知信行健康教育对腹部手术患者术后疼痛管理的作用

目的探讨知信行健康教育模式对腹部手术患者术后镇痛自我管理的影响。方法以2012年1-3月58例患者予以常规疼痛健康教育的为对照组,以2012年4-6月58例患者予以知信行健康教育的为观察组。采用术后镇痛自我管理行为、疼痛程度评分、自控镇痛泵（PCA）的使用量及患者满意度来评价知信行健康教育的效果。结果观察组和对照组术后镇痛自我管理行为之间比较差异有统计学意义（P〈0．05）;对照组在术后48h内的疼痛程度评分明显高于观察组（P〈0．05）;在PCA消耗量方面,观察组明显高于对照组（P〈0．05）;观察组对术后镇痛效果的满意度高于对照组,差异有统计学意义（P〈0．05）。结论应用知信行健康教育模式对腹部手术患者进行健康指导,能够有效促进患者术后镇痛自我管理行为,改善术后疼痛控制效果,提高患者的满意度。     

知-信-行健康教育模式对腹部手术患者术后镇痛自我管理行为的影响

【】目的 探讨知信行健康教育模式对腹部手术患者术后镇痛自我管理行为的影响。方法 将116例腹部手术患者按入院先后顺序进行分组,对照组和观察组各58例。对照组采用常规的疼痛健康教育方式;观察组采用知信行健康教育模式对病人进行术后疼痛教育。结果 对照组和观察组患者术后镇痛自我管理行为之间差异具有统计学意义(P＜0.05)。结论 应用知信行健康教育模式对腹部手术患者进行健康指导,能够有效改善患者术后镇痛自我管理行为。     

术前疼痛知识教育对腹部术后疼痛控制效果的影响

目的了解术前疼痛知识教育对腹部术后患者对疼痛控制的认识、所采取的疼痛控制措施及疼痛控制效果的影响。方法采用非同期对照方法，将84例腹部手术患者分成两组，每组42例。术前对试验组进行疼痛知识教育及常规指导，对照组只进行常规指导，术后第2天下午完成“术后疼痛控制问卷”调查。结果试验组对疼痛控制的认识高于对照组（P〈0．05）。试验组术后采取深呼吸、听音乐的患者较对照组多（P〈0．05）；试验组患者能更为正确地使用镇痛泵（P〈0．05）；两组主动要求使用止痛药的人次及疼痛分值差异无统计学意义（P〉0．05）。试验组术后疼痛分值较对照组低（P〈0．05）。结论术前疼痛知识教育能提高腹部术后患者对疼痛控制的认识，促使其主动参与术后疼痛控制，从而提高术后疼痛控制效果。     

外科护士对术后疼痛知识、态度及行为的认知现状调查

[目的]了解外科护士对病人术后疼痛知识、态度及行为的认知情况。[方法]选取在外科工作的护理人员90名,发放自制的术后疼痛知识、态度及相关行为调查问卷。[结果]外科护士术后疼痛知识得分为(29.20±7.92)分,对疼痛的态度得分为(17.10±2.05)分,疼痛治疗及护理行为得分为(9.66±1.45)分。[结论]目前外科护士对病人术后疼痛在态度和行为上都表现出不同程度的消极性。     

术后早期运动护理对腹部手术患者胃肠功能及术后疼痛的影响

目的探讨术后早期运动护理在腹部手术中的应用效果。方法将100例行腹部手术的患者随机分为观察组和对照组各50例,对照组围术期采用常规护理,观察组在对照组的基础上采用术后早期运动护理,比较两组患者术后恢复的情况。结果观察组的进食时间、肠鸣音恢复时间、排便时间、下床活动时间均显著短于对照组（P〈0．05）。观察组的术后并发症、住院时间显著少于对照组,术后疼痛评分显著低于对照组,护理满意度显著高于对照组（P〈0．05）。结论术后早期运动护理能够促进腹部手术患者胃肠功能恢复,减少疼痛和并发症。     

