术后患者疼痛控制现状及满意度影响因素分析

目的 描述手术后患者对疼痛控制的状况,探讨影响疼痛控制满意度的因素,为进一步有效控制术后患者疼痛提供依据.方法 采用问卷调查法,随机抽取我院88例术后3d内的住院患者进行同卷调查.问卷包括患者一般资料、患者疼痛自评量表、患者疼痛控制现状及影响因素调查表3部分.对疼痛控制现状进行描述性分析,疼痛满意度影响因素进行多因素Logistic回归分析.结果 术后患者疼痛视觉模拟评分为(4.22士2.49),患者对疼痛处理整体满意度为61.4％.是否给予恰当的止痛措施、患者年龄、医护人员是否进行疼痛知识的健康指导、医护人员的反应速度、医护人员是否对患者疼痛程度进行评估,共5个影响因素进入回归模型.结论 外科术后患者具有中度疼痛,治疗性因素、患者自身因素和服务性因素是影响术后患者疼痛控制满意度的主要因素.建议通过转变医护人员的疼痛控制观念、加强对患者疼痛治疗重要性的宣传、加强医护人员对术后患者的疼痛评估及随访,提高术后患者对疼痛控制的满意度.     

创伤骨科患者术后疼痛管理满意度及影响因素分析

目的：了解创伤骨科患者术后疼痛管理满意度状况,分析疼痛管理满意度的影响因素。方法便利抽取56例患者于出院前3d采用“患者对术后疼痛管理的满意度问卷”修订版进行问卷调查。患者疼痛程度评分采用“简易疼痛评估尺”0～10级计量制评分。结果患者围手术期疼痛评分＜5分;患者对疼痛管理的满意度＞4分;影响疼痛管理满意度的主要因素是疼痛评分、镇痛剂的按时应用、疼痛教育、年龄、过去对疼痛的体验。结论创伤骨科患者对术后疼痛管理较为满意;手术后患者疼痛管理满意度受多方面影响。建议针对创伤骨科患者的疼痛特点制定个体化对策,同时实施医生－护理－病患模式的疼痛管理模式,有利于提高创伤骨科患者疼痛管理的满意度。     

腹部手术后疼痛的影响因素分析及护理

目的 探讨腹部手术后患者疼痛的影响因素,并提出了相应的护理对策.方法 采用方便取样法,选取2010年2月~2010年6月入住厦门市中医院的100例腹部手术患者进行术后疼痛的相关因素调查.结果 影响腹部手术后疼痛最大的因素是术后切口因素;其次是疾病性质和治疗和护理的因素;影响最小的因素是环境的因素及心理因素.结论 对腹部手术后患者加强对术后疼痛的观察,及时给予手术后患者有效的控制疼痛控制的方法、缓解疼痛,促进术后患者的舒适,从而提高外科护理质量.     

中医护理干预对混合痔患者术后疼痛控制满意度的影响

目的评价中医护理干预对混合痔患者术后疼痛控制满意度的影响。方法采用临床试验性研究方法,将60例重度混合痔术后患者随机分成两组,各30例。对照组接受常规护理,干预组在此基础上进行的中医护理干预,手术后24 h进行术后疼痛满意度评价。结果干预组在疼痛的减轻、医生对疼痛的处理、要求止痛药物或需要帮助时护士反应的快慢程度、因疼痛受到的所有照顾4个方面的得分高于对照组,差异具有统计学意义(P0.01或P0.05)。结论中医护理干预提高了混合痔患者对术后疼痛控制的满意度。     

老年脊柱骨折患者术后疼痛护理满意度调查及影响因素分析

目的:调查老年脊柱骨折患者术后疼痛护理满意度情况,并分析其影响因素。方法:选取100例接受手术治疗的老年脊柱骨折患者为研究对象,采用问卷调查方式了解患者对术后疼痛护理的满意度,并分析其影响因素,为术后疼痛护理提供有效依据。结果:年龄越大、受教育程度越高、有宗教信仰、无以往手术经验、无术后疼痛经验患者的疼痛信念及感知能力更强且对术后疼痛护理满意度更高(P<0.05)。结论:老年脊柱骨折术后疼痛控制情况需要重视,年龄、受教育程度、宗教信仰、以往手术经验、术后疼痛经验是患者术后疼痛信念、感知能力及术后疼痛护理满意度的重要影响因素,提示临床可根据以上指标对患者进行针对性干预,改善护理质量。     

手术后病人疼痛控制状况的调查研究

[目的]了解手术后病人疼痛控制状况。[方法]随机抽取北京地区5家综合性三级甲等医院,采用休斯顿疼痛情况量表及疼痛治疗指数评估表,对304例手术后第2天的住院病人进行调查。[结果]手术后病人期望术后疼痛为轻度,希望能够缓解疼痛;术后疼痛程度达到了中重度,对情绪和日常活动有轻、中度水平的影响;疼痛治疗指数显示有60.19%的病人存在疼痛治疗不足;病人对控制疼痛服务评价较高,而对疼痛控制教育的满意程度评分较低。[结论]手术后病人疼痛尚未得到有效控制,建议制定术后疼痛控制制度和实践指南,采取针对性措施,改善术后疼痛控制不良的状况。     

