股骨头坏死行游离腓骨移植患者术后疼痛状况及疼痛护理满意度相关因素分析

Situation of postoperative pain and satisfaction to pain nursing in patients with ONFH after FVFG

目的：了解股骨头坏死游离腓骨移植患者术后疼痛状况及疼痛护理满意度，分析疼痛护理满意度相关因素。方法采用便利抽样选取2016年1—10月上海市第六人民医院骨科收治的股骨头坏死行游离腓骨移植术后72 h的患者140例，采用患者一般资料问卷、简明疼痛量表、疼痛护理满意度量表对患者进行调查，并分析疼痛护理满意度的影响因素。结果140例股骨头坏死游离腓骨移植患者术后72 h最大疼痛评分为（4.92±1.36）分；总疼痛护理满意度得分（81.81±9.09）分，其中专业技术能力维度条目均分最高为（4.00±0.61）分，其次为信任关系维度为（3.90±0.53）分，教育关系维度得分最低为（3．77±0.30）分。单因素分析结果显示，患者年龄、教育程度影响疼痛护理满意度（P〈0.05）；多元逐步回归分析结果显示，术后最大疼痛强度、疼痛对功能锻炼的影响、疼痛的缓解程度、患者的教育程度、疼痛对患者睡眠的影响5个因子进入多元回归方程，可解释变异量为70.8%（R2=0.708）。结论股骨头坏死游离腓骨移植患者对术后疼痛控制总体较为满意，术后最大疼痛强度、疼痛对功能锻炼的影响、疼痛的缓解程度、患者的教育程度、疼痛对患者睡眠的影响影响患者的疼痛护理满意度。

Objective To know the situation of postoperative pain and the satisfaction with pain management in patients who suffered osteonecrosis of the femoral head （ ONFH ） and accepted free vascularized fibular grafting （ FVFG ） , and analyze the influencing factors of satisfaction with pain management. Methods By convenience sampling method, 140 inpatients who underwent FVFG for 72 hours were recruited in this study. These patients were admitted in the orthopedic department of the Sixth People′s Hospital of Shanghai from January to October 2016, and were investigated by the general information questionnaire, the brief pain inventory, and the pain treatment satisfaction scale. The influencing factors of satisfaction with pain nursing were analyzed. Results The score of the most severe pain intensity of the 140 patients reached （ 4. 92 ± 1. 36 ） . The total score of patients′ satisfaction with pain management was （81. 81±9.09）, among which, the dimension of professional skills earned the highest average score of （4.00± 0.61）, followed by the dimension of trust, which was up to （3. 90±0.53）. The dimension of the relation of education got the lowest score of （3.77±0.30）. The analysis of single factor showed that the age and the education levels affected the satisfaction of pain management （ P〈0. 05 ） . The stepwise multiple regression analysis reviewed that there were five factors having influences on the satisfaction of pain management, and they were： the most severe pain intensity after FVFG, the influences of pain on functional exercise, the degree of pain relief, the education level of patients, and the influences of pain on patients′sleeping. These can successfully explain 70.8% of the variation of the satisfaction （ R2=0.708） . Conclusions Patients are overall satisfied with postoperative pain treatment. Factors such as the most severe pain intensity after FVFG, the influences of pain on functional exercise, the degree of pain relief, the education level of patients, and the influences of pain on patients′sleeping will affect the degree of satisfaction.