Pain Management Nursing最新文献

Purpose: Despite increased research, understanding of key concepts and trends in pediatric pain education remains limited from a macro perspective. Thus, this study aimed to examine the trajectory, frequency, knowledge structure, and subtopics used within pediatric pain education.

Methods: A quantitative content analysis was conducted by evaluating the text network. We searched the PubMed, Embase, Cochrane, and Cumulative Index to Nursing and Allied Health Literature databases. Additionally, we developed text-mining dictionaries and used and NetMiner 4.5 to analyze frequency, degree centrality, and betweenness alongside the visualized networks. Latent Dirichlet allocation was applied for topic modeling.

Results: Since 1976, a total of 6,777 articles have been published, with the knowledge structure comprising keyword groups such as "patient," "parent," "education," and "health." Nurses were connected with parents and patients through pain education. The topics that emerged included patient diagnosis and medication treatment, nurse-family partnership, community and environmental influences on maternal and child health, symptom and disability management, the health of women and female students, and exercise and education for low back pain management. Temporal trends revealed growth in nurse-family partnerships, comprising about one fourth of all topics; meanwhile, studies on women's and female students' health sharply declined after 2010.

Conclusions: Given nurses' central roles, addressing pain in children and adolescents, including low back pain, and improving symptoms and disability are increasingly recognized as critical, particularly among females, given their higher prevalence of pain. Nurse-led programs should incorporate clinical and diagnostic assessments in community and environmental settings along with exercise, pharmacological therapy, and family partnerships.

Clinical implications: Nurses are well suited for patient education roles and play a crucial role in managing pediatric pain by tackling barriers to diagnosis and management, coordinating pain education, and fostering strong partnerships with patients and parents. Based on these findings, we recommend that nurse-led pain education actively involve parents, integrate nonpharmacological interventions that enhance knowledge and promote exercise alongside medication treatment, and expand into community and environmental settings to improve accurate diagnosis and treatment in collaboration with families. Implementing these approaches in clinical and community settings is vital for enhancing nursing practice in pediatric pain management while also advancing education research.

Objectives: To map and critically examine the use of the Knowledge and Attitudes Survey Regarding Pain (KASRP) as a research and clinical tool for assessing nurses' pain management knowledge and attitudes in high-complexity hospital settings.

Design: Scoping review guided by Joanna Briggs Institute methodology.

Data sources: PubMed, Scopus, Web of Science, EBSCOhost, CINAHL, LILACS, and CUIDEN were searched for studies published between 2005 and 2025.

Review/analysis methods: Data were synthesized narratively and summarized using descriptive tables and mapping.

Results: Of 1,510 screened records, 34 studies from 15 countries were included. Most studies used the original English KASRP (n = 25), while nine applied translated or culturally adapted versions. Overall, nurses demonstrated moderate to low knowledge and mixed to negative attitudes, particularly regarding opioid use, pain assessment, and scale utilization. Higher academic level was more consistently associated with improved scores than years of clinical experience. Psychometric evaluation was limited; Thailand reported the most comprehensive validation, whereas minimal or no testing was identified in China, Ghana, and Italy. Key gaps included inadequate cultural adaptation, limited use in pediatric and emergency contexts, and few intervention-based studies.

Conclusions: Although widely applied, the KASRP is frequently used without adequate validation or cultural adaptation, limiting interpretability. Persistent knowledge deficits indicate the need for targeted education and institutional support to strengthen evidence-based nursing pain management.

Nursing practice implications: Culturally validated pain assessment tools are essential to guide education, improve clinical decision-making, and enhance pain management quality in high-acuity nursing practice.

Purpose: This study investigated the mediating role of self-perceptions of aging (SPA) in the relationship between chronic pain and depression among older adults, aiming to provide a theoretical basis for improving their mental health.

Design: A secondary analysis was conducted using multi-wave data from a large, nationally representative cohort study.

Methods: Data from the Health and Retirement Study database were utilized for analyses spanning the years 2014, 2018, and 2022. A general information questionnaire, self-reported pain, an 8-item scale of attitudes toward aging, and the Center for Epidemiologic Studies Depression Scale-8 depression scale were employed. Mediation analysis was conducted to assess the role of SPA in the relationship between chronic pain and depression.

Results: Regression analyses indicated that the presence of chronic pain was associated with higher levels of depressive symptoms (β = 0.553, p < .001) and lower levels of positive SPA (β = -0.122, p < .001). In turn, more positive SPA was associated with fewer depressive symptoms (β = -0.447, p < .001). Mediation analysis showed a significant indirect effect of chronic pain on depressive symptoms via SPA (ACME = 0.055, 95% CI [0.024, 0.090]), with a significant direct effect (ADE = 0.553, 95% CI [0.392, 0.710]) and total effect (0.607, 95% CI [0.446, 0.770]); the proportion mediated was 9.00% (95% CI [0.041, 0.150]).

Conclusions: These findings suggest that self-perceptions of aging partially mediate the relationship between chronic pain and depression among older adults.

