Analysis of the Significance of Key Points of Patient Interventional Psychological Care and Pain Care

Interventional therapy has become increasingly popular in clinical practice due to advancements in medical technology.However,patients often experience psychological and physiological pressure due to its invasive nature.The management of patient discomfort and tension is crucial to ensure effective treatment.Psychological and pain management are essential components of interventional therapy,as they significantly impact patient recovery and prognosis.This article discussed the importance of interventional psychological and pain care for patients,starting with the development and spread of interventional therapy.The significance of providing high-quality nursing services to patients and improving their quality of life was also discussed.

Application of Wax Therapy in Pain Care of Patients with Rheumatoid Arthritis

Objective: To investigate the effect of wax therapy in pain care of patients with rheumatoid arthritis. Methods: Convenience sampling method was used to select inpatients with rheumatoid arthritis admitted to the rheumatology and immunology department of a 3A hospital in Jingzhou City. 75 patients from January 2021 to June 2021 were selected as the control group, and 75 patients from January 2022 to June 2022 were selected as the observation group. The control group was given routine nursing, and the observation group was implemented wax therapy nursing on the basis of the control group. The relief of clinical symptoms (morning stiffness time, pain score) and quality of life score of the two groups were observed. Results: After intervention, there was statistical significance between the two groups (P Conclusion: Wax therapy can improve the time of morning stiffness, the degree of pain and the quality of life of patients with rheumatoid arthritis.

Kangaroo Care (Skin-to-Skin) for Clustered Pain Procedures: Case Study

Background: Pain management for term newborns undergoing clustered painful procedures has not been tested. Kangaroo Care (chest-to-chest, skin-to-skin position of infant on mother) effectively reduces pain of single procedures, but its effect on pain from clustered procedures is not known. Aim: The aim was to test Kangaroo Care’s effect on pain in one term infant who received clustered painful procedures while determining feasibility of the Kangaroo Care intervention. Design, Setting, and Participant: A case study design was used with one healthy term newborn who received two heel sticks and one injection in one session in the mother’s postpartum room. Method: Heart rate and oxygen saturation (recorded from Massimo Pulse Oximeter every 30 seconds), crying time (total seconds of crying on videotape) and behavioral state (using Anderson Behavioral State Scoring system every 30 seconds) were measured before (5 minutes), during (10.5 minutes) and after (30 minutes) the three clustered painful procedures in a newborn who was in Kangaroo Care during all observations. One staff nurse administered the clustered procedures. Results: Heart rate increased sequentially with each heelstick, oxygen saturation remained unchanged, sleep predominated, and crying was minimal throughout the procedures. Conclusion: Kangaroo Care appeared to reduce pain from clustered painful procedures and can be further tested.

Application of Palliative Care in Improving the Quality of Life of Patients with Cancer Pain

Objective: To explore the effect of palliative care on the quality of life of patients with cancer pain. Methods: For May 2015 to May 2016 hospitalized 57 patients with advanced cancer pain carry out palliative care. At the same time, the quality of life questionnaire, including physical function, role function, emotional function, cognitive function and social function, were investigated at the time of admission and 6 weeks after admission. Results: Patients with various functions have significantly improved after palliative care (P Conclusions: Palliative care can effectively improve the quality of life of patients with cancer pain. It is worth in clinical promotion.

Pain Management and Factors Associated with Its Severity among Post Surgical Patients Admitted in the Intensive Care Unit at Muhimbili National Hospital, Tanzania

