Institute of Family Medicine and Public Health, Faculty of Medicine, University of Tartu, Ravila 19, 50412 Tartu, Estonia; Tartu Health Care College, Estonia.
Research Unit of Nursing Science and Health Management, University of Oulu, Oulu University Hospital, Medical Research Center, Oulu, Finland.
J Pediatr Nurs. 2022 Jan-Feb;62:e156-e163. doi: 10.1016/j.pedn.2021.09.006. Epub 2021 Sep 22.
The purpose of this study was to describe nurses perceptions of infants' procedural pain assessment and alleviation with non-pharmacological methods including parental guidance in departments of neonatal and infant medicine and Neonatal Intensive Care (NICUs).
A descriptive cross-sectional survey was carried out among all nurses (n= 149) who were working in neonatal and infant departments or NICUs in Estonian hospitals. Altogether, 128 questionnaires were returned and 111 respondents were eligible (75% response rate). The data were analysed using statistical methods.
More than half of the nurses agreed that systematic documentation of the measurement of pain is necessary for nursing care and that it affects pain alleviation in infants. Half of the respondents (51%) confirmed that pain scales are important in the measurement of infants' pain, but 58% claimed they were able to assess pain in a reliable way without using pain assessment scales. Nurses also reported that they were unfamiliar with most pain scales and they were not routinely used in everyday practice. Nurses said that the most useful non-pharmacological pain alleviation methods were touching (83%) and positioning infants (78%), the most rarely used were skin-to-skin care (12%) and encouraging mothers to breastfeed the infant (34%). The majority of respondents (79%) reported that they do not know or do not have written instructions on pain assessment in their workplace, and only a few (10%) reported that they have participated in pain management courses during the last year.
There is a need to increase the use of pain assessment scales and pain documentation in everyday practice in those hospitals in Estonia. The use of scales in pain assessment was valued by few nurses. It seems that there is a lack of knowledge on non-pharmacological methods, and nurses reported using only a few non-pharmacological pain alleviation methods and guided parents on using them.
Nurses need pain management guidelines for everyday work, and in addition to nurses, written guidelines for parents are needed.
本研究旨在描述新生儿和婴儿医学科室及新生儿重症监护病房（NICU）护士对婴儿程序性疼痛评估和缓解的认知，包括使用非药物方法（如父母指导）。
采用描述性横断面调查方法，对爱沙尼亚医院新生儿和婴儿科室及 NICU 的所有护士（n=149）进行调查，共收回 128 份问卷，其中 111 份有效（应答率 75%）。采用统计方法对数据进行分析。
超过一半的护士认为系统记录疼痛测量结果对护理很有必要，且这会影响婴儿的疼痛缓解。有一半的受访者（51%）确认疼痛量表在婴儿疼痛测量中很重要，但 58%的人声称他们能够在不使用疼痛评估量表的情况下可靠地评估疼痛。护士还报告说，他们对大多数疼痛量表不熟悉，也没有在日常实践中常规使用。护士表示，最有用的非药物性疼痛缓解方法是触摸（83%）和安置婴儿的体位（78%），最不常使用的是皮肤接触（12%）和鼓励母亲母乳喂养婴儿（34%）。大多数受访者（79%）报告说，他们不知道或工作场所没有关于疼痛评估的书面说明，只有少数（10%）报告说他们在过去一年中参加过疼痛管理课程。
爱沙尼亚的这些医院需要增加在日常实践中使用疼痛评估量表和记录疼痛的频率。很少有护士重视使用量表进行疼痛评估。似乎缺乏对非药物性方法的了解，护士报告仅使用少数非药物性疼痛缓解方法，并指导家长使用这些方法。
护士需要疼痛管理指南来指导日常工作，除了护士，还需要为家长提供书面指南。
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