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老年护理机构疼痛管理的非药物方法:一项前后测研究

Non-Pharmacological Approaches to Pain Management in Residential Aged Care: a Pre-Post-Test Study.

作者信息

Ellis Julie M, Wells Yvonne, Ong June Su Ming

机构信息

a La Trobe University School of Nursing and Midwifery , Bundoora , Australia.

b Physiotherapy Department , Werribee Mercy Health , Melbourne , Australia.

出版信息

Clin Gerontol. 2019 May-Jun;42(3):286-296. doi: 10.1080/07317115.2017.1399189. Epub 2017 Dec 14.

Abstract

OBJECTIVES

The project aimed to evaluate a pain management program (PMP) using non-pharmacological approaches at five residential aged care facilities (RACFs) in Australia.

METHODS

The PMP involved a physiotherapist implementing four sessions per week of treatments (massage therapy, TENS, exercises and stretching, or combinations of these). Ninety-five participants were recruited (average age, 83 years; SD = 7.6; 38% men, 62% women; 56% with dementia). Sessions lasted approximately 10 minutes, and residents' levels of pain were recorded using a 5-point scale before and after each treatment. The intervention period for each participant was the first consecutive 8 weeks in which they received the intervention.

RESULTS

Data analyses showed: (1) a small but statistically significant decrease in the number of as required (PRN) medications; and (2) a decrease in average pain ratings from pre-session to post-session from 2.4 (some to moderate pain) to 1.1 (a little pain). Notably, residents with dementia received lower pain ratings than those without.

CONCLUSIONS

Non-pharmacological approaches to pain in residential care settings are effective, especially when two or more are combined. Staff working in residential care settings should rely on best practice to recognise pain in residents with dementia.

CLINICAL IMPLICATIONS

Non-pharmacological interventions may be effective in reducing pain and reliance on PRN medications in residential care settings, especially when two or more are used. Staff working in residential aged care settings should be provided with training in pain assessment and management, with particular attention to residents with dementia.

摘要

目的

该项目旨在评估澳大利亚五家住宿型老年护理机构(RACFs)采用非药物方法的疼痛管理项目(PMP)。

方法

PMP包括一名物理治疗师每周实施四节治疗课程(按摩疗法、经皮电刺激神经疗法、运动和伸展,或这些方法的组合)。招募了95名参与者(平均年龄83岁;标准差=7.6;男性占38%,女性占62%;56%患有痴呆症)。课程持续约10分钟,每次治疗前后使用5分制记录居民的疼痛程度。每位参与者的干预期为他们接受干预的连续前8周。

结果

数据分析显示:(1)按需(PRN)用药数量有小幅但具有统计学意义的减少;(2)平均疼痛评分从治疗前的2.4(中度疼痛)降至治疗后的1.1(轻度疼痛)。值得注意的是,患有痴呆症的居民的疼痛评分低于未患痴呆症的居民。

结论

住宿型护理机构中采用非药物方法治疗疼痛是有效的,尤其是两种或更多方法联合使用时。在住宿型护理机构工作的员工应依靠最佳实践来识别患有痴呆症居民的疼痛。

临床意义

非药物干预可能有效减轻住宿型护理机构中居民的疼痛并减少对PRN药物的依赖,尤其是在使用两种或更多方法时。应向在住宿型老年护理机构工作的员工提供疼痛评估和管理方面的培训,尤其要关注患有痴呆症的居民。

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