2106例成人住院患者疼痛负担横断面调查及其临床意义

A cross-sectional study of pain burden of 2 106 adult patients during hospitalization and its clinical implication

目的调查重庆医科大学附属第一医院成人住院患者疼痛负担和疼痛相关就医行为,以期改进疼痛诊疗措施,提高患者满意度。方法采用短期(72h)横断面调查方法,于2013年7月22日至24日对重庆医科大学附属第一医院成人住院患者进行问卷调查。结果问卷有效回收率为84%(2 106/2 515)。成人住院患者疼痛患病率为46.96%(989/2 106)。疼痛持续时间小于1个月的手术患者占68.24%(651/954)。手术患者术前静息中重度疼痛发生率为34.80%(332/954),术后为28.83%(275/954)。79.91%(1 683/2 106)的患者认为疼痛与自身疾病相关。81.10%(764/942)的患者认为医师提供的止痛治疗有效。年龄和学历水平等均是患者疼痛负担的影响因素(P<0.05)。结论成人住院患者的疼痛负担较为普遍,外科疼痛发生率较高,急性疼痛分布居多,以轻度疼痛为主;患者的疼痛认知程度和镇痛满意度较高,但仍有部分疼痛未得到有效治疗。医务人员应接受规范化镇痛诊疗培训,采取个体化多模式镇痛诊疗措施,降低疼痛患病率,进一步提高患者满意度。

Objective To investigate the pain burden and pain-related health seeking behaviors in adult patients during hospitalization in the First Affiliated Hospital of Chongqing Medical University, so as to improve the diagnosis and treatment of pain and improve patient satisfaction. Methods A short-term cross-sectional questionnaire survey （72 h） was carried out to investigate the adult patients during hospitalization from July 22nd to July 24th, 2013 in our hospital. Results The effective questionnaire response rate was 84%（2 106/2 515）. The incidence of pain was 46. 96% （989/2 106） in this research. It was found that 68. 24%（651/954） of surgical patients having a pain duration less than 1 month. The incidences of moderate-severe pain of surgical patients was 34. 80% （332/954） at rest preoperatively and 28. 83%（275/954） post-operatively. We found that 79.91% （1 683/2 106） of patients thought the pain was caused by disease, and 81.10% （764/942） of the patients thought the treatment for pain by the doctors was effective. Age and education level were found to be the factors influencing the pain burden of patients（P〈0. 05）. Conclusion Pain burden is common among adult patients during hospitalization. The incidence of surgical pain is high, with acute and mild pain being the most. The patients have a high degree of awareness of pain and a high satisfactory rate with pain control; however, some pain is still not well controlled. Medical staffs should receive systematic and scientific training and give individual analgesic measures, so as to reduce the prevalence of pain and further improve patient satisfaction.