成人术后急性疼痛管理指南中疼痛评估内容的质量评价与分析  

Quality appraisal and content analysis of pain assessment in guidelines for postoperative pain management in adults

作　　者：潘巧 李漓[1] 王灵晓[1] Panqiao;Lili;Wang Lingxiao(Department of Nursing Administration,Zhujiang Hospital,Southern Medical University,Guangzhou,510282,China)

机构地区：[1]南方医科大学珠江医院护理部,广东广州510282

出　　处：《现代临床护理》2020年第4期53-59,共7页Modern Clinical Nursing

基　　金：优化中国术后疼痛管理项目(PAIN OUT project:An Initiative Assisting Healthcare Providers Optimize Management of Postoperative Pain in China by Continuous Quality Improvement and Peer Review),项目编号为223590。

摘　　要：目的评价与分析现有成人手术后急性疼痛管理相关实践指南中疼痛评估相关推荐意见。方法在各类数据库和指南网站上检索2010年1月至2019年4月发表的成人手术后疼痛管理指南,采用AGREEⅡ对纳入指南进行质量评价,对疼痛评估相关内容进行分析、汇总及综合。结果共纳入7篇英文指南,总体质量A级(推荐)1篇,B级(修改完善后推荐)6篇。实践指南质量6个领域的标准化百分比得分中位数分别为范围和目的96.30%、参与人员53.70%、严谨性78.47%、清晰性77.78%、应用性44.44%和独立性80.56%。综合成人手术后疼痛评估相关内容的推荐意见16条,涉及疼痛筛查、评估原则、评估频率、评估内容、评估工具、患者教育和疼痛护理记录等方面。结论纳入指南的总体质量中等,参与人员和应用性领域有待提高,疼痛评估推荐内容可指导中国成人手术后疼痛管理实践。Objective To evaluate and analyze the recommendations related to pain assessment of available clinical practice guidelines for postoperative pain management in adults. Methods Guidelines on postoperative pain management in adults published from January 2010 to April 2019 were retrieved on various databases and guidelines websites. Appraisal of Guidelines for Research and Evaluation Ⅱ(AGREE Ⅱ) was used to evaluate the quality of eligible guidelines. Recommendations on pain assessment were analyzed,sorted, and synthesized. Results Seven guidelines in English were included, with one rated as grade A, and the other six grade B in terms of overall quality. The median scores of AGREE Ⅱ in dimensions of scope and purpose, stakeholder involvement, rigor of development, clarity of presentation, application, and editorial independence were 96.30%, 53.70%, 78.47%, 77.78%, 44.44%, and80.56%, respectively. Sixteen recommendations on postoperative pain assessment in adults were synthesized, including pain screening,principles of pain assessment, frequency and contents of pain assessment, assessment tools, patient education, and documentation of pain management. Conclusions The quality of included guidelines are moderate, so the stakeholder involvement and application of the guidelines need to be improved. The recommendations on pain assessment could guide the practice of postoperative pain management in Chinese adults.

关 键 词：成人 手术 疼痛评估 指南 指南研究与评价工具Ⅱ 

分 类 号：R47[医药卫生—护理学]