Pain Management Nursing最新文献

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.

Background: Patients recovering from bariatric surgery report the highest average pain during hospital admission, compared to patients recovering from other abdominal surgeries. Studies have shown many benefits from early mobilization after surgery, however, the effect of early mobilization after bariatric surgery on pain and physical function is unknown. This study aims to investigate the effects of an early initiated mobilization at the post anesthesia care unit and continued for the first 4 postoperative weeks.

Methods/design: This randomized controlled trial with a nested interview study requires 112 patients randomized 1:1 to intervention or control group. The mobilization intervention is divided in two: during hospitalization and after hospitalization at the patients' home or local healthcare center. The primary outcome for the first part is mean abdominal pain (numerical rating scale) during the first 24 postoperative hours. For the second part, physical function (six-minute walk test) is the primary outcome.

Secondary outcomes: opioid consumption, postoperative nausea and vomiting, physical activity, quantitative sensory testing, readmission rates, workability and sleep quality. Twelve patients will be interviewed twice to investigate their experiences.

Discussion: The study strives to enhance rehabilitation after obesity surgery, i.e., prevent complications caused by pain and physical inactivity. Furthermore, it strives to promote continuity in care between the hospital sector and the municipality.

Trial registration: ClinicalTrials.gov Identifier: NCT06222151.

Background: Effective pain management is essential for individualized nursing care, yet studies report nursing students often have insufficient knowledge in this area. Empathic tendency may act as a key factor, influencing how knowledge about pain management translates into individualized care practices.

Purpose: The aim of this study was to examine the relationship between nursing students' knowledge and attitudes toward pain management and their perceptions of individualized care and to evaluate the mediating role of empathic tendency in this relationship.

Design: This study is a cross-sectional descriptive study.

Methods: This descriptive and correlational cross-sectional study was conducted with 267 nursing students who were studying at a state university in the 2024-2025 academic year and had clinical practice experience. Data were collected using the Student Information Form, Knowledge and Attitudes Survey Regarding Pain, Individualized Care Scale-Nurse, and Empathic Tendency Scale. Pearson correlation, linear regression, and PROCESS Macro (Model 4) were used in statistical analysis.

Results: A significant and positive correlation was found between the level of knowledge about pain and perception of individualized care (r = 0.403, p < .001). Empathic tendency significantly predicted the perception of individualized care (β = 0.346, p < .001) and partially mediated the relationship between knowledge and attitudes about pain and individualized care (Indirect β = 0.168, CI [0.080-0.275]).

Conclusion: Both knowledge about pain and empathic tendency increase nursing students' competence to provide individualized care. Pain management should be integrated with empathy development in educational programs.

Objective: This study aimed to evaluate the efficacy and safety of intravenous (IV) lidocaine as an alternative analgesic approach in the management of postoperative pain.

Methods: A PubMed search was conducted using keywords related to intravenous lidocaine and opioid use in postoperative pain management. We focused on randomized controlled trials and clinical trials published in the past 10 years. Two independent reviewers screened titles, abstracts, and full texts, providing justifications for any exclusions. Of the 44 articles initially identified, 20 met the inclusion criteria and were included in the final analysis and summary tables.

Discussion: The review revealed conflicting evidence regarding the efficacy of IV lidocaine with some studies reporting significant reductions in opioid consumption, improved pain relief, and enhanced recovery parameters, while others questioned its benefit in reducing opioid consumption. Variability in lidocaine dosing regimens, surgical settings, and patient populations may contribute to the discrepancies observed in the literature. Challenges and limitations in the interpretation of study findings, including methodological issues and potential biases, were discussed.

Conclusion: IV lidocaine for postoperative pain management shows mixed and inconclusive results, with both potential benefits and limitations, indicating that no definitive conclusion can be drawn and further research is needed to establish its efficacy.

Purpose: Chronic pain is common for older adults living with dementia in nursing homes. The purpose of this study was to describe the current nonpharmacologic approaches used to treat pain among nursing home residents living with dementia and test the factors associated with the use of nonpharmacologic approaches.

Design and methods: This was a secondary data analysis using baseline data from the first six communities participating in the study, "Testing the Implementation of the Pain Management Clinical Practice Guideline Using the Evidence Integration Triangle." A total of 136 residents were included. Data was obtained from the electronic health record and observations using the Pain in Advanced Dementia Scale.

Results: The mean age of the participants was 80.3 years (standard deviation = 9.8), the majority were female (68%), and approximately half were white (52%), with 4 (3%) being Hispanic. Overall, 28 residents (21%) had pain, and the majority received at least one nonpharmacological intervention (n = 103, 76%). There was a significant association between oral pain medications given (Beta = .24, t = 2.9, p < .001), having diabetes (Beta = 2.1, t = 2.5, p = .01), and cognitive status (Beta = -.17, t = -2.0, p = .05) with the total number of nonpharmacologic interventions received. Age, sex, race, ethnicity, or musculoskeletal or neurologic diagnoses were not associated with the use of nonpharmacologic approaches.

Conclusions: Nonpharmacologic interventions are commonly used in this population, and there was no evidence of disparities in use based on age, sex, race, or ethnicity. As per pain guidelines, nonpharmacologic interventions should be the first treatment approach, particularly for those with cognitive impairment.

Purpose: Pain management is a global health problem. A large number of patients still suffer from pain despite the increasing development of science and technology, and nurses are frequently exposed to patients' pain and play a crucial role in pain management. This study aimed to explore nurses' challenges in managing pain in hospitalized patients.

Methods: This qualitative study was conducted in Arak (one of the central cities of Iran). Researchers used a purposive sampling technique, interviewing 14 clinical nurses, and continued until data saturation. Data were collected through semi-structured face-to-face interviews. The qualitative content analysis was used to analyze data.

Results: The challenges clinical nurses face in managing patients' pain vary depending on their understanding, knowledge, background, and experience. Three main themes were extracted: (1) Nurses' strategies for pain management, including maximum effort for patient comfort, disengaging without consequence, and ignoring patients' pain and suffering; (2) factors affecting pain control, including individual, organizational, and environmental factors; and (3) loss of professional ethics.

Conclusion: The results of the present study showed that nurses face many challenges in managing patients' pain and acting in accordance with their ethical and professional obligations.

Clinical implications: It is suggested that managers should employ a strategy encompassing the auditing of effective pain management and the promotion of ethical behaviors among nurses caring for patients in pain.

Purpose: This study investigates the nursing care for CT-guided percutaneous balloon compression in treating primary trigeminal neuralgia under local anesthesia and intravenous analgesia.

Design: The study is a retrospective analysis of the clinical and nursing data of 54 patients.

Methods: The analysis focused on preoperative, intraoperative, and postoperative nursing aspects for patients treated from November 2022 to July 2023.

Results: The results showