Research Article
Cerrahi Hemşirelerin Ameliyat Sonrası Ağrı Kontrolünde Multimodal Analjeziye Yönelik Bilgileri ile Yordayıcı Faktörlerin Belirlenmesi
Abstract
Amaç: Çalışmanın amacı, cerrahi hemşirelerinin ağrı, analjezik ajanlar, multimodal analjeziye ilişkin bilgilerini ve bilgi durumlarının yordayıcılarını belirlemektir.
Materyal ve Metot: Prospektif ve kesitsel olan çalışmanın evrenini cerrahi klinikler ile yoğun bakımda çalışan 150 hemşire, örneklemini ise katılıma istekli 140 hemşire oluşturdu. Veriler, hemşirelerin sosyodemografik özelliklerini belirleyen “Kişisel Veri Formu” ve akut ağrı, analjezik ajan ve multimodal analjezi bilgilerini değerlendiren “Bilgi Formu” kullanılarak 1 Şubat -30 Haziran 2020 tarihleri arasında toplandı. Verilerin analizinde tanımlayıcı istatistikler ve lojistik regresyon kullanıldı.
Bulgular: Hemşirelerin %24,3’ü multimodal analjezi kavramını duymuştu, duyan hemşirelerin %58,8 ise bilgi kaynağı internetti. Hemşirelerin ağrı, analjezik ajanlar ve multimodal analjeziye verdikleri doğru yanıt puan ortalamalarının sırasıyla 68,86±15,46; 52,93±22,90; 46,19±27,11olduğu saptandı. En az doğru yanıt oranı multimodal analjeziye yönelikti. Multimodal analjeziyi duyma (OR,7,820; CI,1,780-13,861; p=0,012) ağrı, eğitim (OR, 4,720; CI, 0,206-9.234; p=0.041) ve yine daha önceden multimodal analjeziyi duyma (OR, 13,960; CI,5,424-22,497; p=0,002) analjezik ajan, çalışılan klinik (OR, 11,827; CI,3,052–20,603; p=0,009), multimodal analjeziyi duyma (OR, 22,091; CI,12,150-32,032; p=0,000) ise multimodal analjezi bilgisinin yordayıcılarıydı.
Sonuç: Cerrahi hemşirelerinin multimodal analjezi kavramı hakkında bilgi düzeylerinin düşük olduğu belirlendi. Buna göre cerrahi hemşirelere ağrı, analjezik ajanlar ve multimodal ağrı yaklaşımı konusunda hizmet içi eğitim verilmesi ve eğitimlerin düzenli tekrarlanması söylenebilir.
Supporting Institution
Yoktur
Project Number
Proje çalışmasıd eğildir
Thanks
Katılıma destek veren gönüllü hemşire meslektaşlarımıza teşekkür ederiz
References
- Pogatzki-Zahn EM, Segelckea D, Schugb SA. Postoperative pain-from mechanisms to treatment. Pain Rep. 2017;15:2(2):588-603.
- Coll AM, Jones R. Role of the nurse in the assessment and management of post-operative pain. Nurs Stand. 2020;35(4):53-58.
- Gan TJ. Poorly controlled postoperative pain: prevalence, consequences, and prevention. J Pain Res. 2017;10:2287–2298.
- Naqib D, Purvin M, Prasad R, ve ark. Quality improvement initiative to improve postoperative pain with a clinical pathway and nursing education program. Pain Manag Nurs. 2018;19(5):447-455.
- Lavelle-Henry MM. 3C Multimodal analgesia tried and true and those less used. Pain Manag Nurs. 2020;21(2):211-216.
- Savarese JJ, Tabler NG. Multimodal analgesia as an alternative to the risks of opioid monotherapy in surgical pain management. J Healthc Risk Manag. 2017;37(1):24-27.
- Schwenk ES, Mariano ER. Designing the ideal perioperative pain management plan starts with multimodal analgesia. Korean J Anesthesiol. 2018;71(5):345-352.
- Arnstein P. Multimodal approaches to pain management. Nursing. 2013;41(3):60-61.
- Barker JC, DiBartola K, Wee C, Andonian N, Abdel-Rasoul M, Lowery D. Preoperative multimodal analgesia decreases postanesthesia care unit narcotic use and pain scores in outpatient breast surgery. Plast and Reconst Surg. 2018;142(4):443-450.
