ISSN: 1859 - 2872
Tổng quan hệ thống về kiến thức, thái độ và thực hành của nhân viên y tế trong quản lý đau sau phẫu thuật
Main Article Content
Keywords
Kiến thức, thái độ và thực hành, quản lý đau, đau sau phẫu thuật.
Tóm tắt
Mục tiêu: Tổng quan hệ thống này nhằm tổng hợp thực trạng kiến thức, thái độ và thực hành (KAP) của đội ngũ nhân viên y tế trong quản lý đau sau phẫu thuật, xác định các yếu tố ảnh hưởng và những hạn chế hiện tại, từ đó đề xuất định hướng cải thiện chất lượng chăm sóc hậu phẫu. Đối tượng và phương pháp: Tìm kiếm hệ thống trên cơ sở dữ liệu PubMed được thực hiện đến ngày 31/12/2024 với các từ khóa và từ đồng nghĩa theo MeSH cho “kiến thức”, “thái độ”, “thực hành”, “đau sau phẫu thuật” và “nhân viên y tế”. Các nghiên cứu được chọn nếu đánh giá định lượng KAP trong quản lý đau sau phẫu thuật và được công bố bằng tiếng Anh. Kết quả: Từ 667 bài báo, có 37 nghiên cứu đáp ứng tiêu chí lựa chọn. Kết quả cho thấy tình trạng KAP khác biệt rõ giữa các quốc gia. Trên phạm vi toàn cầu, mức độ kiến thức nhìn chung còn hạn chế. Điểm trung bình thường dưới ngưỡng chuẩn 80%, với nhiều thiếu hụt đáng kể về dược lý opioid, nguyên tắc đánh giá đau và giảm đau đa mô thức. Thái độ thường tiêu cực hoặc quá thận trọng, đặc biệt là lo ngại quá mức về opioid và thiếu tin tưởng vào báo cáo của người bệnh. Thực hành cho thấy việc sử dụng công cụ đánh giá đau chưa đồng bộ, còn khoảng cách lớn giữa nhận thức và hành động; giảm đau đa mô thức vẫn chưa được áp dụng triệt để. Các rào cản chính gồm thiếu kinh nghiệm và trải nghiệm trong quản lý đau, đào tạo và chuyên môn của nhân viên y tế, thiếu hướng dẫn lâm sàng, khối lượng công việc lớn, thiếu nhân lực và sự hợp tác liên ngành. Kết luận: Nghiên cứu cung cấp bức tranh toàn cầu về KAP trong quản lý đau sau phẫu thuật, làm rõ các khoảng trống hiện tại và những yếu tố hệ thống, cá nhân, tổ chức ảnh hưởng đến kiểm soát đau, đồng thời đề xuất định hướng cho đào tạo và xây dựng hướng dẫn chuẩn nhằm nâng cao chất lượng chăm sóc sau phẫu thuật.
Article Details
Các tài liệu tham khảo
1. Abdalrahim MS, Majali SA, Stomberg MW and Bergbom I (2011) The effect of postoperative pain management program on improving nurses' knowledge and attitudes toward pain. Nurse Educ Pract 11(4): 250-255.
2. Adams SM, Varaei S and Jalalinia F (2020) Nurses' Knowledge and Attitude towards Postoperative Pain Management in Ghana. Pain Res Manag: 4893707.
3. Amena N, Dechasa A, Kurke A et al (2024) Postoperative pain management practice and associated factors among nurses working at public hospitals, in Oromia region, Ethiopia, 2021: An institution-based cross-sectional study. BMJ Open 14(11): 080252.
4. Belay MZ and Yirdaw LT (2022) Management of postoperative pain among health professionals working in governmental hospitals in South Wollo Zone, Northeast Ethiopia. Prospective cross sectional study. Ann Med Surg (Lond) 80: 104148.
5. Bird A and Wallis M (2002) Nursing knowledge and assessment skills in the management of patients receiving analgesia via epidural infusion. J Adv Nurs 40(5): 522-531.
6. Chapman PJ, Ganendran A, Scott RJ and Basford KE (1987) Attitudes and knowledge of nursing staff in relation to management of postoperative pain. Aust N Z J Surg 57(7): 447-50.
