대한간호학회지 (Journal of Korean Academy of Nursing)

한국간호과학회 (Korean Society of Nursing Science)
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중환자실 내 간호시술에 대한 간호사의 통증인식과 환자의 통증반응

Pain Perception of Nurses and Pain Expression of Patients in Critical Care Units

  • 투고 : 2014.05.12
  • 심사 : 2014.07.29
  • 발행 : 2014.08.29
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초록

Purpose: This study was done to identify pain perception (P-PER) by nurses and pain expression (P-EXP) by patients in critical care units (ICUs) and degree of agreement between nurses' P-PER and patients' P-EXP. Methods: Nurses' P-PER was measured with a self-administered questionnaire completed by 99 nurses working in ICUs during May, 2013. Patients' P-EXP was measured with the Critical Care Non-Verbal Pain Scale through observations of 31 ICU patients during nine nursing procedures (NPs) performed between May and July, 2013. Results: Nurses' P-PER was from 4.49 points for nasogastric tube (NGT) insertion to 0.83 for blood pressure (BP) measurement based on a 9-point scale, Patients' P-EXP was 4.48 points for NGT to 0.18 for BP measurement based on a 10-point scale. Eight NPs except oral care showed higher scores for nurses' P-PER than for patients' P-EXP. Position change (p=.019), subcutaneous injection (p<.001), blood sugar test (p<.001), and BP measurement (p<.001) showed significant differences between nurses' P-PER and patients' P-EXP. Conclusion: Nasogastric tube (NGT) insertion was scored highest by both nurses and patients. Eight NPs except 'oral care' showed nurses' P-PER was higher or similar to patients' P-EXP, which indicates that nurses may overestimate procedural pain experienced by patients.

