Pain Management Nursing最新文献

Recognizing and managing pain is especially challenging for vulnerable populations who cannot communicate their discomfort. Because there is no valid and reliable objective measure of pain, the American Society for Pain Management Nursing advocates for comprehensive assessment practices articulated in a Hierarchy of Pain Assessment. These practices require gathering relevant information to infer the presence of pain and evaluate a patient's response to treatment. Nurses and other healthcare providers must be advocates for those who cannot communicate their pain experience.

Purpose: The aim of the study was to examine the hotspots and global trends of massage in nursing research.

Methods: Based on 241 articles published between 1993 and 2023 obtained from the Web of Science database, methods such as trend analysis and keyword frequency analysis were employed to analyze the evolution of research over time and identify key topics. Additionally, topic clustering of abstracts was conducted to examine thematic areas and connections within massage research.

Results: The analysis shows that the use of massage is prominent in specific fields such as oncology, pediatrics, gynecology, and obstetrics. An analysis of the most cited articles revealed that topics such as the effects of massage on cancer pain and anxiety and the use of complementary therapies in newborns were important. It was determined that the leading authors of massage research generally work in the fields of "massage," "nursing," "pain," "aromatherapy," "anxiety" and "complementary therapies." Collaboration between authors and countries, which is important in terms of global knowledge sharing, is almost nonexistent.

Conclusions: The results of the study show that massage research is particularly prominent in certain medical fields such as cancer and that studies on the effects of massage in these fields are important. Furthermore, the fact that the leading authors of massage research are often specialized in specific fields and that there is limited collaboration between authors plays an important role in determining the future directions of massage research and highlights the need to encourage interdisciplinary collaboration.

Purpose: Pain is a common symptom in cancer patients. It negatively impacts their emotional well-being, cognitive function, and daily communication, thereby reducing their overall quality of life. To enhance the quality of life of patients and their families, healthcare providers need to understand the factors that facilitate effective pain management. This study aimed to explore nurses' perceptions of the factors that facilitate pain management in cancer patients.

Methods: The current research constitutes a qualitative conventional content analysis study conducted from January 2023 to June 2023. The study participants comprised head nurses, clinical nurses and clinical supervisior, totaling 27 individuals selected through purposive sampling. Data collection involved individual, in-depth, and semi-structured interviews. Subsequently, data analysis was performed utilizing the approach outlined by Graneheim and Lundman (2004), leading to the identification of participants' perspectives.

Results: According to the nurses' perspective, two main categories of factors emerged that facilitate pain management. These categories are emotional support, which includes subcategories of family support and peer support, and organizational support, which includes subcategories of experienced nurses, accessible facilities, and financial support for patients.

Conclusions: The study findings highlight the importance of identifying factors that facilitate pain management in cancer patients to enhance their quality of life. These facilitators involve factors related to patients and their families, factors related to healthcare service providers, and various components of the health system. Therefore, strengthening the facilitators associated with each of these factors is critical in pain management and addressing any deficiencies in the health care system.

Background: Pain is a complex condition and affects one's life beyond physical symptoms. National pain management recommendations include a whole-person approach that includes strengths (or resilience).

Purpose: The purpose of this study was to examine de-identified data from the MyStrengths+MyHealth application to examine, Strengths, Challenges, and Needs for the population and a subset of the data for those with and without self-reported Challenges in the Pain concept.

Design: This cross-sectional comparative study used de-identified consumer-generated whole-person strengths data from the MyStrengths+MyHealth (MSMH) application.

Methods: Data was collected from various community settings between 2019 and 2023 and approved by the University's Institutional Review Board. From the sample population (N=1737), we identified those with self-reported Pain (n=1280) and without self-reported Pain (n=457) and compared Strengths, Challenges, and Needs.

