| 吴红,吴菁,傅利勤,张瑜,左丽君,郑苗云.基于生态瞬时评估的膝关节置换患者术后疼痛变化规律的研究[J].上海护理,2024,24(9): |
| 基于生态瞬时评估的膝关节置换患者术后疼痛变化规律的研究 |
| Study on postoperative pain changes of patients with knee replacement based on ecological momentary assessment |
| 投稿时间：2023-12-11 修订日期：2024-09-01 |
| DOI： |
| 中文关键词: 关节置换 术后疼痛 变化规律 |
| 英文关键词:Joint replacement Postoperative pain Change patterns Ecological momentary assessment |
| 基金项目:国家自然科学基金项目（71904200）；校深蓝护理科研项目登峰人才计划（2022KYD01） |
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| 中文摘要: |
| 目的 了解关节置换患者术后疼痛变化规律，为术后疼痛管理提供依据。方法 基于生态瞬时评估原理，跟踪评估95例关节置换患者术后至出院时的每天6时、14时、22时的疼痛水平，采用时变效应模型、混合效应模型分析，分析术后疼痛评分变化趋势、影响因素及各时间点的疼痛水平差异。结果 随着术后时间的延长，患者疼痛评分总体呈下降趋势（P =0.0191），下午14点的疼痛评分显著低于早晨6点（P<0.001），早晨6点显著低于晚22点（P<0.001）。显著影响的疼痛因素包括性别（P=0.035）、年龄（P=0.017）、是否使用口服镇痛药（P=0.013）、既往关节手术史（P=0.008）、是否使用临时镇痛药（P=0.025）。讨论 患者术后疼痛变化趋势总体平稳，且每天各时间点存在差异。有必要积极采取充足的疼痛管理措施控制关节置换患者的术后疼痛，并结合疼痛变化规律合理安排疼痛管理措施和指导康复锻炼。 |
| 英文摘要: |
| Objective: To understand changes in postoperative pain in patients undergoing joint replacement. Method：Based on the principle of ecological instantaneous evaluation, to track and evaluate pain at 6 o'clock, 14 o'clock, and 22 o'clock every day from the first postoperative day to discharge of 95 joint replacement patients. The effect model was used to analyze the trend of postoperative pain score changes and the influencing factors of pain score. Results: As the postoperative time prolonged, the patient's pain score showed an overall downward trend (P=0.0191), with a significantly lower pain score at 14 pm compared to 6 am (P<0.001) and a significantly lower pain score at 6am compared to 22pm (P<0.001). The influencing factors of pain included gender (P=0.035), age (P=0.017), use of oral analgesics (P=0.013), history of joint surgery (P=0.008), and use of temporary analgesics (P=0.025). Conclusion: The overall level of postoperative pain in patients undergoing joint replacement is stable, and there are differences at different times of the day. It is necessary to actively adopt sufficient pain management to control postoperative pain. Rehabilitation exercise and pain management can be reasonably scheduled based on the pattern of pain changes.
Key words: Joint replacement; Postoperative pain; Change patterns; Ecological momentary assessment |
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