Pain management nursing : official journal of the American Society of Pain Management Nurses
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Severe pain is a common symptom of sickle cell disease (SCD). Transitions between adult and pediatric care are a point of particular vulnerability for patients, increasing the risk for poor pain management. The purpose of this literature review was to investigate the relationships among self-efficacy, transition, and SCD health outcomes. ⋯ If providers can identify individuals in this population with low self-efficacy, they may be able to intervene early to improve patient outcomes. Most identified studies point to the positive correlation between self-efficacy and positive health outcomes in adolescents with SCD. Self-efficacy has the potential to guide self-care interventions and further research with the SCD population.
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The aim of this study was to assess the application of nonpharmacologic methods to relieve pain during birthing from the point of view of primiparous women. To achieve this goal, a cross-sectional study was developed with 188 primiparous women interviewed using a standardized form on the day they were discharged from the hospital. Results indicated that the most-used nonpharmacologic method was emotional support provided by the woman's companion (97.3%), followed by warm showers (91.5%); however, the highest degree of satisfaction derived from focused attention. ⋯ There was a significant association between the general score for satisfaction and the emotional support of an obstetrics nurse (p = .0096, OR 3.78, CI 95% 1.49-9.55), of the obstetrician (p = .0031, OR 3.74, CI 95% 1.5-9.33), and of the nurse's aide (p = .0303, OR 4.56, CI 95% 1.03-20.24). We concluded that in the obstetric center where the study was conducted, nearly all the nonpharmacologic methods available are being adopted by the members of the healthcare team, with the participation of a companion. However, those that generate the highest degree of satisfaction are not those most used.
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Randomized Controlled Trial Comparative Study
Applying Manual Pressure before Benzathine Penicillin Injection for Rheumatic Fever Prophylaxis Reduces Pain in Children.
The purpose of this study was to evaluate the efficacy of applying manual pressure before benzathine penicillin injection and compare it with the standard injection technique in terms of reducing discomfort in children with rheumatic heart disease grouped by age and gender. This was a single-blind, randomized, crossover study. Fifty-one patients aged 7.1-19.9 years were recruited for this study carried out in the pediatric cardiology outpatient clinic. ⋯ The application of manual pressure reduces pain in children under the stress of repeated intramuscular injections, which supports the suggestion that it should be used in routine practice. Manual pressure to the injection site is a simple, pain-reducing technique. Implementing this technique in routine practice may also promote adherence to the prophylaxis regimen, especially in children.
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Self-care is an important aspect of managing a chronic disease. In sickle cell disease (SCD), home self-care contributes to individual pain management and thus pain crisis prevention. A better understanding of self-care can help health care providers equip patients with the resources and skills necessary to participate in their disease management. ⋯ Of the hypothesized variables, only income was significantly associated with hospital visits for pain crises (r = -0.219, p = .05). Individuals with SCD may benefit from self-care interventions that enhance social support, SCD self-efficacy, and access to education. To inform intervention development, further investigation is needed regarding daily self-care behaviors used by young adults with SCD.
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Individuals with sickle cell disease (SCD) have reported being stigmatized when they seek care for pain. Nurse attitudes contribute to stigmatization and may affect patients' response to sickle cell cues, care-seeking, and ultimately patient outcomes. ⋯ No significant differences were noted in attitudes by worksite, with nurses from both sites demonstrating high levels of negative attitudes toward patients with SCD. Findings suggest that nurses from both worksites need additional education about SCD and care of this vulnerable, patient population.