资源有限环境下急诊护士关于疼痛管理的知识、态度及感知障碍：横断面研究
Emergency nurses´ knowledge, attitude and perceived barriers regarding pain Management in Resource-Limited Settings: cross-sectional study.
作者信息
Kahsay Desale Tewelde, Pitkäjärvi Marianne
机构信息
Department of Anaesthesia and Critical Care, Asmara College of Health Sciences, Mai Bela Ave, Asmara, Eritrea.
Metropolia University of Applied Sciences, Myllypurontie 1, PO BOX 4000, 00079 Helsinki, Metropolia Finland.
出版信息
BMC Nurs. 2019 Nov 21;18:56. doi: 10.1186/s12912-019-0380-9. eCollection 2019.
BACKGROUND
Pain is a common phenomenon among emergency patients which may lead to chronic pain conditions and alteration of physiological function. However, it is widely reported that proper pain assessment and management, which is often accomplished by adequately trained nurses reduce the suffering of patients. Therefore, the aim of this study was to assess the emergency nurses´ knowledge, attitude and perceived barriers regarding pain management.
METHODS
A cross-sectional quantitative study design was applied to determine the nurses´ knowledge level, attitude and the perceived barriers related to pain management. Hundred twenty-six nurses from the emergency departments of seven referral hospitals of Eritrea participated in the study. Data were collected in August and September 2017. Both descriptive and inferential statistics were used to summarize and elaborate on the results.
RESULT
In general, the knowledge level and attitude of the emergency nurses was poor. The participants' correct mean score was 49.5%. Nurses with Bachelor's Degree had significantly higher knowledge and attitude level compared to the nurses at the Diploma and Certificate level of professional preparation (95% CI = 7.1-16.7 and 9.4-19.1; < 0.001) respectively. Similarly, nurses who had previous training regarding pain scored significantly higher knowledge level compared to those without training (95% CI =1.82-8.99; = 0.003). The highest perceived barriers to adequate pain management in emergency departments were measured to be overcrowding of the emergency department (2.57 ± 1.25), lack of protocols for pain assessment (2.45 ± 1.52), nursing workload (2.44 ± 1.29) and lack of pain assessment tools (2.43 ± 1.43). There was no significant difference in perceived barriers among nurses with different demographic characteristics.
CONCLUSION
The emergency nurses' knowledge and attitude regarding pain management were poor. Nurses with higher educational level and nurses with previous training scored significantly higher knowledge level. This indicates the need for nursing schools and the ministry of health to work together to educate nurses to a higher level of preparation for pain assessment and management.
背景
疼痛是急诊患者中的常见现象，可能导致慢性疼痛状况和生理功能改变。然而，有广泛报道称，由训练有素的护士进行适当的疼痛评估和管理，通常可以减轻患者的痛苦。因此，本研究的目的是评估急诊护士在疼痛管理方面的知识、态度和感知到的障碍。
方法
采用横断面定量研究设计来确定护士在疼痛管理方面的知识水平、态度和感知到的障碍。厄立特里亚七家转诊医院急诊科的126名护士参与了该研究。数据于2017年8月和9月收集。描述性和推断性统计均用于总结和阐述研究结果。
结果
总体而言，急诊护士的知识水平和态度较差。参与者的正确平均得分是49.5%。与专业准备为文凭和证书水平的护士相比，拥有学士学位的护士在知识和态度水平上显著更高（95%置信区间分别为7.1 - 16.7和9.4 - 19.1；P < 0.001）。同样，与未接受过疼痛培训的护士相比，之前接受过疼痛培训的护士在知识水平上得分显著更高（95%置信区间 = 1.82 - 8.99；P = 0.003）。急诊科充分疼痛管理的最高感知障碍被测定为急诊科过度拥挤（2.57 ± 1.25）、缺乏疼痛评估方案（2.45 ± 1.52）、护理工作量（2.44 ± 1.29）和缺乏疼痛评估工具（2.43 ± 1.43）。不同人口统计学特征的护士在感知障碍方面没有显著差异。
结论
急诊护士在疼痛管理方面的知识和态度较差。教育水平较高的护士和之前接受过培训的护士在知识水平上得分显著更高。这表明护理学校和卫生部需要共同努力，将护士教育提升到更高水平，以进行疼痛评估和管理。
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