特殊人群的疼痛管理及评估现状
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摘要
疼痛是临床上最常见的症状之一。科学的疼痛管理可以降低疼痛的负面影响,疼痛评估是疼痛管理的第一步。在我国,特殊人群的疼痛管理相对薄弱,主要原因包括医护人员对特殊人群疼痛的忽视、护士对特殊人群疼痛管理认知现状停留在较低水平、护士未能充分掌握疼痛评估工具的选择及应用。本文从以上三个方面综述了特殊人群的疼痛管理及评估现状,以期引起医护人员对特殊患者疼痛管理的重视,并为临床护士进行准确的疼痛评估提供科学依据,减轻患者痛苦,完善疼痛护理管理。
Pain is one of the most common symptoms in the clinic. Scientific pain management can reduce the negative effects of pain, and pain assessment is the first step in the pain management. In China, the pain management of special populations is relatively weak, and the main reasons include the neglect of pain in special population by medical staff, the low level of nurses′ knowledge of pain management in special population, and the nurses′ inadequate grasp of the choice and application of pain assessment tools. This article reviews the current status of pain management and assessment in special populations from the above three aspects, in order to give medical staff a special attention to the pain management of special patients and provide a scientific basis for clinical nurses to accurately assess the pain of special patients, reduce patient suffering and improve pain management.
Pain is one of the most common symptoms in the clinic. Scientific pain management can reduce the negative effects of pain, and pain assessment is the first step in the pain management. In China, the pain management of special populations is relatively weak, and the main reasons include the neglect of pain in special population by medical staff, the low level of nurses′ knowledge of pain management in special population, and the nurses′ inadequate grasp of the choice and application of pain assessment tools. This article reviews the current status of pain management and assessment in special populations from the above three aspects, in order to give medical staff a special attention to the pain management of special patients and provide a scientific basis for clinical nurses to accurately assess the pain of special patients, reduce patient suffering and improve pain management.
引文
[1]Merboth MK,Barnson S.Managing pain:the fifth vital sign[J].Nurs Clin Am,2000,35(2):375-383.
[2]张秋实,郭明贤,崔艳,等.成年患者的疼痛评估[J].现代生物医学进展,2013,13(11):2185-2187.
[3]Carlson CL.Use of three evidence-based postoperative pain assessment practices by registered nurses[J].Pain Manag Nurs,2009,10(4):174-187.
[4]陈杰,路潜,张海燕,等.患者疼痛评估工具研究进展[J].中国护理管理,2014,14(11):1131-1134.
[5]Azzam PN,Alam A.Pain in the ICU:a psychiatric perspective[J].J Intensive Care Med,1900,28(3):140-150.
[6]叶俏,龚雪,刘颖.新生儿科护士疼痛管理认知现状调查分析与对策[J].护理实践与研究,2017,14(10):4-6.
[7]陈劼,张玉侠,顾莺,等.3~12岁儿童术后疼痛评估的循证实践[J].护士进修杂志,2015,30(11):1020-1024.
[8]李茶香.护士对老年痴呆患者疼痛的认知现状及相关评估工具的引进[D].广州:南方医科大学,2009.
[9]刘要伟,李漓.危重患者的疼痛评估[J].护理学杂志,2013,28(10):87-89.
[10]Anand KJ,Sippell WG,Aynsley-Green A.Randomised trial of fentanyl anaesthesia in preterm babies undergoing surgery:effects on the stress response[J].Lancet,1987,1(8524):62-66.
[11]Carbajal R,Rousset A,Danan C,et al.Epidemiology and treatment of painful procedures in neonates in intensive care unit[J].JAMA,2008,300(1):60-70.
[12]American.Academy of Family Physicians Planning for labor and vaginal birth after cesarean delivery:guidelines from the AAFP[J].Am Fam Physician,2015,91(3):197-198.
[13]邵肖梅,叶鸿瑁,丘小汕,等.实用新生儿学[M].北京:人民卫生出版社,2013:170.
[14]夏冬晴,陈梦莹,李晓南.新生儿疼痛对儿童行为发育的影响和机制研究进展[J].中国儿童保健杂志,2016,24(2):149-152.
[15]李美芳.新生儿疼痛的护理进展[J].当代护士,2014,(9):5-7.
[16]Loizzo A,Loizzo S,Capasso A.Neurobiology of pain in children:an overview[J].Open Biochem J,2009,3(1):18-25.
