Pain management nursing : official journal of the American Society of Pain Management Nurses
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Chronic pain is highly prevalent in older adults and often negatively associated with health-related quality of life (HRQoL). This study compared HRQoL, including physical health and mental health, in persons of differing ethnicities, and identified factors associated with pain intensity and HRQoL in ethnically diverse older adults. Older adults with chronic pain from four ethnic groups (African Americans, Afro-Caribbeans, Hispanics, and European Americans) were recruited from the Florida Atlantic University Healthy Aging Research Initiative (HARI) registry. ⋯ Multivariate linear regression analysis revealed that ethnicity, lower physical health scores, and lower mental health scores were significantly (p ≤ .01) associated with pain intensity. Understanding ethnic variations in response to pain intensity may address gaps in knowledge about HRQoL to reduce disparities in optimal care. Health care providers should consider ethnic norms and cultural diversity to provide optimal interventions for this population.
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Randomized Controlled Trial
The Effect of Virtual Reality Distraction on Pain Relief During Dressing Changes in Children with Chronic Wounds on Lower Limbs.
It has been demonstrated that patients with chronic wounds experience the most pain during dressing changes. Currently, researchers focus mostly on analgesics and appropriate dressing materials to relieve pain during dressing changes of chronic wounds. However, the effect of nonpharmacologic interventions, such as virtual reality distraction, on pain management during dressing changes of pediatric chronic wounds remains poorly understood. ⋯ Virtual reality distraction significantly relieved pain and anxiety scores during dressing changes and reduced the time length for dressing changes as compared to standard distraction methods. The use of virtual reality as a distraction tool in a pediatric ward offered superior pain reduction to children as compared to standard distractions. This device can potentially improve clinical efficiency by reducing length time for dressing changes.
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This study used the Assessment of Multiple Systematic Reviews (AMSTAR) to determine how the quality of methodologies in systematic reviews (SRs) and meta-analyses (MAs) impacts the effectiveness of nonpharmacological cancer pain management. The authors searched 11 electronic databases for published and unpublished studies (in English and Korean) on SRs and MAs relating to "cancer" and "pain management" that were released prior to May 7, 2014. The findings from 17 SRs and MAs were scored for quality using AMSTAR and coded by management type and value of effect size. ⋯ Among the items we tested via AMSTAR, zero studies stated whether they have a conflict of interest in their covered studies, but every study established the research question and inclusion criteria before constructing the review. Rigorous assessment of nonpharmacological cancer pain management using AMSTAR might contribute to healthcare providers making more informed clinical decisions when it comes to handling pain. Based on the finding, researchers should abide by reporting guidelines for SRs and MAs to ensure that research is more rigorously synthesized.
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Patients who undergo a surgical intervention require information in the preoperative phase. Few qualitative studies are available that illuminate the importance of preoperative information for patients' experiences of postoperative pain management. The aim of this study was to examine patients' perceptions of preoperative information about pain treatment as well as its importance for the way pain was managed in the postoperative phase. ⋯ The theme "Participation" emerged from the latent content. Preoperative information on pain relief facilitated increased patient participation. Health care professionals often aim to ensure that patients participate in the care, but the latter sometimes lack the desire, strength, or ability to become involved.
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Pain in the lumbosacral part of the spine in the course of degenerative disease is the most common cause of physical activity limitation in adults. Treatment includes pharmacotherapy, physiotherapy, psychotherapy, health promotion, and sometimes surgery. Surgical treatment is not always successful, and the various clinical and psychosomatic symptoms that result from surgical treatment failure are known as failed back surgery syndrome. ⋯ The study showed that spinal cord stimulation was effective in treating spinal and lower limb pain in 64% of patients, similar to results obtained in other departments. Although back pain and neuropathic pain radiating to the lower limbs decreased, moderate physical activity impairment was still observed according to the Oswestry Disability Index scale. The decrease in neuropathic pain radiating to the lower limbs had the most significant influence on reducing physical activity impairment.