儿科重症监护室患儿应用疼痛管理的效果观察

目的:探讨儿科重症监护室(PICU)患儿应用疼痛管理的效果。方法:选取2015年1月~2016年12月我院收治的PICU患儿56例,均采取疼痛管理,观察患儿护理前后疼痛程度及舒适度(NIPS)评分。结果:护理后患儿疼痛评分和NIPS评分均低于护理前(P0.05)。结论:给予PICU患儿疼痛管理可减轻疼痛程度,提高患儿舒适度。     

疾病管理护理模式在提高骨科患者疼痛控制和舒适度中的应用效果观察

目的：探讨疾病管理护理模式在骨科患者中应用效果。方法98例患者随机分为2组,分别采用常规护理模式和疾病管理护理模式,比较两组疼痛自评得分、止痛剂用量、护理满意度、自我舒适感和日常生活能力。结果观察组疼痛得分（4.86±1.65）分、止痛剂用量（128.65±3.45）,与对照组疼痛得分（6.54±1.42）分、止痛剂用量（143.34±17.44）比较差异均有统计学意义（ P＜0.05）;出院时观察组护理满意度95.92％,舒适度自我打分（93.65±13.45）分,对照组护理满意度85.71％、舒适度自我打分（81.34±17.44）分,两组比较差异有统计学意义（ P＜0.05）;半年后随访,观察组日常活动能力明显优于对照组,差异有统计学意义（ P＜0.05）。结论疾病管理护理模式可以提高患者自我控制能力,减轻疼痛感,提高舒适度,对老年骨折患者具有较大临床应用价值。     

非药物性护理干预在治疗儿童疼痛中的应用

疼痛是一种主观感受到的十分不愉快的感觉。处理儿童疼痛是儿科护理工作的一个重要方面,但这一领域被重视程度远远不够。儿童处于生长发育阶段,其生理结构、器官     

疼痛护理与注意力分散在学龄前儿童静脉采血中的应用观察

目的:分析学龄前儿童静脉采血中实施疼痛护理、注意力分散干预的效果,观察对患儿特殊疼痛行为反应评分(FLACC)的影响。方法:选取2019年6月—2021年6月在我院儿科门诊治疗的80例学龄前期患儿作为研究对象,所有患儿均需静脉采血,按照随机数字表法分为观察组和对照组,各40例。对照组行常规护理,观察组在此基础上行疼痛护理和注意力分散干预。比较两组患儿的采血时间、一次穿刺成功率、FLACC评分、遵医行为、家属满意度。结果:观察组患儿完成采血时间为(1.47±0.33)min、一次穿刺成功率为95.00%,对照组分别为(3.68±1.24)min、75.00%,两组比较,差异有统计学意义(P<0.05);观察组FLACC总评分为(2.17±0.58)分、遵医行为97.50%、家属满意度评分为(92.13±3.64)分,对照组分别为(5.85±1.62)分、70.00%、(76.87±3.78)分,两组比较,差异有统计学意义(P<0.05)。结论:疼痛护理、注意力分散干预能够有效缩短学龄前儿童静脉采血时间,提高一次穿刺成功率和患儿遵医行为,降低患儿FLACC评分,减轻患儿疼痛,同...     

疼痛管理在术后疼痛控制中的应用

术后疼痛是一种急性疼痛,是机体对疾病和手术造成组织损伤的一种复杂的生理心理反应.据统计,75%的手术患者有比较明显的术后疼痛.术后疼痛控制不佳,可导致呼吸和心血管系统并发症,不利于术后康复Ⅲ[1]-311.     

改良疼痛评估图在骨折患儿术后疼痛管理中的应用

目的观察改良疼痛评估图在骨科患儿术后疼痛评估中的效果。方法将74例骨折患儿按改良疼痛评估图使用前后进行分组,使用前收治的患儿34例为对照组、使用后收治的患儿40例为观察组。观察组使用改良疼痛评估图、对照组用传统疼痛评估工具。比较术后医生疼痛处理时间及患儿家长对患儿术后疼痛控制的满意度情况。结果观察组术后医生疼痛处理时间均低于对照组,P0.05;观察组患儿家长对患儿术后镇痛效果及对护士处理方法、医生处理方法满意度均高于对照组,P均0.05。结论改良疼痛评估图可提高骨折患儿术后疼痛管理效果。     

