了解急救部门对止痛药的需要和使用情况
Tjitske D Groenveld1, Roeland A L Arpots2, Marjan de Vries1
1Radboud University Medical Centre, Department of Surgery, Geert Grooteplein 10 (route 618), Postbus 9101, 6500 HB, Nijmegen, the Netherlands.
护士对疼痛的感知和疼痛的接受度显著影响急诊室的阿片类药物管理. 疼痛管理需要的不仅仅是数值疼痛得分,有效的病人护理.
科学领域:
- 紧急医疗 紧急医疗
- 疼痛管理 疼痛管理
- 临床护理 临床护理
背景情况:
- 在紧急情况下实施非药物疼痛干预措施之前,评估患者和临床医生的因素至关重要.
- 了解疼痛评分和阿片类药物管理之间的关联对于优化急性疼痛管理至关重要.
研究的目的:
- 为了调查与在急诊室的阿片类药物管理相关的因素.
- 探索患者和护士在疼痛管理决策中的感知作用.
主要方法:
- 一项前性横截面研究使用了多变量逻辑回归分析.
- 关键变量包括患者人口统计,疼痛评分 (数值评分表 - NRS),疼痛可接受性和护士感知到的疼痛.
- 用专题分析来理解患者对疼痛可接受性的定义.
主要成果:
- 护士感知疼痛的充分性,更高的基线NRS得分,医院前阿片类药物使用和不可接受的疼痛与阿片类药物管理有关.
- 计算的切断期NRS疼痛评分为疼痛接受度7分,对对止痛药的渴望6分.
- 患者将疼痛接受度与特定的疼痛特征和情境背景联系起来.
结论:
- 护士对疼痛评分的感知和患者报告的疼痛接受度是缓解疼痛的关键决定因素.
- 切断NRS得分的有限的区分能力表明,疼痛管理应该整合数值得分之外的因素.
- 这些发现可以改善急诊室急性疼痛患者的选择,用于非药物干预.
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