Tímarit hjúkrunarfræðinga - 01.11.1996, Blaðsíða 15

collected with a semi structured interview at four time points:
prior to surgery, on day 1 and day 3 post operatively and at
home on average 14 weeks post operatively. Pain was measured
by a 10 cm Visual Analogue Scale (VAS), with anchor words
„no pain“ and „could not be worse“ at either end and a verbal
Numerical Rating Scale (NRS), where 0 equalled no pain and
10 worst imaginable pain. Additional information was
collected regarding duration of the pain experience; analgesic
effect; prior experience of pain and pain management; sleep
disturbance due to pain; patient’s evaluation of pain
assessment and pain education; patient’s satisfaction with the
pain management; demographic data; underlying disease and
surgery. The main findings were that the patients expected and
experienced considerable pain during their post operative
period. Approximately half of the patients experienced almost
no pain or no pain on day 1 and 3 post operatively, but at the
same time nearly 25% of them experienced constant or almost
constant pain. The worst mean pain experience at different
times ranged from 3,6 to 4,8; and 16,5% to 31,2% of the
patients experienced pain > 7 at some time. About one fourth
of the patients stated that they experienced considerable or
severe pain when discharged from the hospital and 16,8% still
had constant or almost constant pain when interviewed at
home. Overall the patients were pleased witli their pain
management. Despite the fact that 66% of the patients stated
that no one assessed the analgesic effect, about 35% stated
that the medication had provided only tolerable to no pain
relief, and only 6,5% of the patients received non-
pharmacologic interventions. The main conclusion from the
findings of this study indicate that the patients in this sample
did experienee needless pain and that the pain management
could be improved considerably.
Heimildaskrá
Abbott, F.V., Gray-Donald, K., Sewitch, M.J., Johnston, C.C., Edgar, L. og
Jeans, M.E. (1992). The prevalence of pain in hospitalized patients
and resolution over six months. Pain, 50, 15-28.
Aðalheiður Guðmundsdóttir, Anna Lóa Magnúsdóttir og Brynhildur Þóra
Gunnarsdóttir (1992). Rannsókn á verkjum skurðsjúklinga, vœntingum
til þeirra og verkjameðferði Óbirt BS-ritgerð, Háskóli íslands,
Námsbraut í hjúkrunarfræði.
Agency for Health Care Policy and Research (1992). Acute Pain
Management in Adults. Clinical Practice Guideline (AHCPR skýrsla
nr. 92-0032). Rockville, MD: U.S. Department of Health and Human
Services, Public Health Service.
Ástrós Sverrisdóttir, Guðrún Ósk Ólafsdóttir, Helga Jensen, Ingunn
Steingrímsdóttir, Jónína Guðrún Óskarsdóttir og Kristfn Magnúsdóttir
(1991). Þœttir sem hafa áhrif á hjúkrun sjúklinga með langvinna verki.
óbirt BS-ritgerð, Háskóli íslands, Námsbraut í hjúkrunarfræði.
Carr, E.C.J. (1990). Postoperative pain: Patients’expectations and
experiences. Journal of Advanced Nursing, 75,1,89-100.
Clarke, E.B., French, B., Bilodeau, M.L., Capasso, V.C., Edwards, A. og
Empoliti, J. (1996). Pain management knowledge, attitudes and
clinical practice: The impact of nurses’ characteristics and education.
Journal of Pain and Symptom Management, 11, 18-31.
Donovan, B.D. (1983). Patient attitutes to postoperative pain relief.
Anaesthesia Intensive Care, 11, 125-129.
Donovan, M., Dillon, P. og McGuire, L. (1987). Incidence and characteristic
of pain in a sample of medical-surgical inpatients. Pain, 30, 69-87.
Dóróthea Bergs, Elísabet Hreiðarsdóttir, Helga Lára Helgadóttir og Kristín
Björg Ólafsdóttir (1991). Viðhorf lœkna og hjúkrunarfræðinga til
verkja og verkjameðferðar ungbarna. óbirt BS-ritgerð, Háskólinn á
Akureyri, Heilbrigðisdeild.
Hrund Sch. Thorsteinsson og Elín Hafsteinsdóttir (1994). Þekking íslenskra
hjúkrunarfræðinga á verkjum, verkjalyfjum og verkjameðferð sjúklinga
með krabbamein. Timarit hjúkrunarfrœðinga, 70, 18-26.
Jacox, A., Ferrell, B., Heidrich, G., Hester, N. og Miaskowski, C.
(1992). A guideline for the nation: Managing acute pain. AJN,
92 ,5, 49-55.
