Pain management nursing : official journal of the American Society of Pain Management Nurses
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Assessment is an essential, but challenging, component of any pain management plan. Nurses who care for postoperative patients quantify and document pain by use of unidimensional scales such as the numeric rating scale, the visual analogue scale, or a verbal descriptor scale. Improvements in pain ratings on these scales are viewed as a welcome result by nurses and doctors. ⋯ A unique finding of the study was that the degree of incremental shift on an NRS of pretreatment and posttreatment pain levels is not a good predictor of clinical relevance from the patient's perspective. A more accurate predictor was found by converting the changes on the NRS to percentages. An important implication of this study is the need to include a scale in pain assessment instruments for assessing the level of clinical meaningfulness of pain reduction from the patient's perspective.
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Tonsillectomy is a common surgical procedure usually associated with moderate to severe pain. Although self-report is the gold standard for pain assessment, researchers have not studied young children at home with self-report measures. The purpose of this study was to describe the patterns of self-reported pain intensity and analgesic administration in 3- to 7-year-old children undergoing tonsillectomy during the operative day in the hospital and the first 2 postoperative days at home in Iceland. ⋯ In the hospital, children with pain intensity scores of 4 or 5 received prescribed morphine only 13% of the time. Children experienced clinically significant pain through the second postoperative day and will probably require a change in protocol to provide more aggressive pain management earlier. This study extends to younger children the research evidence that current pain protocols are inadequate.
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There are differences between males and females regarding the perception, expression, and tolerance of pain that stems from a variety of social and psychologic influences. Personal self-efficacy and lifespan socialization are two such influences, and they provide new dimensions for nurses to better understand the pain experience. This article will present a review of the literature regarding personal self-efficacy and lifespan socialization and their effects on pain perception and expression among males and females. Finally, nursing implications related to the topic will be discussed.
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Comparative Study
Nursing students' knowledge and attitudes regarding pain.
The presence of pain is one of the main reasons why people seek health care, yet pain is often undertreated. Inadequate treatment has been linked to health care workers' failure to assess pain and to intervene appropriately. It may also result from the limited attention given to pain management in nursing curricula. ⋯ However, the combined mean score for both groups was 64%, indicating inadequate knowledge of pain management. Despite major initiatives by accrediting agencies, statewide Pain Initiatives, and professional organizations, knowledge of pain management is still inadequate. Nursing faculty need to critically review their curricula to determine whether students are being taught in-depth and up-to-date pain management information that incorporates evidence-based research and current standards of care.
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The management of pain is a primary issue in burn care. Patients hospitalized for burn injuries experience severe pain on a daily basis, immediately after the injury and during the healing of the burn wound. Our clinical experience is that the intensity of pain is increased by wound infection. ⋯ A total of 165 patients with burn injuries were included, 60 of whom were diagnosed with infection. The results of this study showed a significant increase in pain intensity in association with infection. An increase in pain is one of the factors to be considered among the many assessments, tests, and treatments for patients with burn injuries.