Department of Family, Community and Health System Science, College of Nursing, University of Florida, Gainesville, Florida.
Department of Biobehavioral Nursing, College of Nursing, University of Florida, Gainesville, Florida.
J Adv Nurs. 2019 Jun;75(6):1219-1228. doi: 10.1111/jan.13913. Epub 2019 Jan 15.
To examine the effect of psychological distress in mediating the relationship between the severity of pressure injury and pain intensity in hospitalized adults.
Despite the prevalence of pressure injury (previously known as pressure ulcers) in hospitalized adults, the current knowledge of pain associated with pressure injury is limited and findings are inconsistent. There is also a lack of understanding of the relationship between psychological distress and pain from pressure injury.
Retrospective cross-sectional secondary analysis of data from electronic health records.
The data were retrieved from the third day of admission in the period between 2013 - 2016 through the Integrated Data Repository (IDR). Electronic health records were reviewed to collect data as needed. The mediation effect was tested by using path analysis implemented through Mplus.
Path analysis revealed that the severity of pressure injuries and psychological distress have significant direct effects on pain intensity in hospitalized adults. However, the relationship between the severity of pressure injury and pain intensity was not significantly mediated by psychological distress.
Hospitalized adults who have more severe pressure injury and more treatments for psychological distress experienced greater pain intensity. Healthcare providers must pay attention to treating psychological distress among hospitalized adults to manage pain. Further study is needed to validate these findings and it should incorporate more appropriate measures of psychological distress. The lack of standardized nursing documentation in electronic health records severely limits the usefulness of data from electronic health records for nursing research.
探讨心理困扰在多大程度上调节了住院成人的压力性损伤严重程度与疼痛强度之间的关系。
尽管住院成人中的压力性损伤（以前称为压疮）很普遍，但目前对与压力性损伤相关的疼痛的了解有限，且研究结果不一致。此外，人们对心理困扰与压力性损伤疼痛之间的关系也缺乏了解。
对电子健康记录中的数据进行回顾性横断面二次分析。
在 2013 年至 2016 年期间，通过综合数据存储库（IDR）获取入院第 3 天的数据。审查电子健康记录以按需收集数据。通过 Mplus 中实施的路径分析来检验中介效应。
路径分析显示，压力性损伤的严重程度和心理困扰对住院成人的疼痛强度有显著的直接影响。然而，压力性损伤严重程度与疼痛强度之间的关系并没有被心理困扰显著中介。
压力性损伤更严重且接受更多心理困扰治疗的住院成人经历了更大的疼痛强度。医疗保健提供者必须注意治疗住院成人的心理困扰，以管理疼痛。需要进一步的研究来验证这些发现，并应纳入更适当的心理困扰衡量指标。电子健康记录中缺乏标准化的护理文档严重限制了电子健康记录数据在护理研究中的有用性。
