Jeong Ihn Sook, Park Soon Mi, Lee Jeon Ma, Choi Yoon Jin, Lee Joohyun
College of Nursing, Pusan National University, Yangsan, South Korea.
Pusan National University Yangsan Hospital, Yangsan, South Korea.
Asian Nurs Res (Korean Soc Nurs Sci). 2014 Dec;8(4):261-6. doi: 10.1016/j.anr.2014.05.008. Epub 2014 Nov 10.
The present survey was conducted to investigate the perceptions among nurses of neonatal pain and the associated use of pharmacologic measures (PMs) and nonpharmacologic comfort measures (CMs) in neonatal intensive care units (NICUs). Pain perception, the necessity and actual use of PMs and CMs, and their relationships were investigated and compared according to nurses' positions, educational levels, the existence of guidelines, and prior education on neonatal pain management.
Participants were 141 nurses from five NICUs at university hospitals. A questionnaire was developed by researchers based on previous studies of neonatal pain management and current practices in surveyed NICUs. Five-point Likert scales were used to assess nurses' perceptions of pain, the necessity of PMs and CMs, and their actual use in 29 painful procedures.
The mean scores of perceived pain and the necessity of PMs and CMs were 3.68, 2.96, and 3.79 points, respectively. The actual use of PMs and CMs was 1.67 and 2.63 points, respectively. The perceived necessity of PMs correlated with the actual use of PMs (r = .316, p < .001), and CMs were performed (r = .390, p < .001). Keeping or reading guidelines, or receiving education on pain management resulted in a higher perception of the necessity of PMs.
Korean nurses in NICUs often underestimate the necessity of pain relief measures and use few PMs or CMs. Therefore, systematic approaches to implement guidelines, such as adaptation of guidelines for each NICU, dissemination of guideline content to all NICU staff, and regular measurements of compliance with the guidelines, are recommended.
本次调查旨在研究新生儿重症监护病房（NICU）护士对新生儿疼痛的认知以及相关药物措施（PMs）和非药物舒适措施（CMs）的使用情况。根据护士的职位、教育水平、指南的存在情况以及先前接受的新生儿疼痛管理教育，对疼痛认知、PMs和CMs的必要性及实际使用情况及其关系进行了调查和比较。
参与者为来自大学医院五个NICU的141名护士。研究人员根据先前关于新生儿疼痛管理的研究和被调查NICU的当前实践制定了一份问卷。采用五点李克特量表评估护士对疼痛的认知、PMs和CMs的必要性以及它们在29种疼痛操作中的实际使用情况。
疼痛认知、PMs和CMs必要性的平均得分分别为3.68分、2.96分和3.79分。PMs和CMs的实际使用得分分别为1.67分和2.63分。PMs的感知必要性与PMs的实际使用相关（r = 0.316，p < 0.001），CMs的执行情况也相关（r = 0.390，p < 0.001）。遵循或阅读指南，或接受疼痛管理教育会导致对PMs必要性的更高认知。
NICU中的韩国护士经常低估疼痛缓解措施的必要性，并且很少使用PMs或CMs。因此，建议采用系统的方法来实施指南，例如为每个NICU调整指南、向所有NICU工作人员传播指南内容以及定期测量对指南的遵守情况。