- Donahue RE, Bradbury GR, Zychowicz ME, Muckler VC. Multimodal perioperatıve analgesia regimen to improve patients’ outcomes after total knee arthroplasty: A multidisciplinary quality improvement project. JOPAN. 2018;33(2):138-152.
- Acar K, Acar H, Demir F, Eti Aslan F. Cerrahi sonrası ağrı insidansı ve analjezik kullanım miktarının belirlenmesi. ACU Sağlık Bil Derg. 2016;2:85-91.
- Andrews-Cooper N, Kozachik SL. How patient education influences utilization of nonpharmacological modalities for persistent pain management: An integrative review. Pain Manag Nurs. 2020;21(2):157-164.
- Dessie M, Asichale A, Belayneh T, Enyew H, Hailekiros A. Knowledge, and attitudes of Ethiopian nursing staff regarding post-operative pain management: A cross- sectional multicenter study. Patient Relat Outcome Meas. 2019;10:395-403.
- Manworren RB. Multimodal pain management and the future of a personalized medicine approach to pain. AORN. 2015;101(3):308-314.
- C. Multimodal analgesia: optimizing perioperative pain management. Academic Festival. 2018;142:1-3.
- Midilli TS, Eşer İ, Yücel Ş. Cerrahi kliniklerinde çalışan hemşirelerin ağrı yönetiminde nonfarmakolojik yöntemleri kullanma durumları ve etkileyen faktörler. ACU Sağlık Bil Derg. 2019;10(1):60-66.
- Erden S, Akcalı D, Bulut H, Babacan A. Determining the knowledge of the pain and postoperative pain management of surgical nurses:a pilot study. GÜSBD. 2015;4(1):54-69.
- Menlah A, Garti I, Amoo AS. Knowledge, attitudes, and practices of postoperative pain management by nurses in selected district hospitals in Ghana. SAGE Open Nurs. 2018;4:1–11.
- Adams SDM, Varaei S, Jalalinia F. Nurses’ knowledge and attitude towards postoperative pain management in Ghana. Pain Research and Management. 2020;1-7. doi:10.1155/2020/4893707
- Adem AO, Obsa MS, Worji TA. Assessments of health professionals’ knowledge towards post-operative pain management in Asella Teaching and Referral Hospital, Southeast Ethiopia. Int. J. Med. Med. Sci. 2017;9(11):137-141.
- Al Qadire MA, Khalaileh MA. Jordanian nurses’ knowledge and attitude regarding pain management. Pain Manag Nurs. 2014;15(1):220-228.
- Erciyas A, Koçaşlı S, Öztaş D, Silay K. Investigation of surgical nurses’ knowledge and practice levels for multimodal analgesia. LOJ Med Sci. 2019;3(1):218-223.
- Kaiser J. Nurses' knowledge of opioids: Foundations for clinical practice. J Nurs Care Qual. 2020;35(4):348-352.
- Bademci V. Kuder-richardson 20, cronbach’ın alfası, Hoyt’un varyans analizi, genellenirlik kuramı ve ölçüm güvenirliği üzerine bir çalışma. DUZGEF. 2011;17:173-193.
- Kheshti R, Namazi S, Mehrabi M, Firouzabadi D. Health care workers knowledge, attitude, and practice about chronic pain management, Shiraz, Iran. Anesth Pain Med. 2016;16;6(4):e37270. doi:10.5812/aapm.37270
- Umuhozaa O, Chirondab G, Katendeb G, Mukeshimanaa M. Perceived knowledge, and practices of nurses regarding immediate postoperative pain management in surgical wards in Rwanda. IJANS. 2019;(10):145-151.
- Yin HH, Wong FKY. Systematic review of the predisposing, enabling, and reinforcing factors which influence nursing administration of opioids in the postoperative period. PN J NURS SCI. 2015;12:259–275.
- Çelik S, Baş BK., Korkmaz ZN, Karaşahin H, Yıldırım S. Hemşirelerin ağrı yönetimi hakkındaki bilgi ve davranışlarının belirlenmesi, Med J Bakirkoy. 2018;14:17-23.
