患者对术后止痛的期望,经验和可接受性:在一项随机对照试验中进行的嵌套定性研究,比较直肠管导管和胸部外周止痛
S G Brearley1, S Varey1, A Krige2
1Division of Heath Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK.
Anaesthesia
|July 9, 2023
概括
胸部外周止痛引起了手术前的焦虑,与直肠管导管止痛不同. 患者对疼痛管理干预措施的体验始于手术前,包括对技术及其影响的恐惧和焦虑.
科学领域:
- 麻醉学 麻醉学
- 患者体验研究 研究研究
- 质量健康研究 质量健康研究
背景情况:
- 增强的康复计划强调适当的术后止痛.
- 胸部外周止痛疗法提供了卓越的疼痛缓解,但也带有风险.
- 直肠导管止痛提供了潜在的疼痛管理替代方案.
研究的目的:
- 为了探索患者接受度,期望和经验的胸部外周止痛与直肠管导管止痛.
- 了解患者经历这两种术后疼痛管理技术的质量差异.
- 调查预期恐惧和焦虑对整体患者体验的影响.
主要方法:
- 在随机对照试验中使用接地理论进行嵌套的定性研究.
- 半结构面试是在干预后4周对20名参与者进行的.
- 持续进行患者和公众参与的比较分析,以指导数据收集.
主要成果:
- 两组之间在术后疼痛管理的可接受性或经验上没有显著差异.
- 胸腔外围止痛与手术前的恐惧和焦虑有关.
- 在这两种干预中都出现了不良事件,在胸部外周治疗组中相对较多;胸部外周止痛的插入特别负面.
- 对局部麻醉剂输液管理的担忧影响了直肠导管接受者的信心.
结论:
- 患者对疼痛管理干预措施的体验受到手术前预期恐惧和焦虑的显著影响.
- 一种技术对患者的心理影响和感知影响可能比单独的止痛疗效更有意义.
- 未来的研究应该纳入预测因素,而不仅仅是缓解疼痛的有效性,在评估患者接受和经验的术后止痛.
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