{"title":"住院肿瘤患者疼痛管理良好实践指南建议的实施效果","authors":"Ana-Isabel Alcañiz-Mesas , María-Victoria Ruiz-García , María-Pilar Córcoles-Jiménez , María-José Caballero-García , María Teresa González Álvarez","doi":"10.1016/j.enfcli.2024.07.001","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the effectiveness of implementing the Clinical Best Practice Guideline (BPG) “Assessment and Management of Pain” recommendations for pain control in oncological/oncohaematological hospitalized patients.</div></div><div><h3>Methods</h3><div>Ambispective cohort study. Sample and Setting: Adults admitted to oncological unit in Hospital of Albacete. Intervention: Implementation of GBP recommendations. Variables: 1) Demographic data; 2) On implementation of GBP recommendations; 3) Outcome in patients: pain intensity in the first 24<!--> <!-->h after admission and maximum intensity during admission Tools: Numeric and Visual Scales. Data collection: indicators exported from clinical history for evaluation of the BPSO® program. Ethical aspects: anonymous data. Data analysis (SPSS®): Descriptive during periods: baseline (T0<!--> <!-->=<!--> <!-->December 2015); initial (T1<!--> <!-->=<!--> <!-->2017); consolidation (T2<!--> <!-->=<!--> <!-->2018-2019); sustainability (T3<!--> <!-->=<!--> <!-->2021-2022). Measurements of central tendency and dispersion, absolute and relative frequencies. Comparison of proportions (Chi-Square) and averages (Student t-test, ANOVA). Statistical significance: <em>P</em><.05.</div></div><div><h3>Results</h3><div>Included 572 patients, 61.5% (352) men. Daily intervention of pain detection was performed in 94.6% (538) of patients (20%-T0; 98.3%-T1; 98.4%-T2; 91.2%-T3; <em>P</em><.001), pain assessment using an appropriate scale in 97.6% (558) (0%-T0; 98.3%-T1; 99.2%-T2; 100%-T3; <em>P</em><.001); 93.7% (535) had a care plan for assessment and management of pain (0%-T0; 98.3%-T1; 96.3%-T2; 92.3%-T3; <em>P</em><.001). The percentage of patients who had severe pain (6-10) during the first 24<!--> <!-->hours was reduced from T1 to T3 (5.1%-T1; 6.6%-T2; 2.1%-T3; <em>P</em>=.145), but throughout hospitalization increased from T1 to T3 (19.2%-T1; 17%-T2; 22.5%-T3; <em>P</em>=.21).</div></div><div><h3>Conclusions</h3><div>Implementation of recommendations has led to a statistically significant improvement over the periods in the study; however, no effectiveness has been shown to reduce pain intensity.</div></div>","PeriodicalId":46453,"journal":{"name":"Enfermeria Clinica","volume":"34 6","pages":"Pages 448-457"},"PeriodicalIF":0.7000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Efectividad de la implantación de recomendaciones de una Guía de Buenas Prácticas para manejar el dolor en los pacientes oncológicos hospitalizados\",\"authors\":\"Ana-Isabel Alcañiz-Mesas , María-Victoria Ruiz-García , María-Pilar Córcoles-Jiménez , María-José Caballero-García , María Teresa González Álvarez\",\"doi\":\"10.1016/j.enfcli.2024.07.001\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><div>To evaluate the effectiveness of implementing the Clinical Best Practice Guideline (BPG) “Assessment and Management of Pain” recommendations for pain control in oncological/oncohaematological hospitalized patients.</div></div><div><h3>Methods</h3><div>Ambispective cohort study. Sample and Setting: Adults admitted to oncological unit in Hospital of Albacete. Intervention: Implementation of GBP recommendations. Variables: 1) Demographic data; 2) On implementation of GBP recommendations; 3) Outcome in patients: pain intensity in the first 24<!--> <!-->h after admission and maximum intensity during admission Tools: Numeric and Visual Scales. Data collection: indicators exported from clinical history for evaluation of the BPSO® program. Ethical aspects: anonymous data. Data analysis (SPSS®): Descriptive during periods: baseline (T0<!--> <!-->=<!--> <!-->December 2015); initial (T1<!--> <!-->=<!--> <!-->2017); consolidation (T2<!--> <!-->=<!--> <!-->2018-2019); sustainability (T3<!--> <!-->=<!--> <!-->2021-2022). Measurements of central tendency and dispersion, absolute and relative frequencies. Comparison of proportions (Chi-Square) and averages (Student t-test, ANOVA). Statistical significance: <em>P</em><.05.