Pain management nursing : official journal of the American Society of Pain Management Nurses
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Several studies have outlined the impact of patient's beliefs on their level of pain relief after surgery and have underlined that misconceptions are barriers to effective pain relief. The aim of this survey was to evaluate the beliefs of the patients to help create a specifically adapted pain education program. After ethics approval, all patients scheduled to undergo cardiac surgery of any kind were approached and asked to complete a voluntary, non-nominative questionnaire that included the Barriers Questionnaire and the Screening Tool for Addiction Risk (STAR) Questionnaire. ⋯ The average age was 60.3 years, and 66.0% were male. Results of the Barriers Questionnaire showed that 31% of patients were in strong agreement that "it is easy to become addicted to pain medication," 20% agreed that "good patients do not speak of their pain," and 36% believe that "pain medication should be saved in case pain worsens." Little or no gains have been made in decreasing misconceptions related to the treatment of pain. This study underlines the considerable need for and absolute necessity to provide pain education to patients undergoing cardiac surgery.
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Adverse events secondary to opioid-induced advancing sedation and respiratory depression continue to occur during hospitalizations despite efforts to increase awareness and clinical practice guidelines to address prevention strategies. In 2009, ASPMN surveyed membership on current practices surrounding this topic. ⋯ This is a report of the follow-up membership survey. In general, monitoring practices are slowly improving over time, but there are many facilities that have not instituted best practices for avoiding adverse events.
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In the United States it is estimated that over 30% of the population suffers from some form of chronic pain (Institute of Medicine of the National Academies Report, 2011). Therefore, it is likely that 30% of patients who are admitted to the hospital for acute care needs also have an underlying chronic pain issue. ⋯ Although there is a significant body of research related to the management of acute pain (Bell & Duffy, 2009; Brennen, Obs, Carr, & Cousins, 2007; Dihle, Bjolseth, & Helseth, 2006; McDonnell, Nicholl, & Read, 2003; Wang & Tsai, 2010) and the management of chronic pain (Bruckenthal, 2010; Clarke & Iphofen, 2005; Kaasalainen et al., 2011; Matthews & Malcom, 2007; Papaleontiou et al., 2010, Reid et al., 2008), few studies were found that explained how nurses care for patients with pre-existing chronic pain in the acute care setting. The purpose of this study was to develop a theoretical understanding of nurses' assessment and decision-making behaviors related to the care of patients with chronic pain in the acute care setting.
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Adolescent pediatric pain tool for multidimensional measurement of pain in children and adolescents.
Very few multidimensional tools are available for measurement of pain in children and adolescents. We critically reviewed the scientific literature to examine the psychometrics and utility of the Adolescent Pediatric Pain Tool (APPT), a multidimensional self-report tool that evaluates the intensity, location, and quality (including affective, evaluative, sensory, and temporal) dimensions of pain. The APPT is available in English and Spanish for children and adolescents, and was modeled after the McGill Pain Questionnaire in adults. ⋯ The APPT is one of a few multidimensional pain measures that can help to advance the science of pediatric pain and its management. When the APPT is used in practice or research, the multiple dimensions of pain may be characterized and compared in different painful conditions. It may guide the use of multimodal interventions in children and adolescents with a variety of pain conditions.
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Comparing organizational approaches to pain management is warranted to understand best practices and provide decision makers with evidence on which to base resource intensive documentation policy decisions. To provide this evidence, a multilevel modeling (MLM) approach is required to accommodate the interrelatedness and nested nature of pain management factors affecting outcomes. Along with MLM, the widespread adoption of the electronic record provides an ability to capitalize on the repeated measurement benefit of the current pain management documentation output by using pain severity trajectory (PST) as a precise and clinically relevant outcome of interest. ⋯ The presentation of the reassessment data output posed a measurement limitation. An interdisciplinary research team is needed to adequately compare organizational practices. Basing policies on evidence has the potential to improve pain management care.