知信行健康教育对剖宫产产妇术后疼痛管理的作用

目的：探讨知信行健康教育在剖腹产产妇术后疼痛管理中的作用。方法选取我院收治的行剖宫产手术的产妇300例,随机分为对照组给予常和观察组,每组150例。对照组产妇给予常规健康教育方式,观察组产妇给予知信行健康教育护理管理。比较两组产妇术后镇痛自我管理行为的评分、疼痛程度评分、自控镇痛泵（ PCA）的使用量及患者满意度。结果术后观察组患者术后镇痛自我管理行为评分显著低对照组（P＜0.01）,术后48 h内疼痛程度评分评分显著低于对照组（P＜0.01）,术后PCA消耗量方面明显高于对照组（P＜0.01）,产妇术后满意度评分明显高于对照组（P＜0.01）。结论知信行健康教育在一定程度上能够提高患者术后镇痛的自我管理能力,增强了产妇术后疼痛的控制效果,并提高了产妇满意度。     

泌尿外科患者对疼痛知信行状况的调查研究

目的调查泌尿外科患者术后疼痛知识、信念及行为的认知现状,为制订疼痛健康教育模式提供理论依据。方法调选2009年1月至2013年9月收治的泌尿系统疾病患者80例进行抽样分组,通过自拟疼痛知识问卷、疼痛信念问卷、镇痛自我管理行为问卷对比传统常规疼痛健康教育对策(对照组,n=40)和知信行疼痛健康教育模式(观察组,n=40)的应用效果。结果观察组术后知识问卷各项目了解及掌握情况明显优于对照组,比较差异有统计学意义(P0.05);观察组在易感性感知、行为改变的信心和优势3个维度比较结果差异有统计学意义(P0.05);总平均分观察组的(3.289±0.694)分与对照组的(2.164±0.361)分比较差异有统计学意义(P0.05)。结论临床应用知信行健康教育模式对泌尿系统疾病患者进行健康教育指导,能够明显提高患者对术后疼痛相关知识的了解和掌握,坚定战胜病魔的信念,积极促进术后镇痛自我管理行为,从而改善疼痛度的控制效果及患者的生存质量。     

妇科腹部手术患者疼痛的调查分析

目的 了解妇科腹部手术患者的疼痛信念,为解除疼痛提供理论依据,从而有效提高手术疼痛的护理质量.方法 采用调查问卷对200例妇科腹部手术患者进行疼痛信念调查.结果 腹部手术患者疼痛信念总分为29.26±2.20,麻醉性镇痛药不良反应评分为14.43±1.25,忍耐疼痛评分为14.86±1.16;不同文化程度患者的疼痛信念评分比较,差异有显著性意义(P<0.05).结论 腹部手术患者整体疼痛信念趋负向,需对患者加强疼痛控制知识教育.     

腹部手术病人术后疼痛的护理干预效果观察

[目的]观察腹部手术病人术后疼痛的护理干预效果。[方法]将136例腹部择期手术病人随机分为观察组和对照组,每组68例,对照组采取普外科一般常规护理,观察组在常规护理基础上实施护理干预。比较两组病人的护理干预效果。[结果]观察组术后24 h、48 h的视觉模拟评分法(VAS)评分均高于对照组(P均<0.0 5);观察组的镇痛需求及满意度均高于对照组(P均<0.05)。[结论]针对性的护理干预措施可减轻腹部手术病人的切口疼痛,提高病人满意度。     

Risk of Pain and Gastrointestinal Complaints at 6Months After Elective Abdominal Surgery

