护士对儿童临床疼痛管理障碍认知情况的调查分析

Investigation and Analysis of Nurses’Cognition of Clinical Pain Management Disorders in Children

目的为提升儿童慢性疼痛诊疗水平,探索影响儿童疼痛管理的干扰因素。方法2020年5-12月对郑州市某三甲医院的在职护士就儿童疼痛管理的障碍进行了问卷调查。调查问卷有19项潜在的疼痛管理中的障碍,涉及患者和家长、医生和护士以及医疗法规和医院管理。结果126名某三甲医院的护士自愿参与了这项研究。影响儿童疼痛管理的前5项主要障碍分别为患儿疼痛评估不足、处方止痛药剂量不足、家长不愿让孩子服止痛药、对患儿及父母疼痛知识宣教不够以及工作繁重导致处理疼痛的时间不足。而在受教育程度和工作年限评分的比较中,受教育程度高较受教育程度低患者克服障碍的能力更好(P<0.001),而工作年限在克服障碍的能力方面差异无统计学意义(P=0.309)。结论干扰儿童最佳疼痛管理的因素是多方面的,疼痛管理知识和医患沟通不足是主要障碍。

Objective To improve the diagnosis and treatment of chronic pain in children,the interfering factors affecting pain management in children were explored.Methods From May to December 2020,on-the-job nurses in a Grade-A hospital in Zhengzhou City conducted a questionnaire survey on the barriers to pain management in children.The questionnaire had 19 potential barriers in pain management,involving patients and parents,doctors and nurses,medical regulations and hospital management.Results A total of 126 nurses from a third class hospital volunteered to participate in this study.The top 5 major barriers affecting pain management in children were the inadequate assessment of the children’s pain,the doctors were unwilling to prescribe enough drugs to treat children’s pain,parents were reluctant to let their children take analgesics,insufficient education on pain knowledge for children and parents,and the nurses did not have enough time to deal with the children’pain due to heavy workload.And in the comparison of grades of education and years of work,the patients with higher education were better able to overcome obstacles than those with lower education(P<0.001),while there was no significant difference between their working years in their abilities to overcome barriers(P=0.309).Conclusion The obstacles that affect children’s optimal pain management are multifaceted,and the main barriers are the insufficient of pain management knowledge and medical staffs-patient communications.