Clinical implications: These findings highlight the importance of addressing both chronic pain and SPA in clinical settings. Targeting these factors may help reduce depression levels and improve the mental health of older adults.

Purpose: This study aims to investigate the relationship between preoperative kinesiophobia, pain-coping strategies, postoperative pain, and physical mobility levels during the initial mobilization in patients with gonarthrosis undergoing total knee arthroplasty.

Methods: This descriptive and correlational study was conducted between March 2023 and January 2024 with 202 hospitalized patients diagnosed with gonarthrosis. Data were collected using the Demographic Information Form, the TAMPA Scale for Kinesiophobia, the Pain Coping Inventory, the visual analog scale (VAS), the Observer Mobility Scale (OMS), and the Patient Mobility Scale (PMS).

Results: No significant relationship was found between OMS scores and the TAMPA Scale for Kinesiophobia, Pain Coping Inventory, or VAS (p > .05). However, a statistically significant positive correlation was observed between PMS scores and both OMS and VAS scores (p < .001). Kinesiophobia was positively and significantly correlated with PMS scores (p .024).

Conclusions: The greater preoperative pain intensity was linked to higher levels of pain and difficulty during postoperative movement.

Background: Effective pain management is a vital aspect of quality nursing care, requiring sound knowledge, assessment skills, clinical judgment, and patient-centered communication. With advances in healthcare technology, Artificial Intelligence (AI) is emerging as a powerful educational tool to enhance competency-based learning in pain management.

Objectives: This narrative review explores how AI integration in nursing education impacts the development of pain management competencies among nursing students.

Materials and methods: A comprehensive literature search was conducted across PubMed, Scopus, and Google Scholar using keywords such as "artificial intelligence," "pain management," "nursing education," and "competencies." Of the 172 studies identified, nine met the inclusion criteria after screening using Rayyan software.

Results: The selected studies highlight key AI applications including simulation-based learning, real-time feedback, clinical decision support, personalized modules, and automated assessment tools. These approaches help develop core competencies such as accurate pain assessment, critical thinking, reflective practice, and patient education. AI also enhances engagement through interactive and tailored learning experiences, supporting better knowledge retention.

Conclusion: Integrating AI into pain management education equips nursing students with essential clinical skills, promoting higher competence and confidence in managing pain. Ongoing research is vital to explore both the benefits and potential challenges of AI integration to ensure its safe and effective use in nursing curricula.

Nursing practice implications: AI enhances the accuracy in pain assessment, supports clinical decisions, encourages reflective practice, and fosters empathy. It prepares nurses for digital healthcare environments and contributes to improved patient outcomes.

Objective: To explore the chain mediating role of pain acceptance and self-management behavior between antecedent factors and pain adjustment outcomes. Antecedent factors included pain intensity, pain fear-avoidance, pain catastrophizing and self-efficacy, and pain adjustment outcomes were identified as disability and physical and mental well-being.

Design: A cross-sectional study.

Methods: A purposive sampling investigation was performed, recruiting a cohort of 261 patients with chronic pain. Self-reported measurements were used to assess pain acceptance, self-management behavior, antecedent factors and pain adjustment outcomes, and structural equation modeling analysis was performed.

Results: Self-management behavior demonstrated non-significant associations with pain acceptance and pain adjustment outcomes, it was therefore removed from the hypothesized model. A revised model indicated that pain (β = -0.191, p < .001), pain fear-avoidance (β = -0.442, p < .001) and pain catastrophizing (β = -0.328, p < .001) had direct negative effects on pain acceptance while self-efficacy (β = 0.375, p < .001) showed a positive effect. Meanwhile, pain acceptance demonstrated a noteworthy improvement on health outcomes, manifested by less disability (β = -0.519, p < .001) and better physical well-being (β = 0.492, p < .001) and mental well-being (β = 0.622, p < .001). Pain acceptance significantly mediated the associations between antecedent factors and pain adjustment outcomes. In additional analysis, as two dimensions of pain acceptance, pain willingness (β = -0.281, p < .001) and activity engagement (β = 0.301, p < .001) exhibited opposite associations with self-management behavior, and both of them predicted less disability and improved physical and mental well-being.

Conclusion: Influenced by multiple antecedent factors, pain acceptance has a significant potential value in enhancing pain adjustment outcomes; however, self-management does not show a positive role in the process. Culture-specific and scientific interventions should be developed to incorporate pain acceptance notion in self-management programs.

Purpose: Chronic pain in sickle cell disease is more complex and challenging to manage than in other conditions. To better inform chronic pain assessment and management, this study evaluated the role of chronic pain acceptance in the context of pain catastrophizing and their combined association with chronic pain intensity and chronic pain disability in adults with sickle cell disease.

Design: This was a secondary analysis of cross-sectional survey data from 170 adults with sickle cell disease (mean age of 28.05 years and 53.5% female, with moderate to severe chronic pain and high levels of chronic pain disability) who completed the Pain Catastrophizing Scale and Chronic Pain Acceptance Questionnaire.

Methods: Multiple regression was used to analyze predictors of chronic pain intensity and chronic pain disability, with pain catastrophizing and chronic pain acceptance subscales (activity engagement and pain willingness) as primary variables.

