機構關節炎老人之慢性疼痛及其相關因素探討

Chronic Pain and Associated Factors Amongst Institutionalized Elderly With Arthritis

背景：世界衛生組織預測關節炎將是導致全球失能排名第四位的疾病，同時該疾病也是老人慢性疼痛、憂鬱及入住機構最主要原因。關節炎引發的慢性疼痛問題日復一日困擾高齡人口。
目的：本研究旨在探討長期照護機構老年住民關節炎慢性疼痛及其相關因素，進而預測慢性疼痛之重要因素。
方法：本研究採橫斷式、描述相關性研究設計，以方便取樣方式收集114位個案。
結果：安養（護）機構老人關節炎慢性疼痛病患最近三個月平均疼痛達中度（X = 4.51 ± 1.75）。最近三個月平均疼痛與疼痛部位總數、過去疼痛事件之疼痛分數、自覺關節炎嚴重度、憂鬱狀況呈正相關（p < .01）；最近三個月平均疼痛與年齡、罹患慢性病數目、日常活動功能、社會支持呈負相關（p < .01）。過去最痛程度、自覺關節炎嚴重度、慢性病總數、日常活動功能及憂鬱狀況可預測慢性疼痛（p < .01），其總解釋變異量達40.4%。
結論：研究結果建議護理人員在照顧關節炎慢性疼痛病患時，須考慮個人生理、心理以及社會等層面，並期許護理人員於臨床照護中，宜針對長輩之個別性設計相關健康照護措施，提升生活品質。

Background: The World Health Organization has predicted that arthritis will rise to become the fourth ranked global disability among the elderly. Arthritis is already a main cause of chronic pain, depression, and institutionalization in this group. Chronic pain resulting from arthritis is a serious threat to the elderly population. Purpose: Study purposes were to: (1) explore chronic pain in elderly residents with arthritis residing at long-term care facilities and to understand the relationship between associated chronic pain and associated factors, and (2) identify the predictive factors of chronic pain. Methods: This study used a cross-sectional, descriptive correlational research design. A sample of 114 elderly residents, 65 years of age and older, were recruited from five long-term care facilities in Kaohsiung and Pingtung, Taiwan. Results: Findings showed that the average pain intensity resulting from chronic arthritis during the three months of study was medium (4.51 ± 1.75). There were positive relationships amongst average pain intensity, previous pain intensity, self-perception of arthritis severity and depression status . Negative correlations were found amongst age, self-perception of arthritis severity, number of chronic illnesses experienced, function of daily activity and social support. Previous pain intensity, self-perception of arthritis severity, number of chronic illnesses experienced, function of daily activity and depression status were all found to predict chronic pain. Together, these factors explained 40.4% of total variance. Conclusion: Study results provide information for nurses to consider the physical, psychological, and social aspects of chronic pain when caring for the elderly. Healthcare providers should design individualized health care interventions for elderly people to promote their quality of life.