Pain Management Nursing最新文献

Purpose: To compare the effects of different manual therapy techniques in addition to cervical stabilization exercises on pain, range of motion (ROM), functional status, balance, and quality of life (QoL) in patients with chronic neck pain (CNP).

Methods: Ninety CNP patients were randomly allocated into three groups: joint mobilization (Group 1), classic massage (CM) (Group 2), and connective tissue massage (CTM) (Group 3), all receiving cervical stabilization exercises. Pre- and post-intervention evaluations were conducted over a 4-week period, assessing pain severity, pressure pain threshold (PPT), ROM, functional capacity, balance, and QoL.

Results: Significant enhancements in pain severity, ROM, and functional capacity were observed across all groups (p < .05). Group 1 exhibited improvements in static and dynamic balance with eyes closed (mean change -1.10; 95% CI -1.66, -0.53 and -0.87; 95% CI -1.59, -0.16, respectively). Group 2 displayed increased PPT values for both right and left sides (mean change 4.69; 95% CI 0.98, 8.40 and 3.50; 95% CI -0.15, 7.15, respectively). Group 3 demonstrated dynamic balance improvement in eyes open position (mean change -1.05; 95% CI -2.04, -0.06). QoL improvements were noted in Groups 1 and 3 (p < .05). Significant inter-group differences were observed in PPT values (p = .003, p = .002 for right and left, respectively) and flexion ROM (p = .03).

Conclusion: In the management of CNP, different manual therapy techniques plus cervical stabilization exercises can be considered to reduce pain and improve ROM and function. Joint mobilization and CTM can be preferred to improve balance, and QoL. Moreover, CM can be preferred to increase PPT.

Purpose: This study aimed to investigate the prevalence and risk factors of pregnancy-related low back pain (PLBP) and its impact on quality of life among pregnant women in Taiwan.

Design: This cross-sectional study comprised a convenient sample of pregnant women who visited obstetrics clinics in Taiwan's medical centers and regional hospitals between 2021 and 2022.

Methods: Data on demographics and Pain Visual Analog Scale (PVAS), Brief Pain Inventory (BPI), Oswestry Disability Index (ODI), and World Health Organization Quality of Life Assessment-Brief version (WHOQOL-BREF) scores were collected.

Results: Among the 474 participants, 66.2% reported experiencing PLBP, with back pain being common (87.6%). Three risk factors affecting PLBP identified were gestational weight gain, previous experience of low back pain, and work-related repetitive movements and static posture. For PLBP participants, the mean PVAS score was 3.10 ± 1.88, the mean BPI score was 22.25 ± 18.01, and 36.3% had moderate or severe pain; the mean ODI score was 9.71 ± 7.88, and 32.5% had moderate or severe disability, significantly affecting sleep and normal work, such as standing and lifting. The mean WHOQOL-BREF score was 102.18 ± 11.74, with daily functions mediating the association between PLBP severity and quality of life.

Conclusions: The high prevalence of PLBP affects daily functions, including sleep and normal work, due to the severity of pain, thereby impacting the quality of life. Nevertheless, misconceptions about PLBP often discourage many pregnant women from actively seeking treatment.

Clinical implications: Healthcare providers should actively provide PLBP-related knowledge and offer tailored prevention or treatment strategies to high-risk pregnant women.

Background: Diabetic peripheral neuropathy is a significant cause of chronic pain in patients with type 2 diabetes. Although pharmacological treatments are available, complementary therapies such as reflexology massage may offer additional symptomatic relief. However, evidence on the efficacy of reflexology massage in this context remains limited, particularly among women with type 2 diabetes.

Aim: This study aimed to evaluate the effect of foot reflexology massage on neuropathic pain in women with type 2 diabetes.

