慢性疼痛之概念分析

Concept Analysis of Chronic Pain

高美華(Mei-Hua Kao)

《馬偕護理雜誌》 5卷1期 (2011/01) Pp. 7-14

https://doi.org/10.29415/JMKN.201101_5(1).0001

摘要

「慢性疼痛」是個體身心不適的主觀感受，這些不適的感受會影響個人的身心健康。本文目的在於鑑別慢性疼痛的概念，依據Walker及Avant（2004）所提出的概念分析步驟，決定慢性疼痛概念的特徵和特性，內容包括選擇一個概念、概念分析的目的、確認概念的用法、決定概念之定義性特徵、建構典型案例、邊緣案例、相關案例、相反案例、確認概念的之前因後果、闡述實證資料等八個步驟。依據概念分析的結果，歸納出慢性疼痛四項定義性特徵：一、為一種源於傷害性刺激之疼痛不舒服的主觀感覺；二、持續性或反覆發生，時間超過急性疾病或損傷癒合之合理時間一個月以上；三、會伴隨情緒困擾，影響睡眠品質或生活品質；四、個人依據疼痛經驗發展出不同的因應行為或策略。此概念分析能夠協助臨床護理人員區辨慢性疼痛的概念，提供適宜的個別性護理措施，協助個案緩解疼痛。也期待日後能夠發展適合本土之慢性疼痛測量工具，應用於臨床照護上。

關鍵字

慢性疼痛 ； 概念分析 ； 不適

並列摘要

Chronic pain is a personal perception of discomfort that affects a person both physically and mentally. This article reviews the concepts of chronic pain. The symptoms and characteristics are distinguished using the concept analysis method of Walker and Avant. Steps they describe include ”selecting a concept; determining the aims of analysis; identifying all uses of the concept; determining the defining attributes; constructing a model case; constructing borderline, related, and contrary cases; identifying antecedents and consequences; and defining empirical referents.” Four features of chronic pain can be summed up by concept analysis as follows: (1) The pain is initially caused by an injury stimulating pain receptors, leading to the perception of pain. (2) The pain persists, either constantly or intermittently for one month or for longer than would be expected after acute disease or injury. (3) The emotional suffering caused by the pain may interfere with sleep and adversely affect quality of life. (4) Individuals tend to develop their own coping behavior and strategies. Clinical nurses should consider the possibility that a patient has chronic pain. Only by identifying the problem can they provide appropriate nursing intervention. Instruments to assess chronic pain would be a helpful adjunct in caring for such patients.

並列關鍵字

chronic pain ； concept analysis ； discomfort