Nursing Attitude and Intervention for Cancer Related Pain in Children

本研究目的在探讨日本儿童癌痛之有效护理介入。1995年至1997年的研究结果如下：1. 1995年，进行了广泛的文献综述。护士与医师对儿童疼痛的认知与对儿童疼痛的干预存在差异。被动使用镇痛、缺乏足够的信息共享、对疼痛缓解的不正确认识是儿童疼痛缓解不足的一些指征。需要进行更详细的调查研究，以澄清的条件下，护理设置的儿童在疼痛. 1996年进行了调查。结果发现，20%~ 50%的护理人员对儿童疼痛行为的性质及吗啡的使用有误解。镇痛和吗啡的使用被认为是被动的，相当大的反应表明，强烈的镇痛和/或麻醉剂被认为是缓解疼痛的最后手段。疼痛缓解不足的儿童的疼痛状况。1997年，为了了解对疼痛儿童的照料情况，进行了访谈。这位护士一直在一家领先的儿童止痛医院工作。根据研究结果，本研究建构了护理人员如何对疼痛干预需求做出临床判断的过程。这个过程有两个维度：对疼痛性质的判断和确定有效干预的判断。护士们对这些判断的结果感到不满意。本研究提出儿童疼痛照护方法之建议，包括必要之评估程序与项目、需要改善之环境因素、需要厘清照护人员对疼痛经验之价值与信念、组织系统之支援等。

The purpose of this project is to establish the effective nursing intervention for cancer pain in children in Japan. The research findings from 1995 to 1997 studies are follows :1. In 1995, extensive literature review was carried out. There were discrepancy between how nurses and physician had perceive about children's pain and what they intervene for the pain of children. Passive use of analgesia, lack of enough information sharing, incorrect knowledge of pain relief are some of indications for inadequate pain relief for children. The needs for more detailed survey study to clarify the condition of care setting for children in pain.2. In 1996, the survey was conducted. As the results, 20% to 50% of nurses had misunderstanding of the nature of children's behavior in pain and use of morphine. The use of analgesia and morphine was found to be passive and considerable response indicated that strong analgesia and/or narcotics were considered as last resort for pain alleviation. Inadequate pain relief in children's pain condition were indicated.3. In 1997, in order to grasp what is happening in the care situation for children in pain, interview was conducted. The nurse who has been working in the leading hospital for children's pain relief. From the results, the process of how the nurses makes clinical judgment about the need of pain intervention was constructed. The process has two dimensions : judgment about the nature of pain and judgment to determine effective intervention. The nurses were feeling inadequate about outcome of these judgement. Recommendation for approach to children in pain which include the necessary assessment process and items, the list of environmental factors to be improve, the need of clarifying value and belief about pain experience among people involved in the care, the support from organizational system, and others were proposed.