肺部手術病患術後疼痛、疲倦及希望之相關性探討

Pain, Fatigue and Hope in Patients Receiving Lung Surgery

本研究目的為：一、探討肺部手術病患手術後五天內最痛疼痛程度、平均疼痛程度變化型態；二、探討肺部手術病患手術後五天內疲倦程度變化型態；三、探討肺部手術病患手術後五天內疼痛、疲倦與希望之相關性。研究採前瞻性縱貫式研究設計，以立意、取樣，針對北部某醫學中心胸腔外科病房之接受肺部手術病患為對象，於手術後第一天及第三天及第五天以O-10 分數字量表收集疼痛及疲倦資料，並於第五天以赫氏希望指標評估病患之希望程度，資料以描述性統計、重複測量變異數分析及皮爾森積差相關進行分析，共收得45 位個案研究結果顯示：一、病患於手術後五天內，最痛疼痛程度及平均疼痛程度介於中等至嚴重之間，隨著天數增加疼痛強度遞減，然而於第五天仍有疼痛之情形；二、手術後五天內，疲倦程度為中等程度，隨著天數增加疲倦程度有遞減；三、最痛疼痛程度、平均疼痛程度均與疲倦呈正相關，但二者皆與希望狀況無關。本研究發現病患於肺部手術後疼痛和遞減疲倦未被有效處理，及疼痛與疲倦並非影響該群病患術後希望程度之主要因素，臨床及未來研究應進一步探討改善以上二症狀及提高希望程度之方法。The purposes of the study were to 1. examine the pattern of pain intensity (worst and average pain intensity) in patients after lung surgery after 1, 3, and 5 days; 2. examine the pattern of fatigue intensity in patients after lung surgery after 1, 3, and 5 days; and 3. examine the relationships among worst pain intensity, average pain intensity and hope in these patients. A prospectiv longitudinal design with purposive sampling was applied. A 0 to 10 numerical rating scale was used to assess the changes of pain intensity and fatigue at days 1, 3, and 5 (Dl , D3, D5) after the surgery. The Herth Hope Index was used on the fifth day (D5) to assess hope status. Data was analyzed by descriptive statistics, repeated-measure ANOV A, and Pearson correlation. A total of 45 patients were recruited. The results show that 1. patients perceived severe to moderate pain, and it decreased by the days after surgery increased; 2. patients perceived moderate level of fatigue after lung surgery within five days, by the day increase pain intensity decrease; 3. the worst pain intensity was positively correlated to average pain intensity and fatigue, and average pain intensity was positively correlated to fatigue. However, neither pain intensity and fatigue level was associated to hope status. Future research should further examine the factors to influence patients' hope status, and also develop the interventions to decrease patients' pain and fatigue.