体位管理在腰椎内固定术后患者中的应用

摘要：目的：探讨腰椎内固定术后患者给予体位管理的应用效果。方法：选取2020年7月至2021年6月在兴国县人民医院接受腰椎内固定术治疗的共计60例患者,按照随机数字表法分成研究组（30例）与对照组（30例）,对照组给予常规护理,研究组在对照组基础上联合体位管理,比较两组疼痛程度、术后引流量、住院时间、住院费用、舒适度、并发症及住院满意度。结果：两组干预后视觉模拟评分法（VAS）评分降低（P<0.05）,研究组较对照组更低（P<0.05）;研究组与对照组相比术后引流量、住院费用更少（P<0.05）,住院时间更短（P<0.05）;两组干预后舒适状况量表（GCQ）评分提高（P<0.05）,研究组较对照组更高（P<0.05）;研究组与对照组相比并发症发生率更低（P<0.05）;研究组与对照组相比住院满意度更高（P<0.05）。结论：腰椎内固定术后患者给予体位管理,能够降低疼痛程度,促进术后恢复,提高舒适度,降低并发症发生率,提高住院满意度。     

无痛病房管理模式在骨科疼痛护理中的应用

目的:探讨无痛病房管理模式在骨科疼痛护理中的应用效果.方法:将247例患者随机分为A组(手术治疗、心理治疗、物理治疗)71例、B组(手术治疗、心理治疗、物理治疗、术前服药)109例、C组(手术治疗、心理治疗、物理治疗、术前服药及注射)67例.3组均按照无痛护理模式实施护理,比较3组不同的治疗方式导致的疼痛缓解效果.结果:A组患者疼痛缓解有效率为69.0%,B组为79.8%,C组为98.6%,3组比较差异有统计学意义(P＜0.05,P＜0.01).结论:现阶段临床观察初步证实超前镇痛效果高于疼痛不能耐受时用药,术前给药效果好于没有用药.通过创立骨科无痛病房,更新医、护、患无痛理念,建立系统的疼痛管理模式,合理评估患者的疼痛程度,制订有效的治疗方案,可将疼痛程度控制在最小化,从而提高患者对疼痛控制的满意度.     

Difficult pain assessment and lack of clinician knowledge are ongoing barriers to effective pain management in children with cognitive impairment

Identification of barriers that inhibit effective pain treatment in children with cognitive impairment (CI) may facilitate targeted interventions to ensure that they receive optimal care. This study was undertaken to identify factors that impede effective treatment of pain in children with CI. Clinicians who provided direct care to children were surveyed regarding perceptions of pain management issues. 215 nurses and physicians completed and returned surveys. Difficulties with pain assessment, the lack of valid pain assessment tools, and poor documentation were ranked by the majority of clinicians as factors that impeded their ability to effectively manage pain in this population. Additionally, 88% believed that inadequate education impedes effective pain management in this population, and 88% would attend continuing education courses on pain in children. These data suggest that development of valid and clinically useful pain assessment tools, and focused continuing education may provide the best interventions toward the improvement of pain management in this and similar vulnerable populations.     

疼痛控制护理对老年手术患者术后疼痛及舒适度的影响

目的探讨疼痛控制护理在老年手术患者术后疼痛中的应用效果。方法将我院2012年2月至2013年4月行手术治疗的120例老年患者采用抽签法分为观察组和对照组各60例,两组术前护理方法相同,对照组采用术后常规护理,观察组在对照组的基础上采用疼痛控制护理,比较两组患者的术后疼痛情况、术后恢复、舒适度及护理满意度。结果观察组术后的疼痛评分低于对照组,轻度疼痛和中度疼痛的比例高于对照组,重度疼痛的比例低于对照组,镇痛药的使用量少于对照组,差异均有统计学意义（P〈0．05）;观察组术后在生理、心理、社会环境、文化方面的舒适度评分均高于对照组,差异有统计学意义（P〈0．05）;观察组的住院时间短于对照组,护理满意度高于对照组,差异均有统计学意义（P〈0．05）。结论疼痛控制护理符合人性化护理原则,能够显著减轻老年手术患者术后疼痛,提高患者的舒适度。     

Parental catastrophizing about children's pain and selective attention to varying levels of facial expression of pain in children: a dot-probe study

The attentional demand of pain has primarily been investigated within an intrapersonal context. Little is known about observers’ attentional processing of another’s pain. The present study investigated, within a sample of parents (n = 65; 51 mothers, 14 fathers) of school children, parental selective attention to children’s facial display of pain and the moderating role of child’s facial expressiveness of pain and parental catastrophizing about their child’s pain. Parents performed a dot-probe task in which child facial display of pain (of varying pain expressiveness) were presented. Findings provided evidence of parental selective attention to child pain displays. Low facial displays of pain appeared sufficiently and also, as compared with higher facial displays of pain, equally capable of engaging parents’ attention to the location of threat. Severity of facial displays of pain had a nonspatial effect on attention; that is, there was increased interference (ie, delayed responding) with increasing facial expressiveness. This interference effect was particularly pronounced for high-catastrophizing parents, suggesting that being confronted with increasing child pain displays becomes particularly demanding for high-catastrophizing parents. Finally, parents with higher levels of catastrophizing increasingly attended away from low pain expressions, whereas selective attention to high-pain expressions did not differ between high-catastrophizing and low-catastrophizing parents. Theoretical implications and further research directions are discussed.     

