Olden A J, Jordan E T, Sakima N T, Grass J A
Johns Hopkins Hospital, Department of Gyn/Ob Nursing, Baltimore, MD 21287-5201, USA.
J Obstet Gynecol Neonatal Nurs. 1995 Feb;24(2):137-41. doi: 10.1111/j.1552-6909.1995.tb02455.x.
To compare nurses' and patients' assessments of pain and sedation in patients receiving epidural or intravenous patient-controlled analgesia (PCA) after cesarean section.
Prospective, randomized study.
The perinatal unit and labor and delivery unit in a 1,036-bed university hospital in the mid-Atlantic region.
Twenty-six patients receiving epidural PCA or intravenous PCA. Nurses participating in the study were assigned as caregivers to the 26 patients.
Pain and sedation were assessed using 10-cm visual analogue scales completed by both the patient and the patient's nurse twice daily on the day of surgery and on the 1st and 2nd postoperative days.
No significant correlation was found between the nurses' and patients' pain or sedation scores. Chi-square analysis showed that the nurse was as likely to underestimate as to overestimate the patient's pain score. The nurse underestimated the patient's sedation score 85% of the time.
The results suggest that nurses' and patients' assessments of pain and sedation differ. The routine use of a standardized self-assessment tool, such as the visual analogue scale, is recommended to ensure that analgesic treatment is based on the subjective nature of the patient's pain experience rather than the nurse's judgment.
比较剖宫产术后接受硬膜外或静脉自控镇痛（PCA）患者的护士与患者对疼痛和镇静的评估。
前瞻性随机研究。
大西洋中部地区一家拥有1036张床位的大学医院的围产期病房及产房。
26例接受硬膜外PCA或静脉PCA的患者。参与研究的护士被指定为这26例患者的护理人员。
在手术当天及术后第1天和第2天，患者及其护士每天两次使用10厘米视觉模拟量表评估疼痛和镇静情况。
护士与患者的疼痛或镇静评分之间未发现显著相关性。卡方分析表明，护士低估和高估患者疼痛评分的可能性相同。护士在85%的时间里低估了患者的镇静评分。
结果表明护士与患者对疼痛和镇静的评估存在差异。建议常规使用标准化的自我评估工具，如视觉模拟量表，以确保镇痛治疗基于患者疼痛体验的主观性而非护士的判断。
