Pérez Boluda M T, Morales Asencio J M, Carrera Vela A, García Mayor S, León Campos A, López Leiva I, Rengel Díaz C, Kaknani-Uttumchandani S
University Regional Hospital of Málaga, Spain.
Faculty of Health Sciences, University of Málaga, Spain.
Burns. 2016 Aug;42(5):1097-1104. doi: 10.1016/j.burns.2016.03.008. Epub 2016 May 31.
Although pain is one of the main sources of suffering during the acute phase and rehabilitation in burn patients, it remains as a major challenge for burn care, and clinical management not always correlates with the experience felt by patients. The aim of this study was to understand the experience of pain from people who has suffered severe burns, to identify personal strategies used to cope with this challenging event. A qualitative phenomenological study with purposive sampling was carried out with severe burn patients admitted to a Burn Unit. Through individual in-depth interviews, verbatim transcription and content analysis, two main categories were isolated: a dynamic and changing experience of pain, from the onset to the hospital discharge, and diverse strategies developed by patients to cope with pain, being distraction the most frequently used. Pain experienced acquires its maximum intensity during wound care, and divergent patients' opinions about sedation are present. This study highlights how understanding subjective experiences is an invaluable aid to improve care in pain assessment and management. Furthermore, it points out the need to guarantee patient involvement in the organization and improvement of burn care, inasmuch as traditional professional centered approach is not ensuring an optimal management.
尽管疼痛是烧伤患者急性期和康复期间主要的痛苦来源之一，但它仍是烧伤护理面临的一项重大挑战，而且临床管理并不总是与患者的感受相关。本研究的目的是了解重度烧伤患者的疼痛体验，确定他们应对这一具有挑战性事件所采用的个人策略。对一家烧伤科收治的重度烧伤患者进行了一项采用目的抽样的质性现象学研究。通过个体深度访谈、逐字转录和内容分析，分离出两个主要类别：从烧伤开始到出院期间动态变化的疼痛体验，以及患者为应对疼痛而制定的各种策略，其中分散注意力是最常用的策略。在伤口护理期间，疼痛强度达到最大值，并且患者对镇静存在不同意见。本研究强调了理解主观体验对于改善疼痛评估和管理中的护理工作是一项非常宝贵的帮助。此外，它指出需要确保患者参与烧伤护理的组织和改进工作，因为传统的以专业人员为中心的方法并不能保证实现最佳管理。