Methods: This study was conducted between April 2023 and March 2024. The study was conducted as a randomized controlled trial and included 65 women diagnosed with type 2 diabetes and neuropathic pain, randomized into intervention (n = 33) and control groups (n = 32) using a computerized randomization program managed by an independent researcher. The intervention group received routine treatment plus foot reflexology massage administered by trained nurses, while the control group received routine treatment only. Outcomes were assessed using validated instruments for neuropathic pain and sensory function: Douleur Neuropathique 4 Questions (DN4), a 10-item questionnaire identifying neuropathic pain; Leeds Assessment of Neuropathic Symptoms and Signs (LANSS), differentiating neuropathic from nociceptive pain; Visual Analog Scale (VAS), measuring pain intensity on a 0-10 scale; Monofilament test (SWM), evaluating peripheral touch sensation; and Neurothesiometer, assessing vibration perception thresholds. Effect sizes (Cohen's d) and 95% confidence intervals were calculated.

Results: Preintervention measurement characteristics and pain scores did not differ significantly between groups (p > .05). Postintervention, the intervention group demonstrated significant reductions in DNQ4 (p = .001, d = 3.55), LANSS (p = .001, d = 2.34), and VAS scores (p = .001, d = 2.26) compared to the control group. No adverse events related to the intervention were reported.

Conclusion: Foot reflexology massage administered by trained nurses effectively reduces neuropathic pain in women with type 2 diabetes. As a low-cost and accessible therapy, it can serve as a valuable adjunct to routine care and is recommended to be incorporated and maintained in nursing practices for the management of neuropathic pain in individuals with diabetes.

Objective: To analyze the current incidence of acute postoperative pain (APSP) and the associated risk factors to enrich multimodal analgesic regimens and provide the basis for more personalized and precise management of postoperative pain in patients with lung cancer.

Methods: This was a prospective case-control study. A sequential sampling method was used to enroll patients with lung cancer in the thoracic surgery department of a general hospital in Sichuan Province. The demographic data, perioperative psychological state, quality of sleep, and pain perception of patients were collected via questionnaires such as the Hospital Anxiety and Depression Scale (HADS), Pittsburgh Sleep Quality Index (PSQI), and Pain Catastrophizing Scale (PCS). The VonFery mechanical stimulation kit was used to complete the Quantitative Sensory Testing (QST); and surgery-related information was collected through medical records. Postoperative pain was assessed at 12, 24, 36, 48, 60, and 72 hours after surgery. The study participants were grouped by the presence of moderate or severe pain (Numeric Rating Scale, NRS ≥ 4) after surgery, and the risk factors for APSP in patients with lung cancer were analyzed via univariate analysis and binary logistic regression analysis.

Results: A total of 200 adult patients with lung cancer were recruited for this study, including 89 males (44.5%) and 111 females (55.5%). The average age was 55.91 ± 10.42 years, and the average BMI was 23.17 ± 2.81 kg/m². All patients were divided into the APSP group (n = 59) and NOAPSP group (n = 140) according to whether they experienced acute postoperative pain (NRS ≥ 4), so the incidence of APSP was 29.5%. Binary logistic regression analysis revealed that the independent risk factors for APSP included sex, drinking history, preoperative pain score, preoperative anxiety, and surgical history.

Conclusion: Female sex, drinking history, surgical history, preoperative pain, and preoperative anxiety were independent risk factors for poor postoperative pain control. These findings suggest that health care providers should actively consider the control of the above factors and take preventive measures against risk factors when implementing multimodal and individualized analgesia. For example, diverse methods for providing analgesia, controlling preoperative pain and providing perioperative mental care and cognitive therapy to patients with different characteristics have been developed.

Background: Nurses play an important role in effectively assessing and managing patients' pain. There is limited evidence in relation to Australian undergraduate nursing students' knowledge, attitudes, and management of pain and this study attempts to address this gap.

Objective: To explore the current knowledge and attitudes to pain management among undergraduate nursing students.

Methods: This is a cross-sectional study of a convenience sample of 150 undergraduate nursing students from three Australian regional universities measuring student knowledge and attitudes toward pain management and assessment using the Knowledge and Attitudes Survey Regarding Pain (KASRP) tool between May and September 2023.