The incidence of chronic postoperative abdominal pain (CPAP) after abdominal surgery is substantial and decreases overall quality of life. One in 3 patients report pain-related interference with mood, sleep, and enjoyment of life and 12% visit the emergency department for pain-related symptoms. Previous studies lack data on preoperative health and pain status or are limited by small patient samples. The aim of this study was to assess risk factors for CPAP and gastrointestinal complaints 6 months after surgery. A prospective cohort study was performed including patients undergoing an elective laparotomy or laparoscopy at a tertiary referral center. Relevant patient, pain, surgical, and medical data as well as the Gastrointestinal Symptom Rating Scale (GSRS) were assessed before, during, and after hospital stay and at the outpatient clinic until 6 months after discharge. Linear and logistic regression analysis were used to assess risk factors. Of 518 included patients, 184 (36%) had CPAP. The median GSRS score was 5 (interquartile range?=?3–10). The presence of preoperative pain for <3 months (odds ratio [OR]?=?2.69, P = .016) or >3 months (OR?=?3.99, P = .000), use of opioid analgesia preoperatively (OR?=?3.54, P = .001), severe adhesions underneath the incision (OR?=?1.63, P = .040), and the numeric rating scale pain score on postoperative day 2 (OR?=?1.23, P = .004) independently increased the risk for chronic abdominal pain. Chronic pancreatitis as indication for surgery (B?=?4.20, P = .03), ≥3 previous abdominal operations (B?=?1.03, P = .03), presence of pain >3 months before surgery (B?=?1.61, P < .01), upper gastrointestinal tract as the anatomic location of surgery (B?=?1.43, P = .03), and a higher preoperative GSRS score (B?=?.36, P < .01) independently increased the GSRS score 6 months after surgery. The duration and severity of preoperative pain and more severe acute postoperative pain were the most relevant risk factors for CPAP. The number of operations and the anatomic location of the operation showed to be important risk factors for increasing the number of gastrointestinal complaints.Perspective: This prospective observational study shows the incidence and risk factors for CPAP after major abdominal surgery. Preoperative pain-related factors were associated with the occurrence of CPAP.     

HIV/AIDS Related Knowledge, Attitudes, and Preventive Behavior of Pregnant Korean Women

Objective :To assess HIV-AIDS-related knowledge, attitudes, and preventive behavior of pregnant Korean women before designing patient and public education programs.
Design: Pre-experimental cross-sectional survey.
Population, Sample, Setting, Years: Convenience sample of 409 women at six prenatal clinics in Seoul, Korea, in 1993.
Outcome Measures: HIV-AIDS-related knowledge, attitudes, and preventive behavior.
Methods: Self-administered questionnaires.
Findings: The women described high levels of knowledge about HIV and AIDS risk factors but less knowledge about transmission of the virus, as well as attitudes of rejection toward unrelated people with HIV/AIDS; 16% provided condoms for their husband's use in extramarital sex, the primary risk behavior.
Conclusions: Korean women are at risk for heterosexual transmission of HIV despite knowledge of risk factors.
Clinical Implications: Korean education programs for women should focus on modes of heterosexual transmission, care of individuals with HIV or AIDS, self-assessment of HIV-AIDS risk, and self protection.     

腹部手术患者疼痛评估管理的效果观察

目的 探讨对腹部手术患者实施疼痛评估管理的效果.方法 将251例择期腹部手术患者随机分为对照组(n=116)和观察组(n=135),对照组患者采用传统的临床经验法对疼痛进行护理,即患者在术后主诉疼痛难忍和要求药物镇痛时才被动地给予镇痛治疗;观察组在常规围术期护理基础上实施疼痛评估管理,要求护理人员统一掌握使用视觉模拟疼痛量表(Visual Analogue Scale,VAS):护士从患者入院即开始运用规范的语言对患者和家属进行疼痛知识及疼痛治疗观念教育,介绍使用VAS线性标尺表达疼痛的方法,使其对术后疼痛有较全面的认识,能正确地表达术后疼痛,当VAS评分≥5分即报告医生进行镇痛治疗.术后72 h对两组患者进行问卷调查,评估镇痛治疗效果及其满意度.结果 两组患者接受镇痛治疗态度、术后72 h内镇痛治疗频率、疼痛治疗满意度差异均有统计学意义(P＜0.001).结论 规范化疼痛评估管理增强了患者镇痛治疗的依从性,减轻了患者术后疼痛,有利于术后康复.     