Background: Pain is the common experience among post operative patients admitted to the intensive care unit. Inadequate management can lead to undesired complications which can increase risk for morbidity and mortality. Objective: The aim of this study was to assess pain management and factors associated with its severity among post surgical patients admitted in intensive care unit at MNH. Method: A prospective study was conducted from October 2017 to February 2018 involving a total of 123 post operative patients aged 18 years and above admitted to the surgical and obstetric intensive care units. Structured questionnaires were used to obtain the required perioperative information. Severity of pain was assessed by using the Numerical Rating Scale (NRS). Data was analyzed using SPSS version 23.0. Frequency, percentages, tables and charts were used to summarize the study findings. Bivariate analysis and multivariate logistic regression were done. P-value of Results: The prevalence of severe post operative pain within 24 and 72 hours was 32.1% and 41.5% respectively. Pre operative use of analgesia (OR: 2.66, CI: 1.15 - 6.12, P value = 0.02), abdominal surgery (OR: 4.12 CI: 1.12 - 15.88, P value = 0.03) and thoracic surgeries (OR;7.42, CI: 1.54 - 35.88, P value = 0.01) was significantly associated with severe pain. Age, sex, ASA class, duration of surgery, and level of education did not show significant association with pain severity. Opioids prescribed postoperatively were pethidine (70.7%), morphine (11.4%) and fentanyl (11.4%). Other analgesics used were paracetamol (60.2%) and diclofenac (22%). Conclusion: The magnitude of post operative pain was high. Pre operative uses of analgesia, abdominal and thoracic surgery were the factors associated with severe pain. Pethidine and paracetamol were the most prescribed drugs, however the prescription pattern used was inadequate to control pain.

Medical School Students’ Knowledge of Pain and Palliative Care: An Observational Study

Background: Pain and palliative care are a reality in daily routines of medical treatment. However, the theoretical-practical curricula of traditional medical school course still unsatisfactorily contemplate pain management, as well as the palliative care approach. Objective: To assess the knowledge of medical students about pain and palliative care, as well as to identify their perception of teaching these topics during hospitalization. Methods: A cross-sectional observational study, with a descriptive and exploratory approach, data collection for which was carried out between August and November 2020. The target population was medical students, who responded to an online survey of a quantitative, anonymous and follow-up nature. The survey study variables concerned knowledge about pain management and palliative care. Results: An expressive majority of academics showed difficulty in understanding the pathophysiology of pain related to prescribing drugs for pain management purposes, and all of them believe that it is necessary to acquire more knowledge about pain treatment. In parallel, only 9.3% report having received sufficient information regarding palliative care during medical school. Conclusion: The results suggest a certain lack of knowledge and insecurity among medical school students with respect to pain management and care for patients receiving palliative care. The didactical approach to this theme is still deficient in the medical curriculum and requires immediate improvement and new proposals that address the training of these professionals in a more specific and effective way.

Clinical Audit Project Report —Audit of the Palliative Care Practitioners’ Adherence to WHO Guidelines in Managing Patients’ Pain at Cancer Diseases Hospital, Lusaka, Zambia

Appropriate adherence to World Health Organisation (WHO) pain management guidelines is vital in palliative care centres as it promotes the comfort of patients who are experiencing pain and it improves their quality of life. WHO (1996) highlighted the use of the WHO analgesic ladder guideline. This “analgesic ladder” proposes that after proper assessment with an appropriate pain assessment tool, patients in mild pain should be given non-opioids plus or minus adjuvants (including anticonvulsants and steroids);patients in moderate pain should be given weak opioids plus or minus non-opioids plus or minus adjuvants;and patients in severe pain should be given strong opioids plus or minus non-opioids plus or minus adjuvants as per the WHO pain ladder. The audit project was focused on assessing the palliative care practitioners’ (PCPs) adherence to WHO guidelines in managing their patients’ pain at Cancer Diseases Hospital (CDH). 15 participants were involved in the study and the data collection method used was a cross-sectional study in which the auditor observed PCPs, with an observation checklist comparing practice with WHO analgesic ladder guidelines. The result revealed that most of the PCPs were not meeting 80% of the standard set in the specific objectives for the audit. 7 (47%) PCPs were scoring the pain level before analgesia administration, whereas 8 (53%) PCPs were not scoring the pain level before analgesia administration. On the other hand, 47% (7 PCPs) were adhering to the WHO ladder of pain management, but 53% (8 PCPs) were not adhering to the WHO ladder of pain management. Therefore, effective adherence to the WHO analgesic ladder practice is still lacking in the PCPs at CDH. The percentage of PCPs who were not scoring the pain and not adhering to the WHO pain ladder guidelines was high, which is 8 (53%). Therefore, a re-audit is recommended to find out if levels of adherence have improved or not.

