Vas 2006 (1)

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 Α.Τ.Ε.Ι. ΚΡΗΤΗΣ ΣΧΟΛΗ ΕΠΑΓΓΕΛΜΑΤΩΝ ΥΓΕΙΑΣ ΚΑΙ ΠΡΟΝΟΙΑΣ ΤΜΗΜΑ  ΝΟΣΗΛΕΥΤΙΚΗΣ ΠΤΥΧΙΑΚΗ ΕΡΓΑΣΙΑ  ΣΤΑΣΕΙΣ   ΑΠΟΨΕΙΣ   ΝΟΣΗΛΕΥΤΩΝ   ΓΙΑ ΤΗΝ   ΑΝΤΙΜΕΤΩΠΙΣΗ  ΤΟΥ   ΚΑΡΚΙΝΙ ΚΟΥ   ΠΟΝΟΥ  ΕΠΙΒΛΕΠΩΝ ΚΑΘΗΓΗΤΗΣ: ΜΕΡΚΟΥΡΗΣ ΑΝΑΣΤΑΣΙΟΣ ΣΠΟΥΔΑΣΤΡΙΕΣ: ΒΑΣΙΛΑΚΗ ΑΝΝΑ ΠΕΡΑΚΗ ΜΑΡΙΑ ΗΡΑΚΛΕΙΟ 2006

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Vas 2006 (1)

Transcript of Vas 2006 (1)

  • ....

    :

    :

    2006

  • , .

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    8

  • .................................................................................................................8

    ..................................................................................9

    ..........................................................................................................11

    . ...................................................................................................12

    ..................................................................................................................1

    1 ...................................................................3

    1.1. ; .................................................................................................4

    1.2. ............................................4

    1.3. ...................................................................................8

    1.4. ...................................................................10

    1.5. ......................................................................................................10

    1.6. / ............................................................11

    1.7. : GATE CONTROL THEORY....14

    1.8. ..............................................................................15

    2 .................................................................18

    2.1. ......................................................................................20

    2.2. ..............................21

    2.3. .......23

    2.4. .........................................................................26

    2.5. ...........................32

    2.6. ..........................................................38

    3 .......................................................................42

    3.1. 43

    3.2. ...................................45

    3.3. ...........................46

    3.4. ............................................58

    3.5. ............................60

    9

  • 3.6. .................................................................................61

    3.7. .................................................63

    4

    ...............................................66

    4.1. ...............................................68

    4.2. ..........................................................................................70

    4.3.

    ....................................................................................................................73

    4.4. :

    ............................................74

    . ...................................................................................................77

    ................................................................................................................78

    ..........................................79

    ......................................................................................................................................84

    ...................................................................................................86

    - ....................................................................107

    .....................................................................................................110

    .......................................................................................................113

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    Metzack Wall 1965.

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    62

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    , (, 1998):

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    64

  • ,

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    .

    , ,

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    .

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    . (Montaigne, Essays).

    65

  • 4

    ,

    .

    ,

    ,

    90%.

    25 ,

    ,

    .

    ,

    .

    .

    ,

    .

    .

    ,

    ( , 2002,

    . 29-30).

    66

  • .

    ,

    .

    .

    .

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    .

    ,

    .

    . ,

    70%.

    , , , , ,

    ... ( ,

    2002).

    .

    (40 )

    .

    67

  • , (29 )

    .

    ,

    .

    ,

    ...

    .

    4.1.

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    . ,

    .

    .

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    .

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    .

    (..., 1989, . 28-30):

    , ,

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    68

  • ,

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    .

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    69

  • , ,

    .

    ,

    .

    , ,

    .

    :

    .

    .

    .

    .

    .

    4.2.

    (cancer unit)

    (pain team),

    , .

    : ,

    , , , , ,

    .

    70

  • , ,

    , .

    ,

    . , ,

    .

    ,

    (..., 1989).

    ,

    . ,

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    . , , .

    , ,

    .

    .

    .

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    .

    , ,

    .

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    (, 1999).

    71

  • . , ,

    .

