Department of Nursing, Graduate School, Yonsei University, Seoul, Republic of Korea; Acute Pain Service Team, Severance Hospital, Seoul, Republic of Korea.
Mo-Im Kim Nursing Research Institute, Yonsei University College of Nursing, Seoul, Republic of Korea; Yonsei Evidence Based Nursing Center of Korea: A Joanna Briggs Institute Affiliated Group, Seoul, Republic of Korea.
Pain Manag Nurs. 2021 Apr;22(2):111-120. doi: 10.1016/j.pmn.2020.11.005. Epub 2021 Jan 19.
A literature review was conducted to assess nurse-led nonpharmacologic pain management interventions intended for total knee/hip replacement patients.
This was a systematic review and meta-analysis.
The PubMed, Embase, CINAHL, and Cochrane Library databases were searched to identify relevant studies.
The systematic review was conducted based on the Cochrane Handbook for Systematic Reviews of Interventions and all Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) reporting guidelines. Two reviewers independently selected the studies and appraised their quality. Thereafter, the effects of all described nurse-led nonpharmacologic pain management interventions were estimated regarding pain, anxiety, and satisfaction through a meta-analysis.
In total, 219 relevant studies were found through a search. Finally, 23 studies were selected for review, with 17 included in the meta-analysis. Nurse-led nonpharmacologic pain management was effective for pain relief (effect size, -0.22; 95% confidence interval [CI], -0.42 to -0.02), and educational interventions were especially effective (effect size, -0.36; 95% CI, -0.69 to -0.03). Although interventions reduced anxiety and improved satisfaction, these results were not statistically significant based on the analysis.
Our findings support that nurse-led nonpharmacologic pain management interventions could help reduce pain in patients with total knee/hip replacement by supplementing pharmacologic pain management.
Nurse-led nonpharmacologic pain interventions should be considered to reduce patient pain with total knee/hip replacement.
为评估针对全膝关节/髋关节置换患者的护士主导的非药物性疼痛管理干预措施，我们进行了文献回顾。
这是一项系统评价和荟萃分析。
我们检索了 PubMed、Embase、CINAHL 和 Cochrane 图书馆数据库，以确定相关研究。
我们根据 Cochrane 干预措施系统评价手册和所有系统评价和荟萃分析的 Preferred Reporting Items（PRISMA）报告指南进行了系统评价。两位评审员独立选择研究并评估其质量。此后，通过荟萃分析评估所有描述的护士主导的非药物性疼痛管理干预措施对疼痛、焦虑和满意度的影响。
通过搜索共发现 219 篇相关研究，最终有 23 篇研究被选入综述，其中 17 篇被纳入荟萃分析。护士主导的非药物性疼痛管理对缓解疼痛有效（效应量为-0.22；95%置信区间为-0.42 至-0.02），教育干预尤其有效（效应量为-0.36；95%置信区间为-0.69 至-0.03）。虽然干预措施降低了焦虑并提高了满意度，但基于分析，这些结果并不具有统计学意义。
我们的研究结果支持，护士主导的非药物性疼痛管理干预措施可以通过补充药物性疼痛管理来帮助减轻全膝关节/髋关节置换患者的疼痛。
应考虑护士主导的非药物性疼痛干预措施来减轻全膝关节/髋关节置换患者的疼痛。