Associations among pain catastrophizing, muscle strength, and physical performance after total knee and hip arthroplasty

AIM To investigate whether reductions in pain catastrophizing associated with physical performance in the early period after total knee arthroplasty(TKA) or total hip arthroplasty(THA).METHODS The study group of 46 participants underwent TKA or THA. The participants were evaluated within 7d before the operation and at 14d afterwards. Physical performance was measured by the Timed Up and Go(TUG) test, and 10-m gait time was measured at comfortable and maximum speeds. They rated their knee or hip pain using a visual analog scale(VAS) for daily life activities. Psychological characteristics were measured by the Pain Catastrophizing Scale(PCS). Physical characteristics were measured by isometric muscle strength of knee extensors and hip abductors on the operated side. The variables of percent changes between pre-and postoperation were calculated by dividing post-operation score by pre-operation score.RESULTS Postoperative VAS and PCS were better than preoperative for both TKA and THA. Postoperative physical performance and muscle strength were poorer than preoperative for both TKA and THA. The percent change in physical performance showed no correlation with preoperative variables. In TKA patients, the percent change of PCS showed correlation with percent change of TUG(P = 0.016), 10-m gait time at comfortable speeds(P = 0.003), and 10-m gait time at maximum speeds(P = 0.042). The percent change of muscle strength showed partial correlation with physical performances.The percent change of VAS showed no correlation with physical performances. On the other hand, in THA patients, the percent change of hip abductor strength showed correlation with percent change of TUG(P =0.047), 10-m gait time at comfortable speeds(P = 0.001),and 10-m gait time at maximum speeds(P = 0.021). The percent change of knee extensor strength showed partial correlation with physical performances. The percent change of VAS and PCS showed no correlation with physical performances.CONCLUSION Changes in pain catastrophizing significantly associated with changes in physical performance in the early period after TKA. It contributes to future postoperative rehabilitation of arthroplasty.

MDTcare模式下的癌痛药学监护实践1例

目的探讨临床药师参与癌痛多学科团队照护(MDTcare)的工作模式。方法通过1例癌痛患者镇痛治疗期间出现阿片类药物相关不良反应,临床药师在MDT团队中提出个体化治疗方案调整建议,参与患者用药指导和教育,阐述了临床药师的重要作用。结果MDTcare模式下,临床药师与医师紧密协作,患者疼痛控制满意。结论作为MDT团队的成员,临床药师通过优化治疗方案,提供药学监护,保障了患者用药安全有效。

Unrecognised, undertreated, pain in ICU—Causes, effects, and how to do better

Methods: a literature review from 1990 to August 2012. Introduction: pain and its recognition can be a particular problem for patients in intensive care units (ICUs). Studies have suggested that around 70% of ICU patients have unrecognised or undertreated pain. Pain has serious physical and psychological effects, and can impair patient recovery and discharge. Pain relief is also an ethical and professional responsibility of doctors and nurses—and we may be failing in this. Causes: pain may be due to medical and nursing procedures, and the ICU environment. Pain can be under-recognised because ICU patients are often impaired in their ability to communicate (e.g. secondary to confusion from acute illness, endotracheal intubation, or reduced conscious level from sedative agents). Tools for pain assessment: in patients able to communicate verbally, the numerical rating scale (NRS) can be used to rate pain severity. In non-verbal, conscious, patients, the visual analogue scale (VAS) can be used as a visual alternative. Both are well-established. For unconscious/sedated patients, the behavioural pain scale (BPS) and critical care pain observation tool (CPOT) have been developed and validated. Changes in practice: where possible, sedation practice can be changed to allow better recognition of pain. Constant deep sedation can be interrupted with daily “sedation holds” to allow pain assessment. “Analgo-sedation” may also be used, with drug regimes which prioritise analgesia over sedation. “No-sedation” approaches may also be considered, but further research is required.