    .

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    .

    , . ,

    ,

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    (.. , ).

    ,

    ,

    . ,

    ,

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    ,

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    , .

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    , (... 1989, .

    37-39).

    72

  • 4.3.

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    , .

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    .

    . ,

    ,

    (..., 1989, .

    14-15).

    ,

    :

    .

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    73

  • , , .

    .

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    .

    4.4. :

    .

    14 ...

    ( ,

    2002).

    305 ...

    , 23

    . 81%

    2-15

    .

    14

    ,

    .

    , ,

    .

    ...

    (nurse specialist nurse practicioner),

    .

    74

  • .

    ,

    ,

    ,

    .

    .

    ,

    , 46 .

    Nurses Knowledge and Attitudes Survey Regarding Pain

    .

    McCaffery

    .

    .

    Nurses

    Knowledge and Attitudes Survey Regarding Pain 12

    ( , 2002).

    .

    51,5%

    43,3% 74,6% 47,2%

    .

    , , , ,

    .

    75

  • ,

    . ,

    ,

    ,

    ,

    .

    .

    ,

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    Role Model Workshop

    , 50 .

    4 12 ,

    12 (

    , 2002).

    76

  • .

    77

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    .

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    .

    ( )

    .

    78

  • ,

    , 85

    ,

    . (Mc Millan SC , 2000)

    .

    . ,

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    . 82%

    ( ),

    .

    ,

    .

    ,

    3 .

    .

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    .

    .

    ,

    . (Howell D, 2000).

    .

    79

  • .

    .

    .

    . ,

    . (O'Brien S et all ,1996)

    1400

    .

    24%.

    .

    Hollen

    11 7

    .

    30 34 .

    6 .

    . (Hollen CJ et all. 2000)

    ,

    .

    .

    .

    .

    80

  • . 44

    303 . (Rushton P. 2003).

    .

    -

    .

    .

    .

    . .

    350

    . 10.9%.

    .

    . (Broekmans S (et all) 2004).

    Cason CL

    . (Cason

    Cl (et all) 1999 ). 217 1 3,

    (68%)

    .

    .

    .

    Hospital Palliative Care Team (Wells M et all,

    2001 Sep)

    ,

    .

    81

  • .

    135

    ,

    Hospital Palliative Care Team.

    .

    ,

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    .

    .

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    , 1604

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    .

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    . 43%.

    ,

    McCaffery & Ferrel,

    . , ,

    .

    0,87

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    ().

    82

  • .

    -.

    ,

    (Dalton JA, 1989 Mar-Apr).

    ,

    ,

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    .

    59 19 . 2

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    83

  • ,

    ,

    .

    .

    ,

    (Betty R. Ferrell, Margo McCaffery, 1987)

    .

    20 , 13

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    200 , 100 .

    32 (16%) 168 (84%).

    124 (62%) 76 (38%)

    . 34, 386,279

    8,625,896 .

    (=0,006).

    (9,211,813) (8,441,817)

    84

  • 1

    -

    8,44

    9,21

    8

    8,2

    8,4

    8,6

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    9,2

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    8,91 20

    1,85.

    .

    1412108642

    SCORE

    50

    40

    30

    20

    10

    0

    Freq

    uenc

    y

    Mean =8,91Std. Dev. =1,849

    N =200

    Histogram

    , ,

    ,

    .

    85

  • .

    Q1:

    Q1

    200 N / 0

    95 47,5 47,5 47,5 105 52,5 52,5 100

    200 100 100

    Q1

    60

    50

    40

    30

    20

    10

    0

    Perc

    ent

    Q1

    86

  • Q2:

    Q2

    200 N / 0

    192 96 96 96 8 4 4 100

    200 100 100

    Q2

    100

    80

    60

    40

    20

    0

    Perc

    ent

    Q2

    2 (96%)

    .

    87

  • Q3:

    Q3

    200 N / 0

    167 83,5 83,5 83,5 33 16,5 16,5 100

    200 100 100

    Q3

    100

    80

    60

    40

    20

    0

    Perc

    ent

    Q3

    3 83,5% ,

    .

