Pain management nursing : official journal of the American Society of Pain Management Nurses
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Migraine is a significant pain problem for almost one third of women in the United States. Little previous research has been conducted regarding the effects of migraine headache on the lives of women migraineurs. The purpose of this report is to determine the contribution of coping, depressive symptomatology, and the chronic pain experience on disability and quality of life in women with migraine. ⋯ In the second regression analysis, 64.8% of the variance in quality of life was accounted for by depressive symptomatology, migraine headache pain, and the chronic pain experience. The variance in both outcome variables, disability and quality of life, was accounted for by similar predictor variables: depressive symptomatology, the chronic pain experience, and migraine headache pain. Further study is needed to determine specific personal and illness-related factors, pain characteristics, and coping strategies used that may predict outcomes of migraine headache such as disability, quality of life, helplessness, and other as yet unidentified effects of migraine headache.
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Methods to treat cancer pain effectively have existed for more than 2 decades. However, the effective treatment of cancer pain continues to elude many patients with cancer who suffer from poor management. Although efforts to address the problem of cancer pain in the United States have acknowledged the importance of patient education and advocacy, few endeavors, to date, have attended to the special needs of inner-city, low-literacy, or socioeconomically disadvantaged patients from minority cultural groups. ⋯ The focus group approach was used to develop materials that would empower patients and families to more effectively participate in pain management when working with health care providers from cultures other than their own. Qualitative data analysis methods were used to analyze transcripts of taped focus group sessions. Themes emerged from the data regarding pain and its culturally competent management as well as the group process of booklet development.
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The purpose of this study was to determine the knowledge base of long-term care nurses regarding pain assessment and management in the elderly. Three specific themes related to long-term care nurses were investigated: personal beliefs regarding patients' self-reports of pain, documentation of patients' self-reports of pain, and choice of pain medication and dose. Eighty-nine long-term care nurses, from 6 rural counties in California, responded to a questionnaire that consisted of 2 patient scenarios. ⋯ Older nurses with more experience were less likely to believe or document their patient's self-report of pain than younger nurses with fewer years of experience. Less than half of the nurses would increase the analgesic dose for either patient scenario. Nursing implications include the importance of ongoing pain assessment and management education tailored to the geriatric population and long-term care.
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This article provides a descriptive profile of pain in 80 women during the first 2 days after gynecologic surgery in 4 hospitals. Surgical procedures included abdominal hysterectomy, oophorectomy, and laparotomy. Average pain was moderate on both days, but paired t tests indicated that pain increased significantly during ambulation on day 1 (P = .009, sensation; P < .001, distress) and on day 2 (P = .007, sensation; P = .030, distress). ⋯ Although 41% of the women had previously used relaxation techniques for stress or pain, only 9% used it for pain after surgery. Results suggest that postoperative patients have moderate to severe pain that is incompletely relieved with patient-controlled analgesia. Nurses should encourage patients to press the patient-controlled analgesia button more often, report unrelieved pain, and use nonpharmacologic interventions.
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Multicenter Study
Nurses' personal opinions about patients' pain and their effect on recorded assessments and titration of opioid doses.
In many clinical settings, nurses have a vital role in pain assessment and titration of opioid doses. Surveys of nurses have revealed knowledge deficits in these areas that are thought to contribute to under-treatment of pain. ⋯ Nurses are less likely to increase a previously safe but ineffective dose of opioid for a smiling patient than a grimacing patient. Survey results reveal a tendency for nurses' personal opinions about the patients' pain, rather than their recorded assessments, to influence choice of opioid dose and to contribute to undertreatment of pain.