Pain management nursing : official journal of the American Society of Pain Management Nurses
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Up to 100% of patients treated with epidural analgesia can experience urinary retention, which may be related to dermatomal level of the epidural block, epidural medication, and surgical procedure. This study was designed to identify the incidence of urinary retention in patients who receive thoracic patient-controlled epidural analgesia (TPCEA) after thoracotomy. Forty-nine patients were enrolled and received epidural infusion of ropivacaine 0.2% or mixture of bupivacaine 0.1% with hydromorphone 0.015 mg/mL. ⋯ No association was established between catheter level, drug type, infusion rate, and urinary retention. Although 76% of patients did not report any physical discomfort with the indwelling urinary catheter, 66% felt relief after its removal and 18% did not ambulate with the inserted urinary catheter. The incidence of postoperative urine retention was low (10%), indicating that unless required for other purposes, indwelling urinary catheters may be removed between 12 and 48 h after surgery while receiving TPCEA.
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Randomized Controlled Trial Multicenter Study
Postoperative pain management discharge teaching in a rural population.
With health care increasingly administered on an outpatient and in-home basis, the knowledge and education of any patient population including discharged postoperative patients are essential ingredients to optimal pain management. The purpose of this study was to implement and evaluate in a rural setting a predischarge patient education intervention focused on self pain management of uncomplicated postsurgical patients after being discharged home. ⋯ One week after discharge, 68 patients (47%) returned a completed a post-test knowledge and experience questionnaire, Brief Pain Inventory, and a patient pain log used to evaluate the effectiveness of the intervention. Results indicated that although there was no statistically significant difference between the groups regarding knowledge and experience about pain, postoperative pain, and interference of pain with activities of daily living 1 week after discharge, those that received the intervention had lower pain scores and less interference of pain with activities.
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The Brief Pain Inventory (BPI) is a comprehensive instrument for pain assessment and has been validated in several languages. A validated Turkish version has not been available until now. The purpose of this study was to determine the reliability and validity of the BPI for assessing pain in patients undergoing abdominal surgery in Turkey. ⋯ The item-to-total correlations of the scale ranged between 0.42 and 0.69. The Turkish version of the BPI (BPI-Tr) is a reliable and valid instrument for assessing postsurgical pain severity and its interference. The BPI-Tr will be useful for clinical assessment of postsurgical pain in Turkey.
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Chronic pain, mainly associated with musculoskeletal diagnoses, is inadequately and often inappropriately treated in nursing home residents. The purpose of this descriptive study is to identify the musculoskeletal diagnoses associated with pain and to compare pain management of a sample of nursing home residents with the 1998 evidence-based guideline proposed by the American Geriatrics Society (AGS). The sample consists of 215 residents from 13 rural Iowa nursing home homes. ⋯ There was no significant difference between MMSE scores and number of scheduled analgesics. Additionally, residents' self-reported use of topical agents was not documented in the charts. The findings suggest that the 1998 AGS evidence-based guideline for the management of chronic pain is inconsistently implemented.
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This study examined the experiences of nursing assistants (NAs), who have worked with older people in residential aged care facilities (RACFs) who are in pain, to ascertain the role that NAs play in the pain management process. A descriptive, exploratory qualitative approach was used to examine NAs' experiences. Six NAs employed in three RACFs in regional Western Australia participated in the study. ⋯ Nursing assistants may be responsible for initiating and implementing pain management treatments for older residents. This is outside the scope of practice for NAs; therefore, it is imperative that the preparation of NAs give them adequate knowledge to perform this role. As well, it may be timely to consider regulation of this large group of workers who are performing clinical tasks in RACFs.