衛教介入外科門診手術病人疼痛之成效探討

Effects of a Health Education Intervention on Outpatient Surgery Pain

10.6692/KJN.202208_39(2).0001

鍾瑞月(Jui-Yueh Chung)；薛鳳姬(Feng-Chi Hsueh)；蕭思美(Szu-Mei Hsiao)；楊燦(Tsan Yang)

外科門診手術 ； 疼痛 ； 多媒體衛教 ； outpatient surgery ； pain ； multimedia health education

高雄護理雜誌

39卷2期（2022 / 08 / 01）

1 - 14

繁體中文

背景：大部分研究著重於術後疼痛之成效探討，對象多數為全身麻醉病人，較少相關研究探討局部麻醉病人，關注手術期間疼痛及疼痛的影響因素。目的：探討多媒體衛教介入與傳統口頭常規衛教單張，對外科門診局部麻醉手術病人，手術期間疼痛與術後疼痛之成效及疼痛的影響因素。方法：採類實驗性研究設計，對象為接受外科門診手術局部麻醉之病人，每月單週接受門診手術者為對照組、雙週者為實驗組。實驗組觀看「手術全期衛教影片」，對照組接受醫院口頭常規衛教指導。測量工具為研究對象基本屬性、情境－特質焦慮量表、疼痛數字等級量表。結果：實驗組接受「手術全期衛教影片」介入後，比對照組之術後疼痛顯著下降，達到統計上顯著差異（p=.037）。術前情境焦慮、手術部位在軀幹及四肢者，為局部麻醉手術期間疼痛之重要預測因子。結論／實務應用：「手術全期衛教影片」，有效降低外科門診局部麻醉病人之術後疼痛；局部麻醉手術期間疼痛之重要預測因子，可提供臨床醫護人員辨識病人特性，提昇照護品質。

Background: Most related studies have focused on the effects of postoperative pain with most studied patients being those under general anesthesia, and such studies have focused on the issue of pain and its influential factors during surgery. Less research has been conducted on patients under local anesthesia, paying attention to the pain and its influencing factors during surgery. Purpose: To investigate the effects of intraoperative and postoperative pain in patients undergoing local anesthesia with a health education intervention in outpatient clinics. Methods: This study adopted a quasi-experimental research design to examine patients undergoing local anesthesia for outpatient surgery. Patients undergoing clinical surgery on odd weeks of a month were treated as the control group, and those undergoing surgery on even weeks were treated as the experimental group. The experimental group watched the ＂Surgery-Period Health Education Film,＂ whereas the control group was provided with the hospital's routine health education instructions. The recorded measurements were the basic attributes of the patients, scores on the situation-trait anxiety scale, and scores on the Numeric Pain Rating Scale. Results: After the ＂Surgery-Period Health Education Film＂ intervention, postoperative pain in patients undergoing local anesthesia for outpatient surgery had significantly decreased (p=.037). Preoperative situational anxiety and the surgical location in the torso and limbs were important predictors of pain during local anesthesia surgery. Conclusions/Implications for practice: The ＂Surgery-Period Health Education Film＂ effectively reduced postoperative pain in patients who had undergone local anesthesia. The predictors of pain during local anesthesia surgery could provide clinical nursing personnel with the knowledge to identify these characteristics in patients.

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