- Dabrowska WM, Dabrowski S, Wojnicka AG, Basinski A, Jagus KK. Nurses’ knowledge and barriers regarding pain management. J Perianesth Nurs. 2018;33(5):715-726.
- Meadows C, Martin D, LeBaron VA. Cross-sectional survey exploring nursing students’ knowledge and attitudes regarding opioids and the opioid epidemic. Pain Manag Nurs. 2021. doi:10.1016/j.pmn.2021.01.015
Determination of Surgical Nurse’s Knowledge and Predictors Towards Multimodal Analgesia for Controlling Postoperative Pain
Abstract
Objective: Aim of the study was to determine the surgical nurses’ knowledge regarding multimodal analgesia (MA) and to identify predictors.
Materials and Methods: The universe of this prospective, cross-sectional study consisted of 150 nurses who work in surgical clinics and intensive care units, the sample consisted of 140 nurses willing to participate. The data were collected by using the “Personal Data Form” and the “Information Form” to evaluate the nurses' knowledge of acute pain, analgesic agent, and multimodal analgesia between 1 February to 30 June 2020. The data were analyzed using logistic regression and descriptive statistics.
Results: 24.3% of the nurses had heard of the concept of multimodal analgesia, and the majority of the nurses (58.8%) who heard it were on the internet. The correct score rates of nurses about pain, analgesic agents and MA were 68.86±15.46, 52.93±22.90, and 46.19 ± 27.11, respectively. The least correct response of the nurses was MA. To hear the MA was a predictor for pain (OR,7.820; CI,1.780-13.861; p=0.012), education (OR, 4.720; CI, 0.206-9.234; p= 0.041) and heard the MA (OR, 13.960; CI, 5.424-22.497; p=0.002) were predictors for analgesic agents’, working clinic (OR, 11.827; CI,3.052–20.603; p=0.009) and heard the MA (OR, 22.091; CI,12.150-32.032; p=0.000) were predictors for MA knowledge.
Conclusion: The knowledge of the surgical nurses about MA was undesirable. In-service training should be given to surgical nurses and this training should be repeated regularly.
Project Number
Proje çalışmasıd eğildir
References
- Pogatzki-Zahn EM, Segelckea D, Schugb SA. Postoperative pain-from mechanisms to treatment. Pain Rep. 2017;15:2(2):588-603.
- Coll AM, Jones R. Role of the nurse in the assessment and management of post-operative pain. Nurs Stand. 2020;35(4):53-58.
- Gan TJ. Poorly controlled postoperative pain: prevalence, consequences, and prevention. J Pain Res. 2017;10:2287–2298.
- Naqib D, Purvin M, Prasad R, ve ark. Quality improvement initiative to improve postoperative pain with a clinical pathway and nursing education program. Pain Manag Nurs. 2018;19(5):447-455.
- Lavelle-Henry MM. 3C Multimodal analgesia tried and true and those less used. Pain Manag Nurs. 2020;21(2):211-216.
- Savarese JJ, Tabler NG. Multimodal analgesia as an alternative to the risks of opioid monotherapy in surgical pain management. J Healthc Risk Manag. 2017;37(1):24-27.
- Schwenk ES, Mariano ER. Designing the ideal perioperative pain management plan starts with multimodal analgesia. Korean J Anesthesiol. 2018;71(5):345-352.
- Arnstein P. Multimodal approaches to pain management. Nursing. 2013;41(3):60-61.
- Barker JC, DiBartola K, Wee C, Andonian N, Abdel-Rasoul M, Lowery D. Preoperative multimodal analgesia decreases postanesthesia care unit narcotic use and pain scores in outpatient breast surgery. Plast and Reconst Surg. 2018;142(4):443-450.
- Donahue RE, Bradbury GR, Zychowicz ME, Muckler VC. Multimodal perioperatıve analgesia regimen to improve patients’ outcomes after total knee arthroplasty: A multidisciplinary quality improvement project. JOPAN. 2018;33(2):138-152.
- Acar K, Acar H, Demir F, Eti Aslan F. Cerrahi sonrası ağrı insidansı ve analjezik kullanım miktarının belirlenmesi. ACU Sağlık Bil Derg. 2016;2:85-91.
- Andrews-Cooper N, Kozachik SL. How patient education influences utilization of nonpharmacological modalities for persistent pain management: An integrative review. Pain Manag Nurs. 2020;21(2):157-164.
