认知障碍病人疼痛评估工具研究进展

介绍了国外认知障碍病人疼痛评估工具研究进展,对痴呆病人疼痛评估工具和语言交流障碍病人疼痛评估工具进行了综述.     

中文版行为疼痛评估工具的研究进展

介绍了适用于儿童疼痛行为量表(FLACC)、适用于认知障碍病人的晚期老年痴呆疼痛评估量表(PAINAD)和老年痴呆病人疼痛评估量表(Doloplus-2)、成人重症病人行为疼痛量表(BPS)、重症监护疼痛观察工具(CPOT)、非语言成人疼痛评估量表(PAINAD)、非语言疼痛评估工具(NPAT)及修订版非语言疼痛评估工具(NVPS-R)。6个量表均经过汉化及信效度测定,适用于不具备交流能力(包括言语和非言语交流能力)病人的行为疼痛评估,指出量表在使用过程中的注意事项,为医务人员对特殊群体病人开展疼痛评估提供工具应用上的借鉴     

癌症疼痛评估工具的临床应用现状

介绍了近年来用于癌症疼痛评估的工具,包括单维及多维癌症疼痛评估量表,提出医护人员应针对不同病人,正确选用不同的疼痛评估工具,使病人得到及时的治疗和效果评价。     

客观疼痛评估工具在ICU成人机械通气病人中的应用研究与特点分析

介绍ICU成人机械通气病人客观疼痛评估工具及应用情况,提出研制适合中国文化的评估ICU成人机械通气病人的客观疼痛评估工具,以改善病人的疼痛管理及其预后。     

疼痛评估工具的选择及应用研究进展

病人的疼痛评估工具分为单维度、多维度的疼痛评估工具,种类很多,各有优缺点,正确的选择疼痛评估工具可以及时有效地对疼痛进行干预和治疗,提高镇痛水平。     

肿瘤病人术后疼痛护理的探讨

目的探讨肿瘤病人术后疼痛的程度和性质及采取止痛措施的效果。方法采用VRS、VAS疼痛评估的工具,对肿瘤术后病人的疼痛做出及时准确的评估,以选择恰当的止痛措施。结果学会使用正确的评估工具,对肿瘤病人术后疼痛的程度和性质给予准确的评价,根据不同程度采取不同的止痛措施,有效的缓解疼痛。结论正确评估肿瘤病人术后疼痛的程度和性质,掌握有效的护理干预,效果满意。     

老年腰椎压缩性骨折病人术后应用改良疼痛评估图实施疼痛管理的效果

[目的]探讨改良疼痛评估图在老年腰椎压缩性骨折病人术后疼痛管理中的应用效果。[方法]将84例老年腰椎压缩性骨折病人按随机数字表法分为观察组和对照组,每组42例,观察组给予改良疼痛评估图进行评估,对照组采用传统疼痛评估工具。比较两组病人护理效果。[结果]观察组术后疼痛程度低于对照组(P0.05);观察组疼痛出现时间晚于对照组,疼痛评分低于对照组(均P0.05);观察组对护理满意度高于对照组(P0.05)。[结论]改良疼痛评估图的使用有利于准确评估老年腰椎压缩性骨折病人术后疼痛程度,有利于评估病人出现疼痛的时间和掌握疼痛评分,及时给予相应的疼痛控制,提高病人及家属的满意度。     

老年骨折病人术后疼痛护理的研究现状

从老年骨折病人术后急性疼痛评估工具、疼痛影响因素、疼痛护理干预措施及疼痛管理方面进行综述,以期为我国老年骨折术后病人的疼痛护理提供参考,为病人提供更好的镇痛措施,提高其生活质量。     

妇产科病人术后疼痛的评估与护理

近年来,镇痛泵的使用较广泛,但由于缺乏对疼痛程度的正确评估,有时会延长止痛药物泵入的时间。1 疼痛的评估疼痛的评估就是基于对疼痛本质的相信,使用可靠有效的工具并了解一些有关疼痛的问题,对病人的疼痛做出定量或定性的评估。1.1 影响正确评估的因素1.1.1 病人因素。一般来说,年长者较年幼者耐受疼痛;对性格内向者对疼痛的主诉较少,对性格外向者同等程度的疼痛反应更强烈,主诉更多;文化程度高的病人通常能更清     

