HOME CARE MANAGEMENT OF PEDIATRIC PAIN

小儿疼痛的家庭护理管理

• 批准号: 6094539
• 负责人: KIMBERLY A SUTTERS
• 金额: $ 30.65万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2000
• 资助国家: 美国
• 起止时间: 2000-06-01 至 2004-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6094539
• 关键词: acetaminophen; analgesia; analgesics; caregivers; child (0-11); clinical research; clinical trials; codeine; dosage; family nursing; home health care; human subject; human therapy evaluation; nursing intervention; pain; patient care management; pediatric nursing

DESCRIPTION: The pediatric surgery outpatient population has grown extensively in recent years. Tonsillectomy, one of the most prevalent ambulatory surgeries in children, has been associated with a substantial degree of postoperative morbidity, with inadequate pain control cited as a major concern. Therefore, this randomized clinical trial will compare the effectiveness of a structured pain management program (i.e. that combines routine parent postoperative education, with around the clock (ATC) dosing of analgesics and nurse coaching, that is targeted at decreasing barriers to effective pain control in the home), with either standard care (i.e. routine parent postoperative education) and "as needed" analgesic dosing, or standard care and ATC dosing. Patients (N = 300) will be recruited from a large ambulatory surgery program and will be randomized to one of three treatment groups. Parents in the standard care groups will receive routine postoperative education and will be told to administer pain medication to their children every 4 hours "as needed" (Group A), or every 4 hours ATC (Group B). Parents in the structured pain management group (Group C) will receive and educational session that includes standard postoperative instructions and pain management education targeted at increasing knowledge and decreasing barriers to effective pain management as part of a coaching intervention, and will told to administer pain medication every four hours ATC. Parents in all three groups will receive follow-up phone calls on days 1 and 2 following surgery. In the standard care groups, the purpose of the phone calls will be to ascertain level of adherence with completion of the daily logs. Parents in the structured pain management group will receive coaching during the phone calls to include review of pain scores, child adherence to taking pain medicine, strategies for pain medication administration (as indicated), rationale for ATC dosing and instruction for ATC dosing, and potential side effects. Patients will be followed for three days and nights following tonsillectomy and parents will complete diaries in the morning and in the evening. The major outcome variables for this study are: pain intensity scores with and without swallowing, analgesic consumption, oral intake of fluids, negative behaviors and side effects. Patients and parents in all pain management groups will have and end of study interview to describe their experiences with the program.

描述：小儿外科门诊人数大幅增长 最近几年。扁桃体切除术，最流行的门诊手术之一 在儿童中，与术后很大程度上相关 发病率，疼痛控制不足被认为是一个主要问题。所以， 这项随机临床试验将比较结构化的有效性 疼痛管理计划（即结合常规家长术后护理 教育，全天候（ATC）镇痛药剂量和护士指导， 旨在减少在家中有效控制疼痛的障碍）， 采用标准护理（即常规家长术后教育）和“作为 需要”镇痛剂量，或标准护理和 ATC 剂量。患者 (N = 300) 将从大型门诊手术项目中招募并将 随机分配到三个治疗组之一。父母接受标准护理 小组将接受常规的术后教育，并被告知 “根据需要”每 4 小时给孩子服用止痛药（小组 A)，或每 4 小时 ATC（B 组）。家长进行结构化疼痛管理 组（C 组）将接受包括标准的教育课程 术后指导和疼痛管理教育旨在增加 知识和减少有效疼痛管理的障碍作为 教练干预，并被告知每四次服用止痛药 小时空中交通管制。所有三组的家长都将收到后续电话 手术后第 1 天和第 2 天。在标准护理组中， 电话将用于确定完成任务后的遵守程度 每日日志。结构化疼痛管理小组的家长将收到 在电话期间进行指导，包括审查疼痛评分、儿童 坚持服用止痛药、止痛药策略 给药（如所示）、ATC 剂量的基本原理和 ATC 说明 剂量和潜在的副作用。患者将被跟踪三天 扁桃体切除术后的夜晚，父母将在 早上和晚上。本研究的主要结果变量是： 吞咽和不吞咽、镇痛消耗、口服的疼痛强度评分 液体摄入、负面行为和副作用。患者及家长在 所有疼痛管理小组都会在研究结束时进行访谈来描述 他们对该计划的体验。