본문 바로가기
HOME> 논문 > 논문 검색상세

논문 상세정보

International journal of nursing studies v.78, 2018년, pp.1 - 9   SCIE SSCI
본 등재정보는 저널의 등재정보를 참고하여 보여주는 베타서비스로 정확한 논문의 등재여부는 등재기관에 확인하시기 바랍니다.

Nurse practitioner led pain management the day after caesarean section: A randomised controlled trial and follow-up study

Schoenwald, Anthony (Department of Nursing & Midwifery, Ipswich Hospital, P.O. Box 73, Ipswich, QLD 4305, Australia ) ; Windsor, Carol (Queensland University of Technology, School of Nursing, Victoria Park Road, Kelvin Grove, QLD 4059, Australia ) ; Gosden, Edward (Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, QLD 4059, Australia ) ; Douglas, Clint (Queensland University of Technology, School of Nursing, Victoria Park Road, Kelvin Grove, QLD 4059, Australia ) ;
  • 초록  

    Abstract Background Pain on the day after caesarean section is often treated with controlled-release oxycodone to supplement the decline in analgesia from intrathecal opioids. Evidence suggests that caesarean birth is a biopsychosocial experience where a comprehensive approach is needed that promotes control and participation in pain management. Objectives This study compared immediate-release oxycodone integrated with supportive educational strategies to controlled-release oxycodone. A follow-up phase aimed to explore pain over three months. Design This study was a two-group parallel randomised controlled trial. Setting A metropolitan hospital in Australia with a birthing suite, operating rooms, and a postnatal unit. Participants English-speaking women scheduled for elective caesarean section were mailed trial information. Exclusion criteria included contraindications to intrathecal analgesia, herpes simplex infection, a history of chronic pain, opioid tolerance, or substance abuse. A total of 131 participants were recruited and randomised out of 298 eligible participants. Methods Group allocation was undertaken using sequentially numbered opaque sealed envelopes. The nurse practitioner intervention commenced on the day after surgery with immediate-release oxycodone alongside supportive strategies. The control group received scheduled doses of controlled-release oxycodone. All participants could request additional oxycodone or tramadol. Primary outcomes were pain intensity and secondary outcomes included patient global impression of change, pain interference, opioid consumption, and maternal perception of control. A follow-up phase evaluated pain outcomes over three months. Results The final sample size was 122, with 61 participants in each group. Pain intensity scores were analysed by linear mixed regression models. There were no statistical differences over 24h between the control and intervention groups at rest ( p = 0.40, 95% CI – 4.8mm, 11.9mm) or on sitting or moving ( p = 0.561, 95% CI –15.2mm, 8.3mm). Patient global impression of change was significant over three hours ( p = 0.014, OR=2.5, 95% CI 1.2, 5.3). The intervention group reported less pain interference while consuming less oxycodone ( p 0.05). There was no difference between groups in terms of perceived control over pain management ( p = 0.273, 95% CI –16.2mm, 4.6mm). The follow-up analysis graded 5.9% of participants as experiencing severe pain interference. Chronic pain following caesarean was associated with postnatal depression ( p Conclusions The research showed that a nurse practitioner intervention can improve pain management following caesarean section. The results underscore the influence of biological, psychological, and social factors on acute pain. Hence, this study reinforces the need for a biopsychosocial approach to acute pain management following caesarean delivery.


  • 주제어

    Analgesia .   Biopsychosocial .   Caesarean .   Catastrophising .   Depression .   Chronic postsurgical pain .   Nurse practitioner .   Oxycodone .   Pain .   Pain interference.  

 활용도 분석

  • 상세보기

    amChart 영역
  • 원문보기

    amChart 영역

원문보기

무료다운로드
  • 원문이 없습니다.

유료 다운로드의 경우 해당 사이트의 정책에 따라 신규 회원가입, 로그인, 유료 구매 등이 필요할 수 있습니다. 해당 사이트에서 발생하는 귀하의 모든 정보활동은 NDSL의 서비스 정책과 무관합니다.

원문복사신청을 하시면, 일부 해외 인쇄학술지의 경우 외국학술지지원센터(FRIC)에서
무료 원문복사 서비스를 제공합니다.

NDSL에서는 해당 원문을 복사서비스하고 있습니다. 위의 원문복사신청 또는 장바구니 담기를 통하여 원문복사서비스 이용이 가능합니다.

이 논문과 함께 출판된 논문 + 더보기