Articles: pain-management-methods.
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Purpose: To prioritize outcome domains sensitive to the needs of the various stakeholders involved in rehabilitation programs designed for youth with pain-related disability using the International Classification of Function Child and Youth version. Materials and methods: A 5-step nominal group technique was conducted with 13 stakeholders, including two youth with pain-related disability, two parents, five clinicians, two teachers, and two healthcare managers. Once identified by content thematic analysis and International Classification of Function linking, 15 outcome domains were ranked. ⋯ The consensus processes employed allowed for the reconciliation of the different priorities, and the achievement of agreement on participation in life and its related activities as a key desired outcome of rehabilitation programs for youth with pain-related disability. The use of the ICF-CY framework allowed a broader conceptualization of the rehabilitation outcome domains, and the examination of areas beyond reduction of pain, disability and impairment to include functional aspects such as self-care, daily routine and mobility activities, and meaningful participation in life, fostering social roles and responsibilities, and school engagement. As participation in life and its related tasks and activities were key outcomes for all stakeholders, they should be the focus of clinicians' treatment.
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The American surgeon · Jun 2020
Observational StudyAssessment of Unused Opioids Following Ambulatory Surgery.
Surgery is a risk factor for opioid initiation and subsequent abuse. Discharge opioid prescription patterns after surgery are often varied and not evidence based, which may lead to unnecessary prescription of opioids. We aimed to assess opioid prescribing and unused opioid prescriptions in ambulatory surgery patients at our academic hospital. ⋯ Opioid prescribing and unused opioid prescriptions are prevalent in our hospital's ambulatory surgical population. Patients undergoing selected ambulatory surgical procedures may not require as much opioid as is currently being prescribed.
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Anesthesia and analgesia · Jun 2020
Multicenter Study Observational StudyMulticenter Perioperative Outcomes Group Enhanced Observation Study Postoperative Pain Profiles, Analgesic Use, and Transition to Chronic Pain and Excessive and Prolonged Opioid Use Patterns Methodology.
To study the impact of anesthesia opioid-related outcomes and acute and chronic postsurgical pain, we organized a multicenter study that comprehensively combined detailed perioperative data elements from multiple institutions. By combining pre- and postoperative patient-reported outcomes with automatically extracted high-resolution intraoperative data obtained through the Multicenter Perioperative Outcomes Group (MPOG), the authors sought to describe the impact of patient characteristics, preoperative psychological factors, surgical procedure, anesthetic course, postoperative pain management, and postdischarge pain management on postdischarge pain profiles and opioid consumption patterns. ⋯ Therefore, the study serves as a model for future studies using this innovative method. Full results will be reported in future articles; the purpose of this article is to describe the methods of this study.
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To investigate the level of knowledge and attitudes related to pain management among nurses and physicians working in primary medical centres in Jordan. ⋯ The result of this study indicated that Jordanian healthcare professionals have a low level of knowledge and negative attitudes toward pain management, so educational programmes related to the topic are strongly recommended. The findings also revealed a discrepancy between knowledge and practice. Therefore, guidelines and protocols related to pain assessment and management should be designed and implemented to bridge the gap between knowledge and practice.
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Anesthesia and analgesia · Jun 2020
Addressing the Challenge of Pain Education in Low-Resource Countries: Essential Pain Management in Papua New Guinea.
Papua New Guinea (PNG) is a low-resource country in the South-West Pacific with considerable health care challenges, including a high burden of painful disease. The Essential Pain Management (EPM) educational program was developed to address the challenge of inadequate pain education in PNG and the first workshop was held in 2010. The aims of EPM are to improve pain knowledge, teach a simple system for managing pain, and address local pain management barriers. ⋯ There are still significant challenges, including a lack of funding, limited uptake at undergraduate level, the need for more formal evaluation of clinical impact, and the requirement for an all-of-system approach to improve pain management in PNG. Worldwide, EPM has now been taught in more than 60 countries. Our priorities for coming years include support for embedding EPM into health care systems and teaching programs, increased mentorship for instructors, assistance with overcoming local pain management barriers, and development of specific projects that will assess the impact of EPM education on patient outcomes.