手术后患者疼痛控制满意度状况及影响因素的研究

Assessment of patient satisfaction with postoperative pain management and influence factors

目的描述手术后患者对疼痛控制的满意度状况,探讨影响疼痛控制满意度的因素。方法采用多阶段抽样方法,随机抽取北京地区5家综合性三级甲等医院,对符合入选标准的304例手术后第2天的住院疼痛患者进行了调查,问卷由休斯顿疼痛情况调查表、疼痛治疗指数和病历资料核查表3个部分组成。结果术后患者对疼痛控制总体满意度平均评分为7.3。疼痛控制教育、医生对疼痛的处理、疼痛减轻、患者受到的所有针对疼痛的照料、医生或护士是否告诉患者要优先有效地控制疼痛以及手术次数共6个因素进入回归方程,是影响疼痛控制满意度的主要因素。结论患者对术后疼痛控制较为满意;疼痛控制服务因素是影响手术后患者疼痛控制满意度的主要因素。建议制订术后疼痛控制制度和标准,采取针对性措施,改善术后疼痛控制质量,提高术后患者对疼痛控制的满意度。

Objective The purpose of this study was to describe the patient satisfaction with postoperative pain management and the predictors of patient satisfaction. Methods Using a multistage sampling scheme, 304 inpatients on their second postoperative day in 5 tertiary hospitals of Beijing were recruited to complete a questionnaire, which was composed of the Houston Pain Outcome Instrument （HPOI） based on the American Society＇s Patient Outcome Questionnaire, the Pain Management Index and a demographic form. Results Mean rating for general satisfaction with pain management was 7. 3 （0 to 10 point scale）. It was found that general satisfaction with pain management could be predicted by 6 factors： satisfaction with education about pain management, pain relief, the care offered by doctors for the pain, overall care for pain, whether doctor or nurse explained that providing good pain management was a priority of the patient, and patient individual characteristic such as times of operation. Conclusions Patients were satisfied with postoperative pain management. Services about pain management were the main influence factors. It is important to develop Chinese standards about pain management. Applying effective pain interventions and education based on the patient＇s individual characteristics could improve the quality of postoperative pain management and patient satisfaction with it.