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Nursing Pain

Susan V Brammer
SPECIFIC CLINICAL ISSUE: The purpose of this clinical consultation is to offer nurses evidence-based strategies to provide holistic care to their patients with comorbid depression and pain. The combination of depression and pain is common and, if not managed effectively, has negative outcomes. Treatment-resistance is one negative outcome. The worst-case scenario for unrelieved depression and/or pain is suicide. MAJOR PRACTICE RECOMMENDATIONS BASED ON BEST EVIDENCE: Antidepressants, particularly duloxetine, have had efficacy for pain and depression...
October 17, 2018: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
Jessica S Merlin, Kanan Patel, Nicole Thompson, Jennifer Kapo, Frank Keefe, Jane Liebschutz, Judith Paice, Tamara Somers, Joanna Starrels, Julie Childers, Yael Schenker, Christine S Ritchie
CONTEXT: Chronic pain, or pain lasting > 3 months, is common among cancer survivors, who are often prescribed long-term opioid therapy (LTOT). OBJECTIVE: Our objective was to explore palliative care providers' experiences with managing chronic pain in cancer survivors prescribed LTOT, specifically in ambulatory palliative care settings, and their strategies for overcoming challenges. METHODS: We recruited providers through leading national palliative care organizations who manage chronic pain in cancer survivors...
October 17, 2018: Journal of Pain and Symptom Management
Jun Wang, Yin Wang, Hui Zhang, Ming Lu, Weilu Gao, Li Yin, Zongsheng Yin
INTRODUCTION: Osteoarthritis is a common degenerative joint disease that eventually leads to disability and poor quality of life. The main symptoms are joint pain and mobility disorders. If the patient has severe pain or other analgesics are contraindicated, opioids may be a viable treatment option. To evaluate and compare the efficacy and safety of opioids in the treatment of knee or hip osteoarthritis, we will integrate direct and indirect evidence using a Bayesian network meta-analysis to establish hierarchies of these drugs...
October 18, 2018: BMJ Open
Eunhea You, David Kim, Ryan Harris, Karen D'Alonzo
OBJECTIVE: Nearly half of hospitalized patients in the United States have reported experiencing pain even while undergoing treatment for pain. Analgesic use is the most common type of treatment for pain management. Many patients who experience pain seek nonpharmacologic interventions to manage their pain, including forms of complementary or alternative medicine such as auricular acupressure (AA). DESIGN: This study conducted the first systematic review of the studies that have evaluated the effect of AA as an adjunct on pain management...
October 16, 2018: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
Ann Quinlan-Colwell, Kathleen Broglio, Diana Rae, Debra J Drew, Carolyn C Brown, Kimberly Fetty
BACKGROUND: A task force of members of the American Society for Pain Management Nursing (ASPMN) authored a position paper "Prescribing and Administering Opioid Doses Based Solely on Pain Intensity." Some of the authors of this ASPMN position paper presented a concurrent session at the September 2016 ASPMN National Conference discussing the content of the position paper. As a follow-up, the authors designed a research study to identify the impact of the position statement in facilitating change in institutional practice of dosing analgesics based solely on pain intensity...
October 16, 2018: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
Shahnaz Mohammed Ayasrah
PURPOSE: To investigate pain levels and factors that are predictive of pain for mechanically ventilated patients during rest and during routine nursing procedures. MATERIAL AND METHODS: Pain levels were assessed using Behavioral Pain Scale (BPS) and physiological measures among 247 mechanically ventilated patients. RESULTS: At rest, 33.2% of patients suffered pain, with a BPS > 3; of these, 10% presented significant pain levels (BPS ≥ 5)...
October 13, 2018: Journal of Critical Care
Kine Gjesdal, Elin Dysvik, Bodil Furnes
Aim: To explore the experiences with healthcare received by people living with chronic nonmalignant pain in Norway. Design: A descriptive and explorative qualitative design. Methods: A total of 18 individual semistructured interviews was conducted in 2015. Qualitative content analysis was applied. Results: The findings revealed challenges related to a multifaceted pain condition. Participants described interactions with a supportive health care where being listened to, believed in and experiencing mutual trust were emphasized...