Results: The average scores for each year level in relation to the total KASRP were Year 1 (M = 22.98; SD = 4.74), Year 2 (M = 25.09; SD = 4.46), and Year 3 (M = 27.27; SD = 4.22). There were statistically significant differences in KASRP scores between students across the three years of the program. The results also indicated that very few students were able to achieve the overall pass rate (80%). Additionally, medication knowledge was an identified aspect of pain management poorly answered.

Conclusions: Nursing students' pain knowledge and attitudes appear to improve throughout their undergraduate program, however there are significant knowledge deficits that may impede the ability to assess and manage pain in clinical practice. This knowledge may be helpful for nursing educators and curriculum developers to develop strategies to address this gap.

Purpose: This study aimed to evaluate the effect of human caring theory-based nursing interventions on perceived postoperative pain in children undergoing abdominal surgery.

Design and methods: A quasi-experimental pre/post-test design with a nonparallel control group was conducted. The sample included 112 children undergoing abdominal surgery in Iran. The intervention group received postoperative pain management aligned with the ten Caritas Processes of the Human Caring Theory, while the control group received routine care. Postoperative pain was self-reported by the children using the Oucher Pain Scale. The dose and frequency of analgesic administration were also recorded. Data analysis included independent t-tests and repeated measures ANOVA.

Results: At baseline, no significant differences were found between the groups regarding demographic characteristics, preoperative pain intensity, and surgical incision size (p > 0.05). However, postintervention, the intervention group had significantly lower postoperative pain than the control group (p < 0.05), along with a significantly reduced total amount of intravenous acetaminophen (p < 0.001).

Conclusions: Nursing care based on the principles of the Human Caring Theory effectively reduced postoperative pain intensity in children, particularly within the first 24 hours after surgery.

Practice implications: Integrating holistic, theory-driven nursing care that addresses the emotional, psychological, and physical aspects of pain enhances the efficacy of postoperative pain management in pediatric surgical settings.

Purpose: This study evaluated the efficacy of a nurse-led intervention combining filial therapy and sickle cell disease (SCD) education on pain and health-related quality of life (HRQOL) of children with SCD in a Middle Eastern context.

Design: A non-equivalent control group pretest-posttest quasi-experimental design was employed.

Methods: 200 Omani children (aged 5-12) and their caregivers were recruited from two government hospitals. The intervention group (n = 100) received a 10-week nurse-led program integrating filial therapy (structured play sessions) and SCD education, while the control group (n = 100) received routine care. Outcomes were measured using the Pediatric Pain Questionnaire (PPQ) and Pediatric Quality of Life Inventory (PedsQL) SCD Module at baseline, 15 weeks (post-intervention), and 20 weeks (follow-up). Data were analyzed using descriptive statistics, independent t-tests, and repeated-measures ANOVA.

Results: The intervention group demonstrated significant reductions in pain (child report: 51.34%, p < 0.001; parent report: 59.24%, p < 0.001) and improvements in HRQOL (child report: +17.04%; parent report: +18.65%, p < 0.001), with sustained effects at follow-up. Largest gains were observed in pain management and psychological domains (e.g., Worry I: d = 1.79). The control group showed negligible changes. Effect sizes ranged from moderate to large (d = 1.06-1.79), confirming clinical significance.

Conclusion: The nurse-led intervention significantly reduced pain and enhanced HRQOL in children with SCD, underscoring the value of integrating filial therapy and education into routine care.

Clinical implications: Pediatric nurses can implement this structured, culturally adaptable intervention to improve outcomes in SCD management. Policymakers should consider scaling filial therapy training in regions with high SCD prevalence.

Background: Nursing students are at increased risk for low back pain due to physical and psychological stressors encountered during nursing education. Low back pain can interfere with academic performance, clinical readiness, and long-term career sustainability.

Purpose: This study examined the prevalence of low back pain among nursing students and explored how pain-related beliefs, fear-avoidance beliefs, self-activation, and pain intensity are associated with health-related quality of life.

