Tittle M, McMillan S C
University of South Florida, College of Nursing, Tampa.
Am J Crit Care. 1994 Jan;3(1):25-30.
Little research was found to indicate that pain is managed well in hospitalized patients and few studies were found regarding pain management for critical care patients.
To determine the extent to which nurses manage pain effectively without side effects related to narcotic analgesics in an intensive care and a surgical unit.
The sample consisted of 44 patients, 20 from an intensive care unit and 24 from a surgical unit. Patients completed a Visual Analogue Scale to measure pain intensity three times in 24 hours. The narcotic side effects of constipation and sedation were measured using the Constipation Assessment Scale and a sedation scale. Documentation was assessed using the Chart Audit for Pain.
Patients in both units continued to experience pain even with pain management interventions. The critical care nurses administered an average of 30% of the maximum narcotic dose ordered and the surgical unit nurses, 36.8%. Documentation of the effect of the pain medication was scant on both units. Although sedation was not a problem in either unit, the majority of patients reported symptoms of constipation. Documentation of this problem was scant in both units.
Results from this study suggest that nurses in both intensive care and surgical units do not appropriately assess, manage or evaluate pain and pain-related side effects. Patients who experience pain expect to have their pain controlled. Efforts must be made to change nurses' pain management behaviors.
几乎没有研究表明住院患者的疼痛得到了良好管理，关于重症监护患者疼痛管理的研究也很少。
确定在重症监护病房和外科病房中，护士在不产生与麻醉性镇痛药相关副作用的情况下有效管理疼痛的程度。
样本包括44名患者，其中20名来自重症监护病房，24名来自外科病房。患者在24小时内三次完成视觉模拟量表以测量疼痛强度。使用便秘评估量表和镇静量表测量便秘和镇静的麻醉副作用。使用疼痛图表审核评估记录情况。
即使进行了疼痛管理干预，两个病房的患者仍持续感到疼痛。重症监护病房护士平均给予的麻醉剂量为医嘱最大剂量的30%，外科病房护士为36.8%。两个病房关于止痛药效果的记录都很少。虽然两个病房都不存在镇静问题，但大多数患者报告有便秘症状。两个病房关于这个问题的记录都很少。
本研究结果表明，重症监护病房和外科病房的护士在评估、管理或评估疼痛及与疼痛相关的副作用方面都做得不够恰当。经历疼痛的患者期望疼痛得到控制。必须努力改变护士的疼痛管理行为。