以疼痛专科护士为主导的镇痛泵全程管理系统的构建及应用研究

目的构建以疼痛专科护士为主导的镇痛泵全程管理系统,并评价其应用效果。方法以疼痛专科护士为主导、病区护士为主体,构建集专科护士工作站模块和病区护士工作站模块为一体的智能化镇痛泵全程管理系统。于2021年7月—10月在某三级甲等综合性医院进行系统试运行,比较系统应用前后镇痛泵患者24 h内镇痛不全率、镇痛相关不良反应阳性探测率、患者满意度和护士工作耗时的差异。结果镇痛泵全程管理系统使用后,当日20:00镇痛不全发生率由12.9%下降至5.9%(χ^(2)=21.749,P<0.001);次日09:00镇痛不全发生率由20.1%下降至15.1%(χ^(2)=6.759,P=0.009);次日16:00镇痛不全发生率差异无统计学意义;镇痛相关不良反应阳性探测率上升,其中恶心呕吐探测率由9.2%上升到31.5%(χ^(2)=119.46,P<0.001),头晕阳性探测率由3.6%上升到8.1%(χ^(2)=13.96,P<0.001);患者满意度由(4.90±0.40)分提高到(4.96±0.25)分,疼痛专科护士随访前准备和随访后数据录入耗时由(93.85±11.14)min/d下降至<20 min/d,病区护士评估镇痛泵耗时由(29.72±8.80)s/次下降到2 s/次,差异均具有统计学意义(P<0.05)。结论疼痛专科护士主导的镇痛泵全程管理系统,能有效改善术后疼痛管理的质量和患者满意度,优化疼痛管理的工作流程和工作效率。

规范化疼痛干预联合功能锻炼对髋关节置换术患者睡眠质量效果观察

目的:探究在对髋关节置换术患者护理时开展规范化疼痛干预联合功能锻炼对患者睡眠质量、疼痛程度以及关节功能的影响。方法:选取2023年3月至2024年3月厦门大学附属第一医院收治的行髋关节置换术患者66例作为研究对象,按照随机数字表法分为对照组和观察组,每组33例。对照组开展常规护理,观察组开展规范化疼痛干预联合功能锻炼。针对患者睡眠质量、疼痛程度、关节功能进行对比。结果:匹兹堡睡眠质量指数量表(PSQI)、视觉模拟量表(VAS)组间比较,干预后观察组评分较低,差异有统计学意义(P<0.05);日平均睡眠时间、夜间最长连续睡眠时间长于对照组,差异有统计学意义(P<0.05);Harris髋关节功能评分组间比较,干预后观察组较高,差异有统计学意义(P<0.05)。结论:在对髋关节置换术患者护理时开展规范化疼痛干预联合功能锻炼,可以提升患者手术期间睡眠质量,降低疼痛程度,促进关节功能恢复。

联合应用多种中医适宜技术干预阿片类药物相关性便秘的多中心临床研究

目的通过多中心临床研究,评价多项中医适宜技术联合干预对阿片类药物相关性便秘的临床疗效。方法2021年7月至2022年10月,在上海中医药大学附属岳阳中西医结合医院肿瘤科病房、利群医院安宁疗护病房、长征社区卫生服务中心安宁疗护病房选取符合阿片类药物相关性便秘诊断标准及便秘津亏肠燥证辨证标准的住院患者为研究对象,采用随机数字法分为对照组(n=164)与观察组(n=164)。两组患者均参照《阿片类药物相关性便秘中西医结合护理方案》开展常规护理工作。对照组在常规护理的基础上,给予乳果糖口服液(每日3次,每次10 mL空腹服用)及相应的用药指导;观察组在常规护理的基础上,采用中药贴敷、中药离子导入、耳穴压豆3项中医适宜技术联合干预。两组患者干预时间均为14 d,比较两组患者干预后的日均排便次数、平均排便间隔时间,干预前后的便秘症状、便秘相关生活质量及疼痛评分。结果观察组患者治疗便秘的显效率(31.71%)高于对照组(8.54%),且两组便秘症状疗效比较,差异有统计学意义(Z=-5.41,P<0.01);治疗后两组患者的日均排便次数及平均排便间隔时间差异均无统计学意义(P>0.05);两组患者治疗后便秘症状及相关生活质量较治疗前均有明显改善和提高,且观察组便秘症状及便秘相关生活质量评分的变化均比对照组更为明显,差异均有统计学意义(P<0.01);两组患者干预后疼痛评分均明显低于干预前,差异有统计学意义(P<0.01),但组间差异无统计学意义(P>0.05)。结论多种中医适宜技术联合干预可改善阿片类药物相关性便秘患者的便秘情况,同时可有效缓解患者的便秘不适症状、提高患者的生活质量,符合晚期肿瘤患者安宁疗护的理念,具有一定临床推广意义。

