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医护人员对儿科疼痛管理和阿片类药物使用的认知程度。

Degree of knowledge of health care professionals about pain management and use of opioids in pediatrics.

机构信息

Faculty of Pharmacy, Graduated Program of Pharmaceutical Sciences, UFRGS, Porto Alegre, RS, Brazil.

出版信息

Pain Med. 2014 May;15(5):807-19. doi: 10.1111/pme.12332. Epub 2014 Jan 8.

Abstract

OBJECTIVE

To evaluate the degree of knowledge about pain management and opioids use by professionals working at three pediatric units.

DESIGN

This is a cross-sectional study.

SETTING

This study was carried out at three pediatric units (pediatrics, intensive care unit, and oncology) of Hospital de Clínicas de Porto Alegre, which is a university hospital located in southern Brazil.

SUBJECT

The subjects of this study include physicians, pharmacists, physiotherapists, nurses, nursing technicians, and nursing assistants.

METHODS

Cross-sectional study carried out in a university hospital in southern Brazil. A self-applicable semi-structured questionnaire was handed out to 182 professionals from December 2011 to March 2012.

RESULTS

The response rate was 67% (122); the average percentage of correct answers was 63.2 ± 1.4%. The most frequent errors were: an opioid must not be used if the cause of pain is unknown (47%; 54/115); patients often develop respiratory depression (42.3%; 22/52); and confusion about symptoms of withdrawal, tolerance, and dependency syndromes (81.9%; 95/116). Only 8.8% (10/114) reported the use of pain scales to identify pain in children. The most often cited hindrance to control pain was the difficulty to measure and spot pain in pediatric patients. Finally, 50.8% (62/122) of them did not have any previous training in pain management.

CONCLUSIONS

Problems in the processes of pain identification, measurement, and treatment have been found. Results suggest that there is a need for both an investment in continuing education of professionals and the development of protocols to optimize the analgesic therapy, thus preventing increased child suffering.

摘要

目的

评估在三家儿科病房工作的专业人员对疼痛管理和阿片类药物使用的了解程度。

设计

这是一项横断面研究。

地点

本研究在位于巴西南部的阿雷格里港临床医院的三家儿科病房(儿科、重症监护病房和肿瘤科)进行。

对象

本研究的对象包括医生、药剂师、物理治疗师、护士、护理技术员和护理助理。

方法

在巴西南部的一家大学医院进行的横断面研究。2011 年 12 月至 2012 年 3 月期间,向 182 名专业人员发放了一份自我适用的半结构式问卷。

结果

回复率为 67%(122 人);平均正确回答率为 63.2±1.4%。最常见的错误是:如果疼痛原因不明,则不应使用阿片类药物(47%;115/54);患者经常出现呼吸抑制(42.3%;22/52);以及对戒断、耐受和依赖综合征的症状存在混淆(81.9%;95/116)。只有 8.8%(10/114)报告使用疼痛量表来识别儿童的疼痛。控制儿童疼痛的最大障碍是难以测量和发现儿科患者的疼痛。最后,50.8%(62/122)的人之前没有接受过疼痛管理方面的培训。

结论

在疼痛识别、测量和治疗过程中发现了问题。结果表明,需要对专业人员进行继续教育投资,并制定方案来优化镇痛治疗,从而防止儿童痛苦增加。

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