The Evaluation Of Postoperative Pain Management Based On Dynamic Pain Assessment

Objective:This paper is to establish the 4-levels Functional Activity Score(FAS) and evaluate its reliability and validity. It is also to explore the effect of postoperative pain management based on dynamic pain assessment on the pain management quality.Methods:This research consists of two parts:part one is the establishment and the evaluation of the 4-levels FAS and part two is the exploration of the effect of postoperative pain management based on dynamic pain assessment on the pain management quality. In part one, firstly to establish the 4-levels FAS, then to select 63 postoperative patients in hospital A to research the reliability and validity of the 4-levels FAS. In part two,146 cases of postoperative patients with thoracic or abdominal operation in hospital B are selected by convenience sampling.73 cases of postoperative patients from Jun 2015 to Jul 2015 who haven’t received the postoperative pain management based on dynamic pain are pumped as the control group and 73 cases of postoperative patients from Aug 2015 to Sep 2015 who have received the postoperative pain management based on dynamic pain are pumped as the experiment group. The effect of postoperative pain management quality have been appraised in the field of the rate of analgesic treatment adjustment and patients’ pressing the PCA button before taking activities within 24h after surgery, the intensity of Rest and dynamic pain,4-levels FAS and the indicators of acute pain management quality.Result:(1)The result of the reliability and validity:Interclass Correlation Coefficients was 0.95, Cronbach’s a coefficient was 0.98;Comparing with 3 levels FAS, pearson’s correlation coefficient was 0.658, content Validation Index was 0.94;Using the 4-levels FAS to assess the patient before and after taking the analgesic measures, comparison of the two results were statistically different (Z=-4.07, P<0.01) which showed that the sensitivity was good. (2)The result of the pain management practice based on dynamic pain assessment:There were significant differences in the rate of analgesic treatment adjustment and patients’pressing the PCA button before taking activities between the two groups (P<0.05). Intensity of rest and dynamic pain, 4-levels FAS, the level of the most serious pain, frequency of moderate and severe pain, and the pain impacts on the effective cough and the sleep of the experimental group were all lower than that of the control group within 24h after surgery (P< 0.05).There was no significant difference in the evaluation of the adequacy of information the patients received about pain and pain control options while in hospital.Conclusion:The 4-levels FAS is reliable and valid, it is suitable for assessing the postoperative dynamic pain in Chinese patients. The practice of postoperative pain management based on dynamic pain assessment can guide the staff to take effective analgesia measures and make patients involved in the self pain control actively, it also improve the quality of postoperative pain management.