Journal of pediatric nursing
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An exploratory, qualitative study with tenets from grounded theory was used to elicit detailed descriptions of adolescents' chronic illness experiences. The philosophy of symbolic interactionism guided this study. Understanding the adolescents' experiences included exploring adolescents' perspectives of the following: (1) what it is like to have a chronic illness, and (2) how they deal with having a chronic illness. ⋯ Adolescents experience extra effort, restriction, pain, and additional worries because of having a chronic illness. However, adolescents also clearly had ways to help them deal with their illness. These strategies and recommendations for practice and future research are discussed.
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The purpose of this descriptive study was to identify the indicators used by neonatal nurses to interpret the experience of pain in infants in a Neonatal Intensive Care Unit (NICU). A sample of 72 NICU nurses completed a structured questionnaire to identify the physiological and behavioral indicators they used to interpret the experience of pain in the infants entrusted to their care. The 10 pain indicators used by more than 50% of the nurses, listed in decreasing order of frequency, were: fussiness, restlessness, grimacing, crying, increasing heart rate, increasing respirations, wiggling, rapid state changes, wrinkling of forehead, and clenching of fist. These findings are consistent with existing literature, are compatible with the stress cues identified in Als' Synactive Theory of Development, and lend support to the use of such measures for the assessment of infant pain.
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Comparative Study
Construct validity estimation for the African-American and Hispanic versions of the Oucher Scale.
This study examined the construct validity of the African-American and Hispanic versions of the Oucher Scale as measures of pain in 104 children ages 3 to 12 years old. Scores on the Oucher Scale, Analogue Chromatic Continuous Scale, and Child Medical Fear Scale were obtained after being administered concurrently on one occasion, either before or after surgery. ⋯ Preanalgesic scores were significantly higher than postanalgesic scores. These findings support the construct validity of the two new ethnic versions of the Oucher.
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Randomized Controlled Trial Clinical Trial
Relationships between cognitive behavioral techniques, temperament, observed distress, and pain reports in children and adolescents during lumbar puncture.
A limited number of studies have examined relationships between temperament and children's/adolescents' responses to painful procedures and have identified several different dimensions of temperament that are related to children's pain response. The focus of these studies was one-time, acute pain experiences, such as immunization and postoperative pain. In this study, children and adolescents' responses to a moderately painful procedure, lumbar puncture, were examined as they related to temperament. ⋯ At the baseline visit, the temperament dimensions of more positive mood, lower activity, less persistence, and lower distractibility were related to higher pain reports, but not behavioral distress. However, after 5 months, only the dimension of positive mood was significantly correlated with improvement in pain reports. The amount of time parents and children practiced the techniques, their comfort with the techniques and their perceived effectiveness also were correlated with positive mood.
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Comparative Study
A comparison of two regimens of patient-controlled analgesia for children with sickle cell disease.
Recently, patient controlled analgesia (PCA) has gained prominence in the treatment of pain for children suffering from vaso-occlusive crisis associated with sickle cell disease. Because there are several different regimens that can be used for PCA, the purpose of this study was to compare and contrast two regimens of patient controlled analgesia (PCA) in terms of safety, efficacy, and cost for the treatment of vaso-occlusive pain associated with sickle cell disease. In this study a retrospective chart review was conducted. ⋯ Patients were grouped according to the type of PCA regimen they received: high dose PCA/low basal infusion (HPCA/LBI) or low dose PCA/high basal infusion (LPCA/HBI). Children in Group 1 (HPCA/LBI) used significantly less morphine during their hospitalization, were hospitalized fewer days, and reported lower pain scores on day 2. There were considerable cost savings due to decreased length of stay, less morphine consumed overall, and fewer days required for rental of the PCA pump.