October 2018: Nursing Open
Catherine Haighton, Jess Kidd, Amy O'Donnell, Graeme Wilson, Karen McCabe, Jonathan Ling
BACKGROUND: Concurrent alcohol and medication use can result in significant problems especially in mid to later life. Alcohol is often used instead of medication for a number of health-related conditions. This novel qualitative study explored concurrent alcohol and medication use, as well as the use of alcohol for medicinal purposes, in a sample of individuals in mid to later life. METHODS: Twenty-four interviews (12 men/12 women, ages 51-90 years) and three focus groups (n = 27, 6 men/21 women, ages 50-95 years) from three branches of Age UK and two services for alcohol problems in North East England...
2018: PloS One
Cheryl Rodgers, Marika Highberger, Kimberly Powers, Katherine Voigt, Christian Douglas
BACKGROUND: Adolescents undergoing allogeneic hematopoietic stem cell transplantation (HSCT) experience multiple symptoms during and after the transplant. These symptoms can increase the need for medical care and reduce the quality of their life. However, little is known about symptom experiences specific to adolescents undergoing HSCT. OBJECTIVE: The primary aim was to describe symptom incidence, severity, and distress trajectories among adolescents from pre-HSCT through 90 days post-HSCT...
October 17, 2018: Cancer Nursing
Deborah S Keller, Jianying Zhang, Manish Chand
BACKGROUND: Opioids are a mainstay for postsurgical pain management, but have associated complications and costs, and contribute to the opioid epidemic. While efforts to reduce opioid use exist, little study has been done on opioid utilization and its impact across surgical approaches. Our goal was to evaluate the impact of opioid utilization on quality measures and costs after open and laparoscopic colorectal surgery. METHODS: The Premier database was reviewed for inpatient colorectal procedures from January 01, 2014, to September 30, 2015...
October 17, 2018: Surgical Endoscopy
K Blanck-Köster, T Becker, U Gaidys, C Keienburg, A Kaltwasser, A Schäfer
Demographic changes in Germany means that nursing and medical care is becoming increasingly complex. This is especially true for intensive care. Despite the closure of hospitals in Germany, the number of beds in intensive care units rose between 2002 from 23,113 to 26,162 in 2010. At the same time the number of patients treated in intensive care units increased by 148,989 to 2,049,888. The increasing complexity requires specific education for nurses in intensive care based on a model of advanced nursing practice (ANP)...
October 16, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
Virginie Prevost, Bénédicte Clarisse, Natacha Heutte, Alexandra Leconte, Cécile Bisson, Rachel Bignon, Sonia Cauchin, Maryline Feuillet, Sylvie Gehanne, Maud Gicquère, Marie-Christine Grach, Cyril Guillaumé, Christine Le Gal, Joelle Le Garrec, Franck Lecaer, Isabelle Lepleux, Anne-Laure Millet, Marie-Claude Ropartz, Nathalie Roux, Virith Sep Hieng, Carole Van Delook, Constance Bechet, Aline Le Chevalier, Claire Delorme
Pain, one of the most feared symptoms for patients with cancer, remains insufficiently alleviated and impairs quality of life. Therapeutic patient education (TPE) is a relevant approach to this problem while allowing patients to develop skills to better manage their pain. In the "Basse-Normandie" French region, the management of pain relies on two organized networks, thus allowing proximity and accessibility for all concerned. In this context, our team has begun a broad five-step research program that is part of a regional health policy: (1) training in TPE of 10 doctor/nurse pairs; (2) identification of educational expectations of patients and their relatives in the field of cancer pain; (3) design and optimization of a TPE program dedicated to cancer pain; (4) regional pilot study aiming to assess the feasibility, quality and transferability of the program; (5) evaluation of the TPE program by interventional comparative randomization at the national level...
October 13, 2018: Bulletin du Cancer
Emily O Wakefield, William T Zempsky, Rebecca M Puhl, Mark D Litt
Introduction: Chronic pain in adolescents is a significant medical condition, affecting the physical and psychological well-being of youth and their families. Pain-related stigma is a significant psychosocial factor in adolescents with chronic pain that has been understudied, despite its implications for negative health outcomes, poor quality of life, and increased healthcare utilization. Objectives: To examine pain-related stigma in the literature documenting pediatric and adult health-related stigma and present preliminary findings from a focus group of adolescents with chronic pain...
September 2018: Pain Reports (Baltimore, Md.)
