Improving pain outcomes of hospice patients with cancer.

Improving pain outcomes of hospice patients with cancer.
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改善癌症临终关怀患者的疼痛结果。

DOI：
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发表时间：
1999
期刊：
Oncology Nursing Forum
影响因子：
1.9
通讯作者：
M. Weitzner
M. Weitzner
中科院分区：
医学4区
文献类型：
--
作者：
A. Holzheimer;McMillan Sc;M. Weitzner

文献摘要

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宗旨/目标 评估多层面、临终关怀范围的、以护士为中心的疼痛管理干预措施在改善患者疼痛结果方面的成功。 设计 比较的，描述性的。 设置 一种主要提供家庭护理的大型非营利性临终关怀中心。 样本 这项研究包括两个样本。一份样本(n=47)来自干预前于1995年完成的一项研究，一份(n=255)来自干预后于1997年完成的一项研究。所有患者都被诊断出患有癌症，并保持警觉并能够自我报告。 方法 对作为两项生活质量研究一部分收集的数据进行二次分析。四个部分的干预措施包括对护士进行密集的疼痛管理教育，制定和实施疼痛管理政策和程序，改变疼痛评估和管理文件，以及护理人员开发和使用质量保证监测器。 主要研究变量 最严重的疼痛，疼痛的缓解，以及生活质量。 调查结果 调整后的平均疼痛缓解评分在1995年(X=5.8)显著低于1997年(X=8.4)。1995年，43%的患者报告疼痛缓解程度在5分或更低(0-10分)。到1997年，这一数字下降到10%。调整后的最严重疼痛评分在1997年(X=6.1)显著低于1995年(X=6.7)。在两个样本中，疼痛缓解与生活质量呈正相关(r=0.41-0.51)。 结论 临终关怀范围内的疼痛管理干预是有效的。 对护理实践的启示 通过仔细的研究和以护士为重点的多方面干预，癌症临终关怀患者的疼痛结局可以得到改善。
PURPOSE/OBJECTIVES To evaluate the success of a multifaceted, hospicewide, nurse-focused pain-management intervention for improving patient pain outcomes. DESIGN Comparative, descriptive. SETTING A large, nonprofit hospice that primarily provides home care. SAMPLE Two samples were included in the study. One sample (n = 47) was from a study completed in 1995 before the intervention, and one (n = 255) was from a study completed in 1997 after the intervention. All patients had been diagnosed with cancer and were alert and able to self-report. METHODS Secondary analysis of data that were collected as part of two quality-of-life studies. The four-part intervention included intensive pain-management education for the nurses, development and implementation of pain-management policies and procedures, changes in pain assessment and management documentation, and development and use of quality assurance monitors by the nursing staff. MAIN RESEARCH VARIABLES Pain at its worst, pain relief, and quality of life. FINDINGS Adjusted mean pain-relief scores were significantly lower in 1995 (X = 5.8) than in 1997 (X = 8.4). In 1995, 43% of patients reported pain relief at a level of 5 or less (on a 0-10 scale). This number dropped to 10% by 1997. Adjusted mean pain-at-its-worst scores were significantly lower in 1997 (X = 6.1) than in 1995 (X = 6.7). Pain relief was found to be positively correlated (r = 0.41-0.51) with quality of life in both samples. CONCLUSIONS The hospicewide pain-management intervention was effective. IMPLICATIONS FOR NURSING PRACTICE Through careful study and multifaceted nurse-focused interventions, pain outcomes of hospice patients with cancer can be improved.