重症监护病房护士对危重症患者疼痛管理的知识、态度、实践及感知障碍：一项横断面研究
Knowledge, attitude, practice and perceived barriers of nurses working in intensive care unit on pain management of critically ill patients: a cross-sectional study.
作者信息
Sweity Essa M, Salahat Ahmad M, Sada Abd Alrhman, Aswad Ahmad, Zabin Loai M, Zyoud Sa'ed H
机构信息
Department of Cardiology, An-Najah National University Hospital, Nablus, 44839, Palestine.
College of Nursing and Midwifery, Women's Federation Society, Nablus, 44839, Palestine.
出版信息
BMC Nurs. 2022 Jul 26;21(1):202. doi: 10.1186/s12912-022-00990-3.
BACKGROUND
Pain is a major obstacle and one of the main reasons people seek medical attention and is a frequent stressor for many clients in the intensive care unit (ICU). However, clients should not be left complaining, especially when solutions are available; each patient has the right to assess and manage their pain in the best way possible. Therefore, the objective of this study was to analyze nurses' knowledge, attitudes, and practice (KAPs) regarding pain management in Palestinian ICU settings and to determine the possible obstacles that may hinder effective and competent pain management for critically ill clients.
METHODS
This cross-sectional research was conducted online through social media. An approved questionnaire was used to assess KAPs and obstacles in pain treatment approaches for critically ill patients. Bloom's cutoff points for adequate practice, appropriate knowledge, and a positive attitude were applied. IBM SPSS Statistics for Windows, Version 21.0 was used for analyses.
RESULTS
One hundred ninety-one nurses were approached, the majority of the participants in this investigation were males (n = 127, 66.5%), and the mean age of the study participant was 29 ± 7 (year). The overall knowledge score was 15, measured for median knowledge = 7 with an interquartile range (IQR) of 4-8, and higher scores indicate more knowledge about the management and control of pain. The total attitude score = 11, the median = 6, with an IQR of 5-7. The reluctance to prescribe opioids was 79.6%, the lack of proficiency in pain management knowledge was 78.5%, and rigorous controls over opioid use were 77.5%, which was the lion's share of commonly recognized hurdles. The overall practice score was 10, with a median of 5.0 with an IQR of 3.0 to 6.0, and nurses revealed that they would evaluate all the steps involved in pain management in each round they have.
CONCLUSIONS
This research reveals a knowledge, attitude, and practice gap among the working nurses. Therefore, adequate and efficient plans must be aimed at ICU nurses to foster the level of knowledge and direct attitudes toward pain control through applicable interventional programs.
背景
疼痛是一个主要障碍，也是人们寻求医疗护理的主要原因之一，并且是重症监护病房（ICU）中许多患者经常面临的压力源。然而，不应让患者一直抱怨，尤其是当有解决办法时；每位患者都有权以最佳方式评估和管理自己的疼痛。因此，本研究的目的是分析巴勒斯坦ICU环境中护士关于疼痛管理的知识、态度和实践（KAPs），并确定可能阻碍对重症患者进行有效和充分疼痛管理的潜在障碍。
方法
本横断面研究通过社交媒体在线进行。使用一份经过批准的问卷来评估重症患者疼痛治疗方法中的KAPs和障碍。应用了布鲁姆关于充分实践、适当知识和积极态度的临界点。使用IBM SPSS Statistics for Windows 21.0版本进行分析。
结果
共联系了191名护士，本次调查的大多数参与者为男性（n = 127，66.5%），研究参与者的平均年龄为29±7（岁）。总体知识得分是15分，知识中位数为7分，四分位间距（IQR）为4 - 8分，得分越高表明对疼痛管理和控制的知识越多。总体态度得分 = 11分，中位数 = 6分，IQR为5 - 7分。不愿开具阿片类药物的比例为79.6%，疼痛管理知识不熟练的比例为78.5%，对阿片类药物使用的严格控制比例为77.5%，这些是普遍认可的障碍中占比最大的部分。总体实践得分是10分，中位数为5.0分，IQR为3.0至6.0分，护士们表示他们会在每次查房时评估疼痛管理涉及的所有步骤。
结论
本研究揭示了在职护士在知识、态度和实践方面存在差距。因此，必须针对ICU护士制定充分且有效的计划，通过适用的干预项目来提高知识水平并引导对疼痛控制的态度。
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