Iran Journal of Nursing
نشریه پرستاری ایران
IJN
Medical Sciences
http://ijn.iums.ac.ir
108
journal108
2008-5931
2008-5931
10.52547/ijn
fa
jalali
1398
11
1
gregorian
2020
2
1
32
122
online
1
fulltext
fa
نگرش و عملکرد پرستاران در رابطه با مدیریت درد بیماران در بخشهای اورژانس
The Attitude and Performance of Nurses Regarding Pain Management in the Patients Admitted to the Emergency Department
پرستاری
nursing
پژوهشي
Research
<div style="text-align: justify;"><strong><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">زمینه و هدف: </span></span></strong><a name="_Toc505795995"></a><a name="_Toc505587748"></a><a name="_Toc503358811"><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">مدیریت درد یکی از مهمترین اجزای مراقبت درد بیماران در بخش اورژانس است و پرستار نقش کلیدی در مدیریت درد دارد. نگرش مثبت و عملکرد مناسب مراقبین سلامت نسبت به مدیریت درد بسیار مهم میباشد و این مسئله جز حقوق بیماران است. بنابراین مطالعه حاضر با هدف تعیین نگرش و عملکرد پرستاران در رابطه با مدیریت درد بیماران مراجعه کننده به بخشهای اورژانس صورت گرفت.</span></span></a><span dir="LTR"><span style="font-size:10.0pt;"></span></span><br>
<strong><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">روش بررسی:</span></span></strong> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">پژوهش حاضر یک مطالعه مقطعی- توصیفی است که به روش تمام شماری بر روی 150 پرستار شاغل در بخشهای اورژانس بیمارستانهای آموزشی و درمانی وابسته به دانشگاه علوم پزشکی ایران در سال 1397 انجام شد. معیارهای ورود به مطالعه شامل دارا بودن تحصیلات کارشناسی و بالاتر و حداقل شش ماه سابقه کار در بخش اورژانس بودند. ابزار مطالعه پرسشنامه </span></span><span style="color:black;"><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">اطلاعات جمعیت شناختی </span></span></span><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">و پرسشنامه نگرش و عملکرد در رابطه با مدیریت درد بود. دادههای جمع آوری شده با استفاده از آمار توصیفی و استنباطی و با نرم افزار آماری </span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:10.0pt;">SPSS</span></span></span><span style="font-family:B Lotus;"><span style="font-size:10.0pt;"> نسخه 16 تجزیه و تحلیل شدند.</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;"></span></span><br>
<strong><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">یافتهها:</span></span></strong> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">میانگین سن واحدهای مورد پژوهش 98/31 و با انحراف معیار 52/5 بود. بیشتر واحدهای مورد پژوهش (9/82 درصد) سابقه دریافت آموزش در زمینه درد نداشتند. در ارتباط با مدیریت درد بیماران بخش اورژانس، میانگین نمره نگرش 22/5 </span></span><span style="font-family:Cambria,serif;"><span style="font-size:10.0pt;">±</span></span> <span style="font-family:B Lotus;"><span style="font-size:10.0pt;">16/57 و میانگین نمره عملکرد (53/2 </span></span><span style="font-family:Cambria,serif;"><span style="font-size:10.0pt;">± </span></span><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">02/6) بود. بیشتر واحدهای مورد پژوهش (9/82 درصد) سابقه آموزش درد نداشتند. تفاوت معنیدار آماری بین میانگین نمرات نگرش و عملکرد با مشخصات جمعیت شناختی وجود نداشت</span></span> <span dir="LTR"><span style="font-size:10.0pt;">)</span></span><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">05/0 <</span></span><span dir="LTR"><span style="font-size:10.0pt;"> (</span></span><span dir="LTR"><span style="font-family:Times New Roman,serif;"><span style="font-size:10.0pt;">P</span></span></span><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">.</span></span><br>
<strong><span dir="RTL"><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">نتیجهگیری کلی:</span></span></span></strong> <span dir="RTL"><span style="font-family:B Lotus;"><span style="font-size:10.0pt;">نتایج مطالعه نشان داد که پرستاران نگرش متوسط در مورد مدیریت درد داشتند و در خوداظهاری عملکرد خوبی نسبت به مدیریت درد بیماران بیان کردند ولی آگاهی و شناخت کافی از ابزارهای درد و نحوه استفاده از ابزارها را نداشتند. بنابراین آموزش و برگزاری کلاسهای بازآموزی ضمن خدمت در جهت ارتقاء مدیریت صحیح درد بیماران و ارتقاء کیفیت مراقبت درمانی و آموزش استفاده از ابزار سنجش درد پیشنهاد میشود</span></span></span></div>
<div style="text-align: justify;"><strong>Background & Aims:</strong> Pain management is an integral part of patient care in emergency departments. Nurses play a key role in the pain management of patients, and all patients deserve to be free of pain. One of the biggest challenges in nursing is ensuring patients’ comfort and lack of pain. Not only effective pain relief in patients results in their physical comfort but also increases their quality of life and rapid return to daily life and decreases their hospital stay duration and costs. Nurses are the first people present at the patient's bedside during pain and have the longest stay with the patient. Therefore, the most successful nurses are those who have competence in assessing pain. Nurses are required to make timely decisions in the dynamic and changing situation of clients by using technical skills and professional knowledge. In addition, they must make a proper clinical judgment about patients’ health status through acquiring basic information about clients, determining natural and unnatural functions and abilities of clients, and using proper information. Positive attitude and proper performance of health care providers towards pain management is very important and is part of patients' rights. Therefore, the present study aimed to determine the knowledge of nurses regarding pain management in the patient referring to the emergency departments of the hospitals.<br>