Results: The sample population (N=1737) was largely in the age range of 45-64 years (51.2%), Male (56.4%), White (90.5%), non-Hispanic/Latino (86.6%), and Married (74.2%). The Pain group (n=1280) reported significantly fewer Strengths (p<0.001) and more average Challenges and Needs (p<0.001) than the Without Pain Group (n=457) across all concepts. For the Pain Group, the most frequent Strength reported was Role Change (70.5%), the most frequent Challenge Nutrition (96.1%), and the greatest Need was Income (89.9%).

Conclusions: Despite reporting Challenges and Needs, the Pain Group identified many Strengths. The Pain Group identified Role Change (70.5%) as a top Strength was surprising and may suggest adaptability to chronic pain. MSMH has potential to empower individuals to provide a comprehensive whole-person assessment and resilience which may be particularly useful for those living with chronic pain.

Clinical implications: This study has clinical implications for supporting the use of digital health tools such as mobile applications for capturing contextual data directly from patients to enable nurses to provide more accessible and personalized care to patients.

Purpose: While several clinical practice guidelines (CPGs) exist to guide clinical decision-making in patients with generalized cancer pain, to date there has been no comprehensive review of their quality. Our aim was to address this deficiency via the Appraisal of Guidelines for Research and Evaluation (AGREE II) tool.

Design: Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline-based systematic literature search followed by AGREE II appraisal of identified CPGs.

Methods: Embase, MEDLINE via PubMed, and Scopus were searched from inception to March 3, 2021, for relevant CPGs. Four authors (FR, AR, JN, JH) independently performed assessments and evaluations of the selected CPGs using the AGREE II instrument. Scaled domain percentage scores were calculated with 60% as the satisfactory quality threshold. Intraclass correlation coefficients (ICCs) were also calculated to assess interrater reliability.

Results: Twelve guidelines were selected for inclusion. Two guidelines were classified high quality, three guidelines as average quality, and seven as low quality. Domains of clarity of presentation (82.41% ± 18.20%) and scope and purpose (56.48% ± 30.59%) received the highest mean scores, while domains of applicability (44.53% ± 26.61%) and stakeholder involvement (36.81% ± 21.24%) received the lowest. ICCs showed high consistency between reviewers (range 0.85-0.98).

Conclusions: Most CPGs for generalized cancer pain are of low quality. Future guidelines can be improved by better-defining scope and purpose, stakeholder involvement, rigor of development, applicability, and editorial independence during development.

Clinical implications: We hope these critiques improve the quality of published guidelines to promote an improved quality of care and method to measure quality outcomes.

Background: Self-efficacy for pain management is the key to successful pain management, yet little is known about the effect of cognitive performance on self-efficacy for pain management. This study aimed to examine to what extent cognitive performance is related to self-efficacy for pain management in older adults with chronic pain.

Methods: The analyses utilized data from the baseline assessment of the MOBILIZE Boston Study. Five neuropsychological tests-the Clock in the Box Test, Letter Fluency Test, Trail-making Test, Hopkins Verbal Learning Test, and WORLD Test-were performed to measure the cognitive performance domains of 458 participants, aged 70 years and reporting chronic pain and self-efficacy for pain management. We measured self-efficacy for pain management using the Chronic Pain Self-Efficacy Scale. Statistical analyses were done using multiple linear regression analysis.

Results: After adjusting for sociodemographic factors, general cognitive performance, executive function, as measured by the Clock in the Box Test, and attention, as measured by the Trail-Making Test Part A, were significantly associated with self-efficacy for pain management in older adults with chronic pain. However, after controlling for sociodemographic factors, chronic conditions, pain interference, and physical performance, the associations between cognitive performance measures and self-efficacy for pain management weakened.

Conclusion: Greater cognitive performance in attention and executive function might be associated with better self-efficacy for pain management. Future longitudinal research is required to investigate the long-term implications of cognitive performance changes on the progress of self-efficacy for pain management in community-dwelling older adults.

Purpose: In this study, we aimed to investigate the risk of balance disorders and falls in patients with diabetic neuropathic pain and the associated kinesiophobia and physical limitation.

