Zhang Ying, Zhao Fei, Zhang Yuanyuan
Department of Vascular Surgery, Shanxi Provincial People's Hospital, Taiyuan, 030012, People's Republic of China.
Department of Cardiovascular Surgery, Taiyuan Hospital, Peking University First Hospital, Taiyuan, 030009, People's Republic of China.
J Multidiscip Healthc. 2025 May 17;18:2783-2796. doi: 10.2147/JMDH.S509859. eCollection 2025.
To explore effective nursing interventions for severe pain in the early postoperative period following aortic dissection, using a configurational and network perspective.
Convenience sampling was employed, selecting 116 patients from the Vascular Surgery Department of Shanxi Provincial People's Hospital between August 2021 and March 2024. Patients who underwent aortic dissection surgery and had a VAS (Visual Analog Scale) pain score of 6 or higher were provided comprehensive nursing interventions for one week, which included analgesics, cold compresses, musicotherapy, mental intervention, posture guidance, and light physical activity. Nursing intervention was treated as the antecedent variable, while changes in VAS scores were considered the outcome variable of analgesic efficacy. Fuzzy-set qualitative comparative analysis (fsQCA) and network analysis were used to identify the most effective analgesic interventions.
No single nursing intervention was found to be a necessary condition for good postoperative analgesia. Five configurations were found to contribute to effective analgesia, with an overall consistency of 0.959 and overall coverage of 0.262. Cold compresses and musicotherapy emerged as important core conditions. Network analysis showed that cold compresses, posture guidance, and musicotherapy had a direct positive effect on pain relief, while analgesics and mental interventions had less apparent effects, and light physical activity could potentially be detrimental to pain relief.
For early postoperative pain following aortic dissection, besides providing analgesics and psychological counseling as needed, cold compresses and musicotherapy should be tailored according to patient preferences to promote analgesic efficacy.
从构型和网络角度探索主动脉夹层术后早期严重疼痛的有效护理干预措施。
采用便利抽样法，选取2021年8月至2024年3月期间山西省人民医院血管外科的116例患者。对接受主动脉夹层手术且视觉模拟评分（VAS）疼痛评分达到6分及以上的患者进行为期一周的综合护理干预，包括使用镇痛药、冷敷、音乐疗法、心理干预、体位指导和轻度体育活动。将护理干预作为前因变量，VAS评分的变化作为镇痛效果的结果变量。采用模糊集定性比较分析（fsQCA）和网络分析来确定最有效的镇痛干预措施。
未发现单一的护理干预是术后良好镇痛的必要条件。发现有五种构型有助于有效镇痛，总体一致性为0.959，总体覆盖率为0.262。冷敷和音乐疗法是重要的核心条件。网络分析表明，冷敷、体位指导和音乐疗法对缓解疼痛有直接的积极作用，而镇痛药和心理干预的效果不太明显，轻度体育活动可能对缓解疼痛有害。
对于主动脉夹层术后早期疼痛，除根据需要提供镇痛药和心理咨询外，应根据患者喜好定制冷敷和音乐疗法，以提高镇痛效果。
