| Objective:1.To clarify the pain management dilemma after cesarean section.2.Based on the Manchester pain management model,a postoperative pain management program suitable for cesarean section women was constructed.3.To verify the effect of Postoperative Pain Nursing Management Program For Cesarean Section Women on postoperative pain,postoperative recovery and nursing satisfaction of cesarean section women,in order to provide a theoretical basis for the clinical implementation of scientific and effective postoperative pain nursing management,improve the postoperative comfort experience of cesarean section women,and improve nursing satisfaction.Methods:1.Guided by the descriptive phenomenological research method in qualitative research,semi-structured interviews were conducted with cesarean section women and obstetric nurses using a pre-set interview outline,and Colaizzi ’s seven-step analysis method was used to analyze the data,so as to understand the difficulties of pain management after cesarean section.2.Through literature review,expert meeting to design pain care management program,and through the pre-experiment to revise the program.This study systematically searched the relevant literature on postoperative pain care for cesarean section women at home and abroad,and extracted and summarized the main contents.Experts in related fields were invited to convene an expert meeting to discuss and put forward suggestions on the specific content of the plan,and to carry out preliminary experiments to optimize and improve the pain nursing management plan after cesarean section in view of the problems existing in the implementation process.3.The quasi-experimental research method was used to apply the pain nursing management program after cesarean section and evaluate the clinical effect.From September 2021 to June 2022,cesarean section women who underwent cesarean section in a tertiary hospital in Shanxi Province and met the inclusion and exclusion criteria were selected as the research objects.According to the sample size calculation,120 subjects were finally determined.The control group was given routine nursing,and the observation group was given relevant intervention of postoperative pain nursing management program for cesarean section women based on Manchester pain management model.The pain degree,postoperative recovery and nursing satisfaction of the two groups were evaluated at 4h,8h,12 h,24h and 48 h after operation.Results:1.Through semi-structured interviews with 12 cesarean section parturients and 10 obstetric nurses,three core themes and eight sub-themes were extracted :(1)Pain perception,including deep postoperative pain experience of cesarean section parturients and differentiated postoperative pain perception of cesarean section parturients;(2)Pain cognition,including the lack of knowledge about pain after cesarean section and the worry about the side effects of analgesic drugs;(3)Pain coping,including poor attitude towards pain after cesarean section,lack of ability to cope with pain after cesarean section,lack of help and emotion from family members,and desire for more professional support from medical staff.2.By consulting relevant literature at home and abroad,a pain nursing management plan for cesarean section women based on Manchester pain management model was constructed,and the first draft of pain nursing management plan was discussed and revised by experts in obstetric nursing,nursing management,obstetric medical treatment,anesthesia and psychology.Ten parturients with cesarean section were selected as the research objects for pre-experiment.According to the pre-experiment experience,the scheme was adjusted,and finally a pain nursing management scheme with four stages of preparation,evaluation,intervention and rehabilitation was formed.3.There was no significant difference in age,gestational age,body mass index,operation time and complications between the two groups in clinical trials(P > 0.05),which was comparable.There was no significant difference in VAS scores between the two groups at 4 hours after cesarean section in resting state and active state(P > 0.05).The VAS scores of the observation group at 8 h,12 h,24 h and 48 h after cesarean section were lower than those of the control group at the same time period,and the differences were statistically significant(all P < 0.05).Repeated measures analysis of variance showed that there were significant differences in VAS scores between resting state and active state,time effect and interaction between group and time(all P < 0.05).The first time of getting out of bed in the observation group was lower than that in the control group,and the difference was statistically significant(P < 0.05).The success rate of first breastfeeding in the observation group was higher than that in the control group,and the difference was statistically significant(P < 0.05),but there was no significant difference in the first exhaust time and hospitalization time(P > 0.05).The satisfaction of pain control methods,pain education and overall satisfaction of cesarean section women in the observation group were higher than those in the control group,and the differences were statistically significant(P < 0.05).Conclusion:1.Through qualitative interviews,we have an in-depth understanding of the three major pain management dilemmas of pain perception,pain cognition and pain response after cesarean section,which should be focused on.2.Based on the Manchester pain management model,a comprehensive literature review,expert meetings and pre-experiments were conducted to construct a postoperative pain management program for cesarean section.The intervention program is comprehensive and rich in content and can provide reference for clinical practice.3.The application of Manchester pain management model in postoperative pain management of cesarean section women in clinical practice can effectively alleviate the postoperative pain of cesarean section women,promote postoperative recovery and improve nursing satisfaction.In the future,multi-center large sample studies or long-term nursing intervention and effect tracking can be carried out to further verify the effectiveness of the program. |
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