剖宫产术后疼痛灾难化水平影响因素及对策探讨

Influencing factors and countermeasures of the pain catastrophizing level of parturients after cesarean section

目的:观察影响剖宫产术后女性疼痛灾难化水平的有关因素,探究针对性干预策略。方法:采用便利抽样法选取2022年10月-2023年2月本院剖宫产产妇283例作为研究对象,通过一般情况调查表、疼痛灾难化量表(PCS)、数字评定量表(NRS)、疼痛自我效能感量表(PSEQ)、广泛性焦虑量表(GAD-7)、爱丁堡产后抑郁量表(EPDS)、家庭关怀度指数问卷(APGAR)对产妇进行横断面调查。采用多元线性逐步回归分析剖宫产术后女性疼痛灾难化水平的独立影响因素。结果:纳入研究的269例产妇中PCS评分28.1±9.2分,其中≥38分64例(23.8%)。不同文化程度、职业产妇PCS评分有差异(P<0.05)。Pearson相关分析显示,剖宫产产妇PCS评分与NRS、GAD-7、EPDS评分呈正相关,与PSEQ、APGAR评分呈负相关(均P<0.05)。多元线性逐步回归分析发现,文化程度、PSEQ评分、APGAR评分越高女性剖宫产术后疼痛灾难化水平越低,NRS评分、GAD-7评分、EPDS评分越高女性剖宫产术后疼痛灾难化水平越高(均P<0.05)。结论:剖宫产术后女性疼痛灾难化水平的影响因素包括文化程度、疼痛强度、疼痛自我效能感、焦虑症状、抑郁症状、家庭支持,完善术后疼痛管理及健康教育,提高产妇疼痛应对能力,减轻负性情绪,增强家庭支持可能为降低疼痛灾难化水平的有效途径。

Objective:To observe the related factors afecting the level of pain catastrophe of parturients after cesarean section,and to explore the targeted intervention strategics.Methods:A total of 283 parturients who underwent cesarean section in hospital from October 2022 to February 2023 were selected as the research obiects by convenience sampling method.A cross sectional survey was conducted on the parturients through the general situation quecstionnaire.pain catastrophizing scale(PCS),numerical rating scale(NRS),pain self-efficacy scale(PSEQ),generalized anxiety scale(GAD-7),Edinburgh postnatal depression scale(EPDS)and family care index questinnaire(APGAR).Multivariate linear stepwise regression analysis was used to explore the independent influencing factors of the pain catastrophizing level of the parturients after cesarean section.Results:The average PCS score of 269 parturients included in the study was(28.09±9.24)points,of which,there were 64(23.8%)parturients with PCS score≥38 points.There was significant differences in the PCS score among the parturients with different educational levels or among the parturients with different oecupations(P<0.05).Pearson correlation analysis showed that the PCS score of the parturients with caesarcan section was positively correlated with their scores of NRS,GAD7 and EPDS,and was negatively correlated with their PSEQ and APGAR scores(P<0.05).Multivariate linear stepwise regression analysis found that the higher education level,and the higher PSEQ and APGAR scores of the parturients were,the lower level of pain catastrophizing after cesarean section.The higher of the NRS,GAD-7 and EPDS scores of the parturients were,the higher level of pain catastrophizing after cesarcan section(all P<0.05).Conclusion:The influencing factors of the level of pain catastrophizing of the parturients after cesarean section include the education level,the pain intensity,the pain self eficecy,the anxiety symptoms。the depressive symptoms and the family support.The improving postoperative pain management and health education of the parturients can improve their pain coping ability,reduce their negative emotions,and enhance their family support,and which may be efective ways to reduce the level of pain catastrophizing of the parturients.