    88

  • Q4: (.. metenamic acid-Ponstan) (.. mesulid),

    Q4 200 N / 0

    59 29,5 29,5 29,5 141 70,5 70,5 100

    200 100 100

    Q4

    80

    60

    40

    20

    0

    Perc

    ent

    Q4

    89

  • Q5: (.. , , ...)

    ,

    . Q5

    200 N / 0

    46 23 23 23 154 77 77 100

    200 100 100

    Q5

    80

    60

    40

    20

    0

    5 77%,

    .

    .

    Perc

    ent

    Q5

    90

  • Q6: (..

    )

    Q6

    200 N / 0

    88 44 44 44 112 56 56 100

    200 100 100

    Q6

    60

    50

    40

    30

    20

    10

    0

    Perc

    ent

    Q6

    91

  • Q7: pethidine IM 4-5

    Q7 200 N / 0

    50 25 25 25 150 75 75 100

    200 100 100

    Q7

    80

    60

    40

    20

    0

    7 (75%)

    Pethidine.

    Perc

    ent

    Q7

    92

  • Q8: (Phenergan) .

    Q8

    200 N / 0

    135 67,5 67,5 67,5 65 32,5 32,5 100

    200 100 100

    Q8

    60

    40

    20

    0

    Perc

    ent

    Q8

    93

  • Q9:

    Q9

    200 N / 0

    153 76,5 76,5 76,5 47 23,5 23,5 100

    200 100 100

    Q9

    80

    60

    40

    20

    0

    9 76,5%

    .

    Perc

    ent

    Q9

    94

  • Q10: ,

    200 N / 0

    111 55,5 55,5 55,5 89 44,5 44,5 100

    200 100 100

    Q10

    60

    50

    40

    30

    20

    10

    0

    Perc

    ent

    Q10

    95

  • Q11: , .

    Q11

    200 N / 0

    66 33 33 33 134 67 67 100

    200 100 100

    Q11

    60

    40

    20

    0

    Perc

    ent

    Q11

    96

  • Q12: (placebo)

    Q12

    200 N / 0

    53 26,5 26,5 26,5 147 73,5 73,5 100

    200 100 100

    Q12

    80

    60

    40

    20

    0

    Q13:

    Perc

    ent

    Q12

    97

  • Q13

    200 N / 0

    137 68,5 68,5 68,5 63 31,5 31,5 100

    200 100 100

    Q13

    60

    40

    20

    0

    Perc

    ent

    Q13

    98

  • Q14: :

    Q14

    200 N / 0

    190 95 95 95 10 5 5 100

    200 100 100

    Q14

    100

    80

    60

    40

    20

    0

    14 95%

    .

    ( ,

    ,.)

    Perc

    ent

    Q14

    99

  • Q15: , (.. ) :

    Q15

    200 N / 0

    138 69 69 69 62 31 31 100

    200 100 100

    Q15

    60

    40

    20

    0

    Perc

    ent

    Q15

    100

  • Q16: - :

    Q16

    200 N / 0

    Q16

    56 28 28 28 144 72 72 100

    200 100 100

    Q16

    80

    60

    40

    20

    0

    Perc

    ent

    Q16

    101

  • Q17: :

    Q17

    200 N / 0

    53 26,5 26,5 26,5 147 73,5 73,5 100

    200 100 100

    Q17

    80

    60

    40

    20

    0

    Perc

    ent

    Q17

    102

  • Q18 :

    Q18:

    200 N / 0

    99 49,5 49,5 49,5 101 50,5 50,5 100

    200 100 100

    Q18

    60

    50

    40

    30

    20

    10

    0

    Perc

    ent

    Q18

    103

  • Q19: : 0%

    Q19

    200 N / 0

    196 98 98 98 4 2 2 100

    200 100 100

    Q19

    100

    80

    60

    40

    20

    0

    19 (98%)

    .

    .

