The Comprehensive Nursing Intervention On The Pain During Dressing Changes For The Burn Patients

Objective:The purpose of this report is to discuss the influence of the comprehensivenursing intervention which on the pain and the states of physical andpsychological level, and to provide the system methods which can alleviate thepain for the burn patients during the dressing changes.Methods:We selected70burn hospitalized patients from the First Hospital of JilinUniversity during January in2013to December in2013, and randomly dividedinto the experimental groups and the control groups,35cases in each group.Thetwo groups used the tool of the Symptom Checklist(SCL-90), which includesomatization, depression, anxiety three factors, to measure the changes of thepsychology before and after the dressing. During the dressing, patients in thecontrol group were given routine care, the experimental group were given thecomprehensive nursing intervention and the routine care. Two groups used thesame dressing methods by the same physician, and cared by the same nurse. Thentwo groups used the tool of the Visual Analogue Scale(VAS) and electro-cardiogram monitor to record the numerical changes of pain, respiration, pulseand blood pressure during the dressing of five time stages, which included before dressing, changing dressing, debridement wound, coated ointment and afterdressing. All data were processed by SPSS18.0software and Excel form forstatistical analysis. Differences in measurement data were compared with t-testand single factor analysis of variance, the enumeration data were compared bythe Chi-Square test.There were differences with statically significance when P<0.05, anddifference with obviously statically significance when P<0.01.Results:1. Baseline measure results showed: Each group had one patient were notable to participate in the study, because the burn dressing was so painful that theyused of drug treatment, the rest of68burn patients participated the whole experi-ment study. There were not differences from baseline data in the age, sex,educational background, position, depth and area between two groups, there werecomparability(P>0.05).2. The score of the pain results showed: Before the dressing, compared thescore of the pain between two groups, there were not differences with staticallysignificance(P>0.05). During the time of four stages which included changingdressing, debridement wound, coated ointment and after dressing, there weredifferences with statically obviously significance between two groups(P<0.01).Compared the time of changing dressing and debridement to others’ stages, therewere differences with statically significance for two groups(P<0.01). 3.The score of Symptom Checklist (SCL-90) results showed: Before thedressing, compared the scores of the somatization, depression and anxietybetween two groups, there were not differences with statically significance(P>0.05); After the dressing,the scores of experimental group were less than thecontrol group, there were differences with obviously statically significancebetween two groups (P<0.01). For the experimental group, before and afterdressing there were differences with obviously statically significance（P<0.01）；For the control group, before and after dressing, there were differences withobviously statically significance（P<0.01).4.Vital signs results showed: Before dressing, compared the respiration rate,pulse rate and blood pressure between two groups, there were not differenceswith statically significance(P>0.05); During the time of four stages whichincluded changing dressing, debridement wound, coated ointment and afterdressing, there were differences with obviously statically significance betweentwo groups (P<0.01) for the numerical value of respiration, pulse and bloodpressure.Conclusion:1.The comprehensive nursing intervention can reduce the pain thresholdduring burn dressing.2.The comprehensive nursing intervention can keep the stable of respiration,pulse and blood pressure during burn dressing. 3.The comprehensive nursing intervention can alleviate the symptom ofsomatization,depression and anxiety for burn patients.4.The comprehensive nursing intervention can provide effective referencefor the painful burn patients.