Pain management nursing : official journal of the American Society of Pain Management Nurses
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Across all care settings for older patients, pain is often ineffectively managed. A gap still exists between best-practice recommendations for pain assessment/treatment and current clinical practice, despite the availability of guidelines. Using a validated pain scale is critical to objectively evaluate pain intensity. ⋯ Pain undertreatment is a particularly important phenomenon to address, because unrelieved persistent pain can significantly affect older individuals. Approaches tailored to an individual's needs and supported by the best available evidence should be implemented to improve patient outcomes and to increase the consistency with which care is delivered to the growing population of older Americans. The goal of this paper was to provide current evidence-based strategies and tools for pain assessment in older adults, including those with cognitive impairment.
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Postoperative pain is a subjective concept that can only be defined by the individual experiencing it. This research was planned as a descriptive study to make postoperative pain assessments of patients who have undergone major orthopedic surgery. The study sample consisted of 150 patients who met the inclusion criteria and agreed to participate in the study. ⋯ Statistically significant differences were found between patients' pain severity scores (p
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Interference of postoperative pain on women's daily life after early discharge from cardiac surgery.
Women report more postoperative pain and problems performing domestic activities than men in the first month of recovery after cardiac surgery. The purpose of this article is to describe how women rate and describe pain interference with daily life after early discharge from cardiac surgery. A qualitative study was conducted in 2004-2005 with ten women recruited from a large Norwegian university hospital before discharge from their first elective cardiac surgery. ⋯ Despite being advised at the hospital to take pain medication regularly, few women consumed the maximum amount of analgesics. Early hospital discharge after open cardiac surgery implies increased patient participation in pain management. Women undergoing this surgery need more information in hospital on why postoperative pain management beyond simple pain relief is important.
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Feasibility and clinical utility are essential characteristics to consider when it comes to developing or selecting a pain assessment tool to implement into practice. However, these characteristics have not been widely studied with available pain assessment tools in critically ill adults. The objective of this study was to describe nurses' evaluations of the feasibility and clinical utility of the Critical-Care Pain Observation Tool (CPOT) in assessing pain in critically ill ventilated adults. ⋯ On the other hand, six nurses mentioned that they were already sensitive to nonverbal cues of pain before the introduction of the CPOT. In conclusion, the CPOT is a valid behavioral pain scale, which has been suggested by experts in recent critical reviews. So far, the CPOT is being used for research purposes and has been implemented into clinical practice of various health care centers of North America.
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Opioid therapy has been shown to decrease pain intensity, restore levels of function, and improve quality of life for adults with chronic pain. Even so, opioids are rarely used as a long-term treatment option, and the prescription of opioid analgesics for managing chronic nonmalignant pain has remained a highly debated treatment modality. This ongoing debate has resulted in a stigma being associated with both the treatment modality and those individuals receiving it. ⋯ Overall, the data reflected that these individuals encounter much stigma surrounding their pain management regimen, and that the routine course of maintaining that regimen is fraught with barriers. These barriers arise from family, the health care system, and society at large. Awareness of the life-enhancing benefits of opioid therapy in adults with chronic nonmalignant pain, as well as the stigma and barriers that they encounter, will enable clinicians to intervene appropriately and to act as advocates on behalf of adults using chronic opioid therapy.