[17]Herr K.Chronic pain in the older patient:management strategies[A]//Trends in phonological theory[C].Akademisk Forlag,2002:28-34.
[18]尹露,殷小容.FLACC疼痛评估量表在全麻苏醒期患儿疼痛评估中的应用[J].四川医学,2015,36(9):1221-1223.
[19]Cochran J,Ganong LH.A comparison of nurses,and patients,perceptions of intensive care unit stressors[J].J Adv Nurs,1989,14(12):1038-1043.
[20]Turner JS,Briggs SJ,Springhorn HE,et al.Patients,recollection of intensive care unit experience[J].Crit Care Med,1990,18(9):966-968.
[21]Hamill-Ruth RJ,Marohn ML.Evaluation of pain in the critically ill patient[J].Critical Care Clin,1999,15(1):35-54.
[22]Brummel SK,London MR,Drew N,et al.Outcomes of pain in frail older adults with dementia[J].J Am Geriatr Soc,2002,50(11):1847-1851.
[23]Herr K.对老年病人疼痛的评估[J].国外医学护理学分册,2002,21(6):272.
[24]淳雪丽.老年癌症患者疼痛管理及护理的研究进展[J].中华现代护理杂志,2011,17(8):980-982.
[25]王英杰,孙静,李菀,等.名儿科护士的患儿疼痛管理认知现状[J].中华护理杂志,2013,48(2):167-169.
[26]钱丽冰,陈梦莹,陈银花,等.儿科医护人员对儿童疼痛认知和管理现状的调查[J].中华实用儿科临床杂志,2012,27(18):1426-1428.
[27]李漓,刘要伟.护士对危重患者疼痛护理相关知识与实践现状的分析[J].中华护理杂志,2014,49(3):87.
[28]陈晓燕,成守珍,高明榕,等.广东5家三级甲等医院ICU护士疼痛管理知识态度调查分析[J].护理学报,2013,20(17):1-4.
[29]Grunau RE,Oberlander T,Holsti L,et al.Bedside application of the Neonatal Facial Coding System in pain assessment of premature infants[J].Pain,1998,76(3):277-286.
[30]Booker SS,Herr K.The state-of-“cultural validity”of selfreport pain assessment tools in diverse older adults[J].Pain Med,2015,16(2):232-239.
[31]Lawrence J,Alcock D,Mcgrath P,et al.The development of a tool to assess neonatal pain[J].Neonatal Netw,1993,12(6):59-66.
[32]贺芳,张喆,黄小知,等.种量表用于新生儿足跟采血疼痛评估的信效度分析[J].护理学报,2017,24(1):1-4.
[33]Merkel SI,Voepellewis T,Shayevitz JR,et al.The FLACC:a behavioral scale for scoring postoperative pain in young children[J].Pediatric Nursing,1997,23(23):293-297.
[34]Mcgrath P,Johnston G,Goodman JT.CHEOPS:a behavioral scale for rating postoperative pain in children[J].Adv Pain Res Therapy,1985,(9):395-402.
[35]陈杰,吴晓英,战颖,等.中文版成人疼痛行为量表的研制及信效度检验[J].中国疼痛医学杂志,2016,22(1):28-33.
[2]张秋实,郭明贤,崔艳,等.成年患者的疼痛评估[J].现代生物医学进展,2013,13(11):2185-2187.
[3]Carlson CL.Use of three evidence-based postoperative pain assessment practices by registered nurses[J].Pain Manag Nurs,2009,10(4):174-187.
[4]陈杰,路潜,张海燕,等.患者疼痛评估工具研究进展[J].中国护理管理,2014,14(11):1131-1134.
[5]Azzam PN,Alam A.Pain in the ICU:a psychiatric perspective[J].J Intensive Care Med,1900,28(3):140-150.
[6]叶俏,龚雪,刘颖.新生儿科护士疼痛管理认知现状调查分析与对策[J].护理实践与研究,2017,14(10):4-6.
[7]陈劼,张玉侠,顾莺,等.3~12岁儿童术后疼痛评估的循证实践[J].护士进修杂志,2015,30(11):1020-1024.
[8]李茶香.护士对老年痴呆患者疼痛的认知现状及相关评估工具的引进[D].广州:南方医科大学,2009.
[9]刘要伟,李漓.危重患者的疼痛评估[J].护理学杂志,2013,28(10):87-89.
