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印度一家三级护理教学机构的疼痛管理政策制定:一项前瞻性观察研究。

Pain management policy formulation at a tertiary care teaching institute in India: A prospective observational study.

机构信息

Senior Resident, Department of OncoAnaesthesia and Palliative Medicine, Dr. B.R.A.I.R.C.H. and N.C.I., A.I.I.M.S., New Delhi, India.

Assistant Professor, Department of OncoAnaesthesia and Palliative Medicine, Dr. B.R.A.I.R.C.H. and N.C.I., A.I.I.M.S., New Delhi, India.

出版信息

Indian J Public Health. 2022 Apr-Jun;66(2):109-112. doi: 10.4103/ijph.ijph_1769_21.

Abstract

BACKGROUND

Access to pain management has been recognized as a fundamental human right. Inadequate pain relief hampers the quality of life and has a physiological and psychosocial impact on the patient and caregivers. Inadequate pain relief remains the leading cause of suffering in hospitalized patients worldwide.

OBJECTIVE

The objective of this article is to provide adequate pain relief to hospitalized patients through proper assessment, treatment, and monitoring of pain by the trained health-care workers through a sustainable and effective institutional pain management policy.

METHODS

The formulation of pain management policy at a tertiary care teaching institute was conducted in three phases - Phase 1: need assessment by an open-label, uncontrolled, prospective observational study over 1 month period, Phase 2: teaching, training, and awareness of health-care workers, and Phase 3: constitution of the committee at the institute level with the formation of pain resource teams.

RESULTS

An open-label, prospective observational study conducted over 1 month revealed that among 814 hospitalized patients, 108 out of 235 (46%) patients in medical and 385 out of 579 (66.5%) patients in the surgical cohort had NRS score of ≥3, implying an inadequate pain relief even at 24 h following medical or surgical intervention, respectively.

CONCLUSION

The provision of effective and adequate pain relief to hospitalized patients requires trained health-care workers and a uniform and structured pain management policy at the institutional level. Recognition and addressal of the barriers and challenges while framing an institutional pain policy is of utmost importance.

摘要

背景

人们已经认识到,获得疼痛管理是一项基本人权。疼痛缓解不足会降低生活质量,并对患者和护理人员的生理和心理产生影响。在全球范围内,疼痛缓解不足仍然是住院患者痛苦的主要原因。

目的

本文的目的是通过经过培训的医护人员对疼痛进行适当的评估、治疗和监测,通过可持续和有效的机构疼痛管理政策,为住院患者提供充分的疼痛缓解。

方法

在三级教学医院制定疼痛管理政策分三个阶段进行-阶段 1:通过为期 1 个月的开放性、非对照、前瞻性观察研究进行需求评估;阶段 2:医护人员的教学、培训和意识;阶段 3:在机构层面成立委员会,并组建疼痛资源团队。

结果

为期 1 个月的开放性前瞻性观察研究显示,在 814 名住院患者中,235 名内科患者中有 108 名(46%)和 579 名外科患者中有 385 名(66.5%)NRS 评分≥3,这意味着即使在医疗或手术干预后 24 小时,仍有大量患者的疼痛缓解不足。

结论

为住院患者提供有效和充分的疼痛缓解需要经过培训的医护人员,以及机构层面统一和结构化的疼痛管理政策。在制定机构疼痛政策时,认识和解决障碍和挑战至关重要。

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