积极的沟通是否足以调节紧急部门的程序性疼痛和焦虑? 一个随机对照试验
Chantal Berna1, Anne Favre-Bulle, Adélaïde Bonzon
1From the Center for Integrative and Complementary Medicine, Division of Anesthesiology (Berna), Lausanne University Hospital; The Sense (Berna); Faculty of Biology and Medicine (Berna, Favre-Bulle, Bonzon, Gross, Gonthier, Hugli), University of Lausanne; Emergency Department (Favre-Bulle, Bonzon, Gross, Gerhard-Donnet, Hugli), Lausanne University Hospital; Private Practice (Gonthier); and Unisanté, Centre Universitaire de Médecine générale et Santé publique (Taffé), Lausanne, Switzerland.
积极的沟通和护士同情并没有减少外周静脉导管 (PIC) 放置期间的疼痛或焦虑. 这表明,治疗性沟通可能不足以在急诊室 (ED) 管理轻度的手术疼痛.
科学领域:
- 医学沟通 医学沟通
- 疼痛管理 疼痛管理
- 患者的舒适性 患者的舒适性
背景情况:
- 治疗性沟通可以提高医疗程序期间的患者舒适度.
- 有限的研究存在于临床环境中治疗性沟通的有效性,有足够的盲目.
- 信息内容和传递对患者在外周静脉导管 (PIC) 放置等手术过程中的体验的影响尚未完全理解.
研究的目的:
- 调查积极信息和同情的护士互动对PIC在急诊室 (ED) 的安置期间疼痛和焦虑的影响.
- 为了比较音频录制的信息与护士传递的信息在调节患者体验方面的有效性.
- 测试这样的假设:积极的信息传递和同情的互动会导致疼痛和焦虑解消.
主要方法:
- 一个2+2随机对照试验 (NCT03502655) 在两个阶段进行.
- 第一个阶段:双盲传递正面与标准音频录制的信息 (N=131).
- 第2阶段:正确的单盲传递与标准的护士传递的信息 (N=120).
主要成果:
- 在护士交付的互动期间,积极信息组的同情行为更高 (中位数为3对2,p<.001).
- 与假设相反,无论是信息内容还是传递方法都没有显著影响患者在PIC安置期间报告的疼痛或焦虑 (p > .2).
- 在音频录制的消息阶段注意到了低练习者的同情行为.
结论:
- 积极的沟通干预没有显著影响与PIC安置相关的疼痛或焦虑.
- 一个潜在的底层效应,由于相对于呈现条件的过程性疼痛评级较低,可能会限制观察到的效应.
- 仅仅治疗性沟通可能不足以调节ED环境中的轻度程序性疼痛.
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