Articles: pain-measurement.
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Observational Study
Predicting outcomes of acute low back pain patients in emergency department: A prospective observational cohort study.
Low back pain (LBP) is a common complaint among patients presenting to emergency department (ED) in Singapore. The STarT Back Screening Tool (SBT) was recently developed and validated for triage of LBP patients in primary care settings. This study aimed to investigate whether the SBT could provide prognostic information for long-term outcomes of acute LBP patients visiting the ED, who might benefit from appropriate and timely management at an earlier stage. ⋯ In the model, SBT total score and 6-week pain score were significantly associated with 6-month pain score (P < .05) with respective coefficients of 0.125 and 0.500. The model explained 40.1% of the variance for 6-month pain score. This study demonstrated that the multiple linear regression model showed predictive performance in determining long-term outcomes for acute LBP patients presenting to the ED.
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A valid and reliable instrument is needed to assess acute pain in critically ill patients unable to self-report and who may be transitioning between critical care and other settings. ⋯ The MOPAT can be used in the critical care setting as a helpful tool to assess pain in non-communicative patients. The MOPAT is unique in that the instrument can be used over time and across settings.
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The assessment of pain in patients with brain injury is challenging due to impaired ability to communicate. We aimed to test the reliability and validity of the critical-care pain observation tool (CPOT) and the bispectral index (BIS) for pain detection in critically brain-injured patients. This prospective observational study was conducted in a neurosurgical intensive care unit in a University-Affiliated Hospital. ⋯ Both CPOT and BIS increased significantly after suctioning (all P < .001) but remained unchanged after gentle touching (P ranging from .06 to .14). Our criterion and discriminant validity results supported the use of CPOT and BIS to detect pain in critically brain-injured patients. Combining use of CPOT and BIS in different ways might provide comprehensive pain assessment for different purposes.
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Pain assessment in older adults with cognitive impairment is often challenging, and paramedics are not given sufficient tools/training to assess pain. The development of a mobile app may improve pain assessment and management in this vulnerable population. We conducted usability testing of a newly developed iPhone pain assessment application with potential users, in this case as a tool for clinical paramedic practice to improve pain assessment of older adults with cognitive impairment. ⋯ Our results indicate that the pain assessment app constitutes a potentially useful tool in the prehospital setting. By providing access to a tool specifically developed to help identify/assess pain in a user-friendly format, paramedics are likely to have increased knowledge and confidence in assessing pain in patients with dementia.
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This study aimed to describe pain assessment and management practices for neonates based on nurses' perceptions in neonatal intensive care units (NICUs). ⋯ Educational interventions for nurses are needed to improve pain assessment and management practices in the NICUs. In addition, there is a need for national guidelines in order to ensure the equal treatment to all neonates.