Results: Pain catastrophizing was significantly associated with chronic pain intensity and chronic pain disability. Activity engagement, but not pain willingness, was associated with chronic pain disability. There was a significant interaction between pain catastrophizing and activity engagement on chronic pain disability. Additionally, low pain catastrophizing and high activity engagement was associated with lower chronic pain disability.

Conclusions: Study findings suggest that optimal chronic pain management in adults with sickle cell disease may require addressing pain catastrophizing and chronic pain acceptance sequentially.

Clinical implications: Interventions targeting the cognitive framework in addressing pain catastrophizing before promoting functional engagement may positively influence chronic pain outcomes in this population.

Background: There is a gap in understanding young adults' (YA) attitudes toward and use patterns of opioids and cannabis use in the perioperative period. The aim of this qualitative study was to explore patterns and motivations for prescription opioid use and cannabis use among YAs in the postsurgical context.

Methods: Participants were 13 YAs aged 19-25 years (mean age = 22.9 years) who were prescribed opioids for pain management postsurgery. We conducted a qualitative descriptive study using thematic analysis. Interviews took place between 2 and 12 weeks after surgery, and interview prompts were open-ended questions related to patterns and motivations for opioid use, pain and pain management, and cannabis use.

Results: Several themes were developed in the qualitative analysis, e.g., "a fear of opioids," "fear messaging from parents," "choosing to endure pain to avoid negative side effects from opioids," "positive mental health effects from cannabis use," "using cannabis for pain relief," "contradictory perceptions about effects on pain," and "changing cannabis use around surgery." YAs' fear of opioids often resulted in them taking opioids less than prescribed. Many participants used cannabis after surgery for pain and anxiety management and were intentional about their use in the perioperative stage.

Conclusions: This qualitative study offers a unique window into YA perspectives on postoperative care, particularly patterns of and motivations for prescription opioid and cannabis use. Most reports of fear related to prescription opioids were related to a fear of future dependence and addiction, and YAs were aware and knowledgeable about potential risks of prolonged opioid use. YAs also used cannabis frequently and intentionally to manage pain. Future research could expand on this work and focus on whether postoperative pain management is optimized for YAs in the context of fear of opioids and cannabis use.

Introduction: Opioid misuse and abuse during pregnancy can adversely affect maternal and infant outcomes. Factors that drive the burden of opioid misuse and abuse are multifaceted and understudied. This study sought to explore predictors of opioid misuse and abuse among pregnant women in the United States.

Methods: Secondary data analysis of the National Survey on Drug Use and Health (NSDUH) data from 2015-2019 was performed. The primary outcomes were past-year opioid misuse, past-month misuse, and past-year opioid abuse. Data analysis included weight-adjusted univariate, bivariate, and multivariable logistic regression.

Results: The pooled weighted sample comprised 2,258,599 pregnant women. The prevalence of past-year misuse, past-month misuse, and past-year opioid abuse were 5.2%,1.0%, and 0.9%, respectively. Older age and higher household income were protective against past-year misuse. The odds of past-year misuse were lower for pregnant women in their third trimester. Non-Hispanic Black Americans and Hispanics had lower odds of past-year misuse compared to non-Hispanic Whites. However, Non-Hispanic Native Hawaiian /Other Pacific Islanders reported higher odds of past-year misuse; yet lower sample sizes of minority groups may have affected the findings. Good health and excellent health status were protective against past-year misuse. Older age was protective against past-month misuse. Lower odds of past-year opioid abuse were observed in non-Hispanic Black women compared to non-Hispanic White women.

Conclusion: The findings underscore the need for interventions targeting younger pregnant women, women in early pregnancy, from low-income households, who are non-Hispanic Native Hawaiian /Other Pacific Islanders, and women with poor health to mitigate adverse maternal and fetal outcomes.

Objectives: To investigate the impact of massage and music interventions on alleviating pain severity in the intensive care unit (ICU) within the first 48 hours after cardiac surgery.

Design: Systematic review and meta-analysis.

Methods: The study has been proactively registered in PROSPERO (CRD42022297174) to ensure transparency and compliance with scientific standards. Studies published in the English and Turkish languages until December 2024 were included in the search, utilizing various scientific databases such as MEDLINE, CINAHL, Embase, Science Direct, Web of Science, Scopus, Cumulative Index to Nursing, Cochrane Central Register of Controlled Trials, and the Turkish academic Google database. The Critical Evaluation 13 Model Checklist at the Joanna Briggs Institute was utilized to assess the quality appraisal of the studies included in the research. The data were subjected to both meta-analysis and narrative synthesis techniques. Meta-analysis was conducted using Review Manager 5.4.1 software.

Results: The review included 19 randomized controlled trials. Eight were in massage intervention, and 11 were in music intervention. Massage intervention (p < .00001) and music listening (p = .0008) both demonstrated a significant reduction in pain severity within the first 48 hours of ICU admission.

Conclusions: The results of this study show that both massage and music intervention resulted in a tangible and statistically significant reduction in pain severity within the first 48 hours of ICU.