本研究目的旨在發展及驗證術後疼痛處置充能教育措施，對護理人員在術後疼痛處置的知識、態度、行為的成效，及病患在術後疼痛緩程度與疼痛滿意度的成效。
研究採類實驗設計，以立意取樣指定實驗組與對照組，研究對象以北部某醫學中心兩個骨科病房護理人員共39名，及行脊椎與髖關節置換之病患前測、後測1、後測2各120名，共360名。實驗組病房護理人員接受兩小時術後疼痛處置充能教育課程，在後測1與後測2的實驗組病患於術前接受術後疼痛衛教之個別指導。研究工具：護理人員部份為自擬之術後疼痛處置之知識、態度、技能、自我效能量表，病患部份為疼痛處置認知及疼痛處置滿意度問卷，以SPSS 12.0中文版進行資料分析與檢定。
研究結果顯示：1.接受充能教育的護理人員，對術後疼痛處置的知識與態度顯著高於對照組，但技能與自我效能則無差異。2.在後測1與2有接受術前疼痛衛教的實驗組病患，對術後疼痛處置的認知與滿意度顯著高於對照組，但術後疼痛程度與疼痛緩解程度則無差異。骨科病患對術後疼痛處置感到最滿意的部份為：醫師開刀技術的精湛、手術結果很成功、護理人員的照護態度與問題處理的即時性等。再者，病患和護理人員的疼痛信念均偏向術後疼痛是無法避免的，僅在劇烈疼痛感無法忍受時，才會施打嗎啡類止痛劑。
依照本研究結果建議分別以質性研究更深入瞭解醫師、護理人員、病患、及住院主要陪伴者對術後疼痛與止痛藥使用的信念，，進而發展具本土化疼痛信念的測量工具；其次，應推動術後疼痛處置的課程列入每年的外科護理人員常態在職教育課程內，定期舉辦術後疼痛處置相關的研討會，並增加疼痛評估技巧及非藥物性緩解疼痛措施的模擬實作練習等，使護理人員對術後疼痛處置的知識、態度、技能、及自我效能可正向增強。

This study aim at developing and verifying the effectiveness of an
empowering education program, to orthopedic nurses the postoperative
pain management of knowledge, attitude, behavior of result, and patient
of postoperative pain relief degree and pain management satisfaction.
The study design was a quasi-experimental.and specifies experiment set and matched control by purposive sampling, research object with certain medical center in the north two orthopedics sickroom nursing staff is total 39, and undergoing the patient of spine and hip joint replacement, pre-test
, post-test1, post-test2 total 360.Experimental nursing staff accept for two hours, the , at after the post-test 1 anf post-test2 accept with 2 patients before ache health education is individual to guide. With SPSS for Windows 12.0 Chinese versions carry on data to create file and analyze and make use of a description covariance (percentage, average value, Sigma) and reasoning covariance ( Mann-Whitney test, independent t-test and ANCOVA ) carry on analysis.
The results of the research are : 1. The knowledge and attitude in postoperative pain management presented by the nursing staff receiving empowerment education were significantly better than those in the control group. However, no differences were shown in their skills and self-efficacy. 2. The perception and satisfaction of post-op pain management presented the patients from post-test 1 and post-test 2 in the experiment group receiving pre-op health education for pain were significantly better than those in the control group. However, no differences in the degree of post-op pain and degree of pain relief were shown from both groups. The items which orthopedic patients were satisfied most were: physician’s excellent surgical skills, successful surgical result, nursing staff’s attitude to care and immediate response to problems. In addition, both patients and nursing staff thought that it was inevitable to feel painful after operation and no morphine would be given until it was too painful for the patients to bear.
According to the results in this paper, it is suggested to employ qualitative research to further explore the perception of postoperative pain and use of analgesics shown from physicians, nursing staff, patients and caregiver during patients’ hospitalization. In that case, localization measurement tools for pain belief can be developed. Next, post-op pain management courses should be covered in the regular in-service educational programs held for surgical nursing staff every year. It is also recommended to regularly hold workshops in relating to post-op pain management. In addition, it is necessary to enhance pain evaluation techniques and strengthen simulation and practices of the measures taken for non-pharmacological method. As a result, the nursing staff will reach a positive advance in the knowledge, attitude, skills and self-efficacy concerning post-op pain management.

目 錄
指導教授推薦書…………………………………………………………………
口試委員會審定書………………………………………………………………
授權書…………………………………………………………………………….
誌謝………………………………………………………………………………. i
中文摘要…………………………………………………………………………… i i
英文摘要…………………………………………………………………………. i v
目錄………………………………………………………………………………. ix
第一章 緒論…………………………………………………………………….. 1
1.1 研究動機與重要性…………………………………………………… 1
1.2 研究目的………………………………………………………………… 7
1.3 研究假設………………………………………………………………… 8
1.4 名詞解釋………………………………………………………………… 9
第二章 文獻查證………………………………………………….. 11
2. 1疼痛的概念……………………………………………………………… 11
2.2 手術後疼痛的相關研究 ………………………………………………… 15
第三章 研究方法……………………………………………………………. 59
3.1前驅研究……………………………………………… 59
3.2正式研究………………………………………………... 71
3.3 研究場所、對象……………………………………………………… 80
3.4介入措施………………………………………………... 81
3.5研究工具………………………………………………... 83
3.6人權考量………………………………………………... 90
3.7資料收集過程………………………………………………... 91
3.8資料分析………………………………………………... 93

第四章 研究結果………………………………………………………. 94
4.1 研究對象之描述性資料……………………………………………... 94
4.2充能教育之介入成效…………………………………………………...123
第五章 討論 …………………………………………………………. 130
5.1影響充能教育措施在術後疼痛處置的成效因素…………………... 130
5.2術後疼痛處置的成效成效…………………………………………… .142第六章 結論與建議…………………………………………………………. 150
參考文獻…………………………………………………………………….…… 156
附錄 …………………………………………………………………………… 172
附錄一護理人員問卷………………………………………………………… 172
附錄二病患問卷 ………………………………………………………… 178
附錄三疼痛衛教手冊………………………………………………………… 182
附錄四專家效度 ………………………………………………………… 187

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