Pain management nursing : official journal of the American Society of Pain Management Nurses
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Comparative Study
Effects of white noise and holding on pain perception in newborns.
This experimental study on newborns was conducted to compare the effects of various atraumatic care procedures during an infant's crying response to pain. Included in this study were 120 newborns chosen from among healthy infants admitted to the Obstetrics Department of Çanakkale State Hospital between April 2010 and June 2010. The patients were divided into three physically homogeneous groups. ⋯ The highest behavioral reaction was reported by those infants who were held by their mothers but did not listen to white noise. According to the results, white noise is an effective nonpharmacologic method to control pain, reduce crying time, and positively effect vital signs. Therefore, it is recommended that the use of white noise be practiced on newborns when they undergo painful procedures.
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An ongoing concern in long-term care (LTC) is that pain problems are often not identified correctly. There is also evidence that behavioral disturbance due to pain is misattributed to psychiatric conditions and consequently frequently treated with psychotropic rather than analgesic medication. This can result in unnecessary polypharmacy and ineffective pain management. ⋯ At the end of the study, residents in the pain assessment group were administered fewer psychotropic medications than patients in the control group, helping address the problem of polypharmacy. Pain levels were comparable between the groups. Health care staff indicated that the protocol resulted in more careful evaluation of residents' pain and greater appropriateness of prescriptions including reductions in polypharmacy.
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Certification is the outcome of the demonstration of knowledge and skills, which is an important link to licensing and credentialing. Considering the essential role that Certified Registered Nurse Anesthetists play in the practice of nonsurgical pain management, it is important that a certification process be developed that provides the necessary support to licensing and credentialing at the local, state, and federal levels. The goal of this project was to develop the foundational elements for a specialty certification in nonsurgical pain management. ⋯ Results of the query were compiled, analyzed, and compared to feedback about the elements from a sample of certified registered nurse anesthetists involved in nonsurgical pain management to assess reliability. The results provided identification of a target population for competency evaluation, tools for evaluation, resources for knowledge and skills testing, and a table of specifications for testing. A valid process to develop a specialty certification for nurse anesthetists with demonstration of knowledge and skills will help bridge the gap between continuing education and an actual demonstration that an individual practitioner possesses the necessary knowledge and skills to practice nonsurgical pain management.
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Elderly people with cognitive impairment are at risk for under-treatment of pain due to their inability to communicate. Poor knowledge and attitudes of nurses toward pain in this population may result in inadequate pain assessment. This study used a descriptive correlational design to develop and validate a tool to assess nurses' knowledge, attitudes, and reported practice of pain assessment in cognitively impaired elderly patients in acute care settings. ⋯ Cronbach's alphas for all factors were acceptable. TENAP was feasible, valid, and reliable for assessing nurses' knowledge, attitudes, and reported practice of pain assessment in cognitively-impaired elderly patients. Further testing of the tool with a larger sample of nurses in other practice contexts is needed.
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This study was designed to determine the prevalence of post-mastectomy pain and its associated risk factors in women submitted to surgical treatment for breast cancer. A cross-sectional cohort study was conducted involving 250 women treated surgically for breast cancer. The variables evaluated were (a) post-mastectomy pain syndrome (PMPS) (as a dependent variable or outcome) and (b) the patients' social characteristics (schooling, marital status), biological characteristics (body mass index, skin color, age), prior history of headache and dysmenorrhea, occurrence of acute postoperative pain, and type of surgery (mastectomy or quadrantectomy) (as independent or predictive variables). ⋯ The variables that remained strongly associated with PMPS following multiple logistic regression analysis were quadrantectomy with axillary lymphadenectomy (OR = 2.83; 95% CI: 1.60-5.02), prior history of headache (OR = 1.92; 95% CI: 1.10-3.34), and age <50 years (OR = 4.37; 95% CI: 2.43-7.86). PMPS is a common condition, particularly in women submitted to quadrantectomy with axillary lymphadenectomy, those under 50 years of age, and those with a prior history of headache. Attention should be paid to these factors at preoperative evaluation and counseling, and they should be taken into consideration in postoperative management.