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伊朗阿拉克急症病房中镇痛药处方延迟原因的模型确定。

Model determination of delayed causes of analgesics prescription in the emergency ward in arak, iran.

机构信息

Department of Urology, Arak University of Medical Sciences, Arak, Iran.

Department of Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Korean J Pain. 2014 Apr;27(2):152-61. doi: 10.3344/kjp.2014.27.2.152. Epub 2014 Mar 28.

Abstract

BACKGROUND

According to the reports of the World Health Organization 20% of world population suffer from pain and 33% of them suffer to some extent that they cannot live independently.

METHODS

This is a cross-sectional study which was conducted in the emergency department (ED) of Valiasr Hospital of Arak, Iran, in order to determine the causes of delay in prescription of analgesics and to construct a model for prediction of circumstances that aggravate oligoanalgesia. Data were collected during a period of 7 days.

RESULTS

Totally, 952 patients participated in this study. In order to reduce their pain intensity, 392 patients (42%) were treated. Physicians and nurses recorded the intensity of pain for 66.3% and 41.37% of patients, respectively. The mean (SD) of pain intensity according to visual analogue scale (VAS) was 8.7 (1.5) which reached to 4.4 (2.3) thirty minutes after analgesics prescription. Median and mean (SD) of delay time in injection of analgesics after the physician's order were 60.0 and 45.6 (63.35) minutes, respectively. The linear regression model suggested that when the attending physician was male or intern and patient was from rural areas the delay was longer.

CONCLUSIONS

We propose further studies about analgesics administration based on medical guidelines in the shortest possible time and also to train physicians and nurses about pain assessment methods and analgesic prescription.

摘要

背景

根据世界卫生组织的报告,全球有 20%的人口患有疼痛,其中 33%的人在某种程度上疼痛严重,以至于无法独立生活。

方法

这是一项横断面研究,在伊朗阿拉克瓦利雅瑟尔医院的急诊部进行,旨在确定延迟开具镇痛药的原因,并构建一个预测加重少痛觉症况的模型。数据在 7 天内收集。

结果

共有 952 名患者参与了这项研究。为了减轻他们的疼痛强度,有 392 名患者(42%)接受了治疗。医生和护士分别记录了 66.3%和 41.37%患者的疼痛强度。根据视觉模拟量表(VAS),疼痛强度的平均值(标准差)为 8.7(1.5),在开具镇痛药后 30 分钟降至 4.4(2.3)。医嘱后注射镇痛药的中位数和平均(标准差)延迟时间分别为 60.0 和 45.6(63.35)分钟。线性回归模型表明,当主治医生是男性或实习医生且患者来自农村地区时,延迟时间会更长。

结论

我们建议在最短的时间内根据医疗指南进一步研究镇痛药的管理,并对医生和护士进行疼痛评估方法和镇痛药处方的培训。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/35a9/3990824/1f3af168f82f/kjpain-27-152-g001.jpg

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