</div></div><div><h3>Results</h3><div>Included 572 patients, 61.5% (352) men. Daily intervention of pain detection was performed in 94.6% (538) of patients (20%-T0; 98.3%-T1; 98.4%-T2; 91.2%-T3; <em>P</em><.001), pain assessment using an appropriate scale in 97.6% (558) (0%-T0; 98.3%-T1; 99.2%-T2; 100%-T3; <em>P</em><.001); 93.7% (535) had a care plan for assessment and management of pain (0%-T0; 98.3%-T1; 96.3%-T2; 92.3%-T3; <em>P</em><.001). The percentage of patients who had severe pain (6-10) during the first 24<!--> <!-->hours was reduced from T1 to T3 (5.1%-T1; 6.6%-T2; 2.1%-T3; <em>P</em>=.145), but throughout hospitalization increased from T1 to T3 (19.2%-T1; 17%-T2; 22.5%-T3; <em>P</em>=.21).</div></div><div><h3>Conclusions</h3><div>Implementation of recommendations has led to a statistically significant improvement over the periods in the study; however, no effectiveness has been shown to reduce pain intensity.</div></div>\",\"PeriodicalId\":46453,\"journal\":{\"name\":\"Enfermeria Clinica\",\"volume\":\"34 6\",\"pages\":\"Pages 448-457\"},\"PeriodicalIF\":0.7000,\"publicationDate\":\"2024-11-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Enfermeria Clinica\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1130862124000895\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"NURSING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Enfermeria Clinica","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1130862124000895","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"NURSING","Score":null,"Total":0}
Efectividad de la implantación de recomendaciones de una Guía de Buenas Prácticas para manejar el dolor en los pacientes oncológicos hospitalizados
Objective
To evaluate the effectiveness of implementing the Clinical Best Practice Guideline (BPG) “Assessment and Management of Pain” recommendations for pain control in oncological/oncohaematological hospitalized patients.
Methods
Ambispective cohort study. Sample and Setting: Adults admitted to oncological unit in Hospital of Albacete. Intervention: Implementation of GBP recommendations. Variables: 1) Demographic data; 2) On implementation of GBP recommendations; 3) Outcome in patients: pain intensity in the first 24 h after admission and maximum intensity during admission Tools: Numeric and Visual Scales. Data collection: indicators exported from clinical history for evaluation of the BPSO® program. Ethical aspects: anonymous data. Data analysis (SPSS®): Descriptive during periods: baseline (T0 = December 2015); initial (T1 = 2017); consolidation (T2 = 2018-2019); sustainability (T3 = 2021-2022). Measurements of central tendency and dispersion, absolute and relative frequencies. Comparison of proportions (Chi-Square) and averages (Student t-test, ANOVA). Statistical significance: P<.05.
Results
Included 572 patients, 61.5% (352) men. Daily intervention of pain detection was performed in 94.6% (538) of patients (20%-T0; 98.3%-T1; 98.4%-T2; 91.2%-T3; P<.001), pain assessment using an appropriate scale in 97.6% (558) (0%-T0; 98.3%-T1; 99.2%-T2; 100%-T3; P<.001); 93.7% (535) had a care plan for assessment and management of pain (0%-T0; 98.3%-T1; 96.3%-T2; 92.3%-T3; P<.001). The percentage of patients who had severe pain (6-10) during the first 24 hours was reduced from T1 to T3 (5.1%-T1; 6.6%-T2; 2.1%-T3; P=.145), but throughout hospitalization increased from T1 to T3 (19.2%-T1; 17%-T2; 22.5%-T3; P=.21).
Conclusions
Implementation of recommendations has led to a statistically significant improvement over the periods in the study; however, no effectiveness has been shown to reduce pain intensity.
期刊介绍：
Enfermería Clínica is a peer-reviewed scientific journal that is a useful and necessary tool for nursing professionals from the different areas of nursing (healthcare, administration, education and research) as well as for healthcare professionals involved in caring for persons, families and the community. It is the only Spanish nursing journal that mainly publishes original research. The aim of the Journal is to promote increased knowledge through the publication of original research and other studies that may help nursing professionals improve their daily practice. This objective is pursued throughout the different sections that comprise the Journal: Original Articles and Short Original Articles, Special Articles, Patient Care and Letters to the Editor. There is also an Evidence-Based Nursing section that includes comments about original articles of special interest written by experts.
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