經皮冠狀動脈介入治療(percutaneous coronary interventions；簡稱PCI)，是治療及診斷急性心肌梗塞的主要技術，術後預防出血合併症，必須採平躺和制動6至24小時，常造成背痛的發生，本研究目的在探討PCI治療後需平躺和制動8小時的個案，運用翻身擺位措施預防或減輕背痛的成效。採臨床隨機試驗(Randomized clinical trail, RCT)，於南部某醫學中心心臟加護病房、心臟內科病房、心導管室收案，對照組個案提供臨床常規護理照護，實驗組個案於PCI治療後提供每小時翻身擺位的介入措施持續至平躺結束，每小時以視覺疼痛類比量表比較兩組背痛發生率與背痛的程度。以SPSS For Windows 14.0版套裝軟體進行建檔及資料分析，共有30位個案參與研究(實驗組15人、對照組15人)，研究結果發現，實驗組接受翻身擺位措施後背痛程度顯著低於對照組，達到統計上顯著性差異(p<.05)，且在背痛發生率及止痛藥膏使用方面實驗組也低於對照組，在出血合併症方面兩組未達到統計上差異，表示翻身擺位措施並不會增加病患出血的危險性。翻身擺位措施能有效的預防及減輕因平躺制動所導致的背痛，建議將每小時翻身擺位措施成為行PCI治療後的常規護理，以提昇個案之舒適狀態。

Patients are restricted to bed-ridden after percutaneous coronary interventions (PCI), in order to prevent bleeding. Back pain is common among patients after PCI and is associated with immobility and restricted positioning. The purpose of this research is to examine the effect of q1h positioning in preventing back pain among patients after PCI, who was required to restrict to supine position for eight hours. This is a Randomized Clinical Trail. Patients were recruited from cardiac center care, cardiac medicine room, and cardiac catheterization room of a medical center at southern Taiwan. Patients in the control group were provided routine nursing care while patients in the experimental group received position changing every hour after PCI last for eight hours. We compared the differences in the incidence and perception of back pain between two groups. Visual analog scale was applied to measure the presence and level of back pain. Data were analyses by SPSS for windows 14.0. A total of 30 patients agreed to participate in the study (experimental group n=15, control group n=15). The results showed that the perception of back pain in the experimental group was significantly lower than control group (p<0.05). Incidence of back pain and the use of pain-killing agents in the experimental group were also significantly lower than the control group. There was no statistical significance of bleeding complication between the two groups; positioning did not contribute to a risk factor of bleeding. However, positioning can prevent and relieve back pain effectively in patients with restricted bed-ridden in supine position. We suggested that for PCI patients, position changing per hour should be considered as routine nursing care to promote the comfort of patients.

中文部份
丁賢偉(2003)．慢性下背痛危險因子分析模式之建立．未發表的碩士論文．桃園：元智大學資訊管理研究所碩士在職專班。
于潄、余幸宜(2003)．社區老人慢性疼痛問題之處置．護理雜誌，50(3)，43－48。
王文玲、林惠雪(2005)．一位性心肌梗塞患者的照護經驗．慈濟護理雜誌，4(3)，102－109。
世界衛生組織(無日期)．心臟血管疾病．2005年2月13日取自
http://www.who.int/topics/cardiovascular_diseases/en/.
