護理人員在術後疼痛照護中的挑戰

Nursing Challenges in Post-operative Pain Management

郭瑞萍(Jui-Ping Kuo) ； 翁靜美(Ching-Mei Weng) ； 陳金玫(Chin-Mei Chen)

《領導護理》 16卷4期 (2015/12) Pp. 11-20

https://doi.org/10.29494/LN.201512_16(4).0002

摘要

術後疼痛是很常見且重要的健康問題。未能被有效緩解的術後疼痛對病人的身心健康以及醫療費用造成負面的衝擊。國內外研究顯示手術後病人仍常經歷著中度或重度程度的疼痛，顯然術後疼痛至今仍未能被有效地控制，術後病人的疼痛處理仍是護理專業人員需共同攜手克服的挑戰。為提升術後疼痛處理的照護品質，值得護理人員及教育專家們關注的包含:護理人員對疼痛處理的認知不足、低估術後病人的疼痛程度、高估鴉片類藥物呼吸抑制及成癮性副作用的發生率、不完整的術前衛教、年老病人的疼痛處理。給予護理人員完整的疼痛教育課程及確實執行病人衛教對提升術後疼痛處理的成效是極為重要且必須的。

關鍵字

術後疼痛處理 ； 挑戰

並列摘要

Post-operative pain is a common and major health care problem. Unrelieved postoperative pain has negative impacts on not only patient's physical and psychological health but also the cost of healthcare spending. Both domestic and international research reports indicate that post-operative patients often experience moderate or severe pain after surgeries. Nowadays, post-operative pain has apparently not been well managed and controlled, and it remains a challenge for nurses to overcome. To improve the quality of care in pain management for post-operative patients health care professionals need to face the following challenges: staff's insufficient knowledge about pain management, underestimated postoperative patients' pain level, overestimated occurrence of opioid-induced side effects such as respiratory depression and addiction, and incomplete pre-operative patient education and pain management for elderly patients. Providing an integrative pain management educational program for nurses and implementing patient education prior to surgery are important and necessary for promoting the effect of post-operative pain management.

並列關鍵字

postoperative pain management ； challenge

參考文獻

Buyukyilmaz, F. E., & Asti, T. (2010). Postoperative pain characteristics in Turkish orthopedic patients. Pain Management Nursing, 11(2), 76- 84.doi: 10.1016/j.pmn.2009.01.003

Carlson, C. L. (2009). Use of three evidence-based postoperative pain assessment practices by registered nurses. Pain Management Nursing, 10(4), 174-187.doi: 10.1016/j.pmn.2008.07.001

Dunwoody, C. J., Krenzischek, D. A., Pasero, C., Rathmell, J. P., & Polomano, R. C. (2008). Assessment, physiological monitoring, and consequences of inadequately treated acute pain. Pain Management Nursing, 9(1 Suppl), S11-21. doi: 10.1016/j.pmn.2007.11.006

Gordon, D. B., Dahl, J. L., Miaskowski, C., McCarberg, B., Todd, K. H., Paice, J. A.,.. Carr, D. B. (2005). American pain society recommendations for improving the quality of acute and cancer pain management: American Pain Society Quality of Care Task Force. Archives of Internal Medicine, 165(14), 1574- 1580.doi: 10.1001/archinte.165.14.1574

Grinstein-Cohen, O., Sarid, O., Attar, D., Pilpel, D., & Elhayany, A.(2009) . Improvements and difficulties in postoperative pain management. Orthopaedic Nursing, 28(5), 232-239; quiz 240-231. doi: 10.1097/NOR.0b013e3181b579ес