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Patients' Experience with Pain after Total Hip Replacement Surgery
HAVLÍN, František
Fear of postoperative pain is one of the most important concern of patients undergoing total hip arthroplasty and it is therefore important to address this issue in medical, and nursing care. In this research we focus on how patients experience pain after total hip arthroplasty. The diploma thesis is divided into two consecutive parts, namely the theoretical, and empirical part. The theoretical part describes the current state of total hip replacement, coxarthrosis, and postoperative pain management. From this part it is clear that the treatment of postoperative pain is dominated by pharmacological methods. In the empirical part, hypotheses were established which dealt with the measurement of the intensity of postoperative pain after total hip replacement surgery the use of pharmacological and non-pharmacological methods of pain treatment and the timeliness of postoperative pain relief. In the practical part of the work a quantitative survey was used. A query sheet was created which was then distributed to patients in the orthopedic patient department. The query sheets were filled out in the first, third, and fifth postoperative day and participation in it was voluntary. From a non-standardized query sheet the data were analyzed by statistics and the results are shown graphically in the thesis. The research survey shows that female and male respondents rate postoperative pain in the same way. The gradual reduction of postoperative pain is also the same for both sexes of the respondents. At the initial meeting with postoperative pain the medical staff instructed patients about the possibilities of pain treatment as the use of pharmacological and non-pharmacological pain treatment. In the query sheet the 87 (81 %) respondents choose the combination of both therapies on the first postoperative day. The 101 (94 %) respondents stated that they used 3 or more methods of non-pharmacological pain treatment on the fifth day. Research has shown that patients experienced less pain after surgery every day and the treatment of the postoperative pain was successful in terms of the rate of analgesic administration by a nurse according to the doctor's instruction. The use of non-pharmacological interventions in the treatment of pain also increased every day.
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The use of evalution and measurement tools for assessment of pain in surgery
DVOŘÁKOVÁ, Vendula
Pain can be a warning sign, but in surgery it is associated mainly with medical procedures. The aim of the research survey was to map out the pain rating scales that are used in practice in surgical patients, to determine the opinion of surgical nurses on these scales and patient experience. Furthermore, the paperwas aimed at the creation of a recommended procedure for evaluation of pain in surgical patients. In the empirical part of the thesis, quantitative and qualitative research was used. In the quantitative research, two questionnaires were created - for nurses (a non-standardized questionnaire) and for surgical patients (a combination of a non-standardized and standardized questionnaire). The focus group method with surgical patients and nurses was used as a qualitative method. The research survey shows that the most commonly used scale in practice is the visual analogue scale and verbal evaluation. Although these methods are widely used, our results suggest that they are not entirely sufficient. Respondents from the groups of nurses and patients wanted to add more accurate verbal description to the evaluation and increase the frequency of pain evaluation by a doctor and nurse. The most frequent symptoms of pain from the perspective of patients included: limited mobility and self-sufficiency, emotional lability, and verbal manifestations. And from the perspective of nurses: limited mobility, non-cooperation, limited self-sufficiency and verbal manifestations. Among the methods that are used most often by patientsto relieve painare medicinesprescribed by the doctor, relief positions, sleep and rest. More than 90% of patients are satisfied with the cooperation with the nurse and the doctor in the evaluation and treatment of pain. Based on the data analysis, a procedure for assessing pain in surgical patients has been proposed. Its clarity and usability were verified using the focus group method with surgical nurses and patients. Both the nurses and the patients assessed the recommended procedure quite positively. Possible pitfalls were perceived in the necessity of sufficient nurse-patient cooperation and enough time to implement the proposed assessment. The research survey was carried out in the territory of the South Bohemian region and is processed as part of thesolution of the GAJU team grant project - Use of Measuring Instruments in Nursing Practice (059/2018/S).
