一次简短按摩对骨科术后患者疼痛、焦虑及疼痛管理满意度的影响。

Effect of a Brief Massage on Pain, Anxiety, and Satisfaction With Pain Management in Postoperative Orthopaedic Patients.

作者信息

Miller Jane, Dunion Amy, Dunn Nina, Fitzmaurice Carolyn, Gamboa Margaret, Myers Sarah, Novak Paula, Poole Jill, Rice Kimberly, Riley Caroline, Sandberg Ruth, Taylor Daniel, Gilmore Lisa

机构信息

Jane Miller, BS, RN, Staff Nurse, Orthopedic Unit, The William W. Backus Hospital, Norwich, CT. Amy Dunion, BSN, RN, LMT, Staff Nurse, Center for Healthcare Integration, The William W. Backus Hospital, Norwich, CT. Nina Dunn, RN, ONC, Staff Nurse, Orthopedic Unit, The William W. Backus Hospital, Norwich, CT. Carolyn Fitzmaurice, BSN, RN, CPN, ONC, Staff Nurse, Orthopedic Unit, The William W. Backus Hospital, Norwich, CT. Margaret Gamboa, MSN, RN, Staff Nurse, Orthopedic Unit, The William W. Backus Hospital, Norwich, CT. Sarah Myers, PCT, Patient Care Technician, Orthopedic Unit, The William W. Backus Hospital, Norwich, CT. Paula Novak, MA, RN, CHTP, Staff Nurse, Center for Healthcare Integration, The William W. Backus Hospital, Norwich, CT. Jill Poole, PCT, Patient Care Technician, Orthopedic Unit, The William W. Backus Hospital, Norwich, CT. Kimberly Rice, MSN, RN, Staff Nurse, Orthopedic Unit, The William W. Backus Hospital, Norwich, CT. Caroline Riley, BSN, RN, Staff Nurse, Orthopedic Unit, The William W. Backus Hospital, Norwich, CT. Ruth Sandberg, BS, RN, Staff Nurse, Orthopedic Unit, The William W. Backus Hospital, Norwich, CT. Daniel Taylor, PCT, Patient Care Technician, Orthopedic Unit, The William W. Backus Hospital, Norwich, CT. Lisa Gilmore, MSN, MBA, RN, Clinical Leader for Patient Education, The William W. Backus Hospital, Norwich, CT.

出版信息

Orthop Nurs. 2015 Jul-Aug;34(4):227-34. doi: 10.1097/NOR.0000000000000163.

DOI:10.1097/NOR.0000000000000163

PMID:26213879

Abstract

BACKGROUND

The majority of massage therapy studies have evaluated 20- to 45-minute interventions in nonsurgical patients. Studies are needed to evaluate the effects of a brief massage intervention that would be more clinically feasible for bedside clinicians to administer as an adjunct to pharmacologic pain management in acutely ill surgical patients.

PURPOSE

To evaluate the impact of a brief massage intervention in conjunction with analgesic administration on pain, anxiety, and satisfaction with pain management in postoperative orthopaedic inpatients.

METHODS

A convenience sample of postoperative orthopaedic patients was studied during two therapeutic pain treatments with an oral analgesic medication. A pretest, posttest, randomized, controlled trial study design, with crossover of subjects, was used to evaluate the effect of a 5-minute hand and arm massage at the time of analgesic administration. Each patient received both treatments (analgesic administration alone [control]; analgesic administration with massage) during two sequential episodes of postoperative pain. Prior to administration of the analgesic medication, participants rated their level of pain and anxiety with valid and reliable tools. Immediately after analgesic administration, a study investigator provided the first, randomly assigned treatment. Pain and anxiety were rated by the participant 5 and 45 minutes after medication administration. Satisfaction with pain management was also rated at the 45-minute time point. Study procedures were repeated for the participant's next requirement for analgesic medication, with the participant receiving the other randomly assigned treatment. Analysis of variance was used to determine whether pain, anxiety, and/or satisfaction with pain management differed between the two treatment groups and/or if treatment order was a significant factor. The level of significance for all tests was set at p < .05.

RESULTS

Twenty-five postoperative patients were studied during two sequential episodes of pain, which required analgesic medication administration (N = 25 analgesic alone; N = 25 analgesic with massage). Patient ages ranged from 32 to 86 years (average ±SD = 61.2 ± 11.5 years). Pain and anxiety scores after medication administration decreased in both groups, with no significant differences found between the analgesic alone or analgesic with massage treatments (p > .05). Patient satisfaction with pain management was higher for pain treatment with massage than medication only (F = 6.8, df = 46, p = .012).

CONCLUSION

The addition of a 5-minute massage treatment at the time of analgesic administration significantly increased patient satisfaction with pain management.

摘要

背景

大多数按摩疗法研究评估的是针对非手术患者进行的20至45分钟的干预措施。需要开展研究来评估一种简短按摩干预措施的效果，这种干预措施对于床边临床医生在急性病手术患者的药物疼痛管理中作为辅助手段实施而言，在临床上更具可行性。

目的

评估一种简短按摩干预措施联合镇痛药物给药对骨科术后住院患者的疼痛、焦虑及疼痛管理满意度的影响。

方法

在对术后骨科患者进行两次使用口服镇痛药的治疗性疼痛处理期间，对便利抽样的患者进行研究。采用前测、后测、随机对照试验研究设计，并让受试者交叉接受两种处理，以评估在镇痛药物给药时进行5分钟手部和手臂按摩的效果。每位患者在术后疼痛的两个连续阶段均接受两种处理（单独使用镇痛药[对照]；使用镇痛药并进行按摩）。在给予镇痛药物之前，参与者使用有效且可靠的工具对其疼痛和焦虑程度进行评分。在给予镇痛药物后，研究调查员立即提供首次随机分配的处理。在给药后5分钟和45分钟，由参与者对疼痛和焦虑进行评分。在45分钟时间点还对疼痛管理满意度进行评分。针对参与者下次需要镇痛药物时，重复研究程序，让参与者接受另一种随机分配的处理。采用方差分析来确定两个治疗组之间的疼痛、焦虑和/或疼痛管理满意度是否存在差异，以及治疗顺序是否为一个显著因素。所有检验的显著性水平设定为p < 0.05。

结果

在术后疼痛的两个连续阶段对25名患者进行了研究，这些阶段均需要给予镇痛药物（单独使用镇痛药组N = 25；使用镇痛药并进行按摩组N = 25）。患者年龄范围为32至86岁（平均±标准差 = 61.2 ± 11.5岁）。两组给药后的疼痛和焦虑评分均下降，单独使用镇痛药组与使用镇痛药并进行按摩组之间未发现显著差异（p > 0.05）。与仅使用药物相比，使用镇痛药并进行按摩的疼痛处理使患者对疼痛管理的满意度更高（F = 6.8，自由度 = 46，p = 0.012）。