<strong>Materials & Methods: </strong>This descriptive, cross-sectional study was conducted on 150 emergency department nurses selected via census sampling in the hospitals affiliated to Iran University of Medical Sciences in 2018. The inclusion criteria were the minimum education level of master's degree and six months of work experience in the emergency department. Data were collected using the demographic questionnaire (included six items to determine the demographic characteristics of nurses such as age, gender, level of education, type of hospital, and work experience) and the questionnaire of knowledge of pain management (included 20 items), in which the responses of the participants determined their attitude toward the use of narcotics, the person responsible for pain control and use of non-pharmaceutical interventions). The items were scored based on a four-point Likert scale from completely agree (four scores) to completely disagree (one score). In addition, the score range of the instrument was 35-62, where a score above 62%, between 35% and 62%, and below 35% was indicative of positive, moderate and negative attitude, respectively. The construct validity of the tool was assessed by comparing the scores of experienced and skilled nurses, which demonstrated a difference in the expertise of different groups. On the other hand, the performance questionnaire encompassed four items on patients’ pain level and type, analgesics and one item on the tools applied to measure pain (the name of the tool used to measure pain). The tool was completed by nurses (through self-report) and the scores were 0-2 (0=no, 1=to some extent, and 2=yes). In the end, the performance score was obtained, where the lowest and highest scores were zero and eight, respectively. In this respect, a score higher than the median (i.e., four) indicated good performance, whereas a score below the median demonstrated poor performance. Data analysis was performed in SPSS version 16 using descriptive statistics (frequency tables, mean, and standard deviation) and inferential statistics (Pearson's correlation coefficient).<br>
<strong>Results:</strong> Mean age of the participants was 31.98 ± 5.52 years. The majority of the nurses (82.9%) had no prior experience of pain management training. Regarding pain management in the emergency department, 82.7% of the subjects had a moderate attitude (35-62 scores) while 17.3% had a positive attitude and no subject had a negative attitude. Moreover, the mean attitude score was reported to be 57.16 ± 5.22, and the mean and standard deviation of performance was 6.02 ± 2.53, which was higher than the median score of the tool. The results indicated no significant difference between the mean scores of attitude and performance with the demographic characteristics of the participants (P>0.05).<br>
<strong>Conclusion:</strong> According to the results, the emergency department nurses had a moderate knowledge level regarding pain management. In addition, they declared proper performance in this regard. Nevertheless, they had insufficient knowledge of pain tools and their method of use. The findings of the present study showed that although the nurses stated that they had good performance and knowledge about the importance of recording and controlling pain, it seems that the necessity of completing the initial assessment form caused nurses to repeat and practice how to complete the form. In this respect, the forms demonstrated better performance of nurses while they had insufficient knowledge of the tools. Therefore, the provision of periodic training and pain assessment facilities and the implementation of proper policies and methods for pain assessment could be effective in this regard. In addition, the performance of nurses in managing patients' pain in the present study was indicated through a self-report questionnaire. As such, it is recommended that the performance of nurses be assessed through observation. It is also suggested that pain management by nurses in emergency departments be assessed from the viewpoint of patients and the effect of pain management education on the knowledge and performance of nurses.</div>
نگرش, عملکرد, مدیریت درد, اورژانس
Attitude, Performance, Pain Management, Emergency Ward
41
54
http://ijn.iums.ac.ir/browse.php?a_code=A-10-2086-6&slc_lang=fa&sid=1
J
Mohammad Aliha
ژاله
محمد علیها
10800319475328460024806
10800319475328460024806
No
Lecturer, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
مربی، دانشکده پرستاری ومامایی، دانشگاه علوم پزشکی ایران، تهران، ایران
T
Najafi Ghezeljeh
طاهره
نجفی قزلجه
10800319475328460024807
10800319475328460024807
No
Associate Professor, Nursing Care Research Center, School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
دانشیار، مرکزتحقیقات مراقبتهای پرستاری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی ایران، تهران، ایران
SH
Haghani
شیما
حقانی
10800319475328460024808
10800319475328460024808
No
MS in Biostatistics, Nursing Care Research Center, Iran University of Medical Sciences, Tehran, Iran
کارشناسی ارشد آمار زیستی، مرکز تحقیقات مراقبت های پرستاری، دانشگاه علوم پزشکی و خدمات بهداشتی درمانی ایران، تهران، ایران
SH
Nasrollah Nejhad
شیرین
نصرالله نژاد
10800319475328460024809
10800319475328460024809
Yes
MS, Shohada-e Haftom-e Tir Hospital, Iran University of Medical Sciences, Tehran, Iran (*Corresponding author) Tel: 09305803335 Email: nasrolahnejhad.sh@iums.ac.ir
کارشناس ارشد، بیمارستان شهدای هفتم تیر، دانشگاه علوم پزشکی ایران، تهران، ایران (*نویسنده مسئول) شماره تماس: 09305803335 Email: Nasrolahnejhad.sh@iums.ac.ir