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重症监护病房术后患者的疼痛感知

Perception of pain in post-surgical patients in intensive care units.

作者信息

López-Alfaro M P, Echarte-Nuin I, Fernández-Sangil P, Moyano-Berardo B M, Goñi-Viguria R

机构信息

Unidad de Cuidados Intensivos, Clínica Universidad de Navarra, Pamplona, España.

Práctica Avanzada del Área de Críticos, Clínica Universidad de Navarra, Pamplona, España.

出版信息

Enferm Intensiva (Engl Ed). 2019 Jul-Sep;30(3):99-107. doi: 10.1016/j.enfi.2018.12.001. Epub 2019 Apr 20.

Abstract

INTRODUCTION

Pain assessment and treatment are essential for ensuring quality of care as well as for improving patient's satisfaction and clinical outcomes.

OBJECTIVES

  1. To describe pain perception of surgical patients admitted to our Intensive Care Unit(ICU). 2) To compare the patients' pain perception with the assessment carried out by nurses. 3) To correlate International Pain Outcomes Questionnaire results with socio-demographical data.

METHODOLOGY

A prospective descriptive observational study was carried out in the ICU of a third level university hospital over a period of 3 months. Surgical patients' pain-perception was assessed 24hours after their admission to the ICU using the Spanish translation of International Pain Outcomes Questionnaire.

RESULTS

The highest pain score recorded among 109 patients by nurses was 4.47±2.75, while, the lowest was .69±1,25. However, the highest and lowest pain scores reported by patients were 5.59±2.72 and 2.13±2.03, which showed significant differences (P <0.001). The highest pain score seemed to be related to the type of surgery (P <0.027). There are significant variations in the lowest pain score depending on age (P=0.005 r=-0.270). Likewise, the worst pain score correlated with the patients' sex (P=0.004). Patients who reported that pain made them feel very anxious or helpless scored highest with the worst pain, 7.35±1.98, 7.44±1.85 respectively. These differences were statistically significant (P=0.001, P <0.001). Regarding to the score of less pain, there is an association with feeling anxiety (P=0.032) and not with feeling helpless (P=-0.088).

CONCLUSIONS

The post-surgical patients reported pain during the first 24hours following admission to ICU (max score 5.59±.26). The nurses underestimated the patients' reported pain. Improving nurses' education would provide them with assessment strategies for better pain management. Age, sex, anxiety and helplessness caused by pain, were variables that significantly influenced pain.

摘要

引言

疼痛评估与治疗对于确保医疗质量、提高患者满意度及临床疗效至关重要。

目的

1)描述入住我院重症监护病房(ICU)的外科手术患者的疼痛感知情况。2)比较患者的疼痛感知与护士所做评估。3)将国际疼痛结局问卷结果与社会人口统计学数据进行关联分析。

方法

在一所三级大学医院的ICU进行了为期3个月的前瞻性描述性观察研究。使用国际疼痛结局问卷的西班牙语译本,在外科手术患者入住ICU 24小时后评估其疼痛感知情况。

结果

109例患者中,护士记录的最高疼痛评分是4.47±2.75,最低为0.69±1.25。然而,患者报告的最高和最低疼痛评分分别为5.59±2.72和2.13±2.03,差异有统计学意义(P<0.001)。最高疼痛评分似乎与手术类型有关(P<0.027)。最低疼痛评分因年龄不同存在显著差异(P = 0.005,r = -0.270)。同样,最差疼痛评分与患者性别相关(P = 0.004)。报告疼痛使其感到非常焦虑或无助的患者,最差疼痛评分最高,分别为7.35±1.98、7.44±1.85。这些差异有统计学意义(P = 0.001,P<0.001)。关于较轻疼痛评分,与感到焦虑有关(P = 0.032),与感到无助无关(P = -0.088)。

结论

外科手术后患者在入住ICU后的头24小时内报告有疼痛(最高评分5.59±0.26)。护士低估了患者报告的疼痛。加强护士教育可为其提供更好的疼痛管理评估策略。年龄、性别、疼痛引起的焦虑和无助是显著影响疼痛的变量。

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