Effect Study Of Patients Experience Under Ultrasound-Guided Patient-Controlled Subcutaneous Analgesia In The Hospice Care

Objective:(1)To study the application effect of ultrasound-guided patient-controlled subcutaneous analgesia(PCSA)in cancer pain nursing;(2)To deeply explore the causes and experience of patients with advanced cancer pain receiving ultrasound-guided patientcontrolled subcutaneous analgesia,so as to provide reference for improving the nursing process of cancer pain.Methods:(1)Patients with advanced cancer in the pain department and oncology department of a third-class hospital in Wuxi were selected as the research object.Ninety eligible patients were randomly divided into three groups: patient-controlled subcutaneous analgesia group(group S),ultrasound-guided patient-controlled subcutaneous analgesia group(group U)and patient-controlled intravenous analgesia group(group I),with thirty cases in each group.The Numeric Rating Score(NRS),Quality of Life score(QOL),Pittsburgh Sleep Quality Index(PSQI)were compared before treatment(T0),on the 1st(T1),3rd(T3),7th(T7)and 14th(T14)day after treatment.The incidence of adverse reactions and puncture points during treatment were compared.(2)Objective sampling method was used to select some patients who received ultrasound-guided patient-controlled subcutaneous analgesia for semi-structured in-depth interviews.After the interview,the materials were sorted out in time.The phenomenological research method in qualitative research was used to analyze the collected materials,refine the relevant subject content,and summarize the results.Results:(1)Quantitative research①NRSa.Comparison between groups: The NRS of three groups decreased significantly after treatment(P < 0.05).At T1 and T3,the NRS of group S and group U was significantly higher than those of group I(P < 0.05).Compared with group U,the NRS of group S was basically the same(P > 0.05).There was no significant difference in NRS among the three groups at T7 and T14(P > 0.05).b.Intra group comparison: From T0 to T7,the NRS in group S and group U showed a downward trend,and there were significant difference between any adjacent time points in the group(P < 0.05).From T7 to T14,in terms of NRS there was no significant change in group S and group U(P > 0.05).In group I,the NRS showed a downward trend from T0 to T3(P <0.05).NRS decreased slowly from T3 to T7 and T14,and there was no significant difference at adjacent time points(P > 0.05).②QOLa.Comparison between groups: From T3,T7 to T14,QOL scores in group S and U were significantly higher than those of group I(P < 0.05).There was no significant difference between group S and group U during the treatment(P > 0.05).b.Intra group comparison: The QOL scores of group S,group U and group Ⅰ increased continuously from T0 to T14,and there was significant difference at each adjacent time point in each group(P < 0.05).③PSQIa.Comparison between groups: The PSQI scores of group S and group U were significantly higher than those of group Ⅰ at T1(P < 0.05),and then the scores of the two groups showed a downward trend in varying degrees,which were significantly lower than those of group Ⅰ at T3,T7 and T14(P < 0.05).From T1 to T14,there were no significant difference between group S and group U(P > 0.05).b.Intra group comparison: From T0 to T1,there was no significant difference in PSQI scores between group S and group U at adjacent time points(P > 0.05).From T1 to T14,the PSQI scores of group S and group U showed a rapid downward trend,and the difference between adjacent time points in the group was statistically significant(P < 0.05).From T0 to T14,the PSQI scores of group Ⅰ showed a downward trend,and there was significant difference between any two adjacent time points in the group(P < 0.05).④Adverse reactionDuring the treatment period(T1-T14),compared with group S and group U,group Ⅰ had the highest incidence of sleepiness,nausea and vomiting,and the difference was statistically significant(P < 0.05).There was no significant difference in drowsiness,nausea and vomiting between group S and group U(P > 0.05).For the two adverse reactions of constipation and skin pruritus,there was no significant difference between any two groups(P > 0.05).Compared with group I,there was no respiratory depression in group S and group U,and the difference was not statistically significant(P > 0.05).⑤Puncture pointThe incidence rate of puncture point in group Ⅰ was the highest,and group S was the second.The incidence rate of group U was the lowest.The difference between any two groups was statistically significant(P < 0.05).Compared with group I,there was no blood and fluid leakage in group S and group U,and the difference was statistically significant(P < 0.05).(2)Qualitative researchThis study drew three themes and 12 sub themes,as shown below:①Reasons for patients receiving ultrasound-guided PCSAa.Knowing full well himself disease status.b.Obvious deficiencies in traditional analgesic mode.②Experience of patients after ultrasound-guided PCSAa.Good pain control experience.b.Less adverse reaction.c.High puncture success rate,less adverse conditions at puncture points.d.Quality of life improved.e.Sleep quality improved.f.Psychological satisfaction.③Deficiency after ultrasound-guided PCSAa.Insufficient medical publicity.b.Lack of nursing staff.c.Deficient Social Support.d.Lack of Spiritual Care.Conclusions:(1)After ultrasound intervention,the patient-controlled subcutaneous analgesia for patients with advanced cancer pain has a good analgesic effect,which can significantly improve the quality of life and sleep of patients,and reduce the incidence of adverse conditions at the puncture point.(2)Ultrasound intervention can significantly improve the patient’s pain relief experience and the success rate of puncture,reduce the incidence of adverse reactions,and meet the psychological needs of patients.(3)For constructing a new nursing model for cancer pain,we should strengthen the publicity of medical knowledge,increase the number of nurses,and broaden the ideas of nursing intervention.