Knowledge and Attitudes of Health-Care Providers Toward Cancer Pain Management: A Comparison of Physicians, Nurses, and Pharmacists in the State of New Hampshire

The knowledge and attitudes toward cancer pain management of physicians, nurses, and pharmacists in the state of New Hampshire were examined through the use of a statewide survey. Many of the providers who completed the survey, and thus indicated that they treated patients with cancer pain on a regular basis, were not pain or oncology specialists. Most of these providers were quite well informed about the fundamentals of cancer pain management. Approximately 90% of providers in all three groups were not concerned about addiction among cancer patients. Yet, there was a small percentage of providers who responded in less than optimal ways to items dealing with opioid pharmacology, pain assessment, and the importance of pain relief. Comparison of responses among provider groups indicated that nurses were the most knowledgeable and pharmacists the least knowledgeable about pain assessment. Physicians were the most knowledgeable regarding opioid pharmacology but seemed the least committed to providing optimal pain relief. Further analysis identified a small group of physicians that included a disproportionately high percentage of family practitioners and surgeons who consistently responded in less than optimal ways to items dealing with the importance of pain relief. The results of this study indicate a continuing need for broad-based educational programs in cancer pain management and for new initiatives focused on practitioners who see relatively few cancer patients and may have difficulty accessing traditional educational programs.     

Intermittent Wound Perfusion for Postoperative Pain Relief Following Upper Abdominal Surgery: A Surgeon's Perspective

Background: Although there are many methods for postoperative pain management, implementation may be limited in some settings due to practical or financial constraints. Simple, inexpensive and easily implemented analgesic methods may improve access to effective pain relief. Methods: Fifty patients undergoing truncal vagotomy and gastrojejunostomy for pyloric stenosis secondary to chronic duodenal ulceration were studied in this prospective randomized trial. Subjects were assigned to receive either wound perfusion with 8 mL of 0.25% bupivacaine every 5 hours through a catheter placed subcutaneously or intravenous pethidine 0.2 mg/kg on demand for postoperative pain relief. Postoperative pain scores at rest were measured by visual analog scale and the opioid requirement at 0–12 hours, at 12–24 hours and at 24–36 hours were compared. Changes in respiratory parameters were also compared between the two groups. Results: Pain scores at 0–12 hours were significantly lower in the wound perfusion group compared with the intravenous pethidine group (5.7 ± 1.3 vs. 4.3 ± 1.2, mean ± SD; P < 0.001). The number of doses of analgesic required in the wound perfusion group was significantly lower compared with the controls during the 36 hours of study (3.5 ± 1.3 vs. 1.4 ± 1.0, P < 0.001). There were no differences in respiratory parameters, vital capacity, forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and peak expiratory flow rate between the two groups. The FEV1 : FVC ratio, however, was significantly higher in the intravenous pethidine group. There were no wound complications due to catheter placement or systemic toxicity due to the anesthetic. Conclusion: Intermittent wound perfusion with 0.25% bupivacaine is a safe and efficient method to reduce pain scores and opioid requirement in the early postoperative period. Wound perfusion, however, had no beneficial effect on the postoperative respiratory function.     

正颌术后应用镇痛泵的观察与护理

目的　探讨有效减轻正颌术后疼痛的方法。方法　将 14 7例正颌患者随机分为两组 ,术后分别采用镇痛泵和传统给药法镇痛 ,观察其VAS疼痛分值和麻醉并发症。结果　镇痛泵组VAS分值为 2 .3± 1.2 ,传统止痛药组为 5 .4±1.6。两组间VAS值有显著差异。结论　镇痛泵用于正颌术后止痛效果确切 ,方法简便 ,有效地解决了正颌患者术后疼痛的问题