Pain management nursing : official journal of the American Society of Pain Management Nurses
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Review Meta Analysis
The impact of Nonpharmacological Interventions on Cortisol During Heel Lance Procedures on Preterm Infants: A Meta-Analysis Of RCTs.
Current research suggests a need to implement environmental, behavioral, and even nutritional interventions, with the objective of improving the comfort and stability of preterm newborn infants, as well as reducing their stress and pain levels. Several studies have used the salivary reactivity of cortisol to assess stress or pain in preterm infants. The aim of this study was to analyze the results of published randomized controlled trials that tested the effects of nonpharmacological interventions on cortisol as a treatment for heel lance pain/stress in preterm infants. ⋯ Future studies should be performed on nonpainful interventions in order to gain more knowledge about the regulation of cortisol in saliva in preterm infants with involving control group and larger sample sizes.
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Emotion regulation is a regulatory process to modify emotional activation in a wide range of situations and shows potential effects to reduce pain and emotional distress. The purpose of this review was to enhance an understanding of the role of emotion regulation strategies and their outcomes in reducing women's pain from labor to 3 months postpartum. ⋯ Both mindfulness and distraction would be offered to pregnant women as part of alternative self-pain management strategies to prepare them for dealing with pain and other discomforts. Future research needs to test the effects of the intervention beyond childbirth.
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Acupuncture is practiced in many Western countries with increasing evidence supporting its use across the healthcare system. However, this nonpharmacological intervention is yet to be widely integrated into hospitals. Fundamental to the integration of any innovation into healthcare systems is the attitudes of healthcare professionals. ⋯ Healthcare professionals' attitudes to acupuncture are positive. Barriers to integrating acupuncture into the hospital system exist at intrapersonal, interpersonal, and external levels, with lack of resources being the key barrier. Nurses' role in facilitating integration into Western medical pain management practice provides an avenue for future research. The proposed conceptual framework provides guidance for nursing researchers interested in the role of acupuncture and integrated medicine in patient-centric, value-based healthcare.
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The demand for access to Australian pain management services is growing. The dual crisis of opioid misuse and chronic pain, means pain nurses and nurse practitioners (NPs) have a unique opportunity to meet clinical demands and advance their scope of practice. ⋯ Pain nurses have a breadth of knowledge and experience highlight they can contribute to opioid management in the future, with the support of policy and organizations.
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It is morally distressing when a healthcare provider sees patients with undertreated pain but is unable to provide adequate relief because of a surrogate's refusal of such treatment. This issue might occur when there is no clear advanced directive that represents patients' wishes for treatment, and can be further complicated when patients are of minority cultural backgrounds. ⋯ This case highlights the ethical dilemma of withholding opioid treatment in a patient with advanced cancer. We conclude that the obligation to treat pain should be understood beyond the authority of surrogate refusal, in favor of patient quality of life, when an advance directive is not in place.