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The perception of pain versus pain management in the nursing profession
BLÁHOVÁ, Kateřina
The thesis deals with a definition of pain management issues, role of nurses working with patients in pain and, particularly, perception of pain of patients by nurses. The objective of the research was to identify and to study pain management procedures and, at the same time, to present how nurses perceive and experience the care of patients in pain. The empirical part of the thesis was performed through qualitative investigation using semi-structured interviews with nurses and patients. The respondents included 12 nurses and 8 patients. Based on results of the investigation covert participatory observation was selected as a complementary method. 6 nurses were observed while taking care of patients during a post-surgery period. Most frequently, nurses rate pain of patients by means of VAS (Visual Analogue Scale), however, they quite often assess the value subjectively. Nurses then record the found values regularly into the patient´s chart. Nurses would also appreciate more cooperation with physicians in order to increase efficiency of pain rating. Nurses are able to respond very well to patient´s verbalization of pain and they perceive differences in communication in such situations. The majority of nurses choose pro-active approach to pain alleviation. Nurses have the basic knowledge about non-pharmacological pain alleviation. Perception of pain by nurses is partly affected by length of their practice and by their own experience with pain. Nurses perceive negatively those situations when pain management interventions are not sufficiently effective, when they cannot contact physicians or when they cannot act based on their own discretion. In such situations nurses demonstrate signs of distress. This problem aggravates when nurses work with patients suffering from chronic pain. Nurses have only limited opportunities to improve their education in pain management and communication with patients in pain. Patients in pain mostly see the care provided by nurses positively but they have also provided numerous recommendations for the nurses. The empirical research has shown that nurses meet with patients in pain nearly every day while performing their nursing practice and that assessment of pain plays an important role in pain alleviation. In most cases the exposure of nurses to patients in pain causes their negative emotional experience, such as sadness or fear of complications. Their experience is affected by several factors. In general, the issues of pain perception by nurses in comparison with pain management techniques are often neglected. Nevertheless, from the viewpoint of mental stress, pain perception is an indisputable factor that deserves more detailed investigation.
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A systematic review of pain assessment tools
Kroiherová, Tereza ; Vomáčková, Helena (advisor) ; Pánek, David (referee)
Title: A systematic review of pain assessment tools Objectives: The aim of this thesis is to create a systematic review of the most widely used multidimensional tools (questionnaires) for assessing pain in patients with nonspecific pain of the cervical and lumbar spine. From the available sources, describe their use, the purpose it was generated for, their reliability, validity, and finally arrange the questionnaires from the most used and assess their advantages and disadvantages for use in clinical practice of physiotherapist. Method: The thesis is processed through a systematic review. The subject of the thesis are pain evaluating tools, especially in the cervical and lumbar spine. The studies containing questionnaires used to assess pain in the cervical and lumbar spine were searched out. Data extraction was carried out according to pre-specified criteria. Unsatisfactory studies were excluded. After the relevant questionnaires selection a content analysis of each tool was conducted, built a systematic review of the most commonly used questionnaires and their critical evaluation. Results: On the basis of the entire set of relevant studies I described and evaluated 14 questionnaires. Five of them are designed specifically for low back pain. They are the Roland Morris Disability Questionnaire,...
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The experience of children with diagnosis and control of pain during hospitalization on children's wards
ZELLEROVÁ, Kateřina
The diploma thesis entitled "Experience of children in assessment and treatment of pain in hospitalization at children's departments" deals with the topic of children's pain and its treatment. The issue is the main topic of the theoretical and practical part of the thesis and both of them focus on children at their pre-school and school age. The theoretical part of the thesis describes the current state of the issue, the psychology of a child at the pre-school and school age and also pain as such and its specifics in children. It is obvious that pain of a child is different not only in diagnostics and treatment. A child reacts differently also in experiencing pain, and also fables are often among people regarding pain that persist even these days. It is important to realize that a child is not a smaller adult, and that is why care for a child must be different. At the same time a child has to be taken as an integral human being who experiences pain and it always has to be assessed objectively according to scales and other objective methods selected according to the child's age. In this area, a big problem can be fables about children's pain that persist even in the current population. The research part of the thesis is aimed at interviews with children hospitalized at children's departments regarding their pain and also interviews with nurses. It compares information obtained from both groups of respondents and it looks for answers to questions of experiencing pain by a child, assessment by a nurse and treatment. It is apparent from the results of the research that children perceived differences in assessment and treatment of pain at home and in hospital, particularly in the change of the person that have to approach, and also in using non-pharmacological methods that are used more by mothers at home. This regards frequency and the way of pain assessment; children are not aware of regularity of assessment, they do not know the scales that the nurses mentioned as those that are used most often. Treatment of pain in hospitals is mostly pharmacological. But children do not always get the information about effect of a drug when it is administered to them. At the same time this part of the thesis looks for the possibilities and the need to create a standard for assessment and treatment of pain in children as well as the most important parts that the standards should contain. In this connection, a draft of the standard for nursing care of a child in pain was created within the thesis which makes up an appendix hereof.
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