Mędrzycka-Dąbrowska Wioletta A, Dąbrowski Sebastian, Basiński Andrzej, Pilch Dorota
Department of General of Nursing, Medical University of Gdansk, Gdansk, Poland.
Anesthesiology and Intensive Care Unit, District Health Center, Malbork, Poland.
Arch Med Sci. 2016 Aug 1;12(4):808-18. doi: 10.5114/aoms.2015.54768. Epub 2015 Oct 6.
In 2005-2050, the global population of elderly people will increase by 12%. This will lead to increased demand for such healthcare services as hospital care or surgical interventions. Pain in elderly patients is a substantial problem. Insufficiently controlled postoperative pain continues to be a widespread phenomenon. Pain management in Poland is usually based on nursing care supervised by an anesthesiologist or surgeon. The aim of the study was to identify barriers to effective nurse-controlled analgesia in postoperative pain management in elderly patients in hospitals with and without a Hospital Without Pain certificate.
The study was conducted after the approval of the study protocol by the Independent Bioethics Committee for Scientific Research of the Medical University of Gdansk. The study project was multicenter and was conducted from July 2012 to December 2013. The research was questionnaire-based and used the Polish version of the Nurses' Perceived Obstacles to Pain Assessment and Management Practices questionnaire. The project included 676 nurses from hospitals awarded the Hospital Without Pain Certificate and 926 respondents from hospitals without the certificate.
After calculating the overall average result in particular groups, healthcare system-related problems were first among the barriers hindering pain management in elderly patients M = (C = 3.81, N/C = 3.87). Patient-related barriers were second (M = 3.77). Physician- and nurse-related barriers took the subsequent positions, with very similar scores M = (C = 3.47, N/C = 3.44) and M = (C = 3.46, N/C = 3.44), respectively.
The greatest barriers to pain management in elderly patients are related to the healthcare system. Nurses from Hospital Without Pain certified hospitals devoted significantly more time to relieving pain through non-pharmacological methods.
在2005年至2050年期间，全球老年人口将增长12%。这将导致对医院护理或手术干预等医疗服务的需求增加。老年患者的疼痛是一个重大问题。术后疼痛控制不足仍然是一个普遍现象。波兰的疼痛管理通常基于麻醉医生或外科医生监督下的护理。本研究的目的是确定在有和没有“无疼痛医院”认证的医院中，老年患者术后疼痛管理中有效护士控制镇痛的障碍。
本研究在格但斯克医科大学独立生物伦理科学研究委员会批准研究方案后进行。该研究项目是多中心的，于2012年7月至2013年12月进行。该研究以问卷为基础，使用了波兰语版的《护士对疼痛评估和管理实践的感知障碍》问卷。该项目包括来自获得“无疼痛医院”认证医院的676名护士和来自未获得认证医院的926名受访者。
在计算特定组的总体平均结果后，与医疗系统相关的问题是阻碍老年患者疼痛管理的首要障碍（M = 3.81，C = 3.87，N/C = 3.87）。与患者相关的障碍位居第二（M = 3.77）。与医生和护士相关的障碍排在其后，得分非常相似，分别为M = 3.47（C = 3.47，N/C = 3.44）和M = 3.46（C = 3.46，N/C = 3.44）。
老年患者疼痛管理的最大障碍与医疗系统有关。来自获得“无疼痛医院”认证医院的护士通过非药物方法缓解疼痛的时间明显更多。
