NICUにおける新生児の痛み体験 : 看護婦の認識と看護の実情

本研究の目的は、新生児看護に従事する看護婦の新生児の痛みに対する認識や看護実践状況を調査し,今後の課題を明らかにすることである.質問内容は,痛みに対する考え方,痛みを伴う処置,痛みのサイン,痛みへの介入とし,構成型質問紙を553人の新生児看護婦に配布し,260人から有効回答を得た(回収率47%).その結果,1)「新生児は日齢が少ないほうが痛みを感じない」との回答が約9割を占めた;2) ……新生児の痛みの看護を発展させ,新生児を痛みから解放するためには,次の3点が重要な課題と考えられた:1)痛みの観察指標,特に行動学的指標を開発する;2)痛みの緩和法を再評価し,効果的な介入を行なう;薬理学的介入の開発に看護者も取り組む.

The purpose of this survey was to explore nurses' perception and practices with regard to assessment and management of pain in neonates. A survey questionnaire comprised of fixed-alternative items was developed. The questions asked were the following:1) beliefs regarding pain, 2) painful treatment, 3) clinical signs used to assess pain, and 4) interventions used for pain. A questionnaire was distributed to 553 neonatal nurses and 260 responses (47%) were analyzed.The results were as follows:1) 224 nurses (90%) believed that younger neonates will not respond more sensitively to painful stimuli than older.2) ……Nurses need appropriate methods for assessing pain of critically ill neonates. These infants often cannot demonstrate behavioral signs of pain, and physiologic signs are difficult to interpret because of immaturity of the autonomic nervous system. Comfort measures having been used by nurses may be ineffective for relieving severe pain. Guidelines of pain medication need also need to be developed for neonates.