“一病一品”模式在肝癌经皮肝动脉化疗栓塞术患者中的应用效果

目的探讨“一病一品”模式在肝癌经皮肝动脉化疗栓塞(TACE)术患者中的应用效果。方法选取2021年9月至2023年9月江西省肿瘤医院收治的100例肝癌患者,采用随机数字表法将100例患者分为两组,每组均为50例。对照组采取常规护理,观察组采用“一病一品”模式,连续干预至出院。比较两组心理状态、疼痛、自理能力、并发症率、生活质量。结果观察组护理后焦虑自评量表(SAS)、抑郁自评量表(SDS)、数字评价量表(NRS)评分、并发症总发生率均低于对照组,自理能力评估量表评分、世界卫生组织生存质量测定量表(WHOQOL)各项评分均高于对照组,差异有统计学意义(P<0.05)。结论“一病一品”模式能够减轻肝癌TACE术患者不良情绪和疼痛,促进日常生活自理能力和生活质量提升,降低并发症发生风险。

溃疡性结肠炎中西医治疗及护理研究进展

溃疡性结肠炎是由免疫介导的炎症性肠病,临床症状为反复发作的腹泻、腹痛及黏液脓血便。中西医诊疗各有所长,探索行之有效的中西医结合治疗和护理方法对提高溃疡性结肠炎疗效有着积极意义。本研究总结中西医诊疗溃疡性结肠炎的研究现况及临床护理进展,以期为临床进一步提升溃疡性结肠炎的诊疗质量提供一定的理论依据。

“互联网+”移动护理模式在癌痛患者全程关怀护理中的应用效果

目的探讨“互联网+”的移动护理模式对癌痛患者的相关应用效果。方法选取2021年1月—2023年12月广西中医药大学附属瑞康医院肿瘤一病区收治的癌痛患者84例作为研究对象,按入院先后顺序分对照组(42例)和干预组(42例),对照组予以3个月常规宣教护理,干预组在常规健康教育的基础上通过互联网给予全程关怀护理模式干预3个月。对比两组患者服药依从性、爆发痛发生率、癌痛治疗认知度、自我效能感等指标,评估两组临床效果。结果两组患者干预后服药依从性评分、癌痛治疗认知度、自我效能感评分均高于干预前,且干预组均高于对照组,干预组爆发痛发生率低于对照组,差异均有统计学意义(P<0.05)。结论“互联网+”的移动护理模式可有效提高患者的癌痛治疗认知度、服药依从性和自我效能感,使患者疼痛得到缓解,降低了爆发痛的发生率,提高了患者的生存质量。该模式简单便于操作,经济有效,值得在临床上推广。

Labor Pain through the Eyes of Brazilian Women and Delivery Nurses

Objective: Understanding the perception of women who have recently given birth in a Brazilian hospital regarding labor pain and nursing involvement in the labor process. Methodology: exploratory, descriptive and qualitative study carried out in a Maternity part of the supplementary health system in the Federal District (DF). Data were collected between May and July 2015 through interviews using a semi-structured questionnaire. The sample consisted of 16 mothers and data analysis followed Bardin methodology in three phases. Results: The pain experienced during labor is surrounded by feelings and expectations. Both positive and negative feelings experienced by mothers were identified in the interviews and unanimous opinion was the fact that the second stage is the most painful period as continuous pain is experienced. Some of the participants compared pain with strong menstrual cramps, renal colic and back pain;others, said labor pain was the strongest ever experienced. The immediate contact with the newborn was referred to as a reward for coping with breast pain and suffering. Other factors such as the importance of follow-up, support and coping with the pain and care provided by health staff were also highlighted. Conclusion: empowerment of the mother and family through knowledge is considered an important tool to fight pain and cope with the birth process in a positive and physiological way, which in the long run promotes a cultural change in the population regarding the importance of vaginal birth.