7. Chatchumni M, Namvongprom A, Eriksson H, and Mazaheri M (2016) Thai Nurses' experiences of post-operative pain assessment and its' influence on pain management decisions. BMC Nurs 15: 12.
8. Chen YR, Chen CC, Wu WW et al (2024) Nurses' knowledge of and attitude toward postoperative patient-controlled analgesia (PCA) and the associated factors. BMC Nurs 23(1): 21.
9. Coluzzi F, Savoia G, Paoletti F et al (2009) Postoperative pain survey in Italy (POPSI): A snapshot of current national practices. Minerva Anestesiol 75(11): 622-31.
10. Coulling S (2005) Nurses' and doctors' knowledge of pain after surgery. Nurs Stand 19(34): 41-49.
11. Demir ET and Erbas M (2022) Anaesthesiologist's Attitude and Behavior Toward Postoperative Pain Management in Turkey. Turk J Anaesthesiol Reanim 50(1): 37-43.
12. Dessie M, Asichale A, Belayneh T et al (2019) Knowledge and Attitudes of Ethiopian Nursing Staff Regarding Post-Operative Pain Management: A Cross-Sectional Multicenter Study. Patient Relat Outcome Meas 10: 395-403.
13. Dongara AR, Shah SN, Nimbalkar SM et al (2015) Knowledge of and Attitudes Regarding Postoperative Pain among the Pediatric Cardiac Nursing Staff: An Indian Experience. Pain Manag Nurs 16(3): 314-20.
14. Francis L and Fitzpatrick JJ (2013) Postoperative pain: nurses' knowledge and patients' experiences. Pain Manag Nurs 14(4): 351-357.
15. Gan TJ (2017) Poorly controlled postoperative pain: prevalence, consequences, and prevention. J Pain Res 10: 2287-2298.
16. Gan TJ, Epstein RS, Leone-Perkins ML et al (2018) Practice Patterns and Treatment Challenges in Acute Postoperative Pain Management: A Survey of Practicing Physicians. Pain Ther 7(2): 205-216.
17. He HG, Jahja R, Lee TL et al (2010) Nurses' use of non-pharmacological methods in children's postoperative pain management: Educational intervention study. J Adv Nurs 66(11): 2398-409.
18. Ismail A, Forgeron P, Polomeno V et al (2017) Pain Management Practice and Guidelines in Jordanian Pediatric Intensive Care Units. Pain Manag Nurs 19(2): 195-203.
19. Kang MR and Kwon YJ (2022) Nurses' knowledge and attitudes toward patient-controlled analgesia for postoperative pain control in a tertiary hospital in South Korea. BMC Nurs 21(1): 319.
20. Khatib SK, Razvi SS, Kulkarni SS and Parab S (2017) A multicentre survey of the current acute post-operative pain management practices in tertiary care teaching hospitals in Maharashtra. Indian J Anaesth 61(3): 215-224.
21. Kiekkas P, Gardeli P, Bakalis N et al (2015) Predictors of nurses' knowledge and attitudes toward postoperative pain in Greece. Pain Manag Nurs 16(1): 2-10.
22. Liu Y, Xiao S, Yang H et al (2023) Postoperative pain-related outcomes and perioperative pain management in China: A population-based study. Lancet Reg Health West Pac 39: 100822.
23. Mackintosh C and Bowles S (2000) The effect of an acute pain service on nurses' knowledge and beliefs about post-operative pain. J Clin Nurs 9(1): 119-26.
24. Mackova Porter D, Al Harbi M, Tawfeeq NA and Pokorna A (2022) Awareness of general nurses in management of postoperative pain through patient controlled analgesia - Comparison among the Czech Republic and the Kingdom of Saudi Arabia. Saudi J Anaesth 16(1): 10-16.
25. McNamara MC, Harmon D and Saunders J (2012) Effect of education on knowledge, skills and attitudes around pain. Br J Nurs 21(16): 958, 960-4.
26. Mędrzycka-Dąbrowska W, Dąbrowski S, Gutysz-Wojnicka A et al (2017) Nurses' Knowledge and Barriers Regarding Pain Management. J Perianesth Nurs 33(5): 715-726.
