul;38(4):E305-13. doi: 10.1188/11.ONF.E305-E313.

Abstract

PURPOSE/OBJECTIVES: To examine pain severity, satisfaction with pain management, and patient-related barriers to pain management among patients with cancer in oncology units at a teaching hospital in Israel.

DESIGN

Descriptive, cross-sectional, correlational design.

SETTING

Oncology, hematology, and bone marrow trans-plantation (BMT) departments; oncology, hematology, and BMT daycare units; and a radiation department in an Israeli hospital.

SAMPLE

Nonprobability convenience sample (N=144) of ambulatory (n=76) and hospitalized (n=68) patients experiencing pain in the past 24 hours.

METHODS

Patients who had experienced pain in the past 24 hours completed the Revised American Pain Society-Patient Outcome Questionnaire, the Barriers Questionnaire-Short Form, and a demographic data questionnaire.

MAIN RESEARCH VARIABLES

Pain severity, satisfaction with pain management, and patient-related barriers to pain management.

FINDINGS

A significant inverse relationship was observed between patients' pain severity and their expectation of pain relief. Less-educated patients had significantly higher pain severity scores. Ambulatory patients waited longer for their pain medication than hospitalized patients. The greatest barriers to pain control were fear of addiction and the notion that medication should be saved in case the pain gets worse. In addition, ambulatory patients had higher pain barrier scores than hospitalized patients.

CONCLUSIONS

The relationship between pain severity and the expectations of patients with cancer regarding pain relief indicate that patients' expected outcomes and barriers may impede optimal pain relief. This study also identified areas of possible weakness within the hospital's pain palliation program.

IMPLICATIONS FOR NURSING

Nurses should assess for patients' expectations and barriers that could impede pain relief and provide appropriate interventions.

摘要

目的/目标:在以色列一家教学医院的肿瘤科病房,调查癌症患者的疼痛严重程度、对疼痛管理的满意度以及与患者相关的疼痛管理障碍。

设计

描述性、横断面、相关性设计。

地点

肿瘤学、血液学和骨髓移植(BMT)科室;肿瘤学、血液学和BMT日间护理病房;以及以色列一家医院的放射科。

样本

非概率便利样本(N = 144),其中包括过去24小时内经历疼痛的门诊患者(n = 76)和住院患者(n = 68)。

方法

过去24小时内经历过疼痛的患者完成了修订后的美国疼痛协会患者结果问卷、简短形式的障碍问卷和一份人口统计学数据问卷。

主要研究变量

疼痛严重程度、对疼痛管理的满意度以及与患者相关的疼痛管理障碍。

结果

观察到患者的疼痛严重程度与他们对疼痛缓解的期望之间存在显著的负相关。受教育程度较低的患者疼痛严重程度得分显著更高。门诊患者等待止痛药的时间比住院患者更长。疼痛控制的最大障碍是害怕成瘾以及认为应在疼痛加重时节省药物。此外,门诊患者的疼痛障碍得分高于住院患者。

结论

癌症患者的疼痛严重程度与对疼痛缓解的期望之间的关系表明,患者的预期结果和障碍可能会阻碍最佳的疼痛缓解。本研究还确定了医院疼痛缓解项目中可能存在薄弱环节的领域。

对护理的启示

护士应评估可能阻碍疼痛缓解的患者期望和障碍,并提供适当的干预措施。

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