Bondestam E, Hovgren K, Gaston Johansson F, Jern S, Herlitz J, Holmberg S
Department of Medicine 1, Sahlgren's Hospital, Göteborg, Sweden.
J Adv Nurs. 1987 Nov;12(6):677-82. doi: 10.1111/j.1365-2648.1987.tb01369.x.
In 47 patients admitted to the coronary care unit (CCU) at Sahlgren's Hospital in Göteborg, Sweden, due to acute myocardial infarction (MI) the intensity of pain independently assessed by the patient and by the nurse on duty was evaluated during the first 24 hours in CCU. Pain was assessed according to a modified numerical rating scale graded from 0-10, where 0 meant no pain and 10 meant the most severe pain. A positive correlation between the patients' and nurses' assessments was found (r = 0.76; P less than 0.001). However, the nurses under-estimated the patients' pain in 23% of the situations and over-estimated it in 20%. Over-estimation was particularly found when heart rate and blood pressure increased. Many patients scoring their pain to fairly high degrees were not given pain-relieving treatment. Treatment with morphine did not cause substantial pain relief in a substantial number of patients. A significantly positive correlation was found between the patients' and nurses' assessments of pain, although under-estimation as well as over-estimation occurred. A few patients with severe pain were not treated and when treatment was given it was often ineffective.
在瑞典哥德堡萨尔格伦医院冠心病监护病房（CCU）收治的47例因急性心肌梗死（MI）入院的患者中，对患者和值班护士在CCU的最初24小时内独立评估的疼痛强度进行了评估。疼痛根据改良的数字评分量表进行评估，评分范围为0至10分，其中0分表示无疼痛，10分表示最剧烈的疼痛。发现患者和护士的评估之间存在正相关（r = 0.76；P小于0.001）。然而，护士在23%的情况下低估了患者的疼痛，在20%的情况下高估了患者的疼痛。尤其在心率和血压升高时发现了高估情况。许多将疼痛评分相当高的患者未接受止痛治疗。相当多的患者使用吗啡治疗并未带来明显的疼痛缓解。尽管存在低估和高估情况，但患者和护士对疼痛的评估之间仍存在显著的正相关。一些疼痛严重的患者未得到治疗，而当进行治疗时往往无效。