住院患儿疼痛管理决策支持系统的构建与应用研究

目的构建住院患儿疼痛管理决策支持系统,并评价其应用效果。方法以疼痛管理理论与临床决策支持技术为基础,构建集护理程序各环节、医嘱处理和护理任务清单为一体的疼痛管理信息系统。于2018年9月—2019年11月在某三级甲等综合性儿科医院进行系统试运行,比较系统使用前后的护理文书书写质量、医嘱处理及时性及护士使用体验。结果住院患儿疼痛管理决策支持系统使用后,护理文书书写质量各指标均明显提高,与原疼痛管理系统比较,差异具有统计学意义(P<0.05);医嘱处理及时性使用前后均为100%,差异无统计学意义(χ²=0.012,P=0.913);在临床护士使用体验中,使用后"信息质量""服务质量""用户满意""净收益"维度体验性均提高,与原疼痛管理系统比较,差异具有统计学意义(P<0.05)。结论住院患儿疼痛管理决策支持系统的使用提高了住院患儿疼痛管理的同质性、连续性、完整性、及时性,且护士对该系统总体体验良好。     

Abdominal pain in children

Abdominal pain is one of the most common reasons pediatric patients seek emergency care. The emergency physician must be able to distinguish diagnoses requiring immediate attention from self-limiting processes. Pediatric patients can be challenging, particularly those who are preverbal, and therefore, the clinician must rely on a detailed history from a parent or caregiver as well as a careful physical examination in order to narrow the differential diagnosis. This article highlights several pediatric diagnoses presenting as abdominal pain, including surgical emergencies, nonsurgical diagnoses, and extraabdominal processes, and reviews the clinical presentation, diagnostic evaluation, and management of each.     

护理干预对小儿静脉采血前后疼痛的影响

目的：探讨护理干预对小儿静脉采血前后疼痛的影响。方法：对我科2008年5—8月收治的466例需静脉采血的患儿随机分为对照组和干预组各233例。对照组在静脉采血前后不给予任何干预，干预组在静脉采血前后给予抚触、鼓励等护理干预。观察静脉采血过程中两组患儿的疼痛面容持续时间、啼哭时间、不哭人数、心率变化及静脉采血结束后20s内的啼哭人数。结果：静脉采血过程中干预组患儿的疼痛面容持续时间、啼哭时间较对照组明显缩短，不哭人数多于对照组，心率变化明显小于对照组，采血结束后20S内干预组患儿的啼哭人数明显少于对照组。结论：静脉采血过程中护理干预可以减轻患儿疼痛反应，提高护理满意度。     

Development and feasibility testing of a Pain Neuroscience Education program for children with chronic pain: treatment protocol

Background

Current treatment for adults with chronic pain often includes Pain Neuroscience Education (PNE) to make people understand the nature underlying their pain and thus provides a clear rational for a biopsychosocial approach. Despite recommendations to use Pain Neuroscience Education as well in children with chronic pain, a specific program, tailored to children aged 6–12 years is lacking.

Randomized controlled trials of psychological therapies for management of chronic pain in children and adolescents: An updated meta-analytic review

The purpose of this meta-analytic review was to quantify the effects of psychological therapies for the management of chronic pain in youth. Specifically, in this review we updated previous systematic reviews of randomized controlled trials by including new trials, and by adding disability and emotional functioning to pain as treatment outcomes. Electronic searches of the Cochrane Register of Randomised Controlled Trials, MEDLINE, PsycLIT, EMBASE, and the Social Sciences Citation Index were conducted from inception through August 2008. Methodological quality of the studies was assessed, and data extracted on the three primary outcomes of interest. Twenty-five trials including 1247 young people met inclusion criteria and were included in the meta-analysis. Meta-analytic findings demonstrated a large positive effect of psychological intervention on pain reduction at immediate post-treatment and follow-up in youth with headache, abdominal pain, and fibromyalgia. Small and non-significant effects were found for improvements in disability and emotional functioning, although there were limited data on these outcomes available in the included studies. Omnibus cognitive–behavioral therapy, relaxation therapy, and biofeedback all produced significant and positive effects on pain reduction. Studies directly comparing the effects of self-administered versus therapist-administered interventions found similar effects on pain reduction. Psychological therapies result in improvement in pain relief across several different pain conditions in children. Future trials are needed that incorporate non-pain outcome domains, that focus significant therapeutic content on reductions in disability, and that include extended follow-up to better understand maintenance of treatment effects.