Lemay Celeste A, Saag Kenneth G, Franklin Patricia D
University of Massachusetts Medical School, Worcester, Massachusetts.
Department of Medicine, Center for Outcomes and Effectiveness Research and Education, Center for Education and Research on Therapeutics, Division of Clinical Immunology and Rheumatology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama.
Pain Manag Nurs. 2019 Aug;20(4):345-351. doi: 10.1016/j.pmn.2018.12.009. Epub 2019 May 17.
The majority of patients undergoing total joint replacement (TJR) experience surgical pain in the early postoperative period and managing pain can be challenging for orthopedic surgeons and their patients.
The objective of this study was to better understand the postoperative pain management education needs of elective total joint replacement patients.
This study had a descriptive phenomenological, qualitative design using individual interviews.
Nine orthopedic surgeons offices in 8 states.
PARTICIPANTS/SUBJECTS: Twenty-seven patients (mean age: 71 years; 74% female; 78% non-Hispanic white) completed the interview.
Patients were interviewed using open-ended questions, which included experiences with surgical pain after surgery and how it was managed, experiences with pain medicine, experience using non-medicine-related pain reduction methods, and suggestions for delivery of pain management information.
Challenges identified for managing postoperative pain included loss of pain control and lack of information about prescribed opioids and nonopioid methods of managing pain. Facilitators included having a caregiver or family member in a health care field and previous experience managing postoperative pain. Participants believed that information about pain management would be helpful and should be delivered at multiple time points.
With trends toward shorter hospital stays, as well as the growing opioid epidemic and the associated concerns regarding prescribing opioids, home-based pain management should be a priority. Interventions should include education about narcotic use and abuse as well as nonmedication approaches to pain management.
大多数接受全关节置换术(TJR)的患者在术后早期会经历手术疼痛,对骨科医生及其患者来说,疼痛管理具有挑战性。
本研究的目的是更好地了解择期全关节置换术患者术后疼痛管理的教育需求。
本研究采用描述性现象学定性设计,进行个体访谈。
8个州的9个骨科医生办公室。
参与者/受试者:27名患者(平均年龄:71岁;74%为女性;78%为非西班牙裔白人)完成了访谈。
采用开放式问题对患者进行访谈,问题包括术后手术疼痛的经历及疼痛管理方式、止痛药的使用经历、使用非药物止痛方法的经历以及疼痛管理信息传递的建议。
术后疼痛管理面临的挑战包括疼痛控制不佳以及缺乏关于处方阿片类药物和非阿片类疼痛管理方法的信息。促进因素包括有医疗保健领域的护理人员或家庭成员以及既往术后疼痛管理经验。参与者认为疼痛管理信息会有所帮助,应在多个时间点提供。
随着住院时间缩短的趋势,以及阿片类药物流行加剧和开具阿片类药物相关的担忧增加,居家疼痛管理应成为优先事项。干预措施应包括关于麻醉药品使用和滥用的教育以及疼痛管理的非药物方法。