27. Menlah A, Garti I, Amoo SA et al (2018) Knowledge, Attitudes, and Practices of Postoperative Pain Management by Nurses in Selected District Hospitals in Ghana. SAGE Open Nurs 4: 2377960818790383.
28. Negash TT, Belete KG, Tlilaye W et al (2022) Knowledge, attitudes and practices of health professionals towards postoperative pain management at a referral hospital in Ethiopia. Ann Med Surg (Lond) 73: 103167.
29. Nyirigira G, Wilson RA, VanDenKerkhof EG et al (2018) Barriers and facilitators to postoperative pain management in Rwanda from the perspective of health care providers: A contextualization of the theory of planned behavior. Can J Pain 2(1): 87-102.
30. Park R, Mohiuddin M, Arellano R et al (2023) Prevalence of postoperative pain after hospital discharge: systematic review and meta-analysis. Pain Rep 8(3): 1075.
31. Rognstad MK, Fredheim OM, Johannessen TE et al (2012) Attitudes, beliefs and self-reported competence about postoperative pain among physicians and nurses working on surgical wards. Scand J Caring Sci 26(3): 545-52.
32. Samara H, O'Hara L, and Singh K (2024) Nurses' Knowledge and Attitudes about Adult Post-Operative Pain Assessment and Management: Cross Sectional Study in Qatar. Nurs Rep 14(3): 2061-2071.
33. Smeland AH, Twycross A, Lundeberg S, and Rustoen T (2018) Nurses' Knowledge, Attitudes and Clinical Practice in Pediatric Postoperative Pain Management. Pain Manag Nurs 19(6): 585-598.
34. Taylor RS, Ullrich K, Regan S et al (2013) The impact of early postoperative pain on health-related quality of life. Pain Pract. 13(7): 515-523.
35. Teshome ZB, Aychew Y, Mitiku W, and Guta B (2022) Level of attitude, knowledge and practice of nurses toward postoperative pain management, cross-sectional study. Ann Med Surg (Lond) 84: 104902.
36. Tomaszek L and Debska G (2018) Knowledge, compliance with good clinical practices and barriers to effective control of postoperative pain among nurses from hospitals with and without a "Hospital without Pain" certificate. J Clin Nurs 27(7-8): 1641-1652.
37. van Dijk JF, Schuurmans MJ, Alblas EE, Kalkman CJ, van Wijck AJ et al (2017) Postoperative pain: knowledge and beliefs of patients and nurses. J Clin Nurs 26(21-22): 3500-3510.
38. Vu PH, Tran DV, Le YT et al (2020) Postoperative Pain Management among Registered Nurses in a Vietnamese Hospital. ScientificWorldJournal. 2020 Aug 11;2020:6829153.
39. Youngcharoen P and Aree-Ue S (2022) A cross-sectional study of factors associated with nurses' postoperative pain management practices for older patients. Nurs Open 10(1): 90-98.
40. Youngcharoen P and Piyakhachornrot C (2024) Online Learning to Improve Nurses' Knowledge, Attitudes, and Self-Efficacy About Managing Postoperative Pain in Older Adults. Pain Manag Nurs 25(3): 249-257.
41. Youngcharoen P, Vincent C, Park CG et al (2016) Nurses' Pain Management for Hospitalized Elderly Patients With Postoperative Pain. West J Nurs Res 38(11): 1409-1432.
42. Zachodnik J, Andersen JH, and Geisler A (2019) Barriers in pain treatment in the emergency and surgical department. Dan Med J 66(2).
2. Adams SM, Varaei S and Jalalinia F (2020) Nurses' Knowledge and Attitude towards Postoperative Pain Management in Ghana. Pain Res Manag: 4893707.
3. Amena N, Dechasa A, Kurke A et al (2024) Postoperative pain management practice and associated factors among nurses working at public hospitals, in Oromia region, Ethiopia, 2021: An institution-based cross-sectional study. BMJ Open 14(11): 080252.
4. Belay MZ and Yirdaw LT (2022) Management of postoperative pain among health professionals working in governmental hospitals in South Wollo Zone, Northeast Ethiopia. Prospective cross sectional study. Ann Med Surg (Lond) 80: 104148.