    Perc

    ent

    Q19

    104

  • Q20:

    :1-5%

    Q20

    200 N / 0

    134 67 67 67 66 33 33 100

    200 100 100

    Q20

    60

    40

    20

    0

    Perc

    ent

    Q20

    105

  • .

    ..

    1

    / Q1: 47% 58% 52,5% Q2:

    3% 5% 4,0% Q3: 6% 27% 16,5% Q4: (.. metenamic acid-Ponstan) (.. mesulid), 74% 67% 70,5% Q5: (.. , , ...) , . 86% 68% 77,0% Q6: (.. ) 55% 57% 56,0% Q7: pethidine IM 4-5 73% 77% 75,0% Q8: (Phenergan) . 30% 35% 32,5% Q9: 25% 22% 23,5% Q10: , 40% 49% 44,5% Q11: , . 62% 72% 67,0% Q12: (placebo) 72% 75% 73,5%

    Q13: 70% 33% 51,5% Q14: : 3% 7% 5,0% Q15: , (.. ) : 32% 30% 31,0% Q16: - : 76% 68% 72,0% Q17: : 79% 68% 73,5% Q18 : 54% 47% 50,5%

    106

  • Q19: : 0% 0% 4% 2,0% Q20: :1-5% 29% 37% 33,0%

    2

    3% 5%

    . 3

    6%

    27%. 5

    86%

    . 19 (0%)

    (4%)

    -

    , ,

    .

    .

    9,21

    8,44 ,

    .

    8,91

    20 .

    107

  • .

    .

    :

    .

    ,

    .

    ,

    .

    .

    ,

    .

    , .

    .

    108

  • ( ,

    ..)

    .

    . .

    .

    ,

    ,

    .

    .

    109

  • . ., , , , 1986.

    ., , , , 1999.

    Luban pluzza, B. (..), , . , 1998.

    . , , 1989.

    ., , university studio press, 1999.

    . ., ,

    2002, . 28.

    ., , , , , 1998.

    ., , , 1995.

    Betty R. (et all). City of Hope. Nurses knowledge and attitudes

    survey regarding pain, 1987

    Broekmans S( et all). Nurses' attitudes toward pain treatment with opioids: a survey in a Belgian university hospital. Int J Nurs Stud. 2004

    Feb;41(2):183-9.

    Cason CL (et all). Nurses' knowledge of pain management: implications for staff education. J Nurses Staff Dev. 1999 Nov-Dec;15(6):228-

    35.

    Dalton JA.. Nurses' perceptions of their pain assessment skills, pain management practices, and attitudes toward pain. Oncol Nurs Forum.

    1989 Mar-Apr;16(2):225-31

    110

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    Stanley Kl Kirior R., , -. .

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    :

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    112

  • (Betty R. (et all)., 1987)

    /

    1.

    .

    2. .

    3. .

    4. (.. metenamic acid-Ponstan)

    (.. mesulid),

    .

    5. (.. , ,

    ...)

    ,

    .

    6.

    (..

    ).

    7. pethidine IM 4-5 .

    113

  • 8. (Phenergan)

    .

    9.

    .

    10.

    , .

    11. ,

    .

    12. (placebo)

    .

    13.

    .

    14.

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    .

    .

    .

    .

    .

    .

    15.

    , (.. ) :

    .

    .

    .

    114

  • .

    .

    .

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    .

    .

    .

    .

    17.

    :

    .

    .

    .

    .

    18.

    :

    .

    .

    .

    .

    19.

    . [ ].

    0 10 20 30 40 50 60 70 80 90

    100%

    20.

    ;

    .

  • :

    :

    (, , )

    !!!

    116

  • 117

    . 1 1.1. ;1.2.

    1.3.

    1.4. 1.5. 1.6. / 1.7. : GATE CONTROL THEORY1.8.

    2 2.1. 2.2. 2.3.

    2.4.

    2.5.

    2.6.

    3 3.1. 3.2. 3.3. 3.4. 3.5. 3.6. 3.7.

    4 4.1.

    4.2.

    4.3. 4.4. :

    . -

    / !!!