Gerken L, Windisch A, Thalhammer R, Olwitz S, Fay E, Al Hussini H, Reuschenbach B
Katholische Stiftungsfachhochschule München, Preysingstr. 83, 81667, München, Deutschland.
Schmerz. 2017 Apr;31(2):123-130. doi: 10.1007/s00482-016-0181-y.
The assessment of pain as a part of adequate pain management is an integral part of the clinical routine. Much research has been carried out concerning use, relevance and validity of different assessment scales; however, patients' perspective of pain assessment has not yet been studied in Germany. The aim of the present study was to collate patients' experiences regarding pain assessment based on the numeric rating scale (NRS).
The survey was conducted as a qualitative cross-sectional study based on the grounded theory methodology by Strauss and Corbin. Interviews were carried out with 15 surgery patients. A semi-structured interview guide was used to collect data. The structured analysis was performed using MAXQDA. Data were first openly coded followed by thematic coding. Finally, the codes were compared and linked via axial coding. The data analysis was completed by object-related theory construction.
Patients have only vague ideas about the consequences of their responses. They experience pain assessment as a nursing routine, which was perceived as being largely insignificant for therapy. On reflection patients sporadically saw the scaling as being a problem as a reference value is missing and the quality of pain as well as the procedure fail the predetermined measurement system. Metric values not only reflect the level of pain but are also intentionally used to enable targeted measures, e.g. discharge from hospital.
The survey results indicate that the validity of the measurement and therefore the indicated therapy is influenced by subjective concepts. Patients themselves suggested alternatives for detecting the quality of pain. The data should be replicated in larger samples and also take possible influences on the perception of the assessment into account.
疼痛评估作为充分疼痛管理的一部分,是临床常规工作不可或缺的一部分。关于不同评估量表的使用、相关性和有效性,已经开展了大量研究;然而,德国尚未对患者对疼痛评估的看法进行研究。本研究的目的是整理患者基于数字评分量表(NRS)的疼痛评估体验。
本调查采用基于施特劳斯和科尔宾的扎根理论方法的定性横断面研究。对15名外科手术患者进行了访谈。使用半结构化访谈指南收集数据。使用MAXQDA进行结构化分析。数据首先进行开放编码,然后进行主题编码。最后,通过轴心编码对代码进行比较和链接。通过与对象相关的理论构建完成数据分析。
患者对其回答的后果只有模糊的概念。他们将疼痛评估视为一种护理常规,认为这在很大程度上对治疗无关紧要。经过思考,患者偶尔会认为评分存在问题,因为缺少参考值,而且疼痛质量以及评估程序不符合预定的测量系统。度量值不仅反映疼痛程度,还被有意用于采取针对性措施,例如出院。
调查结果表明,测量的有效性以及由此指示的治疗受到主观概念的影响。患者自己提出了检测疼痛质量的替代方法。这些数据应在更大的样本中进行重复,并考虑对评估认知的可能影响。