Brown Carolyn, Constance Kristel, Bédard Denise, Purden Margaret
McGill University Montreal, Canada.
Jewish General Hospital, Montreal, Canada.
Pain Manag Nurs. 2013 Dec;14(4):184-192. doi: 10.1016/j.pmn.2010.12.002. Epub 2011 Feb 2.
This study describes surgical colorectal cancer patients' pain levels, recovery activities, beliefs and expectations about pain, and satisfaction with pain management. A convenience sample of 50 adult inpatients who underwent colorectal surgery for cancer participated. Patients were administered the modified American Pain Society Patient Outcome Questionnaire on postoperative day 2 and asked to report on their status in the preceding 24 hours. Patients reported low current (mean 1.70) and average (mean 2.96) pain scores but had higher scores and greater variation for worst pain (mean 5.48). Worst pain occurred mainly while turning in bed or mobilizing, and 25% of patients experienced their worst pain at rest. Overall, patients expected to have pain after surgery and were very satisfied with pain management. Patients with worst pain scores >7 reported interference with recovery activities, mainly general activity (mean 5.67) and walking ability (mean 5.15). These patients were likely to believe that "people can get addicted to pain medication easily" (mean 3.39 out of 5) and that "pain medication should be saved for cases where pain gets worse" (mean 3.20 out of 5). These beliefs could deter patients from seeking pain relief and may need to be identified and addressed along with expectations about pain in the preoperative nursing assessment.
本研究描述了接受结直肠癌手术患者的疼痛程度、恢复活动情况、对疼痛的信念和期望,以及对疼痛管理的满意度。50名接受结直肠癌手术的成年住院患者组成的便利样本参与了研究。患者在术后第2天接受了改良的美国疼痛学会患者结果问卷,并被要求报告其在前24小时内的状况。患者报告当前疼痛评分较低(平均1.70),平均疼痛评分(平均2.96),但最严重疼痛评分较高且差异较大(平均5.48)。最严重疼痛主要发生在翻身或活动时,25%的患者在休息时经历了最严重疼痛。总体而言,患者预计术后会疼痛,并对疼痛管理非常满意。最严重疼痛评分>7的患者报告恢复活动受到干扰,主要是一般活动(平均5.67)和行走能力(平均5.15)。这些患者可能认为“人们很容易对止痛药上瘾”(平均3.39分,满分5分),以及“止痛药应该留到疼痛加剧时使用”(平均3.20分,满分5分)。这些信念可能会阻碍患者寻求疼痛缓解,在术前护理评估中可能需要与对疼痛的期望一起识别和解决这些信念。