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首页> 外文期刊>Pain. >Patient empowerment and feedback did not decrease pain in seriously ill hospitalized adults.
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Patient empowerment and feedback did not decrease pain in seriously ill hospitalized adults.

机译：患者的授权和反馈并不能减轻重病住院患者的痛苦。

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We tested a nurse clinician-mediated intervention to relieve pain in a group of seriously ill hospitalized adults using a randomized controlled trial at five tertiary care academic centers in the US. The study included 4804 patients admitted between January 1992 and January 1994 with one or more of nine high mortality diagnoses; 2652 were allocated to the intervention and 2152 to usual care. Specially-trained nurse clinicians assessed patients' pain, educated them and their families about pain control, empowered patients to expect pain relief, informed patients' nurses and physicians about level of pain and suggested or used other pain management resources. Patients' pain was determined from hospital interviews with patients and surrogates. Pain 2 and 6 months later or after death and satisfaction with its control at all time periods were also assessed. All analyses were adjusted for baseline risk of being in pain and propensity to be in the intervention group. Overall, 50.9% of patients reported some pain. After adjustment for other variables associated with pain, comparing the intervention to the control group, there was not a statistically significant difference in level of pain (OR for higher levels of pain 1.15; CI 1.00-1.32) or satisfaction with control of pain during the hospitalization (OR for higher levels of pain 1.12; CI 0.91-1.39), 2 or 6 months after discharge, or during the last 3 days of life. A multifaceted intervention using information, empowerment, advocacy, counseling and feedback was ineffective in ameliorating pain in seriously ill patients. Control of pain in these patients remains an important problem. More intensive pain treatment strategies addressing the needs of seriously ill hospitalized adults must be evaluated.
机译：我们在美国的五个三级护理学术中心进行了一项随机对照试验，测试了由护士临床医生介导的干预措施，以减轻一组重病住院的成年人的疼痛。该研究包括在1992年1月至1994年1月之间入院的4804名患者，其中9例被诊断为高死亡率。 2652人被分配到干预措施，2152人被分配到常规护理。经过专门培训的护士临床医生评估了患者的疼痛，对患者及其家人进行了疼痛控制教育，使患者能够缓解疼痛，告知患者的护士和医生有关疼痛的程度，并建议或使用了其他疼痛管理资源。通过医院与患者和代孕者的访谈确定患者的痛苦。还评估了死亡后2个月和6个月或死亡后的疼痛以及对所有时间对其控制的满意程度。调整所有分析的基线疼痛风险和干预组倾向性。总体而言，有50.9％的患者报告有些疼痛。在调整了与疼痛相关的其他变量后，将干预措施与对照组进行比较，在疼痛期间，疼痛水平（或较高疼痛水平为1.15; CI为1.00-1.32）或控制疼痛的满意度没有统计学上的显着差异。出院后2个月或6个月，或生命的最后3天住院（OR较高的疼痛程度1.12; CI 0.91-1.39）。使用信息，赋权，倡导，咨询和反馈的多方面干预措施无法有效缓解重症患者的疼痛。这些患者的疼痛控制仍然是重要的问题。必须评估针对重症住院成年人的更深入的疼痛治疗策略。

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