Methods: This study was designed as a cross-sectional descriptive study and was conducted with 250 patients seen in Family Medicine outpatient clinics between February and March 2023. The Tampa Kinesiophobia Scale (TSK) was used to measure the patients' fear of movement/reinjury, the International Fall Efficacy Scale (FES-I) was used to measure the level of fear of falling, the Berg Balance Scale (BBS) was used to assess balance status, and the International Physical Activity Questionnaire (IPAQ) was used to assess all activities during the day. Patients were divided into three groups according to pain patterns: Neuropathic pain (N = 74), nociceptive/mechanical pain (N = 96), and control group (no pain) (N = 90). In statistical analyses, p < .05 was considered significant.

Results: The mean age was 62.56 ± 9.81 years in the neuropathic pain group, 62.47 ± 11.67 years in the nociceptive/mechanical pain group, and 60.87 ± 10.99 years in the control group. Overall, 60% of the participants were women. In intergroup analyses, there were significant differences between the groups in terms of TSK (p = .012), FES-I (p < .001), IPAQ (p < .001), and BBS (p < .001). The neuropathic pain group had the lowest BBS scores. When comparing the neuropathic pain group to the control group, TSK was significantly higher (p = .009).

Conclusions: Patients with neuropathic pain due to diabetes mellitus are more likely to have increased balance impairment, leading to decreased physical activity and an increased risk of falls.

Background: Pediatric pain management is a constantly developing field. Despite extensive research, several studies have concluded that children's pain is still underestimated and undertreated. Nurses working with children have an important professional and ethical responsibility to possess up-to-date knowledge of pediatric pain management.

Purpose: The purpose of this study was to identify nurses' knowledge and attitudes regarding pain management in pediatric surgical wards and to investigate the short- and long-term effects of a tailored educational intervention.

Methods: This study has a quasi-experimental design without a control group and uses a previously validated questionnaire, the Pediatric Nurses' Knowledge and Attitudes Survey Regarding Pain-Norwegian version (PNKAS-N). Nurses in four pediatric surgical wards in one university hospital in Norway answered the survey once before and three times after a tailored educational intervention.

Results: Eighty-three nurses answered the PNKAS-N at baseline (response rate of 75%). The nurse's total PNKAS-N mean score was 27.8 (77.3%) at baseline. We identified knowledge and attitude deficits regarding items related to opioid doses, the risk of drug addiction, the risk of respiratory depression, and the choice of pain medication for children. The total PNKAS-N mean score was statistically significantly increased after the intervention, at T2 (85.2%), as compared to baseline, and this improvement was sustained at T3 (83.8%) and T4 (81.4%).

Conclusion: The tailored educational intervention had a significant effect on nurses' knowledge and attitudes about pediatric pain management.

Background: Sickle cell disease (SCD) is a hereditary blood disorder with chronic pain that affects over 100,000 people in the United States. Previous research suggests a complex interaction between SCD pain outcomes and social determinants of health (SDOH).

Objective: To explore the impact of SDOH on pain outcomes in SCD.

Design: We used a scoping review design to explore the broad topic of social factors that affect SCD pain.

Data sources: We searched the PubMed/MEDLINE, CINAHL, and Embase databases using combined search and Medical Subject Headings terms ("social determinants of health," "sickle cell," and "pain").

Review methods: We used a content analysis with a summative approach to identify and describe interactions between SDOH and SCD pain outcomes.

Findings: Eight articles reporting studies with 7,992 total participants and a focus on SCD pain outcomes met the inclusion criteria. Three themes related to SDOH and pain were produced: education and employment, social and emotional functioning, and healthcare access.

Conclusion: The key findings highlight the complex interplay between socioeconomic, psychological, and biological factors in SCD pain experiences. This underscores the need for nursing care to consider SDOH in an integrated, holistic approach to SCD pain.

Implications for nursing: To improve pain management among their SCD patients, nurses can assess pain holistically, develop customized individual pain management plans with educational and health literacy support options, and strengthen social support.