儿童外周静脉穿刺疼痛管理相关实践指南的质量评价和分析
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摘要
目的系统地检索并评价现有的儿童外周静脉穿刺疼痛管理相关实践指南的质量,为儿童外周静脉穿刺疼痛管理实践提供建议。方法在各类数据库和指南网站上检索2009年1月至2018年10月发表的指南,使用AGREE II工具对纳入的指南进行质量评价。结果评价纳入5篇临床实践指南,AGREE II 6个领域平均得分前三位的领域依次为:范围和目的(92.24±3.44)%、参与人员(86.62±6.63)%、清晰性(82.94±7.23)%。按照疼痛评估、疼痛测量、疼痛管理和疼痛干预4个方面汇总出23条推荐意见。结论儿童外周静脉穿刺疼痛管理临床实践指南数量不多,指南制定的严谨性、应用性领域有待提高。我国尚无针对性的儿童外周静脉穿刺疼痛管理实践指南,可考虑将国外较为成熟的指南引入我国并进行跨文化调适,指导我国儿童外周静脉穿刺疼痛管理实践。
Objective To systematically retrieve and assess the quality of clinical practice guidelines(CPGs) regarding management of venipuncture pain in children, and to provide suggestions for clinical practice. Methods All CPGs pertaining to venipuncture in children issued between January 2009 and October 2018 were searched in electronic databases and related websites of guidelines, then the included CPGs were evaluated using the Chinese version of the Appraisal of Guidelines for Research and Evaluation(AGREE) II. Results We identified 5 eligible CPGs.The domain of scope and purpose in the AGREE II scored the highest(92.24±3.44)%, followed by stakeholder involvement(86.62±6.63)% and clarity of presentation(82.94±7.23)%. Twenty-three recommendations were summarized into the following categories: pain assessment, measurement, management and intervention. Conclusion The CPGs pertaining to management of venipuncture pain in pediatric patients is limited, and the domains of rigor of development and applicability need to be improved. There is no Chinese CPG regarding this topic, so we can introduce well-accepted CPGs and conduct cross-cultural adaptation, thus to guide evidence-based practice for management of venipuncture pain in pediatric patients.
Objective To systematically retrieve and assess the quality of clinical practice guidelines(CPGs) regarding management of venipuncture pain in children, and to provide suggestions for clinical practice. Methods All CPGs pertaining to venipuncture in children issued between January 2009 and October 2018 were searched in electronic databases and related websites of guidelines, then the included CPGs were evaluated using the Chinese version of the Appraisal of Guidelines for Research and Evaluation(AGREE) II. Results We identified 5 eligible CPGs.The domain of scope and purpose in the AGREE II scored the highest(92.24±3.44)%, followed by stakeholder involvement(86.62±6.63)% and clarity of presentation(82.94±7.23)%. Twenty-three recommendations were summarized into the following categories: pain assessment, measurement, management and intervention. Conclusion The CPGs pertaining to management of venipuncture pain in pediatric patients is limited, and the domains of rigor of development and applicability need to be improved. There is no Chinese CPG regarding this topic, so we can introduce well-accepted CPGs and conduct cross-cultural adaptation, thus to guide evidence-based practice for management of venipuncture pain in pediatric patients.
引文
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[12] The Registered Nurses′Association of Ontario (RNAO).Assessment and Management of Pain(Third Edition)[EB/OL].(2014-02-08)[2018-11-20].www.rnao.ca/bestpractices.
[13] Infusion Nurses Society.Infusion therapy standards of practice[J].J Infus Nurs,2016,39(1S):1-105.
[14] Royal College of Nursing.The recognition and assessment of acute pain in children[EB/OL].(2009-09-09)[2018-11-20].www.rcn.org.uk/childrenspainguideline.
[15] Emergency Nurses Association.Needle-related procedural pain in pediatric patients[EB/OL].(2015-08-24)[2018-11-20].http://www.ena.org.
[16] The Association of Paediatric Anaesthetists of Great Bri-tain and Ireland.Good practice in postoperative and procedural pain management(2nd Edition)[J].Pediatr Anesth,2012,22(1):1-81.
[17] Hicks C L,von Baeyer C L,Spafford P A,et al.The Faces Pain Scale-Revised:toward a common metric in pediatric pain measurement[J].Pain,2001,93(2):173-183.
[2] Dancel R,Liles E A,Fiore D.Acute pain management in hospitalized children[J].Rev Recent Clin Trials,2017,12(4):277-283.
[3] Carbajal R,Rousset A,Danan C,et al.Epidemiology and treatment of painful procedures in neonates in intensive care units[J].JAMA,2008,300(1):60-70.
[4] Papa A,Zempsky W.Nurse perceptions of the impact of pediatric peripheral venous access pain on nurse and patient satisfaction results of a national survey[J].Adv Emerg Nurs J,2010,32(3):226-233.
[5] Humphrey G B,Boon C M,van Linden van den Heuvell G F,et al.The occurrence of high levels of acute beha-vioral distress in children and adolescents undergoing routine venipunctures[J].Pediatrics,1992,90(1 pt 1):87-91.
[6] Bhargava R,Young K D.Procedural pain management patterns in academic pediatric emergency departments[J].Acad Emerg Med,2007,14(5):479-482.
[7] Pate J T,Blount R L,Cohen L L,et al.Childhood me-dical experience and temperament as predictors of adult functioning in medical situations[J].Child Health Care,1996,25(4):281-298.
[8] Papa A,Morgan R,Zempsky W T.Competency,compassion and contentment:nurses′attitudes toward pain associated with peripheral venous access in pediatric patients[J].J Pain,2008,9(4):44.
[9] MacLean S,Obispo J,Young K D.The gap between pediatric emergency department procedural pain management treatments available and actual practice[J].Pediatr Emerg Care,2007,23(2):87-93.
[10] 陈薇,刘建平.循证临床实践指南的制订和评价Ⅲ.循证临床实践指南的评价[J].中华口腔医学杂志,2013,48(4):253-255.
[11] 谢利民,王文岳.《临床指南研究与评价系统II》简介[J].中西医结合学报,2012,10(2):160-164.
[12] The Registered Nurses′Association of Ontario (RNAO).Assessment and Management of Pain(Third Edition)[EB/OL].(2014-02-08)[2018-11-20].www.rnao.ca/bestpractices.
[13] Infusion Nurses Society.Infusion therapy standards of practice[J].J Infus Nurs,2016,39(1S):1-105.
[14] Royal College of Nursing.The recognition and assessment of acute pain in children[EB/OL].(2009-09-09)[2018-11-20].www.rcn.org.uk/childrenspainguideline.
[15] Emergency Nurses Association.Needle-related procedural pain in pediatric patients[EB/OL].(2015-08-24)[2018-11-20].http://www.ena.org.
[16] The Association of Paediatric Anaesthetists of Great Bri-tain and Ireland.Good practice in postoperative and procedural pain management(2nd Edition)[J].Pediatr Anesth,2012,22(1):1-81.
[17] Hicks C L,von Baeyer C L,Spafford P A,et al.The Faces Pain Scale-Revised:toward a common metric in pediatric pain measurement[J].Pain,2001,93(2):173-183.