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[是什么决定了术后疼痛管理的整体质量?一个视角问题]

[What determines the overall quality of postoperative pain management? A question of perspective].

作者信息

Thomas Paula, Weiss Thomas, Meissner Winfried, Baumbach Philipp

机构信息

Geschlechterforschung in der Medizin (GiM), Charité - Universitätsmedizin Berlin, Berlin, Deutschland.

Lehrstuhl für Klinische Psychologie, Friedrich-Schiller-Universität, Jena, Deutschland.

出版信息

Schmerz. 2024 Oct 8. doi: 10.1007/s00482-024-00839-5.

Abstract

BACKGROUND

The outcome domains pain intensity, pain-related interference, side effects, (treatment) information, participation and personal interaction have all been identified as relevant factors in the management of perioperative pain. However, it is not yet clear which of these are particularly significant for the subjectively perceived overall quality of postoperative pain management.

AIM

A newly developed questionnaire was used in this cross-sectional study to assess the relevance of these domains for patients and compare the relevance to healthcare professionals (HCP).

METHODS

The patient survey (n = 40) was conducted on the first postoperative day at Jena University Hospital, Germany. In order to investigate group differences, 63 HCP (disciplines: n = 15 anaesthesiology, n = 17 surgery, n = 31 nursing) were recruited. The questionnaire primarily included all pairwise comparisons between the domains with regard to the overall quality of postoperative pain management. The resulting sum scores for each domain were the primary outcome measure, which were analysed using generalized estimating equations.

RESULTS

Within the group of patients, there were significant differences in the prioritization of the six outcome domains, with personal interaction followed by intensity and interference having received the highest ratings. There were also significant differences within the domains between the perspectives of patients and HCP, as well as between the HCP themselves.

CONCLUSIONS

The study demonstrates that personal interaction and the reduction of pain intensity and interference are three key factors that are significant for patients' experience of postoperative pain management. However, the extent to which the harmonisation of these three factors with those given prominence by HCP would positively impact postoperative pain management remains unclear and should be investigated further.

摘要

背景

疼痛强度、疼痛相关干扰、副作用、(治疗)信息、参与度和人际互动等结局领域均已被确定为围手术期疼痛管理中的相关因素。然而,目前尚不清楚这些因素中哪些对术后疼痛管理的主观整体质量尤为重要。

目的

在这项横断面研究中,使用一种新开发的问卷来评估这些领域对患者的相关性,并将其与医疗保健专业人员(HCP)的相关性进行比较。

方法

在德国耶拿大学医院术后第一天对患者进行调查(n = 40)。为了调查组间差异,招募了63名HCP(学科:n = 15麻醉学、n = 17外科学、n = 31护理学)。问卷主要包括各领域之间关于术后疼痛管理整体质量的所有成对比较。每个领域的所得总分是主要结局指标,使用广义估计方程进行分析。

结果

在患者组中,六个结局领域的优先级存在显著差异,人际互动其次是强度和干扰获得了最高评分。患者和HCP的观点之间以及HCP自身之间在各领域内也存在显著差异。

结论

该研究表明,人际互动以及疼痛强度和干扰的降低是对患者术后疼痛管理体验至关重要的三个关键因素。然而,这三个因素与HCP所强调的因素协调一致对术后疼痛管理产生积极影响的程度仍不清楚,应进一步研究。

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