术后活动性疼痛护理评估对疼痛管理质量的影响  被引量:163

Effect of nursing practice of dynamic pain assessment on the quality of postoperative pain management

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作  者:成燕[1] 童莺歌[1] 刘敏君[2] 田素明[3] Alex H.Konstantatos Dana Boyd 

机构地区:[1]杭州师范大学医学院,杭州市310036 [2]浙江大学医学院附属邵逸夫医院护理教育部 [3]浙江大学医学院附属邵逸夫医院麻醉科 [4]澳大利亚维多利亚州莫那什大学附属阿尔弗莱德医院麻醉及围手术期医学部

出  处:《中华护理杂志》2015年第8期924-928,共5页Chinese Journal of Nursing

基  金:杭州师范大学人才引进基金资助项目(PE13002004023)

摘  要:目的探讨术后活动性疼痛护理评估对疼痛管理质量的影响。方法将140例胸腹部术后1d的患者分为实验组和对照组。实验组在接受病区护士的术后疼痛护理措施的基础上,由疼痛专科护士采用功能活动评分法(Functional Activity Score,FAS)和数字评定量表(Numerical Rating Scale,NRS)评估活动性疼痛,并根据评估结果实施干预措施。对照组仅接受病区护士实施的术后疼痛护理措施。结果实验组和对照组术后24h内镇痛治疗方案调整及功能活动前按压镇痛泵比例的差异具有统计学意义(χ2=7.937,χ2=37.303,均P<0.05)。实验组在术后24h时间点的FAS评级结果、患者自评静息性和活动性疼痛强度,以及术后24h内疼痛最剧烈程度、中重度疼痛发生频度及有效咳嗽受疼痛影响程度均低于对照组(P<0.05),首次下床活动时间也早于对照组(P<0.05)。结论开展活动性疼痛护理评估实践有助于提高术后疼痛管理质量。Objective To evaluate the effect of nursing dynamic practice of pain assessment on improving the quality of postoperative pain management. Methods 140 patients with thorax and abdomen surgery were divided into the experimental group and control group. The control group only received the routine postoperative pain nursing care. Besides the routine postoperative pain nursing care from ward nurses,the experimental group received the interventions which were based on the dynamic pain assessment from Acute Pain Nurse(APN) by Functional Activity Score(FAS) and Numerical Rating Scale(NRS). Results There were significant differences in the rate of analgesic treatment adjustment and patients' pressing the PCA button before taking activities between the two groups(P〈0.05). Intensity of Rest and dynamic pain,FAS,level of the most serious pain,frequency of moderate and severe pain,and the pain impacts on the effective cough of the experimental group were all lower than that of the control group within 24h after surgery(P〈0.05). Time of getting up postoperatively for the first time of the experimental group was earlier than that of the control group(P〈0.05). Conclusion Nursing practice of postoperative dynamic pain assessment can improve the quality of postoperative pain management.

关 键 词:疼痛 手术后 护理评估 疼痛管理 

分 类 号:R473.6[医药卫生—护理学]

 

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