ความปวดเรื้อรัง การทำกิจวัตรประจำวันและการบูรณาการในชุมชนของผู้รอดชีวิตจากการบาดเจ็บรุนแรง

Abstract

This study aimed to describe chronic pain, activities of daily living and community integration of survivors with major trauma and to examine the relationships of chronic pain, activities daily life and community integration. The 102 major trauma survivors from lower Southern region of Thailand were purposively recruited. Data were collected using (1) the General Record Form, (2) Chronic Pain Questionnaire, (3) Sirindhron National Medical Rehabilitation Center-Functional Assessment, and (4) Community Integration Questionnaires. These questionnaires had been tested validity by five experts. The reliabilities of Pain Questionnaire and Community Integration Questionnaires were tested using Intraclass Correlation Coefficient and yielded values of .96 - 1.00 and .83 - 1.00, respectively. The reliabilities of the Sirindhron National Medical Rehabilitation Center Functional Assessment were tested by using Cronbach's alpha coefficient and inter-rater method and yielded values of .99 and 1.00, respectively. The data were analyzed using descriptive statistics and Spearman rank correlation coefficient. The results showed that: 1. The survivors with major trauma mostly were traumatie brain injury (92.16%), had injury more than one location (73.53%), and had chronic pain more than in one location. The locations mostly found were the head (46.08%), followed by leg/foot (24.51%) and arm/hand (22.55%), respectively, Several pain characteristies were found. The pain characteristies commonly found were sharping (29.41%) at leg/foot and aching (25.49%) and shooting (25.49%) at head. The severities of pain including the worst pain (Mdn - 3, IQR - 2(3,5)), the least pain (Mdn - 1, IQR - 2[1,3)), average pain (Mdn - 3, /QR - 3[2,5)) and pain right now (Mdn - 2, IQR - 2[1,31), were at a mild level. 2. The survivors with major trauma had a good level of activities daily living (Mdn = 158, IQR = 23[144,167]). Considering each domain, the three domains with the highest scores were (1) eating, (2) cleaning face, head and hand, and (3) controlling elimination. The lowest scores of three domains were (1) walking or using wheelchair, (2) communicating, and (3) performing instrumental activities of daily living. 3. The survivors with major trauma had an overall average of community integration at a moderate level (M = 15.25, SD = 5.87). Considering each domain, the social integration domain had the highest score (M = 6.75, SD = 2.03) followed by home integration (M = 5.10, SD = 2.63) and productive activity (M = 3.40, SD = 2.41), respectively 4. The severities of chronic pain including worst pain, least pain, average pain and pain right now had statistically significant negative correlations with community integration (r, = -30, p = 002, r, = -32, p = 001, r, = -37, p < and and r, = p p< 001), respectively. Activity of daily living had a statistically significant positive correlation with community integration (r= .79, p < .001). The findings of this study suggest that healthcare professionals should plan for continuous chronic pain management, rehabilitating the walking and those using wheelchair, performing instrumental activities of daily living, and communicating, and should promote productive activity with occupation among the survivors with major trauma to effectively integrate them into the community.