Effect of Orem’s Self-Care Theory Combined with Active Pain Assessment on Pain, Stress and Psychological State of Children with Nephroblastoma Surgery

Abstract

BackgroundWith the development of medical technology and the innovation of various surgical options, the survival time of children with nephroblastoma is significantly prolonged. However, postoperative pain and stress response have been plagued by children with nephroblastoma during the postoperative treatment. At present, there is still a lack of effective care programs.MethodsWe accessed our institutional database to retrospectively screen clinical data from all children with nephroblastoma who were surgically treated in our hospital between July 2020 and July 2021. Some children received routine care, while others received Orem-based self-care theory and active pain assessment.ResultsAccording to the inclusion and exclusion criteria, 150 children with nephroblastoma who underwent surgical treatment were included in this study. On the third day after surgery, the scores of pain control effect and satisfaction degree of pain education in the study group were higher than those in the control group, and the physical and daily life influence, emotion influence, and pain experienced in the study group were lower than those in the control group. The differences were statistically significant (p < 0.001). There was no significant difference in C-SUPPH and ESCA scores between the two groups before nursing (p > 0.05). After nursing, the C-SUPPH and ESCA scores of the two groups were higher than those before nursing, and the C-SUPPH and ESCA scores of the study group were higher than those of the control group (p < 0.05). Before nursing, the levels of ACTH, Cor, and ANP between the two groups were not statistically significant (p > 0.05). The levels of ACTH, Cor, and ANP in the two groups were lower than those before nursing and 3 d and 7 d after nursing, and the index levels after 7 d of nursing were lower than those after 3 d of nursing. After nursing, the levels of ACTH, Cor, and ANP in the study group at each time point were lower than those in the control group (p < 0.05). There was no significant difference in SAS and SDS scores between the two groups before nursing (p > 0.05). After nursing, the SAS and SDS scores of both groups were lower than those before nursing, and the SAS and SDS scores of the study group were lower than those of the control group (p < 0.05). There was no significant difference in PSQI scores between the two groups before nursing (p > 0.05). After nursing, the PSQI scores of the two groups were lower than those before nursing, and the PSQI scores of the study were lower than those of the control group (p < 0.05). The average daily crying time, the average hospitalization time, and postoperative off-bed time in the study group were shorter than those in the control group (p < 0.05).ConclusionOrem’s self-care theory combined with active pain assessment can reduce pain in children undergoing nephroblastoma surgery, improve their stress response and psychological state, and improve their sleep quality, which is conducive to postoperative recovery and worthy of promotion.

Surgical Nurses’ Perceptions of Strategies to Enhance Pain Management Proficiency: A Qualitative Study

“…Our results demonstrate the complexity of implementing nursing strategies to improve nurses’ pain management skills. Nurses taking care of patients with pain recognised that this was part of their professional role, as mentioned in previous studies [ 5 , 6 , 7 , 8 , 9 , 12 ]. Nurses reported partnering with a ‘multidisciplinary team’ for problem-solving while caring for patients in recovery surgery.…”

“…Samarkandi [ 4 ], and Jaleta, Tuji, and Wake [ 5 ] have focused on pain management related to ineffective nursing strategies. Inefficiencies exist in multidisciplinary collaborations, the development of innovative knowledge and training by healthcare teams, and the recognition of individual differences in the delivery of pain management services [ 5 , 6 , 7 , 8 , 9 ].…”

“…Conversely, it was found that nurses did not focus on direct input from patients and families but, instead, relied on their observational and quantitative measurement tools to assess pain and manage it accordingly [ 11 , 12 ]. Nursing strategies based on Orem’s self-care theory emphasize the importance of individuals taking an active role in managing their own health and well-being [ 6 ]. In the context of pain management, this means that nurses must support and empower patients to participate in their own pain management by providing education, resources, and support that promote self-care and self-management.…”

“…In the context of pain management, this means that nurses must support and empower patients to participate in their own pain management by providing education, resources, and support that promote self-care and self-management. This nursing model can be applied to pain management by encouraging patients to take an active role in their pain management by engaging in self-care activities [ 6 ]. These include exercise, stress relief and other complementary therapies.…”

“…These include exercise, stress relief and other complementary therapies. Nurses can provide training and resources for patients to promote these self-care activities and empower them to manage pain [ 4 , 5 , 6 , 7 , 8 ].…”