Melbourne School of Health Sciences, National Ageing Research Institute, Statistical Consulting Centre, The University of Melbourne, Parkville, Victoria, Australia.
Pain Med. 2011 Aug;12(8):1199-215. doi: 10.1111/j.1526-4637.2011.01181.x. Epub 2011 Jun 30.
This study aimed to examine the effectiveness of a structured educational nursing intervention on pain assessment and management in older hospitalized people.
A non-equivalent control group interventional design.
Geriatric evaluation and management units in two metropolitan Australian hospitals.
In total, 192 patients participated, with 32 different patients recruited consecutively for the pre-intervention, intervention, and 3-month post-intervention stages from each unit.
Nurses in the intervention group received a structured intervention comprising 6 hours of instruction and 2 hours of clinical demonstration. Nurses in the control group received "usual" staff development activities.
Five assessment tools for pain were used: the visual analog scale, the Faces Pain Scale-Revised, the Short-Form McGill Pain Questionnaire, the Pain Assessment in Advanced Dementia Tool, and the Abbey Pain Scale. Data were also collected on nurses' use of pain assessment tools and their use of non-pharmacological and pharmacological methods of managing pain.
Improvements were observed in pain intensity at rest and on movement in the intervention unit at the post-intervention stage and at the 3-month post-intervention stage. There was also a trend for patients to be prescribed analgesics on a fixed dose schedule following implementation of the program in the intervention unit.
The comprehensive intervention enabled change in practice and improvements in pain intensity, and the assessment and management of pain. Future research is needed on implementing the intervention with a multidisciplinary team of health professionals in a subacute environment.
本研究旨在考察结构化教育护理干预对老年住院患者疼痛评估和管理的效果。
非均等对照组干预设计。
澳大利亚两家大都市医院的老年评估和管理病房。
共有 192 名患者参与，每个单位连续招募 32 名不同的患者，分别参加干预前、干预和 3 个月后的阶段。
干预组的护士接受了包括 6 小时指导和 2 小时临床示范的结构化干预。对照组的护士接受了“常规”的员工发展活动。
干预组患者在干预后和 3 个月后的阶段，静息和活动时的疼痛强度均有改善。在干预组实施该方案后，患者也有按固定剂量方案开止痛药的趋势。
全面的干预措施使实践发生了变化，疼痛强度以及疼痛的评估和管理得到了改善。需要进一步研究在亚急性环境中，多学科医疗团队实施该干预措施的情况。