行政院衛生署(無日期)．中華民國九十四年台灣地區死因統計結果摘要．2005年12月18日取自http://www.doh.gov.tw/statistic/data/死因摘要/94年/表1.xls。
李璟珮、鄭麗娟(2004)．急性心肌梗塞併發心因性休克患者之護理經驗．慈濟護理雜誌，3(1)，107－116。
李選、徐麗華、李絳桃、邱怡玟、李德芬、雷若莉、史麗珠(2004)．實驗性質之研究設計，護理研究與應用(171-196頁)．台北：華杏。
何雲仙(2003)．規律腹背肌運動訓練對慢性下背疼痛患者影響之探討．未發表的碩士論文．台北：台北醫學大學護理學系研究所。
林頌凱、張煥禎(2004)．下背痛的診斷與治療．基層醫學，19(12)．282－287。
香港中文大學統計網站(無日期)．樣本數計算．2008年6月16日取自http://department.obg.cuhk.edu.hk/researchsupport/Sample_size_Correlation.asp。
紀麗梅(2004)．穴位指壓對緩解原發性經痛成效之探討．未發表的碩士論文，花蓮：慈濟大學護理學研究所。
許淑蓮(2001)．初患心肌梗塞病人不確定感與焦慮反應-因應行為效應之探討．護理研究，9(2)，159－169。
許育誠、程俊傑、李世煌、徐國基、林申昌、洪惠風、劉哲仰、管培良(2000)．急性心肌梗塞病患未接受緊急經皮冠狀動脈氣球擴張術之原因及預後之探討．中華民國急救加護學會雜誌，11(1)，10－15。
孫吉珍、陳玉秀、李從業(2003)．「中心軸」訓練課程對產後婦女背痛之成效研究．慈濟護理雜誌，2(1)，63－69。
陳朝鈞(2005)．下背痛的物理治療檢查，下背痛徒手物理治療導論(11－127頁)．台北：合記。
陳玉枝、陳清惠、蔡仁貞、陳真瑗、康銘文、王珩生、楊菁菁、鄧慶華、陳筱瑀(2006)．擺位與移位．於施陳美津總校閱，復健護理(二版，204－232頁)．台北：華杏。
粘秋桂、柯德鑫(1996)．護理人員下背痛及其職業相關危險因子之調查．中華職業醫學雜誌，3(1)，37－44。
程俊傑(2000)．急性心肌梗塞的最新治療．中華民國急救加護學會雜誌，11(1)，1－9。
翁碧茹(2002)．遠紅外線敷貼對社區中年婦女腰酸背痛指數及經絡成效改善之探討．未發表碩士論文，台北：國立台北護理學院中西醫護理研究所。
蔡靖彥(2003)．常用藥品各論，常用藥品手冊(59－155頁)．台北：杏輝。
鄭碧華、吳聰能(2001)．下背痛病因學和危險因子上的新焦點．台灣衛誌，20(3)，172－174。
蕭惠文(1999)．一位急性心肌梗塞病患於加護病房住院期間的護理經驗．高雄護理雜誌，16(2)，74－82。
謝文祥(2003)．以良導絡評估不同電刺激模式於酸痛症之療效．未發表碩士論文，桃園：私立中原大學醫學工程學系。
謝霖芬(2005)．下背痛的診斷與分類．健康世界，233，45－51。
謝霖芬(2006)．診斷下背痛－談下背痛的分類．健康世界，243，62－64。
英文部份
Adnan, K. C., & Deepak, L. B. (2006). Walk this way: early ambulation after cardiac catheterization—good for the patient and the health care system. Mayo Clinic Proceedings, 81(12), 1535-1536.
American Pain Society. (2007). APS strategic plan. Retrieved November 11, 2007, from http://www.ampainsoc.org/about/strategic_plan.htm.
Brendan, J. D., Brent, A. K., Ryan, J. L., John, F. B., Charanjit, S. R., & Henry, H. T. (2006). Ambulation 1 hour after diagnostic cardiac catheterization: A prospective study of 1009 procedures. Mayo Clinic Proceedings, 81(12), 1537-1540.
Bogduk, N. (2003). Anatomy and biomechanics low back pain handbook. Philadelphia: Hanley & Belfus.
Blenkinsopp, A., Paxton, P., & Blenkinsopp, J. (2004). Lower back pain. Primary Health Care, 13(10), 35-37.
Byrns, G. E., Bierma, T. J., Agnew, J., & Curbow, B. (2002). A new direction in low-back pain research. American Industrial Hygiene Association Journal, 63(1), 55–61.
Bijur, P. E., Silver, W., & Gallagher, E. J. (2001). Reliability of the visual analogue scale for the measurement of acute pain. Academic Emergency Medicine, 8, 1153–1157.
Chair, S. Y., Taylor-Piliae, R. E., Lam, G., & Chan, S. (2003). Effect of positioning on back pain after coronary angiography. Journal of Advanced Nursing, 42(5), 470-478.
Chair, S.Y., Thompson, D. R., & Li, S. K. (2007). The effect of ambulation after cardiac catheterization on patient outcomes. Journal of Advanced Nursing, 16(1), 212–214.
Coyne, C., Baier, W., Perra, B., & Sherer, B. K. (1994). Controlled trial of backrest elevation after coronary angiography. American Journal of Critical Care‚ 3(1), 282-288.
Chandler, A., Preece, J., & Lister, S. (2002). Using heat therapy for pain. Nursing Standard, 17(9), 40-42.
Coll, A. M., Ameen, J. R . M., & Mead, D. M. (2004). Postoperative pain assessment tools in day surgery: Literature review. Journal of Advanced Nursing, 46(2), 124–133.
