Pain management nursing : official journal of the American Society of Pain Management Nurses
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Up to 80% of cancer patients in Kenya suffer from untreated moderate to severe pain. ⋯ Interventions should streamline palliative care training and implementation of pain management guidelines in both units. Interventions should consider the influence of different subcultures while implementing pain management policies and training.
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A key to successful symptom management in patients with cancer is to adapt the treatment to patient needs and complexities in an individual and dynamic manner. Rapid access to a clinician via telephone consultation supports treatment compliance, safety, and effectiveness and reduces the number of patients unnecessarily consulting emergency departments. ⋯ A telephone call service available for patients and other clinicians is an efficient way to enhance continuity of care for ambulatory patients. Continued efforts to make such a service cost effective must be implemented.
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Fibromyalgia (FM) is associated with debilitating pain and a reduced heart rate variability (HRV), reflecting decreased emotional adaptability and resistance to stress. Common pharmacological treatments are ineffective, and opioids are highly addictive and cause an estimated 15,000 overdose deaths per year. Effective recommendations include patient-centered interventions like physical activity, cognitive behavioral therapy, and biofeedback. Heart rate variability biofeedback (HRVB) may be effective in improving HRV, thus increasing stress resistance and emotional adaptability and reducing pain. ⋯ The reviewed studies had methodological flaws. However, HRVB is a promising treatment for chronic pain. Larger, randomized controlled studies are needed to thoroughly evaluate the relationship between HRVB and FM pain.
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The rarity of perianesthetic catastrophic events creates a challenge in training support staff in the treatment of emergencies such as local anesthetic systemic toxicity (LAST). Simulation learning offers a unique venue in which to safely encounter rare events. ⋯ Experiential learning often results in significant knowledge acquisition and retention. Participants in this study improved their test scores regarding LAST and increased their sense of self-efficacy and ability to handle crisis scenarios after taking part in a high-fidelity simulation.