Nursing Attitude and Intervention for Cancer Related Pain in Children

本项目旨在为日本儿童癌症疼痛建立有效的护理干预措施。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。护士和医生对儿童疼痛的认知和干预方式存在差异。被动使用镇痛药，缺乏足够的信息共享，不正确的镇痛知识是儿童疼痛缓解不足的一些指征。需要更详细的调查研究来阐明疼痛儿童护理环境的状况。1996年进行了这项调查。结果显示，20% ~ 50%的护士对儿童疼痛行为的性质和吗啡的使用存在误解。镇痛药和吗啡的使用是被动的，相当大的反应表明强镇痛药和/或麻醉药被认为是减轻疼痛的最后手段。儿童疼痛情况下疼痛缓解不足。1997年，为了了解疼痛儿童的护理情况，进行了一次访谈。一直在一流的儿童镇痛医院工作的护士。从结果出发，构建了护士对疼痛干预必要性的临床判断流程。这个过程有两个维度：判断疼痛的性质和判断确定有效的干预措施。护士们对这些判决的结果感到不满意。提出了对疼痛儿童治疗方法的建议，包括必要的评估过程和评估项目、需要改善的环境因素清单、需要明确参与护理人员对疼痛体验的价值和信念、组织系统的支持等。

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.