Goldsmith Helen, McCloughen Andrea, Curtis Kate
Sydney Nursing School, University of Sydney, NSW, Australia; Trauma Service, St George Hospital, NSW, Australia.
Sydney Nursing School, University of Sydney, NSW, Australia.
Injury. 2018 Jan;49(1):110-116. doi: 10.1016/j.injury.2017.09.027. Epub 2017 Sep 28.
Pain following injury is often intense, prolonged and debilitating. If poorly managed, this acute pain has the potential to delay rehabilitation and lead to chronic pain. Recent quantitative Australian research recommends implementing further information and interventions to improve trauma patient outcomes, however, to ensure effectiveness, exploration of the patient perspective is imperative to ensure the success of future pain management strategies. This study aimed to gain understanding about the experience of pain management using prescribed analgesic regimens of recently discharged adult trauma patients.
Semi-structured interviews were used to explore the experiences and understandings of trauma patients in managing pain using prescribed analgesic regimens during the initial post-hospital discharge period. Twelve participants were purposively selected over a 6-month period at a level one trauma outpatient clinic based on questionnaire responses indicating pain related concerns. Qualitative data were thematically analysed.
The overarching finding was that injuries and inadequate pain management incapacitate the patient at home. Four main themes were developed: injury pain is unique and debilitating; patients are uninformed at hospital discharge; patients have low confidence with pain management at home; and patients make independent decisions about pain management. Patients felt they were not given adequate information at hospital discharge to support them to make effective decisions about their pain management practices at home.
There is a need for more inclusive and improved hospital discharge processes that includes patient and family education around pain management following injury. To achieve this, clinician education, support and training is essential.
受伤后的疼痛通常剧烈、持续时间长且使人虚弱。如果处理不当,这种急性疼痛有可能延迟康复并导致慢性疼痛。澳大利亚最近的定量研究建议实施更多信息和干预措施以改善创伤患者的治疗效果,然而,为确保有效性,必须从患者角度进行探索,以确保未来疼痛管理策略的成功。本研究旨在了解近期出院的成年创伤患者使用规定镇痛方案进行疼痛管理的体验。
采用半结构式访谈来探索创伤患者在出院后初期使用规定镇痛方案管理疼痛的体验和理解。在一家一级创伤门诊诊所,根据表明与疼痛相关担忧的问卷回复,在6个月内有目的地选择了12名参与者。对定性数据进行了主题分析。
总体发现是,伤痛和疼痛管理不足使患者在家中丧失能力。形成了四个主要主题:伤痛疼痛独特且使人虚弱;患者出院时未得到充分告知;患者对在家中进行疼痛管理信心不足;患者自行决定疼痛管理。患者认为他们在出院时没有得到足够的信息来支持他们就家中的疼痛管理做法做出有效决定。
需要有更具包容性和改进的出院流程,包括对患者及其家属进行受伤后疼痛管理方面的教育。要做到这一点,临床医生的教育、支持和培训至关重要。