Mercadante Sebastiano, Prestia Giovanna, Casuccio Alessandra
a Pain Relief and Supportive Care , La Maddalena Cancer Center , Palermo , Italy.
b Palliative Care , Casa di Cura La Maddalena SpA Ringgold Standard Institution , Palermo , Italy.
Hosp Pract (1995). 2016 Oct;44(4):203-206. doi: 10.1080/21548331.2016.1216715. Epub 2016 Aug 2.
To assess the nurses' performance in assessing, treating, and documenting breakthrough pain (BTP) in a palliative care unit where traditionally there is continuous training.
The study was performed in an acute palliative care unit. Once a week, a research nurse examined the documentation regarding all the episodes of BTP registered in a specific pain chart, designed by the institutional nurse board, as part of the routine nurse activity.
The charts of 50 consecutive eligible patients (32 M/18 F), were analysed. The mean number of episodes/patient was 3.3 (SD 1.61; range 1-7). 166 episodes occurred. The main BTP pain intensity was 7.06 (SD 0.82). In 7 episodes, pain intensity was not evaluated at T0. The pain intensity after 15 minutes after BTP medication was 3.01 (SD1.19). In 28 episodes, pain intensity was not evaluated at T15. The change in pain intensity was highly significant (P < 0.0005). BTP episodes were distributed normally through different day intervals. No relevant adverse event attributable to BTP medication was reported in the nurse diary.
Training in a research environment allows a good nurse capability in evaluating and treating BTP, and above all, providing documentation for each BTP episode. The theoretical work and recommendations around BTP need to be translated into day-to-day clinical practice.
在一个传统上有持续培训的姑息治疗病房中，评估护士在评估、治疗和记录爆发性疼痛（BTP）方面的表现。
该研究在一个急性姑息治疗病房进行。每周一次，一名研究护士检查关于在机构护士委员会设计的特定疼痛图表中登记的所有BTP发作的记录，作为护士日常活动的一部分。
分析了50例连续符合条件的患者（32例男性/18例女性）的图表。每位患者的发作平均次数为3.3次（标准差1.61；范围1 - 7次）。共发生166次发作。BTP的主要疼痛强度为7.06（标准差0.82）。在7次发作中，T0时未评估疼痛强度。BTP用药后15分钟的疼痛强度为3.01（标准差1.19）。在28次发作中，T15时未评估疼痛强度。疼痛强度的变化非常显著（P < 0.0005）。BTP发作在不同的日间时段呈正态分布。护士日记中未报告任何可归因于BTP用药的相关不良事件。
在研究环境中的培训使护士具备良好的评估和治疗BTP的能力，最重要的是，为每次BTP发作提供记录。围绕BTP的理论工作和建议需要转化为日常临床实践。
