非药物干预对换药过程中伤口患者疼痛的影响:系统评价。
Effects of non-pharmacological interventions on pain in wound patients during dressing change: A systematic review.
机构信息
Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, Sichuan, P.R. China.
出版信息
Nurs Open. 2024 Feb;11(2):e2107. doi: 10.1002/nop2.2107.
BACKGROUND
Changes to the wound dressing frequently cause pain. Some adverse side effects of pharmacologic pain management may cause problems or even impede wound healing. There is no systematic study of non-pharmacologic therapies for pain during wound dressing changes, despite the gradual promotion of non-pharmacologic pain reduction methods.
OBJECTIVES
To give clinical wound pain management a new direction, locating and assessing non-pharmacological interventions regarding pain brought on by wound dressing changes are necessary.
METHOD
The researchers conducted a comprehensive literature review on non-pharmacological interventions for pain during wound dressing changes across five databases: PubMed, Web of Science, Medline, Embase, and the Cochrane Library spanning the period from January 2010 to September 2022. The evaluation of literature and data extraction was carried out independently by two researchers, and in cases of disagreement, a third researcher participated in the deliberation. To assess the risk of bias in the literature, the researchers utilised the Cochrane Handbook for Reviews of Interventions, version 5.1.0.
RESULTS
In total, 951 people were involved in 11 investigations covering seven non-pharmacological therapies. For pain triggered by dressing changes, virtual reality (VR) distraction, auditory and visual distractions, foot reflexology, religious and spiritual care, and guided imaging demonstrated partially positive effects, with hypnosis therapy and jaw relaxation perhaps having a weak effect.
CONCLUSION
The key to managing wounds is pain management. According to our review, there is some indication that non-pharmacologic interventions can help patients feel less discomfort when having their wound dressings changed. However, the evidence supporting this view is weak. It needs to be corroborated by future research studies with multicentre and large samples. To promote and use various non-pharmacologic interventions in the future, it is also necessary to build standardised and homogenised paths for their implementation.
背景
频繁更换伤口敷料会引起疼痛。一些药物镇痛管理的不良反应可能会引起问题,甚至阻碍伤口愈合。尽管非药物性疼痛缓解方法逐渐得到推广,但对于伤口敷料更换时疼痛的非药物治疗方法,目前尚无系统研究。
目的
为临床伤口疼痛管理提供新方向,有必要定位和评估减轻伤口敷料更换引起疼痛的非药物干预措施。
方法
研究人员在五个数据库(PubMed、Web of Science、Medline、Embase 和 Cochrane Library)中对伤口敷料更换期间非药物性干预措施减轻疼痛的相关文献进行了全面综述,时间范围为 2010 年 1 月至 2022 年 9 月。两名研究人员独立进行文献评价和数据提取,如果存在分歧,则由第三名研究人员参与讨论。研究人员利用 Cochrane 干预措施评价手册(版本 5.1.0)评估文献的偏倚风险。
结果
共有 951 人参与了 11 项研究,涵盖了 7 种非药物治疗方法。对于敷料更换引起的疼痛,虚拟现实(VR)分散注意力、听觉和视觉分散注意力、足部反射疗法、宗教和精神关怀、引导想象显示出部分积极效果,催眠疗法和下颌放松可能效果较弱。
结论
管理伤口的关键是疼痛管理。根据我们的综述,有一些迹象表明非药物干预措施可以帮助患者在更换伤口敷料时减轻不适。然而,支持这一观点的证据很薄弱。需要未来的多中心和大样本研究来证实这一点。为了在未来推广和使用各种非药物干预措施,还需要建立标准化和同质化的实施途径。