NGC™에 등재된 근거중심 노인 급성통증 관리 가이드라인의 국내 적용가능성

Abstract

This study was designed to evaluate the applicability of the evidence based protocol for acute pain management by herr et al.(2000) in National Guideline Clearinghouse^(TM) to Korea based on the korean experts' opinion. The target expert group consisted of 21 registered nurses who were working in medical or surgical units and had experiences in care of the elderly with acute pain. 10 medical doctors and 10 nursing professors who are experts in pain or elderly care. This study used questionnaire survey. The data were collected from 20th February 2004 to 10th April 2004 and the survey was done by mail. With SPSS WIN 11.0 program, the validity, applicability and actual use of each recommendation of the guideline were assessed with average, standard deviation, and actual number. The content analysis was performed about the expert's opinions. The range of validity score of each recommendations was 6.76~8.37 and 5.81~7.90(total 9), which showed similar high tendencies among nurses, medical doctors and nursing professors. The recommendations about 'pain assessment tools of the elderly', 'education of pain assessment', 'route of drug administration', 'drugs to avoid or use with extreme caution', 'specific side effect common to older adults-nausea' and 'cognition and behavior therapy' were lowerly scored. The reasons of low scores were lack of clinicians' knowledge and understanding of pain assessment and management for the elderly, inappropriate recommendations to Korean clinical settings and the belief that nurse doesn't need to care about the amounts and side effects of medication. The experts also noted the use of more detailed and specific standards or terminology is needed. This study will augment the understanding of the actual acute pain management for the elderly in Koran clinical settings and can be used as the baseline data for further study of tailoring the international guidelines into local and national clinical settings.