RESUMEN
This study examined the postoperative pain management practices among registered nurses in an urban hospital in Vietnam. Data of 90 nurses about postoperative pain management practices and pain management at the department were collected. Results indicated that 83.3% of nurses reported that they regularly assessed the degree of pain for postoperative patients. Only 32.2% used assessment tools such as the numeric rating scale to measure pain. Experience in pain management and having guidelines in the department were associated with a higher score in pain management practice. Findings suggested that facilitating the use of pain instruments and developing pain management guidelines should be prioritized.
Asunto(s)
Hospitales , Rol de la Enfermera , Enfermeras y Enfermeros , Manejo del Dolor , Dolor Postoperatorio/diagnóstico , Dolor Postoperatorio/terapia , Adulto , Estudios Transversales , Análisis Factorial , Femenino , Humanos , Masculino , Manejo del Dolor/métodos , Dimensión del Dolor , Atención al Paciente/métodos , Atención al Paciente/normas , Pautas de la Práctica en Enfermería , VietnamRESUMEN
Active participation in pain management is vital to improve postoperative pain outcomes. However, this issue has not been fully examined in Vietnam. This study aimed to examine the active participation of patients in pain management after surgery, as well as explore its effect on acute postoperative pain.A hospital-based survey on 245 patients after surgery was conducted. Information about demographic and clinical characteristics, pain intensity and active participation in pain management was collected. Multivariate regression models were utilized to determine the associations.53.9% of patients reported that they were informed about the postoperative pain relief method before surgery. One-third (33.5%) of patients selected preferred pain relief methods; 46.1% reported that they asked physicians when feeling pain immediately after surgery; 49.8% asked physicians when pain was not relieved after taking medications, and 52.2% asked physicians for their current pain in the time of interview. Age and occupation were found to be positively associated with active participation score. Patients being informed about the postoperative pain relief method before surgery had 0.87 points higher than those not receiving explanation (Coef. = 0.87; 95%CI = 0.49-1.26). Patients with high active participation scores were more likely to have pain improvement (OR = 3.41, 95%CI = 2.37-4.92).This study highlights a low level of active participation in postoperative pain management among Vietnamese patients. Routinely providing information about pain control before surgery, and encouraging patients to actively participate in pain management are essential to improve postoperative pain outcomes.
Asunto(s)
Manejo del Dolor , Participación del Paciente , Humanos , Vietnam , Manejo del Dolor/métodos , Dolor Postoperatorio/tratamiento farmacológico , Hospitales UrbanosRESUMEN
BACKGROUND: Identifying when intubated patients are ready to be extubated remains challenging. The negative inspiratory force (NIF) is a recommended predictor of weaning success. However, little is known about the role of NIF in the weaning process for the Asian surgical intensive population, especially for the Vietnamese population. Here, we aimed to investigate the cutoff threshold and predictive value of the NIF index for predicting the success of ventilator weaning in Vietnamese surgical intensive care patients. METHODS: A cross-sectional study was conducted at the Surgical Intensive Care Unit of Viet Duc Hospital from October 2016 to August 2017. A total of 64 patients aged 16-70 years undergoing ventilatory support through an orotracheal tube satisfied the criteria for readiness to begin weaning. The correlation between the NIF index with outcomes of the weaning process was analyzed. Specificity (Sp), sensitivity (Se), positive predictive value (PPV), negative predictive value (NPV), receiver operating characteristic (ROC) curve, and area under the curve (AUC) were calculated. RESULTS: The success rate of the entire weaning process was 67.2% (43/64). The median NIF values were -26.0 cm H2O (interquartile range [IQR], -28.0 to -25.0) in the successful weaning group and -24.0 cm H2O (IQR, -25.0 to -23.0) in the weaning failure group (P<0.001). According to ROC analysis, an NIF value ≤-25 cm H2O predicted weaning success (AUC, 0.836) with 91% Se, 62% Sp, 83% PPV, and 77% NPV. CONCLUSIONS: An NIF cutoff threshold ≤-25 cm H2O can be used as predictor of weaning success in Vietnamese surgical intensive care patients.