- Dessie M, Asichale A, Belayneh T, Enyew H, Hailekiros A. Knowledge, and attitudes of Ethiopian nursing staff regarding post-operative pain management: A cross- sectional multicenter study. Patient Relat Outcome Meas. 2019;10:395-403.
- Manworren RB. Multimodal pain management and the future of a personalized medicine approach to pain. AORN. 2015;101(3):308-314.
- C. Multimodal analgesia: optimizing perioperative pain management. Academic Festival. 2018;142:1-3.
- Midilli TS, Eşer İ, Yücel Ş. Cerrahi kliniklerinde çalışan hemşirelerin ağrı yönetiminde nonfarmakolojik yöntemleri kullanma durumları ve etkileyen faktörler. ACU Sağlık Bil Derg. 2019;10(1):60-66.
- Erden S, Akcalı D, Bulut H, Babacan A. Determining the knowledge of the pain and postoperative pain management of surgical nurses:a pilot study. GÜSBD. 2015;4(1):54-69.
- Menlah A, Garti I, Amoo AS. Knowledge, attitudes, and practices of postoperative pain management by nurses in selected district hospitals in Ghana. SAGE Open Nurs. 2018;4:1–11.
- Adams SDM, Varaei S, Jalalinia F. Nurses’ knowledge and attitude towards postoperative pain management in Ghana. Pain Research and Management. 2020;1-7. doi:10.1155/2020/4893707
- Adem AO, Obsa MS, Worji TA. Assessments of health professionals’ knowledge towards post-operative pain management in Asella Teaching and Referral Hospital, Southeast Ethiopia. Int. J. Med. Med. Sci. 2017;9(11):137-141.
- Al Qadire MA, Khalaileh MA. Jordanian nurses’ knowledge and attitude regarding pain management. Pain Manag Nurs. 2014;15(1):220-228.
- Erciyas A, Koçaşlı S, Öztaş D, Silay K. Investigation of surgical nurses’ knowledge and practice levels for multimodal analgesia. LOJ Med Sci. 2019;3(1):218-223.
- Kaiser J. Nurses' knowledge of opioids: Foundations for clinical practice. J Nurs Care Qual. 2020;35(4):348-352.
- Bademci V. Kuder-richardson 20, cronbach’ın alfası, Hoyt’un varyans analizi, genellenirlik kuramı ve ölçüm güvenirliği üzerine bir çalışma. DUZGEF. 2011;17:173-193.
- Kheshti R, Namazi S, Mehrabi M, Firouzabadi D. Health care workers knowledge, attitude, and practice about chronic pain management, Shiraz, Iran. Anesth Pain Med. 2016;16;6(4):e37270. doi:10.5812/aapm.37270
- Umuhozaa O, Chirondab G, Katendeb G, Mukeshimanaa M. Perceived knowledge, and practices of nurses regarding immediate postoperative pain management in surgical wards in Rwanda. IJANS. 2019;(10):145-151.
- Yin HH, Wong FKY. Systematic review of the predisposing, enabling, and reinforcing factors which influence nursing administration of opioids in the postoperative period. PN J NURS SCI. 2015;12:259–275.
- Çelik S, Baş BK., Korkmaz ZN, Karaşahin H, Yıldırım S. Hemşirelerin ağrı yönetimi hakkındaki bilgi ve davranışlarının belirlenmesi, Med J Bakirkoy. 2018;14:17-23.
- Dabrowska WM, Dabrowski S, Wojnicka AG, Basinski A, Jagus KK. Nurses’ knowledge and barriers regarding pain management. J Perianesth Nurs. 2018;33(5):715-726.
- Meadows C, Martin D, LeBaron VA. Cross-sectional survey exploring nursing students’ knowledge and attitudes regarding opioids and the opioid epidemic. Pain Manag Nurs. 2021. doi:10.1016/j.pmn.2021.01.015
There are 30 citations in total.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Research article |
| Authors | |
| Project Number | Proje çalışmasıd eğildir |
| Early Pub Date | December 3, 2022 |
| Publication Date | December 10, 2022 |
| Submission Date | December 19, 2021 |
| Acceptance Date | November 3, 2022 |
| Published in Issue | Year 2022 Volume: 7 Issue: 4 |
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