Title

家屬對手術後病人使用止痛劑的擔心與病人疼痛控制的相關性

Translated Titles

The Relationship Between Family Caregivers Concerns about Analgesics and Pain Management of Postoperative Patients

Authors

卓麗鳳

Key Words

家屬 ; 手術後病人 ; 止痛劑的擔心 ; 疼痛控制 ; caregivers ; postoperative patients ; concerns about using analgesia ; postoperative pain control

PublicationName

臺北醫學大學護理學系碩士暨碩士在職專班學位論文

Volume or Term/Year and Month of Publication

2000年

Academic Degree Category

碩士

Advisor

林佳靜

Content Language

繁體中文

Chinese Abstract

本研究目的為探討家屬對止痛劑的擔心與手術後病人疼痛控制的相關性,研究採橫斷式敘述性相關研究法,採方便取樣,以台北市某一所醫學中心為研究地點,以病人障礙問卷、簡明疼痛評估量表及疼痛處理指標等結構式問卷收集207對住院接受手術的術後病人及其術後住院時的主要照顧家屬的資料進行分析。採用的統計方法有描述性及推論性統計法,包括頻率、百分比、平均值、標準差、t檢定、配對t檢定、ANOVA、卡方檢定、皮爾森積差相關及邏輯式迴歸分析等。 研究發現家屬對病人手術後24小時疼痛感受的評估除平均疼痛高於病人外,其餘均與病人無顯著差異;家屬對止痛劑普遍存有中等程度的擔心,其中對時間間隔的擔心最高,其次分別為擔心耐藥性、成癮性害怕注射、及阻礙傷口癒合等,問卷用於手術後病人家屬的Cronbach’s α為0.89,具有良好信度。 家屬年齡愈低者愈害怕注射,而愈高者則愈期望成為好病人及擔心阻礙傷口癒合;具較高教育程度者比較擔心藥物副作用及時間間隔;女性家屬較男性害怕注射及期望成為好病人;有手術經驗的家屬對期望成為好病人的擔心高於無手術經驗家屬。 病人手術後其家屬有猶豫報告疼痛者佔22.7%(n=47),其對期望成為好病人的擔心高於未猶豫報告疼痛者;有猶豫使用止痛劑的家屬佔34.8%(n=72),其對時間間隔、耐藥性、成癮性、影響傷口癒合、分散醫師注意力、副作用、宿命論及期望成為好病人等八項次量表及整體量表上的擔心均高於未猶豫使用止痛劑者;病人手術後有猶豫使用止痛劑者佔38.2%(n=79),其家屬對產生耐藥性、期望成為好病人及整體量表上擔心高於未猶豫使用止痛劑者。家屬對耐藥性的擔心可有效預測其是否猶豫報告疼痛,家屬對整體問卷的擔心可有效預測其是否猶豫使用止痛劑,家屬期望成為「好病人」的擔心,更對病人是否猶豫使用止痛劑及其是否豫報告疼痛與使用止痛劑都具有預測力。研究結果可提供專業人員教育住院手術病人及家屬對止痛劑誤解與疼痛處理知識的基礎,以期能增進手術後病人的疼痛控制。

English Abstract

The purpose of this study was to explore the possible association between caregivers concerns about using analgesics for postoperative pain and pain management among Taiwanese postoperative patients. This is a descriptive correlational study. The sample consisted of 207 dyads of hospitalized postoperative patients and their caregivers. Three structured questionnaires entitled ''’Barriers Questionnaire-Taiwan Form (BQT)’’, ‘’Brief Pain Inventory Short Form’’, and ‘’Pain Management Index (PMI)’’ were used in this study. Data were analyzed using Student’s t-test, paired t-test, chi-square, Pearson correlation, and logistic regression. This result showed that the pain level assessed by the caregiver within 24 hours postoperative was not different from the pain level reported by the patient. The three highest subscores of caregiver’s concerns were ‘’time interval’’ , ‘’tolerance’’ , and ‘’addiction.’’ Forty-seven caregivers (22.7%) reported that they had hesitated to report pain during first 24 hours postoperatively. These caregivers had significantly higher scores on desire to be a ‘’good patient’’ than those caregivers who had not hesitated to report pain. Seventy-two caregivers (34.8%) reported that they had hesitated to administer medications to their patient during first 24 hours postoperatively. These caregivers reported significantly higher scores on ‘’time interval’’, ‘’fear of tolerance’’, ‘’addiction’’, ‘’side effect’’, ’’wound healing’’, ‘’distracting physician’’, ‘’fatalism’’, desire to be a ‘’good patient’’, and the total BQT score than those caregivers who had not hesitated to administer analgesics. Seventy-nine patients (38.2%) reported that they had hesitated to use medication during first 24 hours postoperatively. Their caregivers had significantly higher scores on desire to be a ‘’good patient’’, ‘’fear of tolerance’’, and the total BQT score than those caregivers whose patient had hesitated to use medication. The result of this study revealed that pain management in these postoperative patients was inadequate. According to the levels of pain patient reported, misconceptions about using analgesics among family caregivers still exist. We suggested that in order to improve postoperative pain control for postoperative patients, education for patients and their caregivers could be an effective intervention.

Topic Category 醫藥衛生 > 社會醫學
護理學院 > 護理學系碩士暨碩士在職專班
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Times Cited
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