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术前教育影片对患者术后疼痛及阿片类药物需求的影响。

The effect of a preoperative educational film on patients' postoperative pain in relation to their request for opioids.

作者信息

van Dijk Jacqueline F M, van Wijck Albert J M, Kappen Teus H, Peelen Linda M, Kalkman Cor J, Schuurmans Marieke J

机构信息

Department of Anaesthesiology, University Medical Center Utrecht, Pain Clinic, Utrecht, The Netherlands.

Department of Anaesthesiology, University Medical Center Utrecht, Pain Clinic, Utrecht, The Netherlands.

出版信息

Pain Manag Nurs. 2015 Apr;16(2):137-45. doi: 10.1016/j.pmn.2014.05.006. Epub 2014 Sep 22.

Abstract

Guidelines for postoperative pain treatment are based on patients' pain scores. Patients with an intermediate Numeric Rating Scale (NRS) score of 5 or 6 may consider their pain as either bearable or unbearable, which makes it difficult to decide on pain treatment because guidelines advise professionals to treat pain at NRS > 4. Educating patients in using an NRS score for pain might improve adequate pain treatment. A quasi-randomized controlled trial was conducted in which 194 preoperative patients watched the educational film and 183 the control film. Pain scores were considered discordant when patients reported an NRS ≤ 4 and wanted additional opioids or when patients reported an NRS > 4 and did not want additional opioids. Beliefs, fear, and knowledge of pain; pain assessment; and pain treatment were measured by questionnaires. No significant differences in discordant pain scores between the groups were found: relative risk (RR) 0.73, confidence interval (CI) 0.47-1.15 at rest and RR 0.96, CI 0.72-1.28 at movement. Patients in the intervention group had lower NRS pain scores than patients in the control group. In the intervention group, patients had significantly more knowledge and lower barriers to pain management compared with the control group. We did not find a statistically significant reduction in discordant pain scores when comparing the intervention group with the control group. However, patients in the intervention group had significantly lower pain scores, lower barriers, and more knowledge of pain treatment than patients in the control group.

摘要

术后疼痛治疗指南基于患者的疼痛评分。数字评分量表(NRS)评分为5或6的中度疼痛患者可能认为自己的疼痛可忍受或难以忍受,这使得决定疼痛治疗变得困难,因为指南建议专业人员对NRS>4的疼痛进行治疗。对患者进行使用NRS疼痛评分的教育可能会改善疼痛的充分治疗。进行了一项半随机对照试验,其中194名术前患者观看了教育影片,183名患者观看了对照影片。当患者报告NRS≤4并想要额外的阿片类药物,或者当患者报告NRS>4且不想要额外的阿片类药物时,疼痛评分被认为不一致。通过问卷测量对疼痛的信念、恐惧和知识、疼痛评估以及疼痛治疗。两组之间在不一致疼痛评分方面未发现显著差异:静息时相对风险(RR)为0.73,置信区间(CI)为0.47-1.15;活动时RR为0.96,CI为0.72-1.28。干预组患者的NRS疼痛评分低于对照组患者。与对照组相比,干预组患者对疼痛管理的知识显著更多,障碍更低。在将干预组与对照组进行比较时,我们没有发现不一致疼痛评分有统计学意义的降低。然而,与对照组患者相比,干预组患者的疼痛评分显著更低,障碍更低,对疼痛治疗的知识更多。

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