Pain management nursing : official journal of the American Society of Pain Management Nurses
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This study explored the beliefs and self-reported practices of nurses related to pain assessment in nonverbal patients. A convenience sample of 74 nurses from one Midwestern community hospital responded to a researcher-developed questionnaire based on established pain standards and clinical practice recommendations. Areas of nonverbal pain assessment beliefs and practices with low scores were identified. ⋯ Additional testing using Pearson correlation coefficients demonstrated that only three out of seven questions relating to beliefs were significantly correlated with similar questions related to practices. Good reliability of the instrument was demonstrated by Cronbach alpha coefficient α = 0.82. Recommendations include further education for hospital nurses related to pain assessment standards in nonverbal patients, as well as utilization of techniques to integrate this knowledge into nurses' belief systems and practice environment.
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Randomized Controlled Trial
Preoperative education and use of analgesic before onset of pain routinely for post-thoracotomy pain control can reduce pain effect and total amount of analgesics administered postoperatively.
The purpose of this study was to investigate the efficiency of preoperative pain management education and the role of analgesics administration before the onset of pain postoperatively. The study was a prospective, randomized, and single-blind clinical trial, which was conducted January 1, 2008 through October 1, 2008 in the Thoracic Surgery Unit of Akdeniz University Hospital. A total of 70 patients who underwent thoracotomy (35 in the control group and 35 in the study group) were included in the study. ⋯ The rate of pain, which was defined as sharp, stabbing, and exhausting, was higher in the control group than in the study group, and the difference between the two groups was statistically significant (p < .05). As the doses of analgesics used for pain management in both groups were compared, it was determined that analgesic consumption was lower in the study group than in the control group, and the difference was statistically significant (p < .05). As a result, it was determined that preoperative thoracic pain management education and analgesics administered postoperatively, before the onset of pain, reduced the amount of analgesics used in the first postoperative 48 hours.
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Randomized Controlled Trial
Effect of foot and hand massage in post-cesarean section pain control: a randomized control trial.
One of the problems for mothers in the post-cesarean section period is pain, which disturbs the early relationship between mothers and newborns; timely pain management prevents the side effects of pain, facilitates the recovery of patient, reduces the costs of treatment by minimizing or eliminating the mother's distress, and increases mother-infant interactions. The aim of this study was to determine the effect of hand and foot massage on post-cesarean section pain. This study is a randomized and controlled trial which was performed in Mustafa Khomeini Hospital, Elam, Iran, April 1 to July 30, 2011; it was carried out on 80 pregnant women who had an elective cesarean section and met inclusion criteria for study. ⋯ The pain intensity was found to be reduced after intervention compared with the intensity before the intervention (p < .001). Also, there was a significant difference between groups in terms of the pain intensity and requests for analgesic (p < .001). According to these findings, the foot and hand massage can be considered as a complementary method to reduce the pain of cesarean section effectively and to decrease the amount of medications and their side effects.
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New research, regulatory guidelines, and practice initiatives have improved pain management in infants, children, and adolescents, but obstacles remain. The aim of this study was to identify the prevalence and demographics of pain, as well as pain management practice patterns in hospitalized children in a tertiary-care university hospital. We prospectively collected data including patient demographics, presence/absence and location of pain, pain intensity, pain assessment documentation, analgesic use, side effects of analgesic therapy, and patient/family satisfaction. ⋯ Identified obstacles to optimal analgesic management include lack of documented physician pain assessment (<5%), a high prevalence of "as needed" analgesic dosing, frequent opioid-induced side effects (44% nausea and vomiting, 27% pruritus), and patient/family dissatisfaction with pain management (2%-7%). The data demonstrated that despite a concentrated focus on improving pain management over the past decade, pain remains common in hospitalized children. Identification of patient populations and characteristics that predispose to increased pain (e.g., female, Caucasian, postoperative patient) as well as obstacles to analgesic management provide a focus for the development of targeted interventions and research to further improve care.
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Chronic back pain is globally acknowledged as a common reason why people seek help from health professionals. The complexity of persistent chronic pain can undermine the person's self-esteem and present a number of challenges to an individual's ability to manage their pain. Multi-professional person-centered care is advocated as a key strategy to support people with chronic back pain. ⋯ These categories formed the "conditional partnership" as a theory to explain person-centered care, which related to the way in which the partnership developed between the patients and teams. The findings suggest that person-centered care was influenced by the participants' need to be believed and the relationship developed with health care providers. Crucially, these findings suggest that legitimizing the pain experience through person-centered approaches to care can empower people with chronic back pain to regain control of their lives and their pain.