1. Pre-community training

① The nursing department organized outpatient nurses to learn the three-step analgesic method proposed by WHO. According to a survey in Guangdong province, 70.77% on-the-job nurses don't know the principle of three-step analgesia, and 56.25% oncology nurses don't know it either. Three-step analgesic method was put forward by WHO in 1986, and now it has become the basic method to treat cancer patients' pain. The first step is to give non-narcotic analgesics, the second step is to give weak narcotic analgesics and the third step is to give strong narcotic analgesics.

② There are 0 ~ 10 linear visual analogue scale and Wong-Baker facial expression method commonly used in learning to use pain assessment methods correctly. The latter is not influenced by culture, language, race, age and gender, and is easy to accept and master.

2. Community nursing measures

① Help patients correctly understand the addiction of painkillers. 90% patients and their families in this group are worried about the "addiction" of anesthetics, so they are unwilling to use painkillers. Nurses have the responsibility to educate patients and their families in this regard. Addiction is a compulsory drug use mode, which is a craving for drugs rather than a relief of pain, manifested in the endless pursuit of anesthetics and impulsive and reckless behavior; Cancer patients are not addicted to pain-relieving drugs. No matter how much or how long it takes, once the cause of pain is relieved, they no longer need to use narcotic painkillers. After active education, all patients can fully express their pain feelings and receive analgesic treatment.

② Correct evaluation of pain is a subjective feeling, and the evaluation data should mainly come from patients' complaints. There are two methods to evaluate patients' pain, one is to judge the pain according to patients' subjective feelings, and the other is to accurately evaluate the pain by using evaluation tools.

③ The correct use of analgesics should strictly follow the principle of three-level analgesic method recommended by WHO, starting with non-narcotic analgesics and gradually upgrading to strong narcotic analgesics when ineffective. Nurses should remember to give medicine on time, not on demand, and don't wait until the pain gets worse before starting to take medicine. Under special circumstances, you can master it flexibly and temporarily increase painkillers.

④ Setting a beautiful and comfortable environment, striving for the cooperation of family members, putting patients in a comfortable position and creating a good environment for patients can improve the pain threshold and relieve pain.

⑤ It is a subjective feeling to implement non-drug analgesia technology to assist drug analgesia, which is influenced by physiological, psychological and social factors. Therefore, although drug therapy is the most commonly used analgesic method, non-drug analgesic therapy can not be ignored. According to the location, nature, accompanying symptoms and inducing factors of pain, non-drug analgesic methods such as hot compress, cold compress, massage, acupuncture, stretching and relaxation were used to assist drug analgesia, and good results were achieved.

Effect evaluation

1. Patients' understanding of whether they are addicted to painkillers. All patients can correctly understand the addiction of painkillers, and will take the initiative to complain about the pain and cooperate with drug treatment.

2.90% of patients think that drug therapy plus non-drug measures can relieve pain, promote patients' quiet sleep and reduce negative psychological emotions.

3. Patients and their families' understanding of community nursing. Community nursing enables patients to receive systematic treatment and nursing in their own homes, which alleviates the shortage of hospital beds, shortens hospitalization time, saves expenses, lightens family burden, ensures the continuity of treatment and nursing, alleviates patients' pain and improves their quality of life.

Pain of cancer patients is a common symptom of advanced cancer. Mastering the causes of cancer pain is the key to nursing patients with cancer pain.

1 classification of pain

1. 1 Pain caused by primary disease (1) The tumor keeps growing, and the capsule tightens and oppresses adjacent organs, directly invading nerves, periosteum and organs, causing pain. (2) Paraneoplastic syndrome causes pain. (3) The tumor directly invades the surrounding tissues, causing normal tissues to be destroyed or deformed, thus causing pain and stimulation to local nerve fibers.

1.2 Pain caused by metastasis (1) Pain caused by metastasis spreading to pleura, peritoneum, periosteum and meninges and compressing adjacent organs and nerves. (2) Pain caused by tumor metastasis and embolism. (3) Pain caused by local lymphatic infiltration, blocked venous return or arterial occlusion.

1.3 Pain of complications caused by primary tumor or metastasis, pain of blocking inflammation, pain of serosal cavity adhesion, pain caused by osteolysis or hyperosteogeny. 1.4 Pain caused by other diagnosis and treatment.

2 Effects of pain on the body

(1) Pain will affect the pulse rate. Surface pain can lead to tachycardia. Severe deep pain will slow down the pulse rate and occasionally lead to cardiac arrest. (2) Pain affects breathing. If the pain involves the chest wall, the patient will have abdominal breathing, and if there is abdominal pain, chest breathing can be seen. Severe pain can make breathing shallower and shorter. (3) Severe pain can accelerate the metabolism of patients, and patients may have elevated body temperature. (4) Severe pain is often accompanied by nausea and vomiting.

Treatment and nursing of cancer pain

Understand the beginning and duration of pain, the nature, causes, laws and complications of pain, and carry out nursing according to different situations.

3. 1 Prevention of pain (1) Patients with transient or paroxysmal pain caused by some reasons can be given preventive treatment. For example, for the pain caused by body position change, analgesic or local block can be given before the patient's body position change to help the patient change his body position and prevent pain. (2) Improve the quality of technical operation and reduce the pain of patients, such as avoiding the leakage of injection and gentle and accurate nursing operation.

3.2 Symptomatic analgesics are administered through different routes, such as oral administration, intramuscular injection, intravenous injection, local blocking, local external application, continuous epidural injection, etc. (1) Decompression: Puncture decompression can relieve pain. (2) Local analgesia: used for some tumor ulceration and superficial phlebitis. , can be given cold compress, gargle, rinse, etc. to relieve pain. (3) The common toxic reaction of chemotherapy causes local swelling and pain, so it should be sealed subcutaneously with normal saline or 2% lidocaine immediately, and the leaked liquid should be diluted. Mild people can wet apply 50% magnesium sulfate solution and apply heparin ointment locally to achieve the purpose of relieving pain and swelling. (4) The intramuscular injection of 0. 1g of Qiangtongding or 0. 1g of Demerol can relieve the pain in patients with advanced cancer.

3.3 Strengthening Psychological Nursing to Relieve Pain Cancer patients should give psychological encouragement and comfort, distract their attention from pain and enhance their confidence in overcoming the disease.

3.4 Acupuncture Therapy According to the pain site, different acupoint acupuncture therapy or pain point sealing method is adopted.

References:

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