Peter B White, Alberto V Carli, Morteza Meftah, Narges Ghazi, Michael M Alexiades, Russell E Windsor, Amar S Ranawat
The purpose of this study was to determine if there is a difference in the number of diagnostic tests and interventions, pain and function scores, or satisfaction of patients discharged to inpatient rehabilitation facilities vs to home. From February to May 2015, 171 consecutive patients were prospectively recruited following primary total knee arthroplasty. Six weeks postoperatively, based on the patients' recollections, the number and types of diagnostic imaging tests, number of blood transfusions, and overall satisfaction whether discharged to inpatient rehabilitation facilities (n=85) or to home (n=86) were assessed...
October 15, 2018: Orthopedics
Helen Sisson, Yvonne Wilkinson
The human papillomavirus (HPV) vaccine is a key intervention in the prevention of HPV infection and associated cancers. This review emphasizes the importance of understanding what influences decision-making about this vaccine. Guided by the work of Whittemore and Knafl, and Pluye and Hong, we identified 25 studies, from which four prominent themes emerged: fear and risk, pain, parental involvement, and involvement of others. Fear of cervical cancer was a strong motivation to receive the vaccine, and the extent of parental involvement also had an impact on decision-making...
October 15, 2018: Journal of School Nursing: the Official Publication of the National Association of School Nurses
Jane L Phillips, Nicole Heneka, Louise Hickman, Lawrence Lam
BACKGROUND: Pain is highly prevalent in all health care settings, and frequently poorly managed. Effective pain management is predicated on a continuous cycle of screening, assessing, intervening and evaluating. Identifying gaps in nurses' self-perceived pain assessment competencies is an essential first step in the design of tailored interventions to embed effective pain assessment into routine clinical practice, and improve patient reported pain outcomes. Yet, few validated instruments focus on the competencies required for undertaking a comprehensive pain assessment, with most focusing on clinician's pain management competencies...
October 10, 2018: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
Salehoddin Bouya, Abbas Balouchi, Abdulbaset Maleknejad, Maryam Koochakzai, Esra AlKhasawneh, Abdolghani Abdollahimohammad
The current study evaluated the oncology nurse's knowledge, attitude, related factors of cancer-related pain management (CPM), and clinical recommendations for improving knowledge and attitude. In this systematic review, international databases (PubMed, EMBASE, Web of science (WOS), Science Direct, and Scopus) were searched for relevant studies published in English language from March 30, 2000 to March 30, 2018. The quality of the studies was evaluated using the Hoy instrument. Out of 888 initial studies, 12 studies performed on 3574 participants were included in the final stage of the review...
October 12, 2018: Journal of Cancer Education: the Official Journal of the American Association for Cancer Education
Margaret Louise Phillips, Vijo Kuruvilla, Michael Bailey
BACKGROUND: Pain is a common stressor for ICU patients, necessitating routine assessment. For patients who are unable to communicate, self-report tools are unsuitable, and the use of an observational tool is required to assess pain appropriately. The Critical Care Pain Observation Tool (CPOT) is the most reliable tool currently available to assess pain in these patients. We investigated whether the implementation of the CPOT in one Australian ICU could increase frequency of appropriate pain assessments, and if this would affect the administration of analgesia and sedation...
October 9, 2018: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
Mariana Del Grossi Moura, Luciane Cruz Lopes, Marcus Tolentino Silva, Sílvio Barberato-Filho, Rogério Heládio Lopes Motta, Cristiane de Cássia Bergamaschi
BACKGROUND: Rheumatoid arthritis affects 1% of the world's population and its current treatment options are costly. There are not enough studies that evaluated the efficacy and safety of anti-inflammatory drugs medications used to reduce rheumatoid arthritis's symptoms. This study will evaluate the effectiveness and the safety of steroid and nonsteroidal anti-inflammatory drugs for the treatment of patients with rheumatoid arthritis. METHODS: Randomized clinical trials eligible for our systematic review will enroll adults with rheumatoid arthritis treated with anti-inflammatory drugs compared with a control group (placebo or active control) at any dose, duration, and route of administration and double blind studies...
October 2018: Medicine (Baltimore)
Nigel Lee, Julie Jomeen, Lena B Mårtensson, Vanessa Emery, Sue Kildea
BACKGROUND: The use of sterile water injections (SWI) for the relief of pain in labour is popular amongst midwives in countries such as Sweden and Australia. Anecdotal reports suggest the procedure is used less commonly in the United Kingdom (UK) and that a number of barriers to introducing the practice may exist. OBJECTIVE: The objective of this study was to explore the awareness and use of SWI amongst midwives in the UK. DESIGN: A cross-sectional study using an internet-based questionnaire...
October 3, 2018: Midwifery
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