摘要
目的:基于症状管理理论(SMT)构建产后妇女乳房疼痛管理循证实践方案,并评价其效果。方法:基于知识转移分析框架(KTA),选择循证实践场所,通过利益相关者会议将产后乳房疼痛管理证据总结引入临床实践场所的情景,筛选出适合临床的最佳证据。循证小组基于最佳证据,结合SMT形成方案初稿,通过专家会议法评定方案初稿,构建产后妇女乳房疼痛管理循证实践方案终稿。采用便利抽样法,选取武汉市某三级甲等医院产科产妇为研究对象。将2024年10月1日—10月30日符合纳入标准的产妇33例纳入对照组,实施常规疼痛管理方案。将2024年12月1日—12月30日符合纳入标准的产妇33例为循证实践组,实施优化后的疼痛管理方案。比较两组产妇产后乳房疼痛管理知识得分、产后72 h乳房数字疼痛评分(NRS)、乳房肿胀程度、乳头损伤分级。结果:基于SMT的产后乳房疼痛管理护理目标包括有效的评估、有效的认知干预、安全有效的行为干预、有效的心理干预、持续开展质量评价。循证实践后护理人员循证护理能力得分、产后乳房疼痛管理知识得分及各项审查指标执行率均提升。循证实践组产后72 h乳房疼痛NRS评分、乳房肿胀程度、乳头损伤分级结果及产后乳房疼痛管理知识得分均优于对照组(均P<0.05)。结论:构建的产后妇女乳房疼痛管理循证实践方案有利于改善产妇产后乳房疼痛水平,促进产妇康复。
Objective:To construct an evidence-based practice program for breast pain management in postpartum women based on symptom management theory,and to evaluate its effect.Methods:Based on the knowledge transfer analys framework(KTA),the study selected the evidence-based practice site.The research team introduced the evidence summary of postpartum breast pain management into the scenarios of clinical practice through stakeholder meetings and screened out the best evidence suitable for clinical use.The evidence-based team formed the initial draft of the plan based on the best evidence and in combination with symptom management theory.The initial draft of the plan was evaluated through the expert meeting method.The final draft of the postpartum breast pain management plan for parturients was constructed.By using the convenience sampling method,the obstetric parturients in a tertiary grade A hospital in Wuhan city were selected as the research subjects.From October 1st to October 30th,2024,a total of 33 parturients who met the inclusion criteria were included in the control group and were given a conventional pain management program.A total of 33 parturients who met the inclusion criteria from December 1st to December 30th,2024 were selected as the evidence-based practice group.The optimized pain management program was implemented.The scores of postpartum breast pain management knowledge,Numerical Rating Scale(NRS)scores of breast pain 72 hours postpartum,the degree of breast swelling and the grade of nipple injury were compared between the two groups of parturients.Results:The postpartum breast pain management and nursing goals based on SMT included effective assessment,effective cognitive intervention,safe and effective behavioral intervention,effective psychological intervention,and continuous quality evaluation.After evidence-based practice,the scores of evidence-based nursing ability of nursing staff,postpartum breast pain management knowledge,and the implementation rates of various review indicators all increased.The scores of postpartum breast pain management knowledge,NRS score of breast pain 72 hours after delivery,degree of breast swelling and classification of nipple injury in the evidence-based practice group were better than those in the control group(all P<0.05).Conclusions:The evidence-based practice program for breast pain management in postpartum women could help to improve the level of postpartum breast pain in parturients and to promote their recovery.
作者
彭荷旗
王培红
蒲莉
丁路
胡霞
王焕焕
张纹
程湘玮
PENG Heqi;WANG Peihong;PU Li;DING Lu;HU Xia;WANG Huanhuan;ZHANG Wen;CHENG Xiangwei(Union Hospital,Tongji Medical College,Huazhong University of Science and Technology,Hubei 519000 China)
出处
《护理研究》
北大核心
2025年第24期4121-4128,共8页
Chinese Nursing Research
关键词
症状管理理论
产妇
乳房疼痛
循证护理
symptom management theory
postpartum woman
breast pain
evidence-based nursing
