Dong Ying, Gao Hui, Jin Zheyu, Zhu Jue, Yu Hao, Jiang Yingqing, Zou Jun
Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, China.
Pain Res Manag. 2022 Feb 15;2022:8110896. doi: 10.1155/2022/8110896. eCollection 2022.
To evaluate the outcome of a knowledge, attitude, belief, and practice mode (KABP) in the pain management in patients with acute traumatic fractures complicated with alcohol dependence.
Twenty-nine alcohol-dependent male patients with acute traumatic fractures and who received surgical treatment between January 2019 and December 2020 were included in this retrospective case-control study. The age range was 30-65 years (average 50.03 ± 7.94). . Six cases of spinal burst fractures and 23 cases of limb trauma fractures. Ten patients were treated with routine nursing (control group), and 19 patients were treated with pain management in KABP mode (experimental group). The control group received traditional pain care, including the conventional numerical rating scale (NRS) pain score system, with focus on symptomatic treatment. On this basis, the experimental group managed pain using KABP, including cognitive behavioral intervention, optimization programs, modification of personal beliefs, and behavior patterns. NRS, self-rated anxiety/depression scale (SAS), and quality of life (SF-36) scale were applied at admission, 1 day before surgery, and 3 months after surgery.
The perioperative NRS score of the KABP group was lower than that of the control group, and the postoperative anxiety levels improved. Discharge satisfaction was significantly higher than that in the control group ( < 0.05). There were behaviors promoting health in the experimental group, and five patients expressed abstinence behavior after discharge ( < 0.05).
Patients with alcohol dependence represents a unique set of cases for perioperative pain management. To ensure patient safety, individualized pain management through the application of KABP can significantly reduce postoperative pain and promote the generation of healthy behaviors in patients.
评估知识、态度、信念和行为模式（KABP）在急性创伤性骨折合并酒精依赖患者疼痛管理中的效果。
本回顾性病例对照研究纳入了2019年1月至2020年12月期间接受手术治疗的29例酒精依赖男性急性创伤性骨折患者。年龄范围为30 - 65岁（平均50.03±7.94）。其中6例为脊柱爆裂骨折，23例为四肢创伤性骨折。10例患者接受常规护理（对照组），19例患者采用KABP模式进行疼痛管理（实验组）。对照组接受传统疼痛护理，包括常规数字评分量表（NRS）疼痛评分系统，重点是对症治疗。在此基础上，实验组采用KABP进行疼痛管理，包括认知行为干预、优化方案、个人信念修正和行为模式调整。在入院时、手术前1天和手术后3个月应用NRS、自评焦虑/抑郁量表（SAS）和生活质量（SF - 36）量表。
KABP组围手术期NRS评分低于对照组，术后焦虑水平改善。出院满意度显著高于对照组（<0.05）。实验组有促进健康的行为，5例患者出院后表示有戒酒行为（<0.05）。
酒精依赖患者是围手术期疼痛管理中一组独特的病例。为确保患者安全，通过应用KABP进行个体化疼痛管理可显著减轻术后疼痛，并促进患者产生健康行为。
