- 期刊
急診疼痛病人照護需求滿足與其負向情緒相關性探討
The Correlation between Care Needs and Negative Emotions of the Pain Patient in the Emergency Department
摘要
背景：研究顯示，在急診的高壓環境下，有23%-73%的急診病人可能伴隨有焦慮、憂鬱或壓力的負向情緒反應在急診就診族群中，就診原因為疼痛者約有71%-83%，但過去鮮少針對急診疼痛病人照護需求滿足與其負向情緒作探討。目的：本研究主要是在探討急診疼痛病人之照護需求滿足，包括：對急診環境、疼痛評估、疼痛處置及藥物衛教等四大面向，是否與其產生焦慮、憂鬱、壓力等負向情緒有相關性。方法：本研究採橫斷式調查研究方法（cross-sectional survey research），以結構式問卷調查急診疼痛病人的就診四大照護需求滿足：急診環境的舒適性、充分的疼痛評估、足夠的疼痛處置、良好的藥物衛教，以及焦慮、憂鬱、壓力等負向情緒。結果：共有151份病人問卷。在複迴歸分析中，急診環境（p= .006）、疼痛處置（p = .038）、藥物衛教（p = .024）會影響焦慮量表得分；而急診環境（p =.017）、疼痛評估（p = .005）、疼痛處置（p = .041）、良好衛教（p = .001）等四大照護需求滿足面向皆會影響憂鬱量表的得分；最後，急診環境（p = .0.06）、疼痛處置（p = .021）亦會影響壓力量表得分。而複迴歸分析結果顯示，四大照護需求滿足面向與焦慮、憂鬱及壓力量表可解釋總變異量分為9.3%、12.2%及9%。結論：從整體的研究結果看來，在急診室的這種高壓的環境中，病人有高度負向情緒發生機率，特別是急診環境、疼痛處置這兩大照護需求面向，明顯影響病人焦慮、憂鬱、壓力等負向情緒，醫療人員應該更敏感、積極地去觀察並處理此問題。
並列摘要
Background: The emergency department (ED) is a high-stressful environment in the hospital, previous studies have been shown the 23%-73% of patients in the emergency department have negative emotions such as anxiety, depression and stress perception. However, there were few studies to investigate the negative emotion of patient with pain and their needs in the emergency department. Purpose: The aim of the present study was to investigate the association between care needs of ED environment, pain assessment, pain management and health education, as well as the negative emotions such as anxiety, depression, and stress perception of pain patients in the emergency. Method: This is a cross-sectional survey by collected the patients' self-report via a structured questionnaire. The measurements included four dimensions of care needs: comfortable ED environment, adequate pain assessment, adequate pain management and clearly health education; as well as three negative emotions: anxiety and depression were measured by hospital anxiety depression scale (HADS) and stress perception was measured by perception stress scale (PSS). Result: A total of 151 patients was recruited from one ED in a medical center. The result of multiple regression analysis indicated the care needs about comfortable ED environment (P = .006), adequate pain management (P= .038), and clearly health education (P = .024) has a significant effect on pain patients' anxiety. And the care needs about a comfortable ED environment (P = .017), adequate pain assessment (P = .005), adequate pain management (P = .041) and clearly medical education (P = .001) have a significant effect on pain patients' depression. The care needs about comfortable ED environment (P = .0.06) and adequate pain management (P = .021) also reduce the pain patients' stress perception. Finally, the total explained variation of the care needs on ED pain patients is 9.3% in anxiety, 12.2% in depression and 9% in stress perception. Conclusion: The pain patients with the high vulnerability of negative emotion in the emergency department, especially their complicated care needs about the comfortable environment, adequate pain assessment and management, and clear health education. The medical staff in an emergency situation should be more sensitive and active to observe and react to the problem.