Juhl, I.U., Christensen, B.V., Bulow, H.H., Wilbek, H., Dreijer, N,C. og
Egelund, B. (1993). Postoperative pain relief, from the patients’
and the nurses’ point of view. Acta Anaesthesiologica
Scandinavica, 37, 404-409.
Lewin, J.M.E. og Razis, P.A. (1995). Prescribing practice of take-home
analgesia for day case surgery. British Journal of Nursing, 4,
1047-1051.
Margrét Björnsdóttir og Laura Sch. Thorsteinsson (1996). Könnun á
viðhorfum sjúklinga til þjónustu Borgarspítalans. Dropinn, 3,1,
16-17.
Marks, R.M. og Sachar, E.J. (1973). Under-treatment of medical
inpatients with narcotic analgesics. Annals of Internal Medicine,
78, 173-181.
McCaffery, M (1968). Nursing practice theories related to cognition,
bodily pain, and man-enviromental interactions^ Los Angeles:
University of California at Los Angeles Students’ Store.
McCaffery, M. og Beebe, A. (1989). Pain. Clinical manual for nursing
practice^ Missouri, USA: Mosby Company.
McCaffery, M., Ferrel, B.R., O’Neil-Page, E., Lester, M. og Ferrel, B.A.
(1990). Nurse’s knowledge of opioid analgesic drugs and
psychological dependence. Cancer Nursing, 13, 21-27.
Melzack, R., Abbott, F.V., Zackon, W., Mulder, D.S. og Davis, M.W.L.
(1987). Pain on a surgical ward: A survey of the duration and
intensity of pain and the effectiveness of medication. Pain, 29,
67-72.
Miaskowski, C. (1994). Pain management: Quality assurance and
changing practice. í G.F. Gebhart, D.L. Hammond og T.S.
Jensen (Ritstjórar), Proceedings of the 7th World Congress on
Pain (bls. 75-96). Seattle, USA: IASP Press.
Miaskowsky, C., Nichols, R., Brody, R. og Synold, T. (1994).
Assessment of patient satisfaction utilizing the American Pain
Society’s quality assurance standards on acute and cancer
related pain. Journal of Pain and Symtom Management, 9, 5-11.
Owen, H., McMillan, V. og Rogowski, D. (1990). Postoperative pain
therapy: A survey of patients’ expectations and their
experiences. Pain, 41, 303-307.
Paice, J., Mahon, S.M. og Faut-Callhan, M. (1995). Pain control in
hospitaized postsurgical patients. MEDSURG Nursing, 4, 367-
372.
Price, D.D., Bush, F.M., Long, S. og Harkins, S.W. (1994). A
comparison of pain measurement characteristics of mechanical
visual analogue and simple numerical rating scales. Pain, 56,
217-226.
Scott, I.S. (1992). Nurses’ attitudes to pain control and use of pain
assessment scales. British Journal of Nursing, 2,1, 11-16.
Teske, K., Daut, R.L. og Cleeland, C.S. (1983). Relationship between
nurses’ observations and patients’ self reports of pain. Pain, 16,
289-296.
Vortherms, R., Ryan, P. og Ward, S. (1992). Knowledge and attitudes
regarding pharmacologic management of cancer pain in a
statewide random sample of nurses. Research in Nursing and
Health, 15, 459-466.
Ward, S.E. og Gordon, D. (1994). Application of the American Pain
Society quality assurance standards. Pain, 56x 299-306.
Ward, S.E. og Gordon, D. (1996). Patient satisfaction and pain severity
as outcomes in pain management: A longitudinal view of one
setting’s experience. Journal of Pain and Symptom
Management, llx 242-251.
Ward, S.E., Goldberg, N., Miller-McCauley, V., Mueller, C., Nolan, A.,
Pawlik-Plank, D., Robbins, A., Stormoen, D. og Weissman, D.E.
(1993). Patient-related barriers to management of cancer pain.
Pain, 524 319-324.
Watt-Watson, J.H. (1995). Pain. í W.J. Phipps, V.l. Cassmeyer, J.K.
Sands og M.K. Lehmen (Ritstjórar). Medical Surgical Nursing.
Concepts and clinical practice (5. útg., bls. 450-453). MO: Mosby.
Watt-Watson, J.H. (1987). What do we need to know about pain? AJN,
87, 16, 388-97.
Wilder-Smith, C.H. og Schuler, L. (1992). Postoperative analgesia:
Pain by choice? The influence of patient attitudes and patient
education. Pain, 50x 257-262.
TÍMARIT HJÚKRUNARFRÆÐINGA 5. tbl. 72. árg. 1996