手术后病人疼痛控制状况的调查研究

[目的]了解手术后病人疼痛控制状况。[方法]随机抽取北京地区5家综合性三级甲等医院，采用休斯顿疼痛情况量表及疼痛治疗指数评估表，对304例手术后第2天的住院病人进行调查。[结果]手术后病人期望术后疼痛为轻度，希望能够缓解疼痛；术后疼痛程度达到了中重度，对情绪和日常活动有轻、中度水平的影响；疼痛治疗指数显示有60.19％的病人存在疼痛治疗不足：病人对控制疼痛服务评价较高，而对疼痛控制教育的满意程度评分较低。[结论]手术后病人疼痛尚未得到有效控制，建议制定术后疼痛控制制度和实践指南，采取针对性措施，改善术后疼痛控制不良的状况。     

术后病人疼痛程度控制目标的研究

[目的]探讨术后病人疼痛程度控制的目标。[方法]采用问卷调查方法,对227例术后病人术后疼痛程度和疼痛对病人活动、咳嗽、深呼吸、进食、睡眠、情绪及满意度等的影响进行调查分析,包括当前的疼痛评估和过去24 h疼痛情况的评估。[结果]术后病人疼痛程度与疼痛对病人日常活动、情绪及满意度的影响程度显著相关,且疼痛评分〉4分时各影响因素出现显著变化。[结论]建议将疼痛评分≤4分作为术后病人疼痛程度的控制目标,以指导医务人员和病人有效地控制术后疼痛。     

疼痛干预对鼻内镜术后患者疼痛控制满意度的影响

目的探讨疼痛干预对鼻内镜术后患者疼痛控制满意度的影响。方法选择60例双侧慢性鼻窦炎伴鼻息肉患者随机分为对照组30例和观察组30例。对照组采用常规护理措施,观察组在常规护理基础上实施疼痛干预措施,主要包括疼痛教育,疼痛评估,疼痛记录,疼痛护理等。结果观察组术后疼痛评分明显低于对照组,术后疼痛控制的满意度明显提高,两组比较差异有统计学意义(P0.01)。结论系统的疼痛干预可改善鼻内镜术后患者疼痛控制的满意度。     

术后患者疼痛状况调查研究

目的了解手术后患者的疼痛状况。方法采用问卷调查的方式，在完成问卷设计的基础上，对227例术后疼痛患者进行跟踪性的调查。结果不同年龄组对疼痛控制期望缓解值不同；术后3d疼痛最强烈，程度4—6分的疼痛发生率较高；术后疼痛对患者活动、睡眠、进食以及情绪等的影响程度随着术后天数的增加而逐渐降低。结论应把术后3d作为疼痛控制的重点，以减少疼痛对患者术后恢复的不良影响；根据手术类型的不同，可预见性地对不同手术后患者进行有针对性的疼痛控制，减少患者痛苦。     

Differences in trigeminal and peripheral electrical pain perception in women with and without migraine

Pain perception studies in migraine patients have shown trigeminal and peripheral pain facilitation during the migraine attack. We were interested in differences of trigeminal and peripheral pain perception between migraine patients during the migraine interval and healthy subjects. Perception of electrical pain stimulation was measured in 20 migraine subjects outside a migraine attack (10 migraine with aura and 10 migraine without aura) and in 20 healthy subjects. We recorded sensory and pain thresholds, pain ratings after suprathreshold stimulation, and pain rating after two trains of repetitive stimulation (i.e., pain facilitation). Migraine subjects showed a significantly higher pain rating after suprathreshold stimulation in the trigeminal region as compared to healthy subjects (4.8 ± 1.6 versus 3.8 ± 2.2, p < 0.04 after Bonferroni correction) but not in the peripheral region. Furthermore, migraine subjects showed a pain facilitation after repetitive trigeminal stimulation whereas healthy subjects showed a pain habituation. We observed no significant differences between migraine subjects and healthy subjects for all parameters in the peripheral stimulation. Migraine patients with and without aura did not differ in any parameter. All subjects showed decreased sensory and pain thresholds after trigeminal as compared to peripheral stimulation. Migraine subjects show an increased pain perception after trigeminal but not after peripheral pain stimulation as compared to healthy subjects. This phenomenon is probably due to the observed pain facilitation after painful trigeminal stimulation.     

