RESUMO
BACKGROUND: Obstacles to the use of patient-controlled analgesia (PCA) by elderly surgical patients have not been well-documented. Age differences in preoperative psychological factors, postoperative pain and analgesic consumption, treatment satisfaction, and concerns regarding PCA were measured to identify factors important to effective PCA use. METHODS: Preoperatively, young (mean age +/- SD, 39 +/- 9 yr; n = 45) and older (mean age +/- SD, 67 +/- 8 yr; n = 44) general surgery patients completed measures of attitudes toward and expectations of postoperative pain and PCA, psychological distress, health opinions, self-efficacy, and optimism. On the first 2 postoperative days, pain at rest and with movement and satisfaction with pain control were assessed using visual analog scales. Daily opioid intake was recorded. When PCA was discontinued, satisfaction and concerns about it were assessed. RESULTS: The older patients expected less intense pain (P = 0.003) and preferred less information about (P = 0.02) and involvement in (P = 0.002) health care than young patients. There were no age differences with regard to pain at rest (P = 0.22) or with movement (P = 0.68). The older group self-administered less opioid than the young group (P = 0.0001) and received PCA for more days than the young group (P = 0.004). The groups did not differ in concerns about pain relief, adverse drug effects, including opioid addiction, and equipment use or malfunction. Satisfaction with PCA was high and did not differ between the groups. CONCLUSIONS: Patient-controlled analgesia use was not hindered by age differences in beliefs about postoperative pain and opioids. Younger and older patients attained comparable levels of analgesia and were equally satisfied with their pain control.
Assuntos
Analgesia Controlada pelo Paciente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Analgésicos Opioides/uso terapêutico , Humanos , Pessoa de Meia-Idade , Dor Pós-Operatória/tratamento farmacológico , Satisfação do PacienteRESUMO
Tension and pain are common occupational hazards of modern-day nursing, especially given recent changes to the health care system. The aims of the pilot study were (1) to evaluate the feasibility of carrying out a series of eight 15-minute workplace-based massage treatments, and (2) to determine whether massage therapy reduced pain and stress experienced by nursing staff at a large teaching hospital. Twelve hospital staff (10 registered nurses and 2 nonmedical ward staff) working in a large tertiary care center volunteered to participate. Participants received up to eight, workplace-based, 15-minute Swedish massage treatments provided by registered massage therapists. Pain, tension, relaxation, and the Profile of Mood States were measured before and after each massage session. Pain intensity and tension levels were significantly lower after massage (P < .01). In addition, relaxation levels and overall mood state improved significantly after treatments (P < .01). The results of this pilot study support the feasibility of an eight-session, workplace-based, massage therapy program for pain and tension experienced by nurses working in a large teaching hospital. Further research is warranted to study the efficacy of workplace massage in reducing stress and improving overall mood.