医护人员与癌症患者疼痛评价的比较研究

Comparative study of assessment of pain among medical and nursing staff and cancer patients

目的探讨癌症患者和医、护3方对患者癌痛强度评估结果的差异，为临床应用、选择合适的止痛方案和护理手段提供依据。方法采用Johnson量表收集55例住院癌症患者及相应管床的40名医生和55名护士对患者1周内最痛的癌症疼痛的感觉痛和反应痛的评估结果，并进行比较，同时调查患者对癌痛态度的相关问题。结果多数癌症患者对疼痛治疗仍存在不恰当的认识，患者自我报告及护士评估的反应痛均高于其感觉痛（P〈0．05），但两方面评价结果护士均较患者低（P〈0．05），差异具有统计学意义。医生评价的感觉痛高于反应痛，两方面的评估均低于患者自评，但差异均未达统计学意义（P〉0．05），医生较护士评价结果更准确。结论建议常规建立患者疼痛评价表，指导患者如何记录疼痛强度，加强医护人员疼痛管理知识的规范化培训及对患者疼痛状况的及时沟通。

Objective This study aimed to discuss the different assessment of pain among medical and nursing staff and cancer patients and supply reference for proper analgesic precept for clinical application and nursing measures. Methods We collected the assessment of psychological pain and physiological pain by 55 hospitalization cancer patients,40 physicians in-charge and 55 nurses in-charge in one week by Johnson inventory.The assessment results were compared and at the same time the relevant problems of the attitude to cancer pain by patients was also investigated. Results Improper recognition existed in cancer pain treatment by most cancer patients.The physiological pain was higher than the psychological pain assessed by both patients and nurses（P 〈 0.05 ）.But the pain assessment by patients was higher than that by the nurses （P 〈 0.05）.The assessment of psychological pain was higher than the physiological pain by doctors and both aspects were lower than those by patients,but no statistical difference was seen （P 〉 0.05 ）.The assessment by doctors was more accurate than that by nurses. Conclusions Routine establishment of pain assessment inventory for patients could instruct patients how to record the degree of their pain. We should strengthen the standard training about pain management knowledge and give timely communication with patients＇ cancer pain.