手術前疼痛衛教對改善脊椎術後病人疼痛經驗之成效探討

The Effects of Preoperative Pain Education on Improving Patients' Pain Experience after Spinal Surgery

鄭玉華(Yu-Hua Cheng) ； 盧美秀(Meei-Shiow Lu)

《實證護理》 3卷2期 (2007/06) Pp. 107-118

https://doi.org/10.6225/JEBN.3.2.107

摘要

脊椎手術的病人常經歷劇烈疼痛，而病人對疼痛處置的知識與信念會影響其手術後的疼痛處置結果，因此手術前提供病人適當的疼痛衛教能幫助病人正確處理其手術後疼痛。本研究目的即是探討對脊椎手術病人施予手術前疼痛衛教對改善術後疼痛經驗之成效，採兩組前後測之類實驗設計法，於中部某區域教學醫院骨科病房中，針對進行脊椎手術之80位病人收案，隨機分配至控制組40人接受病房護理人員的手術前常規照護、實驗組40人接受研究者給予之手術前常規照護及手術前疼痛衛教之介入措施。成效評值以部分修正之美國疼痛協會病人結果問卷，比較兩組手術後疼痛強度、疼痛干擾程度、疼痛處置滿意度及疼痛處置信念之差異。研究結果顯示：實驗組手術後最劇烈疼痛強度顯著低於控制組；實驗組手術後疼痛對日常生活、情緒及睡眠的干擾程度顯著低於控制組；手術後實驗組錯誤疼痛處置信念的改善程度顯著大於控制組；兩組手術後的疼痛處置滿意度無顯著差異。手術前疼痛衛教可以改善病人不正確的疼痛處置信念，降低病人手術後的疼痛強度及疼痛干擾程度，臨床上應加強手術前的疼痛衛教，以改善病人術後的疼痛經驗。

關鍵字

脊椎手術 ； 手術前疼痛衛教 ； 疼痛經驗

並列摘要

Patients often suffer from severe pain after spinal surgery. Their knowledge and beliefs about pain management may contribute to pain outcomes after surgery. Preoperative pain education is therefore, considered to be an important tool in managing patients' pain after surgery. The purpose of this study was to evaluate the effect of a preoperative pain education program on improving patients' pain experience after spinal surgery. The study adopted a quasi-experimental design with two groups for pre- and post-test comparison. Eighty subjects were chosen from one orthopedic ward in a regional medical teaching hospital in central Taiwan. Subjects were randomly assigned to the control group, which received routine preoperative care from ward nurses (n=40), or the experimental group, which received routine preoperative care and a preoperative pain education program from the researcher. Outcomes, including pain intensity, pain interference, satisfaction with pain management, and beliefs about pain management were measured using the American Pain Society Patient Outcome Questionnare-Modified (APS-POQ-Modified). The subjects in the experimental group experienced lower levels of severity in pain intensity and pain interference in general activity, mood, and sleep after surgery than the control group. Misconceptions about pain management were significantly more improved after surgery in the experimental group than in the control group. No significant differences were found between the two groups in the scores for satisfaction with pain management. In conclusion, the results of this study indicate that preoperative pain education can improve patients' understanding of pain management, and reduce pain intensity and pain interference after surgery. Preoperative pain education should therefore be administered to improve patients' pain experience after surgery.

並列關鍵字

spinal surgery ； preoperative pain education ； pain experience