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深入了解青少年腹腔镜手术后的疼痛经历:一项前瞻性研究。

Gaining Insight into Teenagers' Experiences of Pain after Laparoscopic Surgeries: A Prospective Study.

作者信息

Visoiu Mihaela, Chelly Jacques, Sadhasivam Senthilkumar

机构信息

UPMC Children's Hospital of Pittsburgh, Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh Medical Center, 4401 Penn Avenue, Pittsburgh, PA 15224, USA.

UPMC Shadyside Hospital, Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh Medical Center 5230 Center Ave, Pittsburgh, PA 15232, USA.

出版信息

Children (Basel). 2024 Apr 20;11(4):493. doi: 10.3390/children11040493.

Abstract

There is an anecdotal impression that teenage patients report exaggerated postoperative pain scores that do not correlate with their actual level of pain. Nurse and parental perception of teenagers' pain can be complemented by knowledge of patient pain behavior, catastrophizing thoughts about pain, anxiety, and mood level. Two hundred and two patients completed the study-56.4% were female, 89.6% White, 5.4% Black, and 5% were of other races. Patient ages ranged from 11 to 17 years (mean = 13.8; SD = 1.9). The patient, the parent, and the nurse completed multiple questionnaires on day one after laparoscopic surgery to assess patient pain. Teenagers and parents (r = 0.56) have a high level of agreement, and teenagers and nurses (r = 0.47) have a moderate level of agreement on pain scores ( < 0.05). The correlation between patient APBQ (adolescent pain behavior questionnaire) and teenager VAS (visual analog scale) and between nurse APBQ and teenager VAS, while statistically significant ( < 0.05), is weaker (r range = 0.14-0.17). There is a moderate correlation between teenagers' pain scores and their psychological assessments of anxiety, catastrophic thoughts, and mood (r range = 0.26-0.39; < 0.05). A multi-modal evaluation of postoperative pain can be more informative than only assessing self-reported pain scores.

摘要

有一种坊间印象是,青少年患者报告的术后疼痛评分过高,与他们实际的疼痛程度不相符。护士和家长对青少年疼痛的认知可以通过了解患者的疼痛行为、对疼痛的灾难化思维、焦虑和情绪水平来补充。202名患者完成了该研究,其中56.4%为女性,89.6%为白人,5.4%为黑人,5%为其他种族。患者年龄在11至17岁之间(平均=13.8;标准差=1.9)。患者、家长和护士在腹腔镜手术后第一天完成了多份问卷,以评估患者的疼痛。青少年与家长在疼痛评分上的一致性较高(r=0.56),青少年与护士在疼痛评分上的一致性中等(r=0.47)(<0.05)。患者青少年疼痛行为问卷(APBQ)与青少年视觉模拟量表(VAS)之间以及护士APBQ与青少年VAS之间的相关性虽然具有统计学意义(<0.05),但较弱(r范围=0.14 - 0.17)。青少年的疼痛评分与他们对焦虑、灾难化思维和情绪的心理评估之间存在中等程度的相关性(r范围=0.26 - 0.39;<0.05)。对术后疼痛进行多模式评估可能比仅评估自我报告的疼痛评分更具信息量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4454/11049025/a6bdc2f04e55/children-11-00493-g001.jpg

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