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一项关于实施安大略省注册护士协会术后疼痛评估和管理指南以及放松疗法对 312 例骨和软组织恶性肿瘤患者影响的病例对照研究。

A Case-Control Study of the Effects of Implementing the Registered Nurses' Association of Ontario Guidelines for the Assessment and Management of Postoperative Pain and the Use of Relaxation Therapy in 312 Patients with Bone and Soft-Tissue Malignancy.

机构信息

Nursing Department, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China (mainland).

Department of Orthopaedics, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China (mainland).

出版信息

Med Sci Monit. 2022 Sep 13;28:e937496. doi: 10.12659/MSM.937496.

Abstract

BACKGROUND The present study aimed to investigate the effects of implementing the Registered Nurses' Association of Ontario (RNAO) guidelines for the management of postoperative pain and the use of Jacobson's relaxation technique (JRT) in patients with bone and soft-tissue malignancy at a single center in China. MATERIAL AND METHODS A total of 312 patients were recruited and randomly divided into 2 groups. In the intervention group, the RNAO pain-management technique of JRT was adopted, while the control group received the standard institutional nursing management. Pain scores after the operation, according to the Numerical Rating Scale (NRS) combined with the Wong-Baker Faces Pain Rating Scale and Short-Form McGill Pain Questionnaire, were compared between the 2 groups. Nursing satisfaction was compared as well. RESULTS At 6, 24, and 72 h after the operation, the NRS scores combined with the Wong-Baker Faces Pain Rating Scale in the intervention group were significantly lower than those in the control group (P<0.001); 72 h after the operation, the Pain Rating Index, Visual Analogue Scale, present pain intensity, and total scores for the intervention group were significantly lower than those for the control group (P<0.001 for all 4 scores). The scores reported from the patients for nursing response and consequent care (P<0.001), nursing competence (P=0.029), and surgical pain-control satisfaction (P<0.001) in the intervention group were also significantly higher than those in the control group. CONCLUSIONS JRT can improve postoperative pain-control and nursing satisfaction in patients with malignant bone and soft-tissue tumors. These data suggest a benefit for application of JRT in clinical care.

摘要

背景

本研究旨在探讨在我国某单一中心实施安大略注册护士协会(RNAO)术后疼痛管理指南和雅各布森放松技术(JRT)对骨与软组织恶性肿瘤患者的影响。

材料与方法

共招募了 312 名患者,并随机分为 2 组。在干预组中,采用 RNAO 的 JRT 疼痛管理技术,而对照组则接受标准的机构护理管理。比较两组患者术后的疼痛评分(根据数字评分量表(NRS)结合 Wong-Baker 面部疼痛评分量表和简短 McGill 疼痛问卷)、护理满意度。

结果

术后 6、24 和 72 h,干预组 NRS 评分结合 Wong-Baker 面部疼痛评分量表明显低于对照组(P<0.001);术后 72 h,干预组疼痛评分指数、视觉模拟评分、目前疼痛强度和总分均明显低于对照组(4 项评分均 P<0.001)。干预组患者对护理反应和后续护理(P<0.001)、护理能力(P=0.029)和手术疼痛控制满意度(P<0.001)的评分也明显高于对照组。

结论

JRT 可以改善恶性骨与软组织肿瘤患者的术后疼痛控制和护理满意度。这些数据表明 JRT 在临床护理中有一定的应用价值。

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