Pain management nursing : official journal of the American Society of Pain Management Nurses
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This paper reports a study of the perceptions of nursing staff regarding barriers to postoperative pain management in hip fracture patients with dementia, their expectations, and facilitators offered by their employers to overcome these barriers. Patients with dementia are at high risk for insufficient postoperative pain treatment, mainly owing to inability to articulate or convey their pain experience. Nursing staff have an essential role in the treatment and care of patients who are vulnerable, and therefore unable to advocate for their own pain treatment. ⋯ There were statistically significant differences between the sufficiency of pain management and barriers. Those who expected pain management to be insufficient identified more barriers than those who expected pain management to be sufficient (p < .001). Further updating education for nursing staff in pain detection and management is needed so that nursing staff are also able to recognize behavioral symptoms as potential signs of pain and provide appropriate pain management.
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For decades, nurses (RNs) have identified barriers to providing the optimal pain management that children deserve; yet no studies were found in the literature that assessed these barriers over time or across multiple pediatric hospitals. The purpose of this study was to reassess barriers that pediatric RNs perceive, and how they describe optimal pain management, 3 years after our initial assessment, collect quantitative data regarding barriers identified through comments during our initial assessment, and describe any changes over time. The Modified Barriers to Optimal Pain Management survey was used to measure barriers in both studies. ⋯ To our knowledge, this is the first study to reassess RNs' perceptions of barriers to pediatric pain management over time. While little change was seen in RNs' descriptions of optimal pain management or in RNs' perceptions of barriers, no single item was rated as more than a moderate barrier to pain management. The implications of these findings are discussed in the context of improvement strategies.
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The objective of this review is to evaluate the evidence regarding the use of music as an adjuvant therapy for pain control in hospitalized adults. The search terms music, music therapy, pain, adults, inpatient, and hospitalized were used to search the Cochrane Library, Cinahl, Medline, Natural Standard, and Scopus databases from January 2005 to March 2011. (A systematic review conducted by the Cochrane Collaboration has extensively covered the time frame from 1966 to 2004.) Seventeen randomized controlled trials met criteria for review and inclusion. ⋯ The combined findings of these studies provide support for the use of music as an adjuvant approach to pain control in hospitalized adults. The use of music is safe, inexpensive, and an independent nursing function that can be easily incorporated into the routine care of patients.
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Randomized Controlled Trial Multicenter Study
Effectiveness of a stretching exercise program on low back pain and exercise self-efficacy among nurses in Taiwan: a randomized clinical trial.
The purpose of this study was to examine the effectiveness of a stretching exercise program (SEP) on low back pain (LBP) and exercise self-efficacy among nurses in Taiwan. A total of 127 nurses, who had been experiencing LBP for longer than 6 months and had LBP with pain scores greater than 4 on the Visual Analogue Scale for Pain (VASP), were randomly assigned to an experimental group and a control group. The experimental group (n = 64) followed an SEP, whereas the control group (n = 63) was directed to perform usual activities for 50 minutes per time, three times a week. ⋯ A total of 81% of the participants in the experimental group reported a moderate to high level of LBP relief. The findings can be used to enhance self-care capabilities with SEP for nurses that experience LBP or are vulnerable to such work-related pain. SEP is an effective and safe nonpharmacological intervention for the management of LBP.
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Opioids represent a mainstay in the pharmacologic management of persistent pain. Although these drugs are intended to support improved comfort and function, the inherent risk of abuse or addiction must be considered in the delivery of care. The experience of living with persistent pain often includes depression, fear, loss, and anxiety, leading to feelings of hopelessness, helplessness, and spiritual crisis. ⋯ This companion article to the American Society for Pain Management Nursing "Position Statement on Pain Management in Patients with Substance Use Disorders" (2012) focuses on the intersection of persistent pain, substance use disorder (SUD), and chronic opioid therapy and the clinical implications of monitoring adherence with safe use of opioids for those with persistent pain. This paper presents an approach to the comprehensive assessment of persons with persistent pain when receiving opioid therapy by presenting an expansion of the biopsychosocial model to include spiritual factors associated with pain and SUD, thus formulating a biopsychosocial-spiritual approach to mitigate risk. Key principles are provided for adherence monitoring using the biopsychosocial-spiritual assessment model developed by the authors as a means of promoting sensitive and respectful care.