骨科围术期患者疼痛教育满意度分析

Satisfaction analysis of pain education in patients during perioperative period of othopaedic surgery

目的 通过对骨科围术期患者进行疼痛教育,探索临床药师在疼痛管理中的作用.方法 将上海交通大学附属新华医院2013年1-9月住院患者设为非疼痛教育组（126例）,2013年10月至2014年6月住院患者设为疼痛教育组（127例）,2组患者均采用疼痛数字评价量表（NRS）对术后48 h疼痛进行评分,疼痛教育组给予疼痛教育,首次评分后72 h再评分,比较疼痛程度及认知行为的变化;记录与评估围术期镇痛药物治疗过程;患者填写疼痛教育满意度调查表.结果 2组患者使用非甾体消炎药物者占多数,药物使用比率比较,差异无统计学意义（P＞0.05）;2组患者不同手术部位术后72 h后再次进行疼痛评分,疼痛教育组患者NRS评分分值较非疼痛教育组明显降低,差异有统计学意义[四肢骨折手术：4（3,4）分比4（4,4）分,髋、膝关节手术：4（3,4）分比4（4,5）分,脊椎手术：4（3,4）分比4（4,4）分,其他部位骨折手术：3（3,3）分比4（3,4）分,P＜0.05].疼痛教育组教育前后患者认知行为比较差异有统计学意义（P＜0.05）;疼痛教育组91.3％（116/127）患者对疼痛教育满意,对个体化疼痛教育方式接受度为92.9％（118/127）.结论 临床药师通过对术后患者开展疼痛教育,在控制疼痛和疼痛管理中能够发挥积极的作用.

Objective To explore the role of clinical pharmacists on pain management by giving pain education in patients during perioperative period of othopaedic surgery.Methods Totally 126 inpatients from January to September 2013 were set as non pain-education group; 127 inpatients from October 2013 to June 2014 were set as pain-education group.The numberial rating scale （NRS） was used to assess the pain degrees 48 h after operation ; the pain education was carried out in pain-education group and the pain degree was assessed 72 h later.The pain degree and cognitive behavior were evaluated ; the therapeutic process of the analgesics was recorded and the satisfaction of pain education was filled out by patients.Results The utilization rates of non-steroidal anti-inflammatory drug in two groups were both high without significant differences （P 〉 0.05）.The NRS score after pain education were all significantly lower in different operative sites in pain-education group compared with those in non pain-education group[limb fracture operation：4（3,4） scores vs 4（4,4） scores,hip and knee joint operation：4 （3,4） scores vs 4 （4,5） scores,spinal operation：4 （3,4） scores vs 4 （4,4） scores,other fracture operation：3（3,3） scores vs 4 （3,4） scores] （P 〈 0.05）.The pain-education included emphasizing the importance of compliance and instructing patients to take medicine properly.The cognitive behavior was significantly improved after pain education （P 〈 0.05）.Totally 91.3% （116/127） patients were satisfied with paineducation and the acceptability was 92.9% （118/127） in pain-education group.Conclusion Clinical pharmacists play a positive role in pain management by carrying out pain-education in postoperative patients.