Sollami Alfonso, Marino Leonardo, Fontechiari Simona, Fornari Marta, Tirelli Pierangela, Zenunaj Elisabetta
Azienda Ospedaliero Universitaria di Parma.
Acta Biomed. 2015 Sep 9;86 Suppl 2:150-7.
PROBLEM/BACKGROUND: Pain management is a major worldwide health problem. It manifests itself in a variety of forms involving in turn a multiplicity of responses and therapeutic strategies. Following from this, the training of health personnel must deal with this situation and must not only offer technical assistance, but must also deal with the psychological and social aspects of the problem. In recent years various guidelines and protocols have become popular for pain management. The aim of this paper is to present a literature review of the major international databases. Type of research: Systematic review.
To identify relevant studies in the literature on pain management and identify the guidelines recognized by the scientific community.
A literature search was conducted using the keywords "pain management" and "nurse" published since 2000 in English and Italian in the following databases: PubMed, CINAHL, Med Line. Excluding items which did not meet the inclusion criteria, 49 articles were included in the review.
Despite a growing availability of evidence-based guidelines, drugs for pain control and the enactment of legislation to promote the use of opioid analgesics in pain therapy, a substantial proportion of the European population continues to have pain. Estimates of the prevalence of pain symptoms in the literature show that between 40% and 63% of hospitalized patients reported pain, peaking at 82.3% in cancer patients in advanced stages of the disease or terminally ill (in hospital or at home). Several studies published in recent years have agreed on a definition of some key points in the management of pain. Studies agree that pain should be recognized as the 5th vital sign, hence the need for validated scales whether single or multi-dimensional, quantitative or qualitative. The approach to the management of pain must be multi-professional, and the use of pharmacology must be in accordance with the WHO three-step approach. Several studies have demonstrated that communication and training of operators, associated with accurate information to patients, are effective elements to improve health care delivered to patients. These studies have led to the publication of guidelines by various scientific societies, indicating timely strategies for effective pain management both in hospital and in the territory. A possible development of this research could be to conduct a retrospective study in accordance with the AUDIT methodology so that we can check the implementation of guidelines and propose corrective actions to meet the defined standards.
问题/背景：疼痛管理是一个全球性的重大健康问题。它以多种形式表现出来，相应地涉及多种反应和治疗策略。因此，卫生人员的培训必须应对这种情况，不仅要提供技术援助，还必须处理该问题的心理和社会层面。近年来，各种疼痛管理指南和方案广受欢迎。本文旨在对主要国际数据库进行文献综述。研究类型：系统综述。
识别文献中有关疼痛管理的相关研究，并确定科学界认可的指南。
使用关键词“疼痛管理”和“护士”，检索2000年以来在PubMed、CINAHL、Med Line等数据库中以英文和意大利文发表的文献。排除不符合纳入标准的文献后，本综述纳入了49篇文章。
尽管循证指南、疼痛控制药物以及促进在疼痛治疗中使用阿片类镇痛药的立法越来越多，但相当一部分欧洲人仍遭受疼痛困扰。文献中对疼痛症状患病率的估计表明，40%至63%的住院患者报告有疼痛，在疾病晚期或临终的癌症患者（住院或在家）中这一比例高达82.3%。近年来发表的多项研究就疼痛管理中的一些关键点达成了定义。研究一致认为，应将疼痛视为第五 vital 体征，因此需要经过验证的量表，无论是单维度还是多维度、定量还是定性的。疼痛管理方法必须是多专业的，药理学的使用必须符合世界卫生组织的三阶梯方法。多项研究表明，与向患者提供准确信息相关的操作人员沟通和培训，是改善患者医疗服务的有效要素。这些研究促使各种科学协会发布了指南，指明了在医院和社区进行有效疼痛管理的适时策略。这项研究的一个可能发展方向是按照AUDIT方法进行回顾性研究，以便我们能够检查指南的实施情况，并提出纠正措施以达到既定标准。