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참고문헌

  1. International Association for the Study of Pain Subcommittee on Taxonomy. Pain terms: A list with definitions and notes on usage. Recommended by the IASP subcommittee on taxonomy. Pain. 1979;6(3):249-252.
  2. Carbajal R, Rousset A, Danan C, Coquery S, Nolent P, Ducrocq S, et al. Epidemiology and treatment of painful procedures in neonates in intensive care units. JAMA : the Journal of the American Medical Association. 2008;300(1):60-70. http://dx.doi.org/10.1001/jama.300.1.60
  3. Puntillo KA, Max A, Timsit JF, Vignoud L, Chanques G, Robleda G, et al. Determinants of procedural pain intensity in the intensive care unit. The $Europain^{(R)}$ study. American Journal of Respiratory and Critical Care Medicine. 2014;189(1):39-47. http://dx.doi.org/10.1164/rccm.201306-1174OC
  4. Puntillo KA, White C, Morris AB, Perdue ST, Stanik-Hutt J, Thompson CL, et al. Patients' perceptions and responses to procedural pain: Results from thunder project II. American Journal of Critical Care. 2001; 10(4):238-251.
  5. de Jong A, Molinari N, de Lattre S, Gniadek C, Carr J, Conseil M, et al. Decreasing severe pain and serious adverse events while moving intensive care unit patients: A prospective interventional study (the NURSE-DO project). Critical Care. 2013;17(2):R74. http://dx.doi.org/10.1186/cc12683
  6. Greisen J, Juhl CB, Grofte T, Vilstrup H, Jensen TS, Schmitz O. Acute pain induces insulin resistance in humans. Anesthesiology. 2001;95(3): 578-584. https://doi.org/10.1097/00000542-200109000-00007
  7. Alsaadi SM, McAuley JH, Hush JM, Lo S, Lin CW, Williams CM, et al. Poor sleep quality is strongly associated with subsequent pain intensity in patients with acute low back pain. Arthritis & Rheumatology. 2014;66(5):1388-1394. http://dx.doi.org/10.1002/art.38329
  8. Courtenay M, Carey N. The impact and effectiveness of nurse-led care in the management of acute and chronic pain: A review of the literature. Journal of Clinical Nursing. 2008;17(15):2001-2013. http://dx.doi.org/10.1111/j.1365-2702.2008.02361.x
  9. Registered Nurses' Association of Ontario. Assessment and management of pain. 3rd ed. Toronto, CA: Author; 2013.
  10. Hwang KH, Ryoo EN, Park KS. A study of the nurses' knowledge and attitude about pain management. Journal of Korean Academy Society of Nursing Education. 2007;13(1):41-51.
  11. Song SS, Park CS. Pain management knowledge and attitude of internal medicine and surgery stream nurses. Journal of Korean Academic Society of Home Care Nursing. 2010;17(1):55-62.
  12. Bergeron DA, Leduc G, Marchand S, Bourgault P. Descriptive study of the postoperative pain assessment and documentation process in a university hospital. Pain Research & Management. 2011;16(2):81-86. https://doi.org/10.1155/2011/480479
  13. Puntillo K, Neighbor M, O'Neil N, Nixon R. Accuracy of emergency nurses in assessment of patients' pain. Pain Management Nursing. 2003;4(4):171-175. https://doi.org/10.1016/S1524-9042(03)00033-X
  14. Payen JF, Bru O, Bosson JL, Lagrasta A, Novel E, Deschaux I, et al. Assessing pain in critically ill sedated patients by using a behavioral pain scale. Critical Care Medicine. 2001;29(12):2258-2263. https://doi.org/10.1097/00003246-200112000-00004
  15. Gelinas C, Fillion L, Puntillo KA, Viens C, Fortier M. Validation of the critical-care pain observation tool in adult patients. American Journal of Critical Care. 2006;15(4):420-427.
  16. Choi EH, Kim JH, Choi KO, Yoo JS, Kim MS, Kim PJ, et al. Development of a pain assessment tool for critically ill patients. Journal of Korean Clinical Nursing Research. 2012;18(1):136-148.
  17. Choi EH, Kim JH, Ko MS, Kim JY, Kwon EO, Jang IS. Validation of critical care non-verbal pain scale for critically ill patients. Journal of Korean Clinical Nursing Research. 2013;19(2):245-254.
  18. Gelinas C, Fortier M, Viens C, Fillion L, Puntillo K. Pain assessment and management in critically ill intubated patients: A retrospective study. American Journal of Critical Care. 2004;13(2):126-135.
  19. Rose L, Haslam L, Dale C, Knechtel L, Fraser M, Pinto R, et al. Survey of assessment and management of pain for critically ill adults. Intensive and Critical Care Nursing. 2011;27(3):121-128. http://dx.doi.org/10.1016/j.iccn.2011.02.001
  20. Chanques G, Jaber S, Barbotte E, Violet S, Sebbane M, Perrigault PF, et al. Impact of systematic evaluation of pain and agitation in an intensive care unit. Critical Care Medicine. 2006;34(6):1691-1699. http://dx.doi.org/10.1097/01.ccm.0000218416.62457.56
  21. Chanques G, Sebbane M, Barbotte E, Viel E, Eledjam JJ, Jaber S. A prospective study of pain at rest: Incidence and characteristics of an unrecognized symptom in surgical and trauma versus medical intensive care unit patients. Anesthesiology. 2007;107(5):858-860. http://dx.doi.org/10.1097/01.anes.0000287211.98642.51
  22. Payen JF, Chanques G, Mantz J, Hercule C, Auriant I, Leguillou JL, et al. Current practices in sedation and analgesia for mechanically ventilated critically ill patients: A prospective multicenter patient-based study. Anesthesiology. 2007;106(4):687-695. http://dx.doi.org/10.1097/01.anes.0000264747.09017.da
  23. Gelinas C. Management of pain in cardiac surgery ICU patients: Have we improved over time? Intensive and Critical Care Nursing. 2007;23(5):298-303. http://dx.doi.org/10.1016/j.iccn.2007.03.002
  24. Kim DH, Kim C, Sohn KT, Jeong KM, Chung Y, Choi YS, et al. Statistics: Theory and application. Paju: Freeacademy; 2003.
  25. Siffleet J, Young J, Nikoletti S, Shaw T. Patients' self-report of procedural pain in the intensive care unit. Journal of Clinical Nursing. 2007;16(11): 2142-2148. http://dx.doi.org/10.1111/j.1365-2702.2006.01840.x
  26. Resnick S, Morrison RS. Physicians' perceptions of procedural pain and discomfort. Journal of Palliative Medicine. 2004;7(5):646-651. https://doi.org/10.1089/jpm.2004.7.646
  27. Koeppen BM, Stanton BA. Berne & Levy physiology. 6th ed. Philadelphia, PA: Mosby; 2009.
  28. Korea Institute for Healthcare Accreditation. KOIHA evaluation criteria for healthcare accreditation: Tertiary general hospital (Ver 2.0). Seoul: Ministry of Health & Welfare, Korea Institute for Healthcare Accreditation; 2014.
  29. Li KK, Harris K, Hadi S, Chow E. What should be the optimal cut points for mild, moderate, and severe pain? Journal of Palliative Medicine. 2007;10(6):1338-1346. http://dx.doi.org/10.1089/jpm.2007.0087
  30. World Health Organization. Pain relief ladder for cancer pain relief [Internet]. Geneva: World Health Organization. 2012 [cited 2014 July 28]. Available from: http://www.who.int/cancer/palliative/painladder/en/.

피인용 문헌

  1. Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU vol.46, pp.9, 2014, https://doi.org/10.1097/ccm.0000000000003299
  2. 중환자 통증 평가 도구에 관한 체계적 문헌고찰 vol.13, pp.1, 2014, https://doi.org/10.34250/jkccn.2020.13.1.44