目的 了解伤口治疗师在换药过程中创面操作性疼痛管理现状及有效管理的障碍因素，为提高创面操作性疼痛管理水平提供参考。方法 采用自行设计的创面操作性疼痛管理问卷对228名伤口治疗师进行调查。结果 44.3%伤口治疗师所在医院建立伤口疼痛管理制度与流程；64.0%认为创面操作性疼痛不可避免；51.3%在换药时会始终进行创面操作性疼痛评估，31.6%始终会采取措施控制创面操作性疼痛；85.5%认为创面操作中存在镇痛不足的情况。创面操作性疼痛管理的障碍因素主要包括：患者认为自己可以忍耐疼痛，不愿如实汇报疼痛情况；不愿使用镇痛药，担心镇痛药成瘾或不能控制不良反应，以及对药物产生耐药性等；换药人员疼痛管理知识不足；医院或科室疼痛管理制度不完善；换药人员工作负荷重等。结论 伤口疼痛管理组织制度有待完善，伤口治疗师对创面操作性疼痛的认知水平和疼痛管理程序有待提高与规范，镇痛效果有待提升。建议规范创面操作性疼痛管理程序，解决创面操作性疼痛管理的障碍因素，从而提升创面操作性疼痛的镇痛效果，改善患者伤口换药体验。
Objective To understand the current situation of wound-related procedural pain management by certified wound specialists during dressing change, to find out barriers to effective management, and provide a reference for improving the level of wound-related procedural pain management. Methods A self-designed wound-related procedural pain management questionnaire was used to survey 228 certified wound specialists. Results Of the 228 certified wound specialists, 44.3% were working for hospitals that had established wound-related pain management systems and procedures; 64.0% thought wound-related procedural pain was inevitable; 51.3% always performed wound-related procedural pain assessment during dressing change; 31.6% always took measures to control the wound-related procedural pain; 85.5% believed that there was insufficient analgesia during dressing change. The main barriers to wound-related procedural pain management included the following aspects: patients thought they could endure pain and didn′t want to report the pain truthfully; they were reluctant to use painkillers attributable to worries about painkillers addiction, inability to control its side effects or developing drug resistance, etc.; the wound dressing-change staff lacked knowledge of pain management; flawed pain management system in hospitals or departments; heavy workload of wound dressing-change staff, etc. Conclusion The wound-related pain management system needs to be improved. Certified wound specialists′ knowledge on the wound-related procedural pain, and the pain management procedures need to be enhanced and standardized; the analgesic effect is less satisfactory. It is suggested to standardize the wound-related procedural pain management procedures and solve the barriers to pain management, so as to improve the analgesic effect for wound-related procedural pain and patients′ wound dressing change experience.