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2009, vol. 66, br. 2, str. 156-162
Procena kvaliteta zdravstvene nege u tretmanu akutnog postoperativnog bola
aUniverzitet u Novom Sadu, Medicinski fakultet
bVojnomedicinska akademija, Beograd
cKlinički centar Vojvodine, Novi Sad
dInstitute for public health of Vojvodina, Novi Sad

e-adresamilutind@uns.ns.ac.yu
Sažetak
Uvod/cilj. Značajan interes za sve hospitalne ustanove trebalo bi da bude rešavanje akutnog postoperativnog bola kao jednog od ključnih pokazatelja zadovoljstva bolesnika, kvaliteta zdravstvene nege i ishoda lečenja. Cilj ovog rada bio je da se izvrši procena kvaliteta zdravstvene nege u tretmanu akutnog postoperativnog bola i utvrde faktori koji utiču na procenu istog od strane bolesnika. Metode. Istraživanje je sprovedeno na uzorku od 135 bolesnika hospitalizovanih na hirurškim klinikama Kliničkog centra Vojvodine u Novom Sadu u obliku studije preseka, anketiranjem bolesnika drugog postoperativnog dana i prikupljanjem sociodemografskih podataka, vrste hirurškog zahvata i primenjene analgetičke terapije iz medicinske dokumentacije. Kao instrument istraživanja korišćen je modifikovani upitnik Strateški i klinički pokazatelji kvaliteta tretmana postoperativnog bola (Strategic and Clinical Quality Indicators in Postoperative Pain Management - SCQIPP). Podaci su obrađeni multivarijantnom analizom varijanse (MANOVA), Royovim testom i Piersonovim koeficijentom kontingencije. Rezultati. Prosečan skor na pojedinačnim obeležjima SCQIPP upitnika kretao se od 2 do 4,7 (veći skor označavao je bolji kvalitet nege), a procenat odgovora bolesnika 'potpuno se slažem' varirao je od 4,4% do 77%. Bolesnici su dali najmanje pozitivnih odgovora na obeležje 'Da bi procenili jačinu bola, neko od osoblja me je najmanje jednom ujutro, posle podne i uveče molio da pokažem broj od 0-10'. Većina bolesnika (57%) su najjači bol u prethodna 24 sata ocenili kao umereno jak bol, što je značajno više od broja bolesnika, koji su se žalili na jak ili blag bol (p < 0,001). Analiza ocena bolesnika (MANOVA p < 0,05 i diskriminativna p < 0,05) ukazala je na značajnu razliku između procene kvaliteta zdravstvene nege u zbrinjavanju akutnog postoperativnog bola u odnosu na kliniku kao mesto zbrinjavanja bola, pol bolesnika i njegova očekivanja. Ocene iz supskale 'komunikacija' najviše su doprinosile razlici između posmatranih klinika, a ocene iz supskale 'postupak' razlici među polovima bolesnika u proceni kvaliteta nege. Zaključak. Rezultati ove studije pružaju korisne dokaze i identifikuju aspekte zdravstvene nege u zbrinjavanju akutnog postoperativnog bola koje treba poboljšati. Na osnovu rezultata testa najbolji način poboljšanja zdravstvene nege bio bi redovna procena jačine bola i provera analgetskog učinka datih lekova.
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O članku

jezik rada: engleski
vrsta rada: originalan članak
DOI: 10.2298/VSP0902156M
objavljen u SCIndeksu: 27.04.2009.

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