[10]Anand KJ,Sippell WG,Aynsley-Green A.Randomised trial of fentanyl anaesthesia in preterm babies undergoing surgery:effects on the stress response[J].Lancet,1987,1(8524):62-66.
[11]Carbajal R,Rousset A,Danan C,et al.Epidemiology and treatment of painful procedures in neonates in intensive care unit[J].JAMA,2008,300(1):60-70.
[12]American.Academy of Family Physicians Planning for labor and vaginal birth after cesarean delivery:guidelines from the AAFP[J].Am Fam Physician,2015,91(3):197-198.
[13]邵肖梅,叶鸿瑁,丘小汕,等.实用新生儿学[M].北京:人民卫生出版社,2013:170.
[14]夏冬晴,陈梦莹,李晓南.新生儿疼痛对儿童行为发育的影响和机制研究进展[J].中国儿童保健杂志,2016,24(2):149-152.
[15]李美芳.新生儿疼痛的护理进展[J].当代护士,2014,(9):5-7.
[16]Loizzo A,Loizzo S,Capasso A.Neurobiology of pain in children:an overview[J].Open Biochem J,2009,3(1):18-25.
[17]Herr K.Chronic pain in the older patient:management strategies[A]//Trends in phonological theory[C].Akademisk Forlag,2002:28-34.
[18]尹露,殷小容.FLACC疼痛评估量表在全麻苏醒期患儿疼痛评估中的应用[J].四川医学,2015,36(9):1221-1223.
[19]Cochran J,Ganong LH.A comparison of nurses,and patients,perceptions of intensive care unit stressors[J].J Adv Nurs,1989,14(12):1038-1043.
[20]Turner JS,Briggs SJ,Springhorn HE,et al.Patients,recollection of intensive care unit experience[J].Crit Care Med,1990,18(9):966-968.
[21]Hamill-Ruth RJ,Marohn ML.Evaluation of pain in the critically ill patient[J].Critical Care Clin,1999,15(1):35-54.
[22]Brummel SK,London MR,Drew N,et al.Outcomes of pain in frail older adults with dementia[J].J Am Geriatr Soc,2002,50(11):1847-1851.
[23]Herr K.对老年病人疼痛的评估[J].国外医学护理学分册,2002,21(6):272.
[24]淳雪丽.老年癌症患者疼痛管理及护理的研究进展[J].中华现代护理杂志,2011,17(8):980-982.
[25]王英杰,孙静,李菀,等.名儿科护士的患儿疼痛管理认知现状[J].中华护理杂志,2013,48(2):167-169.
[26]钱丽冰,陈梦莹,陈银花,等.儿科医护人员对儿童疼痛认知和管理现状的调查[J].中华实用儿科临床杂志,2012,27(18):1426-1428.
[27]李漓,刘要伟.护士对危重患者疼痛护理相关知识与实践现状的分析[J].中华护理杂志,2014,49(3):87.
[28]陈晓燕,成守珍,高明榕,等.广东5家三级甲等医院ICU护士疼痛管理知识态度调查分析[J].护理学报,2013,20(17):1-4.
[29]Grunau RE,Oberlander T,Holsti L,et al.Bedside application of the Neonatal Facial Coding System in pain assessment of premature infants[J].Pain,1998,76(3):277-286.
[30]Booker SS,Herr K.The state-of-“cultural validity”of selfreport pain assessment tools in diverse older adults[J].Pain Med,2015,16(2):232-239.
[31]Lawrence J,Alcock D,Mcgrath P,et al.The development of a tool to assess neonatal pain[J].Neonatal Netw,1993,12(6):59-66.
[32]贺芳,张喆,黄小知,等.种量表用于新生儿足跟采血疼痛评估的信效度分析[J].护理学报,2017,24(1):1-4.
[33]Merkel SI,Voepellewis T,Shayevitz JR,et al.The FLACC:a behavioral scale for scoring postoperative pain in young children[J].Pediatric Nursing,1997,23(23):293-297.
[34]Mcgrath P,Johnston G,Goodman JT.CHEOPS:a behavioral scale for rating postoperative pain in children[J].Adv Pain Res Therapy,1985,(9):395-402.
[35]陈杰,吴晓英,战颖,等.中文版成人疼痛行为量表的研制及信效度检验[J].中国疼痛医学杂志,2016,22(1):28-33.
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