NURSING INTERVENTIONS FOR ACUTE ORAL PAIN AND MUCOSITIS

强化细胞还原后继发的急性口腔疼痛和粘膜炎 癌症的治疗对许多患者来说是一个重大的问题，但没有 系统的护理研究已经存在。使用独特的多维 癌症疼痛的概念化，本研究的主要目的是 一名护士在随机、两组临床试验中的效果测试- 对选定的结果进行心理教育干预 被诊断为血液系统或实体肿瘤恶性肿瘤的成年人。这个 需要检验的假设是，护士实施心理教育 结合疼痛和口腔护理实践进行干预 标准将降低急性口腔疼痛的严重程度和持续时间 粘膜炎，减少情绪困扰，增加认知力 和行为应对策略。三个次要目标是：1) 探索六个维度的综合性和互动性 疼痛体验，2)检查干预对这些的影响 疼痛的维度，以及3)检查与疼痛相关的 急性口腔疼痛和粘膜的生物标志物和临床措施 组织损伤。该项目将对两名住院患者进行护理 佐治亚州亚特兰大埃默里大学医院的一个研究小组 代表护理、医学、牙科等学科， 生物统计学、药剂学和临床心理学。同意的病人 将随机分为对照组(接受常规护理 和医疗)或试验组(接受 由具体目标构成的心理教育干预 在启动之前提供的信息和应对技能培训 细胞减少性治疗和强化教学贯穿始终 住院)。急性疼痛和口腔护理的实践标准将是 用于管理两个研究组的症状。疼痛、粘膜炎和其他症状 从入院开始，每天都会收集所有患者的相关数据 在开始治疗后至少21天内。结果将 指导临床护理实践，提高认识 关于疼痛的多维体验及其与 干预措施，并提供对生物标志物的初步理解 疼痛和粘膜炎的症状。

Acute oral pain and mucositis secondary to intensive cytoreductive therapy for cancer are a significant problem for many patients, yet no systematic nursing research exists. Using a unique multidimensional conceptualization of cancer pain, the primary aim of this research is to test in a randomized, two-group clinical trial effects of a nurse- administered psychoeducational intervention on selected outcomes in adults diagnosed with hematologic or solid tumor malignancies. The hypothesis to be tested is that a nurse-administered psychoeducational intervention used in conjunction with pain and oral care practice standards will decrease severity and duration of acute oral pain and mucositis, decrease emotional distress, and increase the use of cognitiv and behavioral coping strategies. Three secondary aims are to: 1) explore the integrated and interactive nature of six dimensions of the experience of pain, 2) examine the effects of interventions on these dimensions of pain, and 3) examine relationships between pain-related biologic markers and clinical measures of acute oral pain and mucosal tissue injury. The project will be conducted on two inpatient nursing units at Emory University Hospital, Atlanta, GA, by a research team representing the disciplines of nursing, medicine, dentistry, biostatistics, pharmacy, and clinical psychology. Consenting patients will be randomly assigned to the control group (receiving usual nursing and medical care) or to the experimental group (receiving a psychoeducational intervention consisting of concrete objective information and coping skills training given prior to initiation of cytoreductive therapy, and reinforcement teaching done throughout hospitalization). Acute pain and oral care practice standards will be used to manage symptoms in both study groups. Pain, mucositis, and othe relevant data will be collected daily on all patients from admission through at least 21 days after initiation of therapy. Results will provide guidance for clinical nursing practice, increase understanding of the multidimensional experience of pain and its relationship with interventions, and provide a beginning understanding of biologic markers of pain and mucositis.