標題: An innovative nonpharmacological intervention combined with intravenous patient-controlled analgesia increased patient global improvement in pain and satisfaction after major surgery
作者: Chuang, Chia-Chun
Lee, Chien-Ching
Wang, Li-Kai
Lin, Bor-Shyh
Wu, Wen-Ju
Ho, Chung-Han
Chen, Jen-Yin
交大名義發表
影像與生醫光電研究所
National Chiao Tung University
Institute of Imaging and Biomedical Photonics
關鍵字: acute pain service;patient-physician communication;nonpharmacological approach;patient-controlled analgesia;patient satisfaction
公開日期: 1-一月-2017
摘要: Purpose: This study aimed to evaluate whether a nonpharmacological approach through implementation of a communication improvement program (named CICARE for Connect, Introduce, Communicate, Ask, Respond and Exit) into standard operating procedure (SOP) in acute pain service (APS) improved satisfaction in patients receiving intravenous patient-controlled analgesia (IV-PCA). Patients and methods: This was a nonrandomized before-after study. Adult patients (aged between 20 and 80 years) who received IV-PCA after major surgery were included. Implementing CICARE into SOP was conducted in APS. Anonymous questionnaires were used to measure outcomes in this prospective two-part survey. The first part completed by APS nurses contained patients' characteristics, morphine dosage, delivery/demand ratios, IV-PCA side effects and pain at rest measured with an 11-point numeric rating scale (NRS, 0-10). A score of NRS. 4 was defined as inadequately treated pain. The ten-question second part was completed by patients voluntarily after IV-PCA was discontinued. Each question was assessed with a 5-point Likert scale (1: extremely poor; 5: excellent). Patients were separated into "before" and "after" CICARE groups. Primary outcomes were patient global impression of improvement in pain (PGI-Improvement) and patient satisfaction. Secondary outcomes included quality of communication skills, instrument proficiency and accessibility/availability of IV-PCA. Results: The response rate was 55.3%, with 187 usable questionnaires. CICARE effectively improved patient global impression of improvement in pain, patient satisfaction, communication skills and accessibility/availability of IV-PCA. No significant differences were noted in instrument proficiency, morphine dosage, delivery/demand ratios, rates of inadequately treated pain at rest and side effects of IV-PCA between groups. Paradoxical findings were noted between the rates of inadequately treated pain/side effects and PGI-Improvement in pain/patient satisfaction, which were affected by psychological factors. Conclusion: Nonpharmacological interventions carried out by implementing CICARE into SOP for APS effectively improved patient satisfaction and postoperative pain management quality, but this did not affect actual pain.
URI: http://dx.doi.org/10.2147/NDT.S131517
http://hdl.handle.net/11536/145315
ISSN: 1178-2021
DOI: 10.2147/NDT.S131517
期刊: NEUROPSYCHIATRIC DISEASE AND TREATMENT
Volume: 13
起始頁: 1033
結束頁: 1042
顯示於類別:期刊論文


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