Pain Clinic, Ryhov County Hospital, Jönköping, Sweden.
J Clin Nurs. 2013 Mar;22(5-6):638-47. doi: 10.1111/j.1365-2702.2012.04225.x. Epub 2012 Sep 4.
To (1) examine the clinical applicability of compiled mode and maximum values from the Numeric Rating Scale (NRS) by comparing the correspondence between patient perceptions of pain and pain values from monitoring records, as well as (2) to study the relationship between mode and maximum values and self-assessed ability for early postoperative recovery.
Documentation of pain remains a problem despite recommendations of quality improvements. To examine the correlation between patient perceptions and documented pain therefore becomes important. Few have studied how pain affects recovery.
A quantitative cross-sectional design was used in which 157 postoperative patients answered a questionnaire on pain intensity and recovery. A parallel examination of pain in monitoring records was conducted.
A total of 57% had a mode value calculated from records between 0 and 3 on postoperative day 1 and 69% on day 2. A maximum value between 4 and 10 was found in monitoring records for 73% on day 1 and for 67% on day 2. The correspondence between mode value from monitoring records and the patients' retrospective perceptions was 88% for NRS 0-3 and 92% between maximum value and NRS 4-10. The correlation between documented pain and retrospectively identified pain for mode value of the NRS in all (0-10) was rather weak (r = 0·37), while maximum value had a stronger correlation (r = 0·53).
Mode and maximum values could be used as outcome measures when evaluating postoperative pain. Pain affects recovery negatively, but more research is needed to strengthen the evidence for the use and clarify the link between pain and recovery.
International organisations emphasise the importance of improving pain assessment. Mode and maximum values are easy to compile for nurses and can, together with assessments of how experienced pain levels affect postoperative recovery, improve treatment of postoperative pain.
（1）通过比较监测记录中患者对疼痛的感知与疼痛值之间的一致性，检验 NRS 中编译模式和最大值的临床适用性；（2）研究模式和最大值与术后早期自我评估康复能力之间的关系。
尽管有质量改进建议，但疼痛记录仍然存在问题。因此，检查患者感知与记录疼痛之间的相关性变得尤为重要。很少有研究探讨疼痛对康复的影响。
本研究采用定量横断面设计，对 157 名术后患者进行问卷调查，内容包括疼痛强度和康复情况。同时对监测记录中的疼痛进行平行检查。
共有 57%的患者术后第 1 天记录的模式值在 0-3 之间，69%的患者术后第 2 天记录的模式值在 0-3 之间。监测记录中 73%的患者术后第 1 天的最大值在 4-10 之间，67%的患者术后第 2 天的最大值在 4-10 之间。监测记录中的模式值与患者回顾性感知之间的一致性在 NRS 0-3 时为 88%，在 NRS 4-10 时为 92%。NRS 0-10 时，记录的疼痛与回顾性识别的疼痛之间的相关性较弱（r = 0.37），而最大值的相关性较强（r = 0.53）。
模式值和最大值可作为评估术后疼痛的结果测量指标。疼痛会对康复产生负面影响，但需要更多的研究来加强证据支持，并阐明疼痛与康复之间的联系。
国际组织强调了改善疼痛评估的重要性。模式和最大值易于护士编制，与评估疼痛程度如何影响术后康复相结合，可以改善术后疼痛的治疗。
