护理干预对癌性疼痛病人疼痛管理影响的系统评价

Systematic evaluation on influence of nursing intervention on pain management in patients with cancer pain

[目的]评价实施护理干预措施提高癌性疼痛病人疼痛管理的效果。[方法]计算机检索The Cochrane Library(2015年)、The Joanna Briggs Institute Library、Nursing Consult、MEDLINE(1946年—2015年)、EMBASE(1989年—2015年)、PubMed(1966年—2015年)、中国生物医学文献服务系统(1978年—2015年)、万方数据资源系统(1990年—2015年)中关于护理干预措施对提高癌性疼痛病人疼痛管理的随机对照试验(RCTs),检索时限为建库至2015年8月1日。由2名研究员按照纳入和排除标准筛选文献、提取资料、评价质量,然后采用Review Manager 5.3软件进行Meta分析或只采用描述性分析。[结果]共纳入9项随机对照试验,共1 155例病人;Meta分析结果显示:护理干预1个月和1个月以上能够降低癌性疼痛病人的疼痛强度[WMD=-0.82,95%CI(-1.11,-0.53),P<0.000 01;SMD=-0.20,95%CI(-0.36,-0.03),P=0.02],但对提高癌性疼痛病人的疼痛控制效果尚不显著[RR=0.94,95%CI(0.80,1.10),P=0.45];描述性分析结果显示:护理干预措施能显著提高癌痛病人的疼痛知识水平,但尚不能改善癌痛病人的生活质量。[结论]实施护理干预措施能提高癌性疼痛病人的疼痛知识水平并可降低其疼痛强度,但对改善生活质量和疼痛控制效果不显著。

Objective：To evaluate the effect of implementation of nursing interventions for improving the pain management in patients with cancer pain .Methods：The randomized controlled trials （RCTs） were retrieved on nursing interventions improving the cancer pain management in patients with cancer pain by computer in the Cochrane Library（2015） ,the Joanna Briggs Institute Library ,Nursing Consult ,MEDLINE（from 1946 to 2015） , EMBASE（from 1989 to 2015） ,PubMed（from 1966 to 2015） ,China biomedical literature service system （from 1978 to 2015） ,the data resources system （from 1990 to 2015） ,the retrieval time limit was from building time to August 1 ,2015 .According to the inclusion and exclusion criterias ,two researchers screened literature ,extracted data ,evaluated quality ,and then had Meta analysis by using Manager Review 5 .3 software or only had descrip-tive analysis .Results：Nine randomized controlled trials were included ,which included a total of 1 155 patients ;Meta analysis results showed ：receiving nursing intervention for a month and more than a month could reduce pain intensity [WMD= -0 .82 ,95% CI（-1 .11 ,-0 .53） ,P〈0 .000 01;SMD= -0 .20 ,95% CI（-0 .36 ,-0 .03） ,P=0 .02] ,but the improving of pain control effect in patients with cancer pain was not significant [RR=0 .94 ,95%CI（0 .80 ,1 .10） ,P=0 .45];the descriptive analysis showed that ：nursing intervention could significantly improve the pain knowledge level of patients with cancer pain ,but it still could not improve their quality of life .Conclu-sion：The implementation of nursing interventions could improve the pain knowledge level and reduce the pain intensity of patients with cancer pain ,but it was not significant to improve their quality of life and pain control .