骨科患者術後未使用「病患自控式止痛」之疼痛經驗

The Experiences of Postoperative Pain in Orthopedic Paticets Without Patient－controlled Analgesia

術後疼痛是病人最常面臨的治療性問題，深入剖析病人未使用自控式止痛(PCA)之疼痛經驗，將利於護理人員發展其他有效的止痛措施，以協助緩解病人術後之急性疼痛。本研究採質性研究方法，目的在探討骨科病人術後未使用自控式止痛之疼痛經驗。使用深度訪談及錄音機輔助工具，真實地將二位骨科手術病人進行手術後疼痛經驗內容撰寫成文字稿，採用持續比較方法進行資料的分析與歸納。研究結果發現骨科手術病人於術後未使用自控式止痛之疼痛經驗，包含四個經驗主題：(1)無法緩解的抽痛；(2)經濟考量而選擇忍痛；(3)使用自控式止痛的相關訊息不足；(4)對於疼痛緩解觀念的錯誤認知。根據病人在術後所提供的照護方式的感受及建言，醫護人員須正視病人於術後未使用自控式止痛之疼痛經驗及緩解疼痛之需求，主動提供其他止痛策略及相關照護資訊，以緩解術後的急性疼痛。

Postoperative pain is one of the most common therapeutic problems caused from surgery. To explore the pain experience of surgical patients without the patient-controlled analgesia (PCA) after operation will contribute nurses to develop other effective analgesic interventions to alleviate patients' postoperative pain. A qualitative descript study with a semi-structure interview on two orthopedic surgical patients with acute pain was designed and conducted. All interviews were tape-recoded and transcribed verbatim. Data from the interviews were analyzed and categorized according to the constant comparative method of data analysis. Three themes emerged were (1) unalleviated pain, (2) the endurance of pain because of economy, (3) information shortage about PCA, and (4) misconception on analgesic methods. According to the patients' perspective and suggestion on the needs of postoperative care, medical and nursing personnel should to face the patient's pain experiences without the PCA after surgery and actively provide analgesic strategies and information to alleviate postoperative pain.