疼痛评估工具选择的研究进展

疼痛是一种常见的不舒适形式.鉴于未缓解的疼痛会给患者造成多方面的损害,国际上已将疼痛定义为继体温、脉搏、呼吸、血压四大生命体征之后的第五生命体征.但最近的研究表明,医务人员对疼痛的管理较为薄弱,疼痛仍是困扰病人的一个常见问题[1-2].准确的疼痛评估是疼痛管理的第一步,也是关键的一步.但许多研究表明,在临床上缺少疼痛评估工具,并且医务人员很少使用它们去评估病人的疼痛[3-4].同时,在一些特殊群体中,如新生儿和婴幼儿、认知障碍者以及危重症患者中,疼痛的评估对医护人员来说显得尤为困难,并经常被忽视.针对上述问题,笔者对疼痛评估的原则和方法及疼痛评估工具在不同人群中选择的新进展做一综述,旨在对临床选择疼痛评估工具提供参考.     

ICU患者疼痛评估工具研究进展

疼痛是ICU患者的常见问题,有效的评估是疼痛管理的基础。由于镇静或其他原因,ICU患者的疼痛评估往往比较复杂。能获得患者主诉时可以使用主观疼痛评估工具,不能获得患者主诉时宜使用客观疼痛评估工具。本文就ICU患者常用的主观和客观疼痛评估工具进行综述,为完善ICU患者的疼痛评估和疼痛管理流程提供科学的依据。     

Pain assessment tools: is the content appropriate for use in palliative care?

Inadequate pain assessment prevents optimal treatment in palliative care. The content of pain assessment tools might limit their usefulness for proper pain assessment, but data on the content validity of the tools are scarce. The objective of this study was to examine the content of the existing pain assessment tools, and to evaluate the appropriateness of different dimensions and items for pain assessment in palliative care. A systematic search was performed to find pain assessment tools for patients with advanced cancer who were receiving palliative care. An ad hoc search with broader search criteria supplemented the systematic search. The items of the identified tools were allocated to appropriate dimensions. This was reviewed by an international panel of experts, who also evaluated the relevance of the different dimensions for pain assessment in palliative care. The systematic literature search generated 16 assessment tools while the ad hoc search generated 64. Ten pain dimensions containing 1,011 pain items were identified by the experts. The experts ranked intensity, temporal pattern, treatment and exacerbating/relieving factors, location, and interference with health-related quality of life as the most important dimensions. None of the assessment tools covered these dimensions satisfactorily. Most items were related to interference (231) and intensity (138). Temporal pattern (which includes breakthrough pain), ranked as the second most important dimension, was covered by 29 items only. Many tools include dimensions and items of limited relevance for patients with advanced cancer. This might reduce compliance and threaten the validity of the assessment. New tools should reflect the clinical relevance of different dimensions and be user-friendly.     

You'd Better Believe It: The Conceptual and Practical Challenges of Assessing Malingering in Patients With Chronic Pain

Chronic pain is a prevalent and costly condition, with many patients receiving income support and funded treatment. Given that pain cannot be assessed objectively, patients may be suspected of exaggerating their pain and disability to receive additional funding. Although numerous methods of detecting malingering have been suggested, it is unclear whether clinicians can reliably identify malingering in patients with chronic pain. The present focus article was developed to assess the theoretical basis and empirical support for proposed methods of detecting malingering in patients with chronic pain. Five approaches were identified: the evaluation of behavioral signs, effort testing, pen and paper measures, symptom validity tests, and combined methods. An examination of the literature revealed that proposed assessment tools have little theoretical basis or empirical support in patients with chronic pain. Additionally, assessment tools are inconsistent with advances in pain science and scores or observations are likely to be influenced by the typical features of chronic pain, including fear-avoidance and central sensitization. Clinicians should be aware that as yet neither subjective clinical opinions nor clinical detection methods can reliably identify malingering in patients with chronic pain.Perspective: There is interest in the development of assessment tools to detect malingering in patients with chronic pain. An evaluation of methods reveals theoretical and empirical limitations that undermine the usefulness of these approaches. As yet, there is no reliable way for clinicians to identify malingering in patients with chronic pain.     

