Hall-Lord M L, Larsson G, Steen B
Department of Geriatric Medicine, Göteborg University, Sweden.
Heart Lung. 1998 Mar-Apr;27(2):123-32. doi: 10.1016/s0147-9563(98)90020-6.
To investigate elderly intensive care unit (ICU) patients' experiences of pain and distress, as well as interventions aimed at reducing these conditions, and to compare these experiences with the way nurses and assistant nurses, respectively, assess their patients' responses related to these issues.
Descriptive, correlational, comparative.
Two medical-surgical ICUs at county hospitals in two medium-sized cities in Sweden.
Fifty-one elderly patients, 44 nurses, and 37 assistant nurses in two Swedish ICUs.
Data were collected through personal interviews with patients and questionnaires completed by each nurse and assistant nurse responsible for the patients.
Patients' experiences of pain and distress do not fully agree with nurses' and assistant nurses' assessments; nor is there consistency between the views of nurses and those of assistant nurses. Nurses overestimated patients' breathing and intellectual problems. Assistant nurses assessed that patients received more assistance to relieve physical pain, physical discomfort, fatigue, and fear than patients reported. Compared with nurses' assessments, assistant nurses also perceived patients to suffer less from physical discomfort, breathing problems, and fatigue.
Nurses need more systematic procedures to assess patients' distress and pain experiences. To reduce the discrepancies observed between nurses and assistant nurses, organization of care should optimize the possibilities for the caregivers to carry out the desired assessments and interventions with a high degree of continuity and communication among staff.
调查老年重症监护病房（ICU）患者的疼痛和痛苦经历，以及旨在减轻这些状况的干预措施，并将这些经历与护士和助理护士分别评估患者与这些问题相关反应的方式进行比较。
描述性、相关性、比较性研究。
瑞典两个中等城市的县级医院的两个内科-外科ICU。
瑞典两个ICU中的51名老年患者、44名护士和37名助理护士。
通过对患者的个人访谈以及由负责这些患者的每位护士和助理护士填写的问卷收集数据。
患者的疼痛和痛苦经历与护士和助理护士的评估不完全一致；护士和助理护士的观点之间也不存在一致性。护士高估了患者的呼吸和智力问题。助理护士评估患者在缓解身体疼痛、身体不适、疲劳和恐惧方面得到的帮助比患者报告的更多。与护士的评估相比，助理护士还认为患者身体不适、呼吸问题和疲劳的程度较轻。
护士需要更系统的程序来评估患者的痛苦和疼痛经历。为了减少护士和助理护士之间观察到的差异，护理组织应优化护理人员进行所需评估和干预的可能性，工作人员之间要有高度的连续性和沟通。