5. Bird A and Wallis M (2002) Nursing knowledge and assessment skills in the management of patients receiving analgesia via epidural infusion. J Adv Nurs 40(5): 522-531.
6. Chapman PJ, Ganendran A, Scott RJ and Basford KE (1987) Attitudes and knowledge of nursing staff in relation to management of postoperative pain. Aust N Z J Surg 57(7): 447-50.
7. Chatchumni M, Namvongprom A, Eriksson H, and Mazaheri M (2016) Thai Nurses' experiences of post-operative pain assessment and its' influence on pain management decisions. BMC Nurs 15: 12.
8. Chen YR, Chen CC, Wu WW et al (2024) Nurses' knowledge of and attitude toward postoperative patient-controlled analgesia (PCA) and the associated factors. BMC Nurs 23(1): 21.
9. Coluzzi F, Savoia G, Paoletti F et al (2009) Postoperative pain survey in Italy (POPSI): A snapshot of current national practices. Minerva Anestesiol 75(11): 622-31.
10. Coulling S (2005) Nurses' and doctors' knowledge of pain after surgery. Nurs Stand 19(34): 41-49.
11. Demir ET and Erbas M (2022) Anaesthesiologist's Attitude and Behavior Toward Postoperative Pain Management in Turkey. Turk J Anaesthesiol Reanim 50(1): 37-43.
12. Dessie M, Asichale A, Belayneh T et al (2019) Knowledge and Attitudes of Ethiopian Nursing Staff Regarding Post-Operative Pain Management: A Cross-Sectional Multicenter Study. Patient Relat Outcome Meas 10: 395-403.
13. Dongara AR, Shah SN, Nimbalkar SM et al (2015) Knowledge of and Attitudes Regarding Postoperative Pain among the Pediatric Cardiac Nursing Staff: An Indian Experience. Pain Manag Nurs 16(3): 314-20.
14. Francis L and Fitzpatrick JJ (2013) Postoperative pain: nurses' knowledge and patients' experiences. Pain Manag Nurs 14(4): 351-357.
15. Gan TJ (2017) Poorly controlled postoperative pain: prevalence, consequences, and prevention. J Pain Res 10: 2287-2298.
16. Gan TJ, Epstein RS, Leone-Perkins ML et al (2018) Practice Patterns and Treatment Challenges in Acute Postoperative Pain Management: A Survey of Practicing Physicians. Pain Ther 7(2): 205-216.
17. He HG, Jahja R, Lee TL et al (2010) Nurses' use of non-pharmacological methods in children's postoperative pain management: Educational intervention study. J Adv Nurs 66(11): 2398-409.
18. Ismail A, Forgeron P, Polomeno V et al (2017) Pain Management Practice and Guidelines in Jordanian Pediatric Intensive Care Units. Pain Manag Nurs 19(2): 195-203.
19. Kang MR and Kwon YJ (2022) Nurses' knowledge and attitudes toward patient-controlled analgesia for postoperative pain control in a tertiary hospital in South Korea. BMC Nurs 21(1): 319.
20. Khatib SK, Razvi SS, Kulkarni SS and Parab S (2017) A multicentre survey of the current acute post-operative pain management practices in tertiary care teaching hospitals in Maharashtra. Indian J Anaesth 61(3): 215-224.
21. Kiekkas P, Gardeli P, Bakalis N et al (2015) Predictors of nurses' knowledge and attitudes toward postoperative pain in Greece. Pain Manag Nurs 16(1): 2-10.
22. Liu Y, Xiao S, Yang H et al (2023) Postoperative pain-related outcomes and perioperative pain management in China: A population-based study. Lancet Reg Health West Pac 39: 100822.
23. Mackintosh C and Bowles S (2000) The effect of an acute pain service on nurses' knowledge and beliefs about post-operative pain. J Clin Nurs 9(1): 119-26.
24. Mackova Porter D, Al Harbi M, Tawfeeq NA and Pokorna A (2022) Awareness of general nurses in management of postoperative pain through patient controlled analgesia - Comparison among the Czech Republic and the Kingdom of Saudi Arabia. Saudi J Anaesth 16(1): 10-16.
25. McNamara MC, Harmon D and Saunders J (2012) Effect of education on knowledge, skills and attitudes around pain. Br J Nurs 21(16): 958, 960-4.
