Pain management nursing : official journal of the American Society of Pain Management Nurses
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Public hospitals in Catalonia (Spain) recommend using the Spanish version of the Pain Assessment in Advanced Dementia (PAINAD-Sp) scale for assessing pain in adult patients unable to self-report. However, since its inclusion in Catalonian nursing care plans in 2010, there have been no training programs for nurses, contributing to its current underuse. ⋯ Theoretical and practical training may be an effective way to improve nurses' approach to identifying, assessing, and managing pain in patients unable to self-report.
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Enhancing pain patient's ability to function and cope is important, but assessing only intensity ignores those aspects of pain. The Functional Pain Scale (FPS), addresses these dimensions but lacked validation in hospitalized adults with chronic pain. ⋯ Although statistically significant, the reliability and validity of FPS were not as strong in hospitalized chronic pain patients as reported for older adults in other settings.
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A variety of valid tools are available to assess staff knowledge and attitudes regarding pain, among which is the Knowledge and Attitudes Survey Regarding Pain. Although this instrument has been widely and successfully used, a valid and adapted Spanish version is yet to be developed. The purpose of this study was to validate the Spanish version of the Knowledge and Attitudes Survey Regarding Pain. ⋯ Palliative care nurses had the highest score, 70.8%, which differed significantly from the rest of the groups. The Spanish version of the Knowledge and Attitudes Survey Regarding Pain can effectively differentiate nursing staff in terms of their pain expertise. The results indicate that Spanish nurses have a gap in pharmacologic knowledge that is comparable to that found in other countries, but their foundation in general pain concepts was solid.
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Managing pain in those vulnerable populations who are unable to self-report or communicate is challenging due to difficulty recognizing pain presence and severity. As no valid and reliable objective measure of pain exists, the ASPMN supports assessment practice recommendations that gather relevant information to infer presence of pain and evaluate response to intervention. Nurses and other healthcare professionals must be advocates for those who are unable to speak for themselves regarding their pain experience.
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Current guidelines support family members' participation in care, but little is known regarding their potential contribution to pain assessment using validated behavioral pain scales. ⋯ Future research is needed to explore the views of more family members and to compare their Critical-Care Pain Observation Tool scores to the ones of nurses' for interrater reliability testing.