两种非语言疼痛评估工具的应用现状分析

目的：通过对两种非语言疼痛评估工具相关研究进行文献分析,为我国非语言疼痛评估工具的选择提供参考。方法运用疼痛评估工具性能评分系统对计算机检索获取的相关文献进行分析。结果共纳入29篇文献,疼痛行为量表( BPS)与重症监护疼痛观察工具( CPOT)平均得分分别为9.20分、9.32分。结论疼痛行为量表( BPS)与重症监护疼痛观察工具( CPOT)逐渐被广泛应用于非语言疼痛患者的疼痛评估,但在不同人群中两者的信效度都存在差异,仍需进一步被验证。     

Pain assessment tools for older people with cognitive impairment

This article summarises and critiques various tools available for the assessment of pain in older people with cognitive impairment. Definitions of pain are numerous and are not always relevant to people with cognitive impairment because these individuals are often unable to describe or communicate their pain. This makes it difficult for healthcare professionals to assess the absence or presence of pain in these patients. The aim of this article is to establish which of the available pain assessment tools are most appropriate for use in older people with cognitive impairment. From a review of the literature, the authors conclude that pain assessment in older people with any degree of cognitive impairment is complex and there is no gold standard.     

Pain assessment and management in end of life care: a survey of assessment and treatment practices of hospice music therapy and nursing professionals

The primary focus of this paper is to describe current trends in pain assessment in end of life care with a secondary focus on music therapy techniques commonly used to address pain for hospice patients. These trends were determined through a survey of 72 board certified music therapists and 92 hospice and palliative nurses. Survey results indicate that most music therapists in the hospice setting incorporate formal pain assessment into their practice; both nursing professionals and music therapists surveyed utilize multiple assessment tools to assess patient pain. Although there are currently a variety of pain assessment tools used, this study indicates that nursing professionals most frequently use the Numerical Rating Scale (NRS) and FACES scales, and identified them as appropriate for use by nonnursing members of the interdisciplinary hospice team. This paper also describes music therapy techniques most often utilized by music therapists with hospice patients to address acute and chronic pain symptoms.     

Biobehavioral Measures for Pain in the Pediatric Patient

Pain is a complex biobehavioral phenomenon. The quantification of pain involves the incorporation of many factors, including physiologic, behavioral, and psychologic factors. Recognition of pain relies heavily on the expression of the patient as well as the interpretation of the caregiver. There are many studies published on biobehavioral pain assessment tools, such as neuroimaging, neuromuscular, biomarker, and behavioral pain assessment scales. These tools present a clinical challenge to appropriately assess and manage pain in the noncommunicative pediatric patients, such as infants, preverbal toddlers, and intubated and/or unconscious or cognitively impaired patients. Pain is a combination of physiologic, behavioral, and psychologic interactions. Any tool that incorporates the measurement of only one of those domains is inherently incomplete in the assessment of pain. Therefore, the purpose of this literature review was to provide a comprehensive overview of these biobehavioral pain assessment tools used in pain assessment in the noncommunicative pediatric population.     

老年痴呆患者疼痛评估及管理最佳证据总结

目的 总结老年痴呆患者疼痛评估及管理的最佳证据,为老年痴呆患者疼痛的评估和管理提供证据支持,改善老年痴呆患者的疼痛护理质量。方法 用PICO模型构建循证护理问题,按照“6S”证据金字塔模型依次检索2010年1月1日—2020年2月29日发布在UpToDate、BMJ Best Practice、JBI、NICE、RNAO、CINAHL、中国生物医学数据库、知网、万方等数据库的相关文献,2名具备硕士学位的循证护理师独立进行文献质量评价及证据筛查,证据汇总后由项目团队综合归类。结果 共纳入文献12篇：证据总结3篇,指南2篇,系统评价5篇,随机对照试验2篇。从纳入的文献中共提取55条证据,最终综合成26条最佳证据共6个维度,分别是疼痛评估时机与量表、疼痛评估方法、干预措施、疼痛管理、培训与教育、组织保障。结论 临床管理者需重视老年痴呆患者疼痛评估,使用适宜疼痛评估工具及方法,采取针对性干预措施,并且需对医务人员进行老年痴呆患者疼痛相关知识的培训,在证据应用的过程中应评估临床情景及现有的医疗环境,制订符合临床实际的老年痴呆患者疼痛管理计划。