Pain management nursing : official journal of the American Society of Pain Management Nurses
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Randomized Controlled Trial Clinical Trial
Music reduces sensation and distress of labor pain.
Labor pain is often severe, and analgesic medication may not be indicated. In this randomized controlled trial we examined the effects of music on sensation and distress of pain in Thai primiparous women during the active phase of labor. The gate control theory of pain was the theoretical framework for this study. ⋯ Distress was significantly lower than sensation in both groups (p <.05). In this controlled study, music--a mild to moderate strength intervention--consistently provided significant relief of severe pain across 3 hours of labor and delayed the increase of affective pain for 1 hour. Nurses can provide soft music to laboring women for greater pain relief during the active phase when contractions are strong and women suffer.
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Randomized Controlled Trial Comparative Study Clinical Trial
A study of the effectiveness of a pain management education booklet for parents of children having cardiac surgery.
Parents need education about pain so they can support their hospitalized child and manage their child's pain at home. The purpose of this study was to examine the effectiveness of a pain booklet on parental pain support to children experiencing postoperative pain. A randomized, repeated measures, experimental design using a pain education booklet and a standard care comparison group was used to study parents of 51 children (3 to 16 years of age) having cardiac surgery. ⋯ Child and parent pain ratings were significantly and positively correlated. Practice implications include the use of an educational booklet about pain with parents before surgery to increase their knowledge about and attitudes toward pain management. Additionally, a parent may provide an alternative pain report when a child is unable to or unwilling to self-report their pain.
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Comparative Study
Postoperative pain management on surgical wards--do quality assurance strategies result in long-term effects on staff member attitudes and clinical outcomes?
Postoperative pain management (POPM) remains suboptimal on surgical wards in many countries despite the availability of effective analgesics, new technologies for drug administration, and clinical practice guidelines for pain management. The aim of the present study was to assess remaining long-term effects on pain management routines, patient experiences, and staff member attitudes in surgical wards more than 3 years after introduction of a quality assurance program for POPM and compare the findings to those of an organization where a corresponding systematic, entire hospital, quality assurance program had not been completed. ⋯ The quality assurance program, anesthesia-based pain services using a nurse-based anesthesiologist-supervised model, resulted in more adequate pain management routines, better patient satisfaction with POPM, and increased confidence in pain management among nurses on the surgical wards. On the basis of the present study it may be concluded that more than 3 years after the introduction of a quality assurance program for POPM in surgical wards, the pain management routines, patient experiences, and staff member attitudes have remained markedly improved and in accordance with the aims of accepted clinical practice guidelines for surgical pain management.
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The aim of the current investigation was to examine the barriers encountered by Tasmanian registered nurses when attempting to provide optimal pain management. The impact of nurse satisfaction with their professional relationship with physicians during pain management on the types of barriers encountered was also examined. A total of 1,015 registered nurses completed a 21-item survey that examined the types of barriers encountered during pain management. ⋯ The barriers to effective pain management encountered by nurses were affected by their relationship with physicians. Education, for both nurses and physicians, concerning the role of the nurse in the workplace will help to ensure that nurses encounter fewer barriers during pain management. Optimal pain management practice will result if guidelines for dealing effectively with barriers are tailored to the specific type of institution and the unit within those institutions.
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The effective management of pain at the end of life relies on the accurate assessment of pain. Language is the mechanism through which pain is assessed using self-report pain tools. The purpose of this study was to explore how elderly hospice patients describe their pain and to compare their descriptions with three commonly used pain assessment tools (i.e., McGill Pain Questionnaire, Memorial Pain Assessment Card, and the Visual Analogue Scale). ⋯ In describing their pain, participants used many words, emphasized their pain by repeating those words, and used similes to describe their pain. The participants used approximately 30% of the standardized language found in three commonly used self-report instruments. These findings suggest that in conjunction with self-report instruments, the patient's own verbal descriptions should be used in the assessment of pain.