Pain management nursing : official journal of the American Society of Pain Management Nurses
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The decision to include a Spanish-speaking sample in a study of pain in children with leukemia necessitated translation of the data collection tools. Therefore, the Adolescent Pediatric Pain Tool (APPT) was translated by using the standard translation, back-translation procedure. The Spanish word list consists of 66 descriptors in the sensory, affective, evaluative, and temporal domains. ⋯ Two of these studies were completed with well children and adolescents, and one study that was part of a clinical research project focused on pain in children and adolescents with leukemia. Although content; construct, concurrent validity; and test-retest reliability were tested, further studies are necessary with larger populations of children and adolescents. This series of pilot studies supports the usefulness of the Spanish translation of the APPT word list, particularly for clinical or research situations in which multiple versions of a tool would counteract ease of use.
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Although sedation is acknowledged to be one of the most common side effects of opioid analgesics, the mechanisms and characteristics of this phenomenon remain elusive, and research in this area is extremely limited. This report integrates research findings on the mechanism of action of opioids with research findings on the phenomenon of consciousness to develop a model of how opioids may act in the central nervous system to produce sedation. Based on this integration, a definition of opioid-induced sedation is proposed to encourage dialogue and research on this perplexing and clinically significant phenomenon.
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Clinical Trial
An examination of critical care nurses' knowledge and attitudes regarding pain management in hospitalized patients.
The purpose of this study was to determine the effectiveness of an educational intervention focused on pain management. The sample consisted of 30 medical/surgical intensive care nurses (age range, 23 to 62 years) employed in a large metropolitan hospital in the southeastern United States. McCaffery and Ferrell's Nurses' Knowledge and Attitude Survey Regarding Pain was administered at 2 points in time: before and after the educational program. ⋯ These results support previous research findings related to the problem of inadequate pain management in the hospital setting. Further, the findings indicate that education regarding pain control is crucial for current nursing students as well as practicing nurses. The challenge for nurses is to be responsive to and integrate current pain management techniques in an effort to decrease the discomfort of hospitalized patients.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Documentation of pain assessment and treatment: how are we doing?
The purpose of this analysis was to evaluate documentation of practice provided by a multidisciplinary team of nurses, physicians, and pharmacists who participated in an educational program on postoperative pain management. Chart audit of 787 patient charts at 6 sites revealed documentation of pain histories in approximately 75% of the charts, most often in the surgeon's history and physical examination. Examination of multiple assessment items indicated that the experimental group, relative to the control group, experienced an increase of more than 10% in the documentation of pain intensity, pain quality, pain duration, numeric rating scale used, pain behavior, factors that increase pain, vital signs, sedation level, cognitive status, social interaction, and mood from before the program to 6 months after the program. ⋯ Calculation of documentation of 4 items that constituted a focused assessment of postoperative pain on the surgical floor revealed a significant program effect for assessment of pain quality and pain intensity. A postprogram survey of participants in the educational program revealed an increase in discussion of postoperative pain management with other practitioners and an increase in use of a 0 to 10 scale to rate pain. More documentation of patient pain history, clinical problems, treatment, and follow-up action is needed to improve practice and research.
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The purposes of the study were to describe outcomes of pain management and predictors of patient satisfaction in a minority sample. By using a survey design, 3 instruments were used to collect data: (1) The American Pain Society's Patient Outcome Questionnaire-Modified, a 16-item self-report tool about pain and patient satisfaction; (2) a demographic form; and (3) the Pain Management Index. The sample consisted of 104 hospitalized Hispanic inpatients in a Rio Grande Valley hospital. ⋯ By using logistic regression, satisfaction with pain management was predicted by general pain in the last 24 hours (odds ratio = 4.02), pain-related interference with mood (odds ratio = 7.31), and age (odds ratio = 1.8). Clinical implications include the need to apply standardized guidelines, such as those from the Agency for Health Care Policy and Research, and to educate patients, particularly minority elders, about pain management approaches. The emergence of Hispanics as the fastest growing minority group increases the need for research regarding pain management outcomes to plan more effective intervention.