全膝關節置換術後病人疼痛及其相關因素之探討

The Study of Postoperative Pain and Related Factors in Patients with Total Knee Arthroplasty

陳嘉慧(Chia-Hui Chen)

指導教授 ： 胡月娟

中臺科技大學/護理學院/長期照顧碩士學位學程/碩士(2020年)

摘要

本研究旨在了解接受人工膝關節置換術病人其術後疼痛情形與相關因素，並採橫斷式研究設計及方便取樣方式於中部某醫院探討41位全膝關節置換術病人疼痛情形。調查時間為手術前一天及手術後第一天，以結構式問卷進行資料蒐集。問卷包括個案基本資料、焦慮量表及疼痛數字量表；所蒐集之量性資料擬經編碼後，以SPSS 22.0版統計套裝軟體進行建檔及統計分析。針對研究對象基本人口學屬性、術前情形、術後病徵及疼痛程度及疼痛干擾程度進行描述性統計及推論性統計(獨立樣本t檢定、變異數分析及皮爾森相關分析)。結果發現個案以中老年病人為主，平均年齡落在61.8+18.3歲且其中以已婚男性者居多，曾經手術經驗達63.2%。97.3%最痛部位為手術部位；手術後第一天68.3%病人仍感到嚴重疼痛；50%以上病人覺得嚴重影響日常生活、情緒、活動、他人關係、睡眠及生活樂趣。性別、教育程度及手術後PCA使用會影響術後疼痛情形(p<.05)。冀望此研究結果可作為日後接受全膝關節置換術病人疼痛之照護參考，以提升全膝關節置換術病人的照護品質。

關鍵字

全膝關節置換術 ； 術後疼痛

並列摘要

The purpose of this study aimed to analyze patient perception of postoperative pain and related factors when patients underwent artificial knee arthroplasty. The study adopted the cross-sectional design and the convenience sampling method to probe the perception of 41 patients who had an operation of total knee arthroplasty in a hospital where located in central Taiwan. It selected the day before the surgery and the first day after the surgery as investigation timings and collecting data via structured questionnaire. This questionnaire contains subjects’ basic personal information, anxiety scale and numerical rating scale for pain intensity. The collected quantitative data was coded, and then filed and statistically analyzed by SPSS Statistics V22.0, which focused on assaying those factors including the basic demographic attributes, the preoperative status, the postoperative symptoms, the patient perception of postoperative pain and the interference of pain through descriptive statistics and inferential statistics (such as independent sample t test, one-way ANOVA, and Scheffe post-hoc comparison software package, etc).
The results showed that the cases mainly were at middle-aged and elder patients, with the average ages fell within 61.8 + 18.3 years old; married men among these cases were in majority. The subjects who ever had the previous surgical experiences had reached 63.2%, and 97.3% of the most painful part was at the surgical site. There were 68.3% patients felt severe pain after the first day of surgery; more than 50% patients felt that their daily life, mood, activities, relationships, sleep, and zest of their life were strictly affected. According to the analysis, the gender, education, and the usage of PCA after surgery will affect the perception of postoperative pain (p<.05).
The results of this study are expected to be the care reference for those patients who are undergoing the perception of pain after artificial knee arthroplasty, so as to improve the nursing quality in the future.

並列關鍵字

Total knee replacement ； postoperative pain

參考文獻

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