Pain management nursing : official journal of the American Society of Pain Management Nurses
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Quality measurement in health care is complex and in a constant state of evolution. Different approaches are necessary depending on the purpose of the measurement (e.g., accountability, research, improvement). Recent changes in health care accreditation standards are driving increased attention to measurement of the quality of pain management for improvement purposes. ⋯ Analyses of data led to consensus on six quality indicators for hospital-based pain management. These indicators include: the intensity of pain is documented with a numeric or descriptive rating scale; pain intensity is documented at frequent intervals; pain is treated by a route other than intramuscular; pain is treated with regularly administered analgesics, and when possible, a multimodal approach is used; pain is prevented and controlled to a degree that facilitates function and quality of life; and patients are adequately informed and knowledgeable about pain management. Although there are no perfect measures of quality, longitudinal data support the validity of a core set of indicators that could be used to obtain benchmark data for quality improvement in pain management in the hospital setting.
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Clinical Trial Controlled Clinical Trial
Nurse-led pain management program: effect on self-efficacy, pain intensity, pain-related disability, and depressive symptoms in chronic pain patients.
Nurses routinely use a variety of nonpharmacologic and patient education interventions designed to reduce pain and promote independence. Research on group programs that combine these nursing strategies in a systematic approach provides evidence that chronic pain patients can realize an enhanced confidence in their ability to manage pain (improved self-efficacy) in addition to reductions in pain, emotional distress, and disability. The purpose of this study was to investigate the effect of participating in a nurse-led cognitive-behavioral treatment (CBT) pain management program on self-efficacy, pain intensity, pain-related disability, and depressive symptoms among patients with chronic pain. ⋯ Patients in this study reported significant improvements in all scores postprogram. Self-efficacy, pain-intensity, pain-related disability, and symptoms of depression can be changed through participation in a nurse-led outpatient CBT program. In concert with results from other research on CBT pain programs this study provides further evidence that reduction in suffering and improved sense of well-being is possible even for people who have experienced pain for many years.
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Older adults manage their pain at home after outpatient surgery. Yet the experience and management of postoperative pain outside the hospital is largely unknown. The purpose of this study was to examine older adults' experiences of postoperative pain and their methods of pain management after discharge from outpatient surgery. ⋯ Pain management instructions did not make a difference in the way pain was managed. Overall, findings indicate that older postoperative patients are not adequately medicating themselves for pain after discharge. Furthermore, when participants were asked, "From this list of nonpharmacologic activities, which activities helped relieve pain?" the most frequently selected answer was "to stay still or not move." This finding requires further investigation to determine if older adults are using immobility as a way to control their pain.
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The effective management of pain at the end of life relies on the accurate assessment of pain. Language is the mechanism through which pain is assessed using self-report pain tools. The purpose of this study was to explore how elderly hospice patients describe their pain and to compare their descriptions with three commonly used pain assessment tools (i.e., McGill Pain Questionnaire, Memorial Pain Assessment Card, and the Visual Analogue Scale). ⋯ In describing their pain, participants used many words, emphasized their pain by repeating those words, and used similes to describe their pain. The participants used approximately 30% of the standardized language found in three commonly used self-report instruments. These findings suggest that in conjunction with self-report instruments, the patient's own verbal descriptions should be used in the assessment of pain.