Pain management nursing : official journal of the American Society of Pain Management Nurses
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Surgical patients consider information about pain and pain management to be highly important (Apfelbaum, 2003). At the same time, evidence indicates that members of racial and ethnic minorities are more likely to experience inadequate pain management (Green, Anderson, Baker, Campbell, Decker, Fillingim, & Todd, 2003; Mossey, 2011). ⋯ Similar to English-fluent participants (Kastanias et al., 2009), participants who primarily spoke either Cantonese, Italian, or Portuguese at home placed moderate to high importance on all of the information items. and neither surgical subtype, health status nor age had any effect on the importance of any item. The multilingual sample in this study placed more importance than English-fluent participants on information regarding help with paying for pain medication (p = .001) and the side effects they were most likely to experience (p < .05). Due to a paucity of literature in this area, further research is warranted. Results may assist with evaluating and improving current approaches to surgical patient pain management education.
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Chronic pain is a complex integration of biological, psychological, and social variables. Multidisciplinary pain management experts design interventions that treat the multidimensional experience. Children and adolescents with sickle cell disease (SCD) are at risk for chronic pain. Increased risk is associated with multiple characteristics including sickle cell genotype, age, gender, frequency of hospitalization, duration of hospitalization, and certain comorbid diagnoses. Referral to pain management professionals for this population is often delayed. ⋯ Eighty-four percent of all eligible patients were screened during their routine sickle cell appointments resulting in a 110% increase in multidisciplinary pain management referrals. Future interventions and PDSA cycles are targeted at improving attendance at scheduled appointments, reducing hospitalizations, decreasing 30-day readmissions, and shortening length of stay.
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One of the critical components in pain management is the assessment of pain. Multidimensional measurement tools capture multiple aspects of a patient's pain experience but can be cumbersome to administer in busy clinical settings. ⋯ Our review identified eight multidimensional pain measurement tools that nurses can use in ambulatory or acute care settings to capture patients' experience of pain. The most important element in selecting a multidimensional pain measure, though, is that one tool is selected that best fits the practice and is used consistently over time.
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Many patients in the intensive care unit (ICU) suffer from pain and are non-communicative. Therefore, alternative pain measures are necessary. Although behavioral pain measures are available, physiological measures are lacking. The Nociception Level index (NOL™) provides a value from combination of multiple physiological parameters to measure pain and its use in the ICU is new. ⋯ The study procedures with the NOL were found feasible; NOL values could discriminate between nociceptive and non-nociceptive procedures, and values were associated with reference pain measures. Further NOL testing is required in other ICU patient groups and procedures.
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Chronic tension type headache (CTTH) is one of the common cause of hospital visits among adolescents and adults. Chronic tension type headache produces pain, sleep disturbances, and disability among patients leading to a poor quality of life. Knowledge pattern of headache and various associated factors will aid appropriate management. ⋯ Patients with chronic tension-type headache experience moderate to high severity of headache, along with substantial duration and frequency, an outcome that was associated with various lifestyle-related factors that can result in stress. Lifestyle modification and nonpharmacological management are thus essential to reduce the severity, frequency, and duration of headache in patients with a chronic tension-type headache and medication overuse.