Effects Of Operation Room Pain Nursing Combined With Acute Pain Service On Pain Among Cesarean Section Women

ObjectivesInvestigate theatre nurses'knowledge and attitude of pain management and explore its influencing factors so as to provide scientific basis for establishing a training system of pain management oriented to theatre nurses;comprehend the preoperative pain cognition of women undergoing elective cesarean section through qualitative research;explore the effect of APS-based surgical pain nursing on maternal anxiety,blood pressure,and heart rate physiological indicators for patients receiving cesarean section;explore the postoperative pain cognition and overall satisfaction of pain control of patients receiving cesarean section towards APS-based surgical pain nursing.Methods1.The first part uses general demography,relevant data questionnaires concerning pain management and knowledge and attitudes survey regarding pain(KASRP)to carry out questionnaire survey towards 124 in-service theatre nurses of three tertiary hospitals in Zhenjiang City.Use SPSS17.0 software for data entry and statistics,meanwhile adopting description analysis,variance analysis and multiple linear regression analysis.2.The second part employs phenomenological research method in qualitative research.10 women undergoing elective cesarean section receive face-to-face,semi-structured interview.3.The third part adopts convenience sampling method to select 240 cases undergoing cesarean section in obstetrics wards of a top-three hospital in Zhenjiang city.The subjects are divided into four groups according to the time,group A?B?C?D,60 cases in each group.A group uses preoperative routine care.B group increases pain education for the patients by circulating nurses of the operating room 1 day before the surgery,instruct the patients in relaxation therapy,prepare the patient's favorite music library,and let the patient listen to music while patients enter the waiting area for surgery and run touch therapy.C group adopts the APS group management model,the personnel of which mainly consists of anesthesiologists,obstetricians,obstetrical nurses,nurses in anesthesia recovery room and pharmacists trained for acute pain,who are mainly responsible for the accurate assessment of postoperative acute pain,prompt management of insufficient analgesia and various adverse drug reactions.C group employs a comprehensive measure of APS team management in combination with interventions in operating room.Measure maternal anxiety before intervention(Visual Analogue Scale,VAS)and physiological indicators of blood pressure and heart rate in surgical waiting area;assess pain cognition(pain cognition scale)and pain management quality(Houston pain scale)of patients~'24 hours after operation.Results1.116 valid questionnaires were returned,the repossession rate of which was95.4%;the questionnaire correct rate of respondents were 20%to 60%,and the total score was(16.47±3.00)points.Professional title is the key influencing factor of KASRP of theatre nurses.2.A total of four themes were extracted in preoperative pain cognition for women undergoing elective cesarean section:fear of pain and anxiety;the source of pain cognition;the trust towards senior anesthesiologists;expectations on postoperative analgesia effect.3.227 research objects were eventually included in the study,including 56 cases in the A group,57 in B group,58 in C group,and 56 in D group.There showed no statistical difference in general demographic data between groups(P>0.05).4.Before the intervention,the visual analog anxiety scale,blood pressure and heart rate of each group showed no statistical difference(P>0.05).After the intervention,the visual analog anxiety scale in operating room group(3.52±0.68points)and joint group(3.12±0.69)decreased markedly(P<0.001),and was lower than that of the control group(5.23±0.87 points)and APS group(5.01±1.08 points,P<0.001).After intervention,the heart rate and blood pressure of women in the operating room group was significantly decreased(P<0.001),lower than that of the control group and APS group(P<0.001).5.Patients in the D group had better pain cognition than the other three groups with the A group demonstrating the lowest level.The B group prevailed over C group in partial items.6.The overall quality of pain in D group was higher than the other three groups,with C group higher than B group,and A group was the lowest.Conclusions1.There is a deficiency in the KASRP of operation nurses,and a corresponding pain management training program needs to be established.2.Through operation room pain nursing,an effective pain management model can be established to alleviate fear of pain and anxiety of patients and improve satisfaction with pain management.3.Operation room pain nursing can relieve patients'preoperative anxiety while waiting and reduce blood pressure and heart rate.4.Operation room pain nursing combined with postoperative APS pain management can effectively improve pain cognition?reduce postoperative pain?improve the overall satisfaction of pain control.