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插管患者疼痛管理中的障碍与实践:对约旦河西岸南部医院重症护理护士的一项研究

Barriers and practices in pain management for intubated patients: A study of critical care nurses in Southern West Bank hospitals.

作者信息

Salim Ibrahim, Ejheisheh Moath Abu, Ayed Ahmad, Aqtam Ibrahim, Batran Ahmad

机构信息

Al Mezan Specialized Hospital, Hebron, Palestine.

Faculty of Allied Medical Sciences, Department of Nursing, Palestine Ahliya University, Bethlehem, Palestine.

出版信息

PLoS One. 2025 Mar 25;20(3):e0320430. doi: 10.1371/journal.pone.0320430. eCollection 2025.

Abstract

INTRODUCTION

Effective pain management is vital for intubated patients in intensive care units, as these individuals cannot verbally communicate their discomfort. The knowledge, attitudes, practices, and perceived obstacles of nurses are critical factors that influence successful pain management.

OBJECTIVE

This study aimed to evaluate the knowledge, attitudes, practices, and perceived obstacles faced by critical care nurses regarding pain management in intubated patients within hospitals located in Southern West Bank.

METHODS

A cross-sectional survey was carried out with 199 critical care nurses utilizing the Nurses' Knowledge and Attitudes Survey Regarding Pain, alongside a modified tool for assessing perceived barriers to pain management. The data collected were analyzed to pinpoint deficiencies in knowledge and barriers impacting effective pain management strategies.

RESULTS

The analysis showed that 192 out of 199 nurses (96.5%) lacked sufficient knowledge regarding pain management. System-related barriers, including the lack of standardized protocols and ineffective communication with physicians, were frequently identified as obstacles, averaging a score of 2.41 out of 3. Additionally, nurse-related barriers comprised insufficient time for providing non-pharmacological interventions (73.9%) and a lack of confidence in utilizing assessment tools (43.7%). Patient-related issues, such as difficulties in communication (72.4%) and hesitancy to report pain (58.8%), were also noted. A notable difference in knowledge scores was observed based on prior education in pain management, with those having received training (41.7%) performing better.

CONCLUSION

The findings underscore the need for focused educational initiatives, the establishment of standardized protocols for pain management, and enhanced interdisciplinary communication. These improvements are essential for optimizing pain management practices and ensuring better patient outcomes. The results suggest that addressing knowledge gaps and systemic barriers could lead to significant enhancements in patient care and health policies.

摘要

引言

有效的疼痛管理对于重症监护病房中插管患者至关重要,因为这些患者无法通过言语表达他们的不适。护士的知识、态度、实践以及感知到的障碍是影响成功疼痛管理的关键因素。

目的

本研究旨在评估约旦河西岸南部医院中重症护理护士在插管患者疼痛管理方面的知识、态度、实践以及感知到的障碍。

方法

对199名重症护理护士进行了横断面调查,使用了护士疼痛知识与态度调查问卷,以及一个用于评估疼痛管理感知障碍的改良工具。对收集到的数据进行分析,以找出知识方面的不足以及影响有效疼痛管理策略的障碍。

结果

分析表明,199名护士中有192名(96.5%)在疼痛管理方面缺乏足够的知识。与系统相关的障碍,包括缺乏标准化方案以及与医生沟通不畅,经常被视为障碍,平均得分为2.41(满分3分)。与护士相关的障碍包括提供非药物干预的时间不足(73.9%)以及对使用评估工具缺乏信心(43.7%)。与患者相关的问题,如沟通困难(72.4%)和不愿报告疼痛(58.8%)也被提及。根据先前在疼痛管理方面的教育情况,知识得分存在显著差异,接受过培训的护士(41.7%)表现更好。

结论

研究结果强调了开展针对性教育举措、建立疼痛管理标准化方案以及加强跨学科沟通的必要性。这些改进对于优化疼痛管理实践和确保更好的患者结局至关重要。结果表明,解决知识差距和系统障碍可能会显著改善患者护理和卫生政策。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6941/11936293/7897cdb1df71/pone.0320430.g001.jpg

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