Prevalence of pain in public hospital: correlation between patients and caregivers

The prevalence of patients suffering pain in hospital is high. This situation is censured during congresses on the study and treatment of pain, which highlight how little consideration the problem is given. Our study, which measured exactly how far pain is underestimated and inappropriately treated, took place as part of the project “Towards a Pain-Free Hospital” in San Bortolo Hospital, Vicenza. Data were collected by means of a questionnaire consisting of 5 questions and 2 numeric scales concerning the presence of pain, its intensity and its causes, and on the type of treatment received. Data were collected for each patient regarding their sex, the ward they were in, the type of analgesics used and how they were taken. Prevalence of pain in this study was 44% (95% CI, 41%–48%). It was higher among women than men (47% vs. 41%), as it was in the 62–72 years age group (49.7%) compared to other age groups and in the surgical wards as opposed to general medicine wards, without there being, however, a significant difference between groups. There was little agreement between patients' perceived pain and nurses' interpretation of their pain (Cohen's k =0.17, 95% CI, 0.09–0.25); these findings show a tendency for caregivers to underestimate the patient's pain. Among those patients in pain, 59% were taking analgesics. Of these, 67% were taking them only on a prn basis, 20% at fixed times and 12% both at fixed times and on a prn basis; 82% were being treated only with non-steroidal anti-inflammatory drugs (NSAIDs), 8% only with opioids, and 3.7% with both. Of the patients using NSAIDs, 72% were taking them on a prn basis, while 86% of those using opioids were taking them according to a fixed schedule. These data are rather disappointing as they indicate a certain negligence towards patients (40% of patient with pain were not treated) and an inappropriate use of analgesics. Received: 5 March 2001 / Accepted in revised form: 28 August 2001     

Pain prevalence and characteristics in three Dutch residential homes

Background: In Anglo‐Saxon countries, high prevalence rates of pain have been reported for elderly living in nursing homes, residential homes and for community‐dwelling elderly. No information on pain prevalence is available for elderly living in Dutch residential homes. Methods: We performed an explorative study on pain prevalence, characteristics and treatment in three residential homes in Rotterdam, the Netherlands. Residents were interviewed using a standardized pain questionnaire. Results: The overall prevalence of pain was 69%. In case of pain, it was chronic in 93% of residents. Present pain and mean pain during the preceding week were substantial (numeric rating scale ≥4) in 68% and 85% of residents, respectively. Of the residents with pain, 22% did not receive any analgesics and only 3% was prescribed a strong opioid. When analgesics were prescribed, they were given only ‘as needed’ in 31% of residents. In a majority of residents, pain interfered with daily living and mood. Almost 60% of the elderly was convinced that pain is a part of ageing, 70% indicated that they did not always report their pain to the caregivers. Thirty‐seven percent was satisfied with the caregivers’ and 39% with the doctors’ attention towards pain. Conclusions: The pain prevalence rate in Dutch residential homes is similar to rates found in other Anglo‐Saxon countries. Furthermore, they are also comparable to rates reported from European nursing homes. Pain treatment is insufficient and although pain interferes with daily activities and mood, elderly tend to accept pain as an unavoidable part of aging.     

Behavioural evaluation in patients affected by chronic pain: a preliminary study

The aim was to analyse the existing relation between a subjective evaluation of pain with the use of the Verbal Numerical Scale (VNS) and an objective behavioural measure associated with pain, by means of the Pain Behaviour Rating Scale (UAB). An observational correlation study was carried out in a hospital environment. The study included 61 patients affected with multiple forms of non-malignant chronic pain; the behaviour was observed by the nursing staff. In general, a positive but moderate correlation was obtained between VNS and UAB scales (r=0.29, p<0.0001). Observing behaviour and listening to the patient constituted two complementary and non-interchangeable methods for assessing the level of pain capable of providing a global and objective portrayal of the pain experience.     

Association Between Trapezius Muscle Tenderness and Tension-Type Headache in Female Office Workers: A Cross-sectional Study

Objective

The purpose of the study was to determine the association between trapezius muscle tenderness and tension-type headache among female office workers.

疼痛患者疼痛灾难化影响因素的研究进展

疼痛是世界范围内的一个普遍健康问题,疼痛会导致许多不良结果。越来越多的研究表明疼痛灾难化是疼痛的一个重要心理风险因素,影响一系列疼痛相关的结果。因此,提高对疼痛患者疼痛灾难化的关注度,及时干预预防,对疼痛管理有重要意义。本研究旨在通过对疼痛灾难化的影响因素进行全面综述,以期为临床医护人员制定针对性的和有效的预防干预措施提供参考,进一步促进疼痛患者的康复。     

Adult attachment and reports of pain in experimentally‐induced pain

Attachment theory has been proposed as a framework for understanding the development of chronic pain, with evidence supporting the overrepresentation of insecure attachment styles in chronic pain populations and links between insecure attachment and factors known to impact one's ability to cope with pain. The present study sought to extend two earlier studies exploring the relationships between adult attachment and communication of an acute pain experience, in anticipation of providing insight into individual differences in vulnerability in development of chronic pain. It was hypothesised that: (a) fearful attachment would be associated with perceptions of the pain as less intense, and (b) anxious attachment would be associated with lower pain thresholds. A convenience sample of 82 healthy adults completed self‐report measures of attachment, neuroticism, and negative affect prior to taking part in a coldpressor pain inducement task. Results demonstrated that fearful attachment was associated with lower levels of pain intensity throughout the coldpressor task. In addition, dismissing attachment was also associated with less intense pain, as well as increased coldpressor endurance (tolerance) in the presence of a known assessor. These associations were retained after controlling for measures of neuroticism, negative affect, age, and social desirability. The results of this study are consistent with the proposition that fearful and dismissing individuals tend to mask their underlying distress caused by the pain experience, potentially leading to difficulties coping with pain over time.