肿瘤科疼痛管理循证实践现状及影响因素分析  

Status and influencing factors of evidence-based pain management practices of oncology department

作　　者：袁芳[1] 邓婵 徐娟[1] 李冉冉[1] 杨荣[1] 周涛[1] YUAN Fang;DENG Chan;XU Juan;LI Ran-ran;YANG Rong;ZHOU Tao(Department of Radiation Oncology,Shandong Cancer Hospital and Institute,Shandong First Medical University and Shandong Academy of Medical Sciences,Jinan250117,P.R.China)

机构地区：[1]山东省肿瘤防治研究院·山东省肿瘤医院放疗科,山东第一医科大学(山东省医学科学院),山东济南250117

出　　处：《中华肿瘤防治杂志》2020年第23期1931-1936,共6页Chinese Journal of Cancer Prevention and Treatment

基　　金：山东自然科学基金(ZR2013HM080)。

摘　　要：目的疼痛影响患者的生活质量,实施疼痛管理循证实践能促进疾病的恢复,本研究旨在分析肿瘤科护士疼痛管理循证实践现状及影响因素。方法采用便利抽样方法,选取山东省5所三级医院,便利抽取290名肿瘤科护士作为研究对象(山东省肿瘤医院100名,青岛市中心医疗集团60名,临沂市肿瘤医院38名,聊城市人民医院60名,章丘区人民医院32名)。采用一般资料调查表、护士疼痛评估循证护理实践问卷、中文版卡尔森循证式疼痛管理先决条件量表、疼痛管理自我效能问卷进行疼痛管理循证实践行为现状调查及影响因素分析,数据分析采用t检验、单因素方差分析和多元线性回归等方法。结果肿瘤科护士的疼痛评估循证护理实践总分为(4.27±0.62)分,全面疼痛评估维度得分最高,为(4.40±0.68)分,疼痛评估中的交流维度得分最低,为(4.09±0.72)分;疼痛管理先决条件总分为(3.81±0.66)分,疼痛管理自我效能总分为(3.76±0.75)分。多元线性回归分析显示,是否为GPM病房、是否参加循证护理培训、年龄、最高学历、疼痛管理先决条件、疼痛管理自我效能为疼痛管理循证实践行为的正向预测因子,可解释总变异的59.1%。结论肿瘤科护士疼痛管理循证实践行为水平较高,但仍存在不足之处,需要进一步推广癌痛规范化治疗示范病房的创建,加强对护士循证培训力度及创新意识的培养,提高护理人员疼痛管理循证实践水平。OBJECTIVE Pain affects the quality of life of patients,and the implementation of evidence-based pain management practice(EBPMP)can promote the recovery of the disease.This study aimed to analyze the current situation and influencing factors of EBPMP in oncology nurses.METHODS In this study,the convenience sampling method was used to enroll 290oncology nurses from 5tertiary hospitals in Shandong Province.The general information questionnaire,the nurse pain assessment evidence-based nursing practice questionnaire,the Chinese version of Carlson's evidence-based pain management prior conditions instruments and the pain management self-Efficacy questionnaire were used to investigate the current situation of EBPMP and analyze the influencing factors.The data were analyzed by t-test,one-way ANOVA and multiple linear regression.RESULTS The total score of EBPMP of oncology nurses was 4.27±0.62.The score of comprehensive pain assessment dimension was the highest(4.40±0.68),and the communication dimension score of pain assessment was the lowest(4.09±0.72),the total score of preconditions for pain management was 3.81±0.66,the total score of pain management self-efficacy was 3.76±0.75.Multiple linear regression results showed that Good Pain Management(GPM)ward,evidence-based training,age,highest education level,prerequisite of pain management and self-efficacy of pain management were positive predictors of EBPMP,which can explain 59.1%of the total variance.CONCLUSIONS Oncology nurses have a relatively high level of evidence-based practice in pain management,but there are still shortcomings.It is necessary to further promote the construction of GPM wards,strengthen the training of evidencebased training and innovative awareness of nurses,and improve the level of EBPMP for nursing staff.

关 键 词：疼痛管理 疼痛评估 循证实践 先决条件 自我效能 

分 类 号：R730.6[医药卫生—肿瘤]