Doven, A., Akkus, M. N., Camsari, A., Pekdemir, H., Cicek, D., & Kanik, A. (2004). Impact of invasive strategy for the management of patients with cardiogenic shock after acute myocardial infarction. Coronary Artery Disease, 15(6), 361-366.
Fowlow, B., Price, P., & Fung, T. (1995). Ambulation after sheath removal: A comparison of 6 and 8 hours of bedrest after sheath removal in patients following a PTCA procedure. Heart and Lung, 24(1), 28-37.
Freeman, K., Smyth, C., Dallam, L., & Jackson, B. (2001). Pain measurement scales: A comparison of the visual analogue and faces rating scales in measuring pressure ulcer pain. Journal of Wound Ostomy and Continence Nursing, 28, 290–296.
Goodfellow, L. M. (2003). The effects of therapeutic back Massage on psychophysiologic variables and immune function in spouses of patients with cancer. Nursing Research, 52(5), 318-328.
Good, M., Stiller, C., Zauszniewski, J. A., Anderson, G. C., Stanton-Hicks, M., & Grass, J. A. (2001). Sensation and distress of pain scales: Reliability, validity and Sensitivity. Journal of Nursing Measurement, 9(3), 219-238.
Hsieh, L. C., Kuo, C. H., Yen, M. F., & Chen, H. H. (2004). A randomized controlled clinical trial for low back pain: Treated by acupressure and physical therapy. Preventive Medicine, 39, 168-76.
International Association for the Study of Pain. (2007). Global year against pain. Retrieved November 11, 2007, from http://www.iasp-pain.org.
Krismer, M., & Tulder, M. V. (2007). Low back pain (non-specific). Best Practice & Research Clinical Rheumatology, 21(1), 77-91.
Kolcaba, K., ＆ Steiner, R. (2000). Empirical evidence for the nature of holistic comfort. Journal of Holistic Nursing, 18(1), 46-62.
Lean, M. E., Han, T. S., & Seidell, J. C. (1999). Impairment of health and quality of life using new US federal guidelines for the identification of obesity. Archives of Internal Medicine, 159, 837-843.
Megan, E. (2002). Effectiveness of specific lumbar stabilization exercises: a single case study. The Journal of Manual & Manipulative Therapy, 10(1), 40-46.
Nachemson, B. A. (1975). Towards a better understanding of low-back pain: A review of the mechanics of the lumbar disc. Rheumatology and Rehabilitation, 14, 129-143.
Noto, T. J., Johnson, L. W., Krone, R., Weaver, W. F., Clark, D. A., Kramer, J. R., & Vetrovec, G. W. (1991). Cardiac catheterization 1990: A report of the registry of the society for cardiac angiography and intervention. Catheterization and Cardiovascular Diagnosis, 24(1), 75-83.
Olanrewaju, O. O., Steven, J. S., Marianne, M., & Malcolm, P. (2007). City bus driving and low back pain: A study of the exposures to posture demands, manual materials handling and whole-body vibration. Applied Ergonomics, 38(1), 29-38.
Pooler-Lunse, C., Barkman, A., & Bock, B. F. (1996). Effect of modified patients and mobilization on back and delayed bleeding in patient who had received heparin and undergone angiography: A pilot study. Heart and Lung, 25(2), 117-123.
Richards, K. C., Gibson, R., & Overton-McCoy, A. L. (2000). Effects of massage in acute and critical care. American Association of Critical-Care Nurses Clinical Issues, 11(1), 77-96.
Ratzon, N. Z., & Froom, P. (2006). Postural control in nurses with and without low back pain. Work, 26(2), 141-145.
Sulzbach, L. M., Munro, B. H., & Hishfeld, J. W. (1995). A randomized clinical trial of the effect of bed position after PTCA. American Journal of Critical Care, 4(3), 221-227.
Sullivana, Peter. B., Mitchell, T., Bulich, P., Waller, R., & Holte, J.(2006). The relationship between posture and back muscle endurance in industrial workers with flexion-related low back pain. Manual Therapy, 11(4), 264–271.
Sek, Y. C., Ruth, E. T., Gay, L., & Sophia, C. (2003). Effect of positioning on back pain after coronary angiography. Journal of Advanced Nursing, 42(5), 470-478.
Tuaun, C., Yorulmaz, I., Cindas, A., & Vatan, C. (1999). Low back pain and posture. Clinical Rheumatology, 18(4), 308–312.
Vertical or horizontal visual analogue scales. Annals of the Rheumatic Diseases, 38, 560.