中药热奄包联合多功能艾灸仪对剖宫产产妇的影响

目的观察中药热奄包联合多功能艾灸仪对剖宫产产妇的影响。方法采用回顾性研究方法,根据护理方法不同将180例剖宫产产妇分为观察组和对照组,每组各90例。对照组给予快速康复护理,观察组在对照组的基础上使用中药热奄包联合多功能艾条仪,1日2次,持续3d。对比两组产妇术后24~72 h宫缩疼痛、生活自理能力评分、舒适度评分和术后肛门排气时间。结果干预后,观察组术后24-72 h宫缩痛评分均低于对照组(P<0.05);观察组术后24 h生活自理能力评分、舒适度评分虽高于对照组,但无统计学意义(P>0.05),观察组术后48 h、72 h生活自理能力评分和舒适度评分高于对照组(P<0.05);观察组术后肛门排气时间短于对照组(P<0.05)。结论中药热奄包联合多功能艾条仪能够减轻剖宫产产妇的宫缩痛,加速胃肠蠕动,促进肛门排气,提升生活自理能力,改善产妇舒适度。

认知行为干预对固定矫正器正畸患者心理负担和自护能力的影响

目的:探讨认知行为干预对固定矫正器正畸患者心理负担和自护能力的影响。方法:选取2020年1月-2021年1月某院收治的90例固定矫正器正畸患者为研究对象,按照入院先后分为对照组和观察组,每组各45例;对照组采取常规干预,观察组采取认知行为干预;对比两组治疗依从性,干预前后心理负担[汉密尔顿焦虑自评量表(HAMA)、汉密尔顿抑郁自评量表(HAMD)]、舒适度和疼痛情况[Kolcaba简化舒适状况量表、视觉模拟评分法(VAS)]、自护能力[自我护理能力量表(ESCA)]及自我效能[口腔保健自我效能量表(SESS)]。结果:两组治疗依从性比较,观察组高于对照组(χ^(2)=5.404,P<0.05)。干预后,两组HAMA、HAMD评分均下降(P<0.05),且观察组均低于对照组(t=-8.993,-7.187;P<0.05);干预后,两组Kolcaba量表评分均升高(P<0.05),且观察组均高于对照组(t=10.804,P<0.05);两组VAS评分均降低(P<0.05),且观察组均低于对照组(t=-15.429,P<0.05);干预后,两组自我概念、健康知识水平、自我护理技能、自我护理责任感及ESCA量表总分均高于干预前(P<0.05),且观察组均高于对照组(t=6.692,3.663,5.640,5.183;P<0.05);干预后,两组口腔就诊、正确刷牙、平衡饮食得分均高于干预前(P<0.05),且观察组均高于对照组(t=4.295,7.013,7.427;P<0.05)。结论:对固定矫正器正畸患者采用认知行为干预效果显著,可提高治疗依从性,减轻心理负担,缓解疼痛,提高舒适度、自护能力和口腔保健自我效能。

住院患者急性疼痛智能管理平台的构建与应用

目的:基于临床照护分类系统构建住院患者急性疼痛智能管理平台,并评价应用效果,为提高住院患者疼痛管理质量提供借鉴。方法:以临床照护分类系统2.5中文版知识库和编码库为基础,开发包括评估工具智能推荐、评分高值预警、护理任务排程、疼痛程度自动触发个体化护理诊断及护理措施等功能的住院患者急性疼痛智能管理平台,于2022年4月试运行,比较平台使用前后住院患者疼痛管理质量指标及满意度。结果:使用平台后,住院患者的首次疼痛评估覆盖率、疼痛动态评估率、疼痛处置及时率均高于使用平台前(P<0.05),护士对信息系统使用满意度、患者对疼痛护理满意度均高于平台运行前(P<0.05)。结论:基于临床照护分类系统的住院患者急性疼痛智能管理平台的使用提升了住院患者急性疼痛管理效果,提高了患者满意度,同时提高了护士工作效率,具有临床推广使用价值。