Pain management nursing : official journal of the American Society of Pain Management Nurses
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Psychologic variables such as attitudes and beliefs may account for patients choosing not to seek treatment for pain; however, there is a dearth of empirical research to support this contention. The aim of this study was to explore the help-seeking behavior, individual characteristics, attitudes, and beliefs of older adults with chronic pain in an Irish community setting. A descriptive correlational design was used. ⋯ High levels of stoicism were reported, indicating that participants were more likely to believe they had superior pain control and courage in the face of pain and were not willing to disclose their pain to others. These attitudes were significantly associated with lower levels of expressed need for treatment. Participants had moderate age-related beliefs about the origin of pain, but those who believed pain had an organic cause were more likely to seek help.
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Individuals who are unable to communicate their pain are at greater risk for under recognition and undertreatment of pain. This position paper describes the magnitude of this issue, defines populations at risk and offers clinical practice recommendations for appropriate pain assessment using a hierarchical framework for assessing pain in those unable to self-report. ⋯ Just like all other patients, these special populations require consistent, ongoing assessment, appropriate treatment, and evaluation of interventions to insure the best possible pain relief. Because of continued advances and new developments in strategies and tools for assessing pain in these populations, clinicians are encouraged to stay current through regular review of new research and practice recommendations.
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The American Society for Pain Management Nursing (ASPMN) holds the position that a placebo should not be used by any method to assess and/or manage an individual's pain regardless of their age or diagnosis. The only justifiable use of placebos is for participants enrolled in a blinded clinical trial. These clinical trials must be Institutional Review Board (or equivalent) approved with participants clearly informed that they may receive a placebo before they consent to participate and actually have the sham treatment administered.
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The purpose of this study was to report the prevalence and impact of pain among Taiwanese oncology outpatients who had experienced moderate pain. Ninety-two cancer outpatients in two teaching hospitals in the Taipei area of Taiwan were enrolled in a descriptive cross-sectional study. Outpatients aged ≥18 years who had been prescribed opioid analgesics for cancer-related pain completed the Brief Pain Inventory-Chinese questionnaire. ⋯ Only 10.9% of patients experienced good pain relief (defined as 90%-100% of pain relief in the past 24 hours), whereas 45.7% experienced poor pain relief (defined as 0%-60% of pain relief in the past 24 hours). The mean pain interference with the patients' daily activities was 5.69 (SD 2.33, range 0-10). The findings of this study indicate the need for better programmatic efforts to improve relief of cancer pain in Taiwanese outpatients.
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Comparative Study Clinical Trial
Comparison of two pain assessment tools in nonverbal critical care patients.
It is recommended that patient's self-report of pain should be obtained as often as possible as the "gold standard." Unfortunately in critical care, many factors can alter verbal communication with patients, making pain assessment more difficult. Scientific advances in understanding pain mechanisms, multidimensional methods of pain assessment, and analgesic pharmacology have improved pain management strategies. However, pain assessment for nonverbal patients in critical care continues to present a challenge for clinicians and researchers. ⋯ Internal consistency reliability for the PAINAD was 0.80 and for the CPOT 0.72. Limits of agreement indicated that there was no difference in PAINAD and CPOT scores for assessing pain in nonverbal patients in critical care. Further research in the area of pain assessment for nonverbal patients in critical care is needed.