From Florida State University, College of Nursing, Tallahassee, FL, USA.
From Florida State University, College of Nursing, Tallahassee, FL, USA.
Pain Manag Nurs. 2021 Feb;22(1):28-35. doi: 10.1016/j.pmn.2020.09.004. Epub 2020 Nov 11.
Although a transitional approach promoting continuity of care is warranted to prevent chronic post-surgical pain (CPSP) and opioid misuse, there is limited research examining interventions targeting the subacute phase after cardiac surgery. Contextual multi-level factors may explain this scarcity.
The purpose of this study was to explore the potential implementation of a nursing intervention to prevent CPSP in the subacute phase by describing nurses' viewpoints of current barriers and facilitators.
A descriptive qualitative study was conducted using secondary data analysis.
A Web-based survey was used along with in-person interviews.
75 perioperative nurses.
Qualitative data from individual interviews (n=10) and open-ended responses to a survey (n=65) regarding the intervention's acceptability were used. Content analysis was conducted using a deductive approach.
The introduction of nurses from various clinical settings to a new intervention allowed reflection on current practice and represented a shift toward a preventive approach. The main barrier expressed was the lack of communication and continuity of care between clinical settings. Several policy implications were outlined such as increasing the involvement of rehabilitation programs and strengthening collaboration between pain specialists and primary care providers.
Based on perceptions of nurses involved at different stages of the continuum, the findings provide a preliminary picture of clinical challenges and potential avenues for the prevention of CPSP in the subacute phase after cardiac surgery. An expanded pain management nursing role in primary care would allow earlier interventions and contribute to the prevention of CPSP for a tremendous number of patients undergoing surgeries.
尽管需要采取过渡性方法来促进连续性护理，以预防慢性术后疼痛（CPSP）和阿片类药物滥用，但针对心脏手术后亚急性期的干预措施研究有限。背景多水平因素可能解释了这种稀缺性。
本研究旨在通过描述护士对当前障碍和促进因素的看法，探讨在亚急性期预防 CPSP 的护理干预措施的潜在实施情况。
使用二次数据分析进行描述性定性研究。
使用基于网络的调查和面对面访谈。
75 名围手术期护士。
使用个人访谈（n=10）和针对干预措施可接受性的调查（n=65）的开放式回答的定性数据。使用演绎法进行内容分析。
引入来自不同临床科室的护士参与新干预措施，使他们能够反思当前的实践，并代表向预防方法的转变。表达的主要障碍是临床科室之间缺乏沟通和连续性护理。概述了一些政策影响，例如增加康复计划的参与度，加强疼痛专家和初级保健提供者之间的合作。
根据参与连续性不同阶段的护士的看法，研究结果提供了心脏手术后亚急性期预防 CPSP 的临床挑战和潜在途径的初步情况。在初级保健中扩大疼痛管理护理角色将允许更早地进行干预，并有助于预防大量接受手术的患者发生 CPSP。