26. Mędrzycka-Dąbrowska W, Dąbrowski S, Gutysz-Wojnicka A et al (2017) Nurses' Knowledge and Barriers Regarding Pain Management. J Perianesth Nurs 33(5): 715-726.
27. Menlah A, Garti I, Amoo SA et al (2018) Knowledge, Attitudes, and Practices of Postoperative Pain Management by Nurses in Selected District Hospitals in Ghana. SAGE Open Nurs 4: 2377960818790383.
28. Negash TT, Belete KG, Tlilaye W et al (2022) Knowledge, attitudes and practices of health professionals towards postoperative pain management at a referral hospital in Ethiopia. Ann Med Surg (Lond) 73: 103167.
29. Nyirigira G, Wilson RA, VanDenKerkhof EG et al (2018) Barriers and facilitators to postoperative pain management in Rwanda from the perspective of health care providers: A contextualization of the theory of planned behavior. Can J Pain 2(1): 87-102.
30. Park R, Mohiuddin M, Arellano R et al (2023) Prevalence of postoperative pain after hospital discharge: systematic review and meta-analysis. Pain Rep 8(3): 1075.
31. Rognstad MK, Fredheim OM, Johannessen TE et al (2012) Attitudes, beliefs and self-reported competence about postoperative pain among physicians and nurses working on surgical wards. Scand J Caring Sci 26(3): 545-52.
32. Samara H, O'Hara L, and Singh K (2024) Nurses' Knowledge and Attitudes about Adult Post-Operative Pain Assessment and Management: Cross Sectional Study in Qatar. Nurs Rep 14(3): 2061-2071.
33. Smeland AH, Twycross A, Lundeberg S, and Rustoen T (2018) Nurses' Knowledge, Attitudes and Clinical Practice in Pediatric Postoperative Pain Management. Pain Manag Nurs 19(6): 585-598.
34. Taylor RS, Ullrich K, Regan S et al (2013) The impact of early postoperative pain on health-related quality of life. Pain Pract. 13(7): 515-523.
35. Teshome ZB, Aychew Y, Mitiku W, and Guta B (2022) Level of attitude, knowledge and practice of nurses toward postoperative pain management, cross-sectional study. Ann Med Surg (Lond) 84: 104902.
36. Tomaszek L and Debska G (2018) Knowledge, compliance with good clinical practices and barriers to effective control of postoperative pain among nurses from hospitals with and without a "Hospital without Pain" certificate. J Clin Nurs 27(7-8): 1641-1652.
37. van Dijk JF, Schuurmans MJ, Alblas EE, Kalkman CJ, van Wijck AJ et al (2017) Postoperative pain: knowledge and beliefs of patients and nurses. J Clin Nurs 26(21-22): 3500-3510.
38. Vu PH, Tran DV, Le YT et al (2020) Postoperative Pain Management among Registered Nurses in a Vietnamese Hospital. ScientificWorldJournal. 2020 Aug 11;2020:6829153.
39. Youngcharoen P and Aree-Ue S (2022) A cross-sectional study of factors associated with nurses' postoperative pain management practices for older patients. Nurs Open 10(1): 90-98.
40. Youngcharoen P and Piyakhachornrot C (2024) Online Learning to Improve Nurses' Knowledge, Attitudes, and Self-Efficacy About Managing Postoperative Pain in Older Adults. Pain Manag Nurs 25(3): 249-257.
41. Youngcharoen P, Vincent C, Park CG et al (2016) Nurses' Pain Management for Hospitalized Elderly Patients With Postoperative Pain. West J Nurs Res 38(11): 1409-1432.
42. Zachodnik J, Andersen JH, and Geisler A (2019) Barriers in pain treatment in the emergency and surgical department. Dan Med J 66(2).
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HàN. T., HuyP. V., MỹL. T., AnhL. T. P., HươngN. T. L., HạnhN. T. H., TrangT. T. T., & SơnN. T. (2025). Tổng quan hệ thống về kiến thức, thái độ và thực hành của nhân viên y tế trong quản lý đau sau phẫu thuật. Journal of 108 - Clinical Medicine and Phamarcy, 20. https://doi.org/10.52389/ydls.v20i0.2843