Methods: A cross-sectional survey was conducted among 200 nursing students enrolled in traditional and accelerated programs at a one central Israeli nursing school. Validated self-report instruments assessed low back pain prevalence, beliefs, activation, coping strategies, and health-related quality of life. Regression analyses were used to identify predictors of health-related quality of life.

Results: A total of 63.5% of participants reported low back pain during the past 12 months, with 90.6% indicating symptom onset during nursing education. While most episodes were short in duration, students with low back pain reported significantly lower health-related quality of life. Notably, fear-avoidance beliefs-but not pain intensity-emerged as the strongest predictor of diminished health-related quality of life.

Conclusions: This study underscores the need to address psychological contributors to pain-related disability among nursing students. Fear-avoidance beliefs emerged as key modifiable factors associated with diminished quality of life, independent of pain intensity. Incorporating evidence-based pain management approaches that target maladaptive beliefs and promote active coping may reduce the burden of low back pain in this vulnerable population and support workforce sustainability in clinical settings.

Objective: This study aimed to determine the effects of breathing exercises and the Valsalva maneuver on invasive pain associated with peripheral intravenous catheterization (PIVC).

Method: This randomized controlled trial was conducted between March and June 2025 with three groups: Valsalva group (n = 46), breathing exercise group (n = 46), and control group (n = 46). Data were collected using the "Nurse Descriptive Information Form" and the "Visual Analog Scale (VAS)."

Results: Pain levels during and after peripheral intravenous catheterization were significantly lower in the Valsalva maneuver and breathing exercise groups compared to the control group (p < .001, p < .001; η² = 0.195, η² = 0.169, respectively). However, there was no statistically significant difference between the Valsalva manoeuvre and breathing exercise groups in terms of pain reduction (p > .05).

Conclusion: The findings indicate that the Valsalva manoeuvre and breathing exercises are effective non-pharmacological techniques for reducing pain during peripheral intravenous catheterization.

Relevance to clinical practice: Simple, non-pharmacological interventions such as the Valsalva maneuver and breathing exercises can effectively reduce pain during peripheral intravenous catheterization. Integrating these easy-to-apply methods into nursing practice may enhance patient comfort and support patient-centered care.

Reporting method: This study adhered to the CONSORT guidelines for non-pharmacological randomized clinical trials.

Trial registration: This study was registered at ClinicalTrials.gov with registration number NCT06872671.

Purpose: Currently, there is a notable gap in the nursing literature addressing guidance for the care of pediatric surgical patients receiving peripheral nerve blocks (PNBs). This article aims to bridge that gap by equipping pediatric surgical nurses with essential knowledge on the postoperative care of pediatric patients receiving PNBs, including indications for use, targeted areas of analgesia, common local anesthesia medications, potential complications, and key aspects of nursing care.

Methods: A comprehensive literature review was conducted to locate current evidence-based practice articles on pediatric regional anesthesia in the category of PNBs. Databases searched included PubMed, CINAHL, Ovid, and the University of Pittsburgh Health Sciences Library System. Key words included in the search were pediatric peripheral nerve block, pediatric regional anesthesia, peripheral nerve block complications, nursing care peripheral nerve block, and nursing care regional anesthesia. The clinical guidelines on the management of postoperative pain from the American Pain Society, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Anesthesiologists was reviewed to ensure best practices.

Results: Drawing from the evidence base, core components of nursing management were identified. Primary considerations include understanding the pharmacology of local anesthetics, proper care of infusion pumps and catheters, assessment of the insertion site, comprehensive pain evaluation, sensory and motor function monitoring, early identification of complications, and family and patient education.

Conclusion: A review of the literature and professional guidelines highlighted the essential components of nursing care. This information supported the development of informed, evidence-based practices contained within this manuscript.

Clinical implications: Nurses are critical in providing high-quality patient care, particularly with respect to pain management in pediatric surgical settings. With the increasing use of regional anesthesia for postoperative pain management, it is essential for nursing staff to have a comprehensive understanding of its benefits and applications. Enhancing pediatric surgical nurses' knowledge of PNBs ensures proper management, optimizes patient comfort and safety, and contributes to improved clinical outcomes.