Pederson C, Matthies D, McDonald S
School of Nursing, University of Minnesota, Minneapolis, USA.
Am J Crit Care. 1997 Jul;6(4):289-95.
Although nurses are accountable for pain management, it cannot be assumed that they are well informed about pain. Nurses' knowledge base underlies their pain management; therefore, it is important to measure their knowledge.
To measure pediatric critical care nurses' knowledge of pain management.
A descriptive, exploratory study was done. After a pilot study, an investigator-developed Pain Management Knowledge Test was distributed to 50 pediatric ICU nurses. Test responses were collected anonymously and coded by number. Item analysis was done, and descriptive statistics were calculated. Modified content analysis was used on requests for pain-related information.
The test return rate was 38%. The overall mean score was 63%. Mean scores within test subsections varied from 50% to 92%. Other mean scores were 85% on a nine-item scale of drug-action items and 92% on a two-item scale of intervention items. However, no nurse recognized that cognitive-behavioral techniques can inhibit transmission of pain impulses; only 32% indicated that meperidine converts to a toxic metabolite, only 47% recognized nalbuphine as a drug that may cause signs and symptoms of withdrawal if given to a patient who has been receiving an opioid; and only 63% indicated that when a child states that the child has pain, pain exists. Thirteen nurses requested pain-related information, and all requests focused on analgesic medications.
Testing nurses' knowledge of pain indicated gaps that can be addressed through educational interventions. Research is needed in which the test developed for this study is used as both pretest and posttest in an intervention study with pediatric critical care nurses or is modified for use with nurses in other clinical areas.
尽管护士对疼痛管理负有责任，但不能假定他们对疼痛有充分的了解。护士的知识基础是其疼痛管理的基础；因此，衡量他们的知识很重要。
衡量儿科重症监护护士对疼痛管理的知识水平。
进行了一项描述性探索性研究。在预试验之后，将研究者编制的疼痛管理知识测试发放给50名儿科重症监护病房护士。测试答卷以匿名方式收集并进行数字编码。进行了项目分析并计算了描述性统计数据。对与疼痛相关信息的请求采用了改良的内容分析法。
测试回复率为38%。总体平均分为63%。测试各子部分的平均分数从50%到92%不等。其他平均分数在九项药物作用项目量表上为85%，在两项干预项目量表上为92%。然而，没有护士认识到认知行为技术可以抑制疼痛冲动的传递；只有32%的人指出哌替啶会转化为有毒代谢物，只有47%的人认识到纳布啡是一种如果给予正在接受阿片类药物治疗的患者可能会引起戒断症状的药物；只有63%的人指出当儿童表示自己疼痛时，疼痛确实存在。13名护士请求提供与疼痛相关的信息，所有请求都集中在镇痛药上。
测试护士的疼痛知识表明存在一些差距，可通过教育干预加以解决。需要开展研究，将本研究编制的测试用作针对儿科重症监护护士的干预研究的前测和后测，或者对其进行修改以便供其他临床领域的护士使用。
