急重症醫護人員的疼痛處理知識與態度及其相關因素

Knowledge of and Attitudes toward Pain Management and Related Factors among Physicians and Nurses Working in Critical and Emergency Care Wards

10.6225/JEBN.1.4.292

顏慧芳(Hui-Fang Yen)；邱麗文(Li-Wen Chiu)

疼痛處理 ； 急重症 ； 醫師 ； 護理人員 ； pain management ； critical and emergency care ； physicians ； nurses

實證護理

1卷4期（2005 / 12 / 01）

292 - 301

繁體中文

本研究為描述性橫斷式相關研究，目的是為了解某醫學中心急重症醫護人員的疼痛處理知識與態度，以及疼痛處理知識與態度的相關性探討。本研究採立意取樣法，於台南縣一所醫學中心，以中文版的Ferrell和McCaffery疼痛處理知識與態度問卷，對324位急診和加護病房醫護人員進行資料收集。問卷得分平均為19.5（標率差4.12）分，滿分為37分，平均答對率為52.7%，表示對疼痛處理知識與態度低。各題答對率少於30%的有十題，其內容涵蓋非藥物止痛措施的使用時機、鴉片類藥物之藥效和副作用（呼吸抑制）發生率、常用止痛藥物間的藥效關係、不同類型（急性、慢性或癌症）的疼痛病患藥物使用原則和認為病患會過度報告疼痛程度。疼痛處理知識得分與醫護人員別、最高學歷、有無接受在職教育相關；而與人員的工作職位、專業層級、宗教信仰、臨床服務年資、曾有過之疼痛經驗和自我疼痛的處理行為無關。護理人員的得分比醫師略高。較高的學歷或受過疼痛處理在職教育的人員普遍有較高的得分。雖然醫師的科別不是得分的相關因素，但外科加護病房的護理人員普遍有較高的疼痛得分。本研究結果將提供作者做為院內在職教育規劃及課程內容設計之指引。

The purpose of this descriptive cross-sectional survey study was to investigate critical and emergency care physicians and nurses' knowledge of and attitude toward pain management. A convenient sampling method was used to recruit subjects from a medical center in Tainan County. Ferrell & McCaffery's Nurses' Knowledge and Attitudes Survey Regarding Pain (Chinese version, total score: 37), completed and submitted by 324 respondents who worked in intensive care units (ICUs) and the emergency department, was used to collect data. Study results revealed respondents to be deficient in both their knowledge of and attitude toward pain management. The average score was 19.5(SD 4.12) and the average percentage of correct answers was 52.7%. Questions testing knowledge of analgesia in terms of choice, duration and adverse effects, of alternative non-analgesia interventions, and of pain assessment had the lowest correct percentage of correct answers. Neither respondent background nor personal experience with pain were found to affect significantly respondent performance on the survey. Nurses had a generally higher score than physicians, as did both physicians and nurses with either higher education levels or previous in-service pain education. Although differences in medical departments did not significantly affect the survey performance of physicians, nurses serving in the surgical ICU achieved significantly higher pain management scores than their peers in other units. Survey results may provide guidance for designing and improving relevant in-service education programs.