Influencing factors of pain control among abdominal surgery patients with the enhanced recovery after surgery

L. Fu, Xia Feng, Danying Qiu, Xiaofen Yu, Xiaomin Chen
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Abstract

Objective To explore the influencing factors of pain control among abdominal surgery patients with the enhanced recovery after surgery (ERAS) so as to provide a basis for improving pain control. Methods From May 2018 to November 2018, we selected 15 abdominal surgery patients with ERAS in Hepatobiliary and Pancreatic Surgery at Zhejiang Provincial People's Hospital by purposive sampling. Semi-structured interview was carried out with the method of phenomenology in qualitative research. Colaizzi 7-step analysis was used in data analysis to conclude themes. Results By interview data analysis, a total of 5 themes that had influences on pain control were concluded: activity-related pain and pain management after removing patient-controlled analgesia (PCA) ; adverse reaction related to pain management; recognition of patients and their family members on pain or pain treatment; information support for pain treatment; influence of non-medical service on patient satisfaction with pain control. Conclusions We should explore the operation mode of acute pain service organization suitable for our country. Muti-disciplinary team should be used for abdominal surgery patients to strengthen the management of activity-related pain and removing PCA, prevention and treatment for adverse reaction related to pain treatment, information support for pain treatment, and improve the recognition of patients and their family members on pain or pain treatment, and pay attention to the influence of non-medical service on patient satisfaction with pain control so as to improve pain control. Key words: Pain, postoperative; Pain management; Enhanced recovery after surgery; Abdominal surgery; Qualitative research; Phenomenology
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腹部手术患者术后恢复力增强后疼痛控制的影响因素
目的探讨腹部手术术后增强恢复期(ERAS)患者疼痛控制的影响因素,为改善疼痛控制提供依据。方法选择2018年5月至11月浙江省人民医院肝胆胰外科腹部手术era患者15例,采用目的抽样方法。采用质性研究中的现象学方法进行半结构化访谈。数据分析采用Colaizzi七步分析法对主题进行归纳。结果通过访谈数据分析,共得出影响疼痛控制的5个主题:活动相关性疼痛和解除患者自控镇痛(PCA)后的疼痛管理;与疼痛管理有关的不良反应;患者及其家属对疼痛或疼痛治疗的认识;疼痛治疗的信息支持;非医疗服务对患者疼痛控制满意度的影响。结论应探索适合我国国情的急性疼痛服务机构的运作模式。腹部手术患者应采用多学科团队,加强对活动性疼痛的管理和PCA的移除,对疼痛治疗相关不良反应的预防和治疗,对疼痛治疗的信息支持,提高患者及其家属对疼痛或疼痛治疗的认知,关注非医疗服务对患者疼痛控制满意度的影响,从而改善疼痛控制。关键词:疼痛;术后;疼痛管理;增强术后恢复;腹部手术;定性研究;现象学
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