Hemşire ve cerrah tarafından kaydedilen VAS ağrı skorlarının karşılaştırılması: Vaka-kontrol çalışması

Amaç: VAS (Vısual Analog Scale); özellikle postop ağrının değerlendirilmesinde sık kullanılan, kolay anlaşılan ve uygulanan bir ölçektir. Hastanın ameliyat sonrası dönemde takibinde birçok parametre esas olarak hemşire tarafından gerçekleştirilmekte yine önemli şikayetlerden olan ağrının izlemi de yine hemşireler tarafından yapılmaktadır. Çalışmanın amacı VAS ağrı skorlamasının sorgulanmasında; sorgulayıcının kimliğinin yani sorumlu hemşire ya da cerrahı tarafından yapılmasının VAS ölçeğinde değişime neden olup olmadığını ortaya koymaktır.Yöntemler: Elektif laparoskopik kolesistektomi yapılan 120 hastanın postoperatif ağrı skorları 1.,6. Ve 24. saatlerde VAS (Visual Analog Scale) ile değerlendirildi. Ağrı sorgulaması önce sorumlu hemşire tarafından, 15 dakika sonra da cerrahı tarafından gerçekleştirildi. Her iki sorgulayıcı arasında hastalara herhangi analjezik uygulaması yapılmadı. Ağrı skorları arasındaki farkın, sorgulayıcının kimliği ile değişip değişmediği istatistiksel olarak değerlendirildi.Bulgular: VAS 1, VAS 6 ve VAS 24 skor ortalamalarının cerrah ve hemşirelere göre anlamlı düzeyde farklılık gösterdiği tespit edildi (p<0,05). 1.saatte hemşire için VAS ortalaması; 2,39±1,42, cerrah için VAS ortalaması; 1,19±0,79, 6.saatte hemşire VAS ortalaması; 2,15±1,73, cerrah VAS ortalaması; 1,35±1,25, 24.saat hemşire VAS ortalaması; 1,23±0,96, cerrah VAS ortalaması; 0,68±0,75 olarak bulundu. Her bir VAS skoru için hemşirelerin verdikleri VAS skorları, cerrahların verdiği VAS skoru ortalamalarından anlamlı derecede daha büyük olduğu tespit edildi (p<0,05).Sonuç: VAS ağrı skoru kullanarak yapılan postoperatif ağrının değerlendirilmesinde sorgulayıcının kimliğinin de hasta tarafından ifade edilen ağrı skorunda etkili olduğu, bu skala kullanılarak yapılacak ağrı palyasyonunda ağrının kimin tarafından sorgulandığının da değerlendirilmesi gerektiğini düşünmekteyiz.

Anahtar Kelimeler:

Postoperative ağrı, VAS, Ağrı takibi

Comparison of VAS scores recorded by nurse vs surgeon: A case-control study

Aim: VAS (Visual Analogue Scale) is a scale that is frequently used, easily understood and applied especially in the assessment of postoperative pain. Many parameters are performed mainly by the nurses in the follow-up of the patient in the post-operative period, and follow-up of the pain from the major complaints is also performed by the nurses. The purpose of the study is to exhibit whether the identity of the questioner, i.e., the nurse in charge or surgeon in charge, causes a change in the VAS scale in questioning VAS pain scoring.Methods: 120 patients who underwent elective laparoscopic cholecystectomy were included the study and the postoperative pain scores of the patients were evaluated with VAS (Visual Analogue Scale) at 1st, 6th and 24th hours. The pain questioning was first performed by the nurse in charge and also 15 minutes later by the physician in charge. No analgesic administration was performed to the patients between the two questioners. The difference between the pain scores was assessed statistically whether it had changed with the identity of the questioners.Results: It was detected that VAS 1, VAS 6 and VAS 24 score averages were significantly different according to physicians and nurses (p<0.05). VAS average of the nurse in the 1st hour was 2.39±1.42 and VAS average of the physician was 1.19±0.79, VAS average of the nurse in the 6th hour was 2.15±1.73 and VAS average of the physician was 1.35± 1.25, VAS average of the nurse in the 24th hour was 1.23±0.96 and VAS average of the physician was 0.68±0.75. For each VAS score; it was detected that VAS scores given by the nurses were significantly higher than the VAS score averages given by the physician (p<0.05).Conclusion: We think that the identity of the questioner is also influential on the pain score expressed by the patient in the assessment of the postoperative pain made by using the VAS pain score, who questions the pain in the pain palliation made by using this scale should also be evaluated.

Keywords:

Postoperative pain, VAS, Pain follow-up,

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