Effects of prompts on the use of PCA and the outcomes of the behavior of the post-operative patients

• Main Authors: Fang Su-Ying, 方素瓔
• Other Authors: Ching-Chu Liang
• Format: Others
• Language: zh-TW
• Published: 1999
• Online Access: http://ndltd.ncl.edu.tw/handle/29751460162745168829

碩士 === 國立臺灣大學 === 護理學研究所 === 87 === The purpose of this present study was to understand the effect of cueing post-operative patients to the use of patients-controlled analgesia (PCA) in controlling post-operative pains. How the pain locus of control characteristics affect the acceptance of the cues to the pain control and the worries to the use of analgesia were also investigated. Quasi-experimental design was used and purposive sampling was conducted at two general surgical wards of a medical center. Eighty-one sample subjects were randomly assigned into experimental and control groups. Subjects in both groups received an one to one, standard and systematic teaching program that focused on how to use the PCA correctly. A pamphlet regarding the safety of using PCA was also provided to each subject. The only difference between the experimental and control groups was subjects in the experimental group received six times standard active prompting that cued them to use the PCA within 48 hours after the operation. Findings from the study were the followings: (1) Ss had higher tendency on the medical professional locus control to their post-operative pains. Further, the older the Ss the stronger they tended to be medical professional locus of control to their pains. Before the operation, the most strong worries to the use of analgesia were "time to give the analgesia is fixed", "afraid of addiction to the analgesia", and "afraid of injection". (2) Effects of cueing patients to the use of PCA could significant increase the frequencies and total doses of using PCA, decrease worries to the use of analgesia, and decrease the pain perception. Further, Ss in the experimental group had lower pain threshold to the use of PCA than the Ss in the control group. (3) Sex and education were the two factors influenced the effect of cueing on the use of PCA. Female and subjects with moderate education after receiving the cues tended to use more frequencies and doses of PCA. Patients with older age and had experiences in receiving operation and using analgesia tended to have lower worries to the use of analgesia after receiving cues on the use of PCA. (4) The characteristics of pain locus of control had little effect on the cues of using PCA. There were no significant differences among patients with the internal, fate external, medical professional external, and other external locus of pain control to the use of PCA in both experimental and control group. (5) This study also found that the frequencies of using PCA didn't affect the pain perception. Cues on the use of PCA had direct effect on the pain perception. Further, the higher the worries to the use of analgesia, the higher pain threshold the patient to the use of PCA. Results of this study suggested that the intervention of cueing patient to use PCA is not only an easy and time-saving nursing intervention, but also has strong effect on the decreasing of post-operative pain and the worries to the use of analgesia. Key words : cues, pain, PCA, pain locus of control, behavior modification