骨科患儿父母代理评估术后疼痛强度的调查研究  

Study on parents′ proxy-assessment post-operative pain intensity of orthopedic children

作　　者：张素梅 梁培荣[2] 阐玉英[3] 赖丽莉[1] Zhang Sumei;Liang Peirong;Chan Yuying;Lai Lili(Orthopedic Department,the First Affiliated Hospital,College of Medicine,Zhejiang University,Hangzhou 310003,China;Orthopedic Department,Children′s Hospital of Soochow University,Suzhou 215025,China;Union,Children′s Hospital of Soochow University,Suzhou 215025,China)

机构地区：[1]浙江大学医学院附属第一医院骨科,杭州310003 [2]苏州大学附属儿童医院骨科,苏州215025 [3]苏州大学附属儿童医院工会,苏州215025

出　　处：《中国实用护理杂志》2022年第33期2575-2580,共6页Chinese Journal of Practical Nursing

摘　　要：目的调查骨科患儿父母代理评估术后疼痛强度,并分析相关影响因素。方法采用目的抽样法,于2020年8—12月选取苏州大学附属儿童医院骨科符合纳入和排除标准的200例患儿及其父母,应用一般资料调查表和Wong-Baker面部疼痛评估量表进行调查。结果有效回收问卷195份。195例父母代理评估患儿术后第1、2、3天中重度疼痛强度占比分别为44.6%(87/195)和28.7%(56/195)、36.9%(72/195)和5.1%(10/195)、8.2%(16/195)和1.0%(2/195),且与患儿自我报告Kappa一致性系数为0.556~0.631,均高于患儿-护士(Kappa一致性系数为0.318~0.406);多元线性回归分析结果显示,患儿使用止痛药最终进入回归方程,可解释13.5%(R2=0.135)的变异量。结论患儿自我报告与父母代理评估疼痛强度的一致性较好,其评估疼痛强度受患儿已使用止痛药的影响。因此,医疗机构和医务人员应创造支持性的环境,重视父母的积极作用,以完善儿童术后疼痛管理临床实践。Objective To investigate parents′proxy-assessment post-operative pain intensity of orthopedic children,and to analyze the relevant influencing factors.Methods Using the purposive sampling method,200 children and their parents who met the inclusion and exclusion criteria were mainly selected in pediatric orthopedics of Children′s Hospital of Soochow University from August to December in 2020.A general information questionnaire and the Wong-Baker Facial Pain Rating Scale(WBFP)were used to survey.Results One hundred and ninety-five questionnaires were effectively recovered.Nearly 44.6%(87/195)and 28.7%(56/195),36.9%(72/195)and 5.1%(10/195),8.2%(16/195)and 1.0%(2/195)of parents reported(using WBFP Rating Scale)moderate to severe pain intensity of 1 d,2 d and 3 d after surgery and the Cohen′s Kappa coefficient with child′s self-report which ranged from 0.556 to 0.631 were all higher than child-nurse(Cohen′s Kappa coefficient ranged from 0.318 to 0.406).The results of multiple linear regression analysis showed that using painkillers by children entered in the regression equation,which could explain the variation of 13.5%(R2=0.135).Conclusions The self-report of the children was in good agreement with the assessment of the pain intensity by the parental agent,and the assessment of the pain intensity was affected by the painkillers used by the children.Therefore,medical institutions and personnel should create a supportive environment that values the positive role of parents to promote the management of children′s post-operative pain.

关 键 词：小儿骨科 术后疼痛 父母 疼痛评估 

分 类 号：R473.72[医药卫生—护理学]