Unver Seher, Eyi Semra, Ozkan Zeynep Kizilcik
Faculty of Health Sciences, Department of Surgical Nursing, Trakya University, Edime, Turkey.
School of Health, Department of Nursing, Trakya University, Edime, Turkey.
Ostomy Wound Manage. 2018 Dec;64(12):38-48.
Pain during negative pressure wound therapy (NPWT) has been reported in the literature.
The study was conducted to describe patients' pain experience, pain-coping skills, and the effect of NPWT-related pain on daily life activities following abdominal surgery.
Using a descriptive, qualitative design, semi-structured face-to-face interviews were conducted between April 3, 2016 and December 26, 2016, in the surgical ward of a university hospital in Edirne, Turkey. Patients aged ≥18, receiving NPWT, who had at least 1 dressing change, and with no diagnosis of diabetes mellitus or neurological disease were included. Interviews were conducted at the patients' bedside 1 day after wound debridement. All wounds were covered with the NPWT black foam dressing, and NPWT settings were -50 mm Hg to -125 mm Hg. One (1) researcher led the interviews using a voice-recorder while 2 researchers observed and took notes. Data were analyzed using Colaizzi's phenomenological method.
The themes identified were: 1) pain experience, 2) pain coping, 3) pain prevention, and 4) affects daily life activity. Patients mostly reported pain during foam dressing changes and wrap removal unless the dressing change occurred while receiving anesthesia. Self-applied pain-coping strategies between dressing changes included limiting mobility, trying not to cough, applying pressure, or walking; these strategies were mostly ineffective. The results are supported by many findings from other studies investigating the effects of NPWT on patient pain.
This study provides further insight into the patients' wound pain experiences during NPWT and its effect on daily activities. Increased awareness about NPWT-associated pain and pain control measures as well as qualitative and controlled quantitative studies are needed. Inservice training and educational meetings should be conducted at surgical clinics to expand surgical nurse and physician knowledge and awareness of how to efficiently manage pain during NPWT treatment and related procedures.
负压伤口治疗(NPWT)期间的疼痛在文献中已有报道。
本研究旨在描述腹部手术后患者的疼痛体验、疼痛应对技巧以及NPWT相关疼痛对日常生活活动的影响。
采用描述性、定性设计,于2016年4月3日至2016年12月26日在土耳其埃迪尔内一所大学医院的外科病房进行了半结构化面对面访谈。纳入年龄≥18岁、接受NPWT、至少有1次换药且未诊断为糖尿病或神经疾病的患者。在伤口清创术后1天在患者床边进行访谈。所有伤口均覆盖NPWT黑色泡沫敷料,NPWT设置为-50 mmHg至-125 mmHg。一名研究人员使用录音机主持访谈,两名研究人员进行观察并做笔记。采用科莱齐现象学方法对数据进行分析。
确定的主题有:1)疼痛体验,2)疼痛应对,3)疼痛预防,4)影响日常生活活动。患者大多报告在更换泡沫敷料和拆除包扎时疼痛,除非在接受麻醉时进行换药。换药期间自我应用的疼痛应对策略包括限制活动、尽量不咳嗽、施压或行走;这些策略大多无效。其他研究关于NPWT对患者疼痛影响的许多发现支持了本研究结果。
本研究进一步深入了解了患者在NPWT期间的伤口疼痛体验及其对日常活动的影响。需要提高对NPWT相关疼痛和疼痛控制措施的认识,以及开展定性和对照定量研究。应在外科诊所举办在职培训和教育会议,以扩大外科护士和医生关于如何在NPWT治疗及相关操作过程中有效管理疼痛的知识和认识。