Pain management nursing : official journal of the American Society of Pain Management Nurses
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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.
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The purpose of this study was to determine the self-report pain rating scale(s) that can be used to quantify pain in elderly persons across cognitive functioning levels. Randomly selected elderly subjects (N = 100) completed the Short Portable Mental Status Questionnaire to categorize their level of cognitive impairment: intact (n = 36), mild (n = 9), moderate (n = 15), and severe (n = 40). Pain was measured with the Memorial Pain Assessment Card verbal subscale, FACES, COOP pain subscale, a numeric rating scale, and the Present Pain Intensity subscale of the McGill Pain Questionnaire. ⋯ Of the severely impaired, 30% were able to complete 1 or more pain assessment tools. Intraclass correlations showed a high degree of consistency among all pairs of tools (intraclass correlation > 0.74). We conclude that most elderly, with normal to moderately impaired cognitive functioning, as well as some severely impaired elderly, are capable of using self-report tools to rate their pain.
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Randomized Controlled Trial Multicenter Study Clinical Trial
An educational implementation of a cancer pain algorithm for ambulatory care.
Algorithms are proposed as a means of operationalizing guidelines or standards for cancer pain management. Professional education is used as the means to translate knowledge into practice. Outcomes measurement is the gold standard for validating improvement. ⋯ There was a clear deterioration in the impact of the training over time. The most significant effect occurred within the first 140 days after the intervention and was followed by a gradual return to baseline practice. In conclusion, algorithmic interventions can be successfully transferred into community practice, but further work must be performed to develop methods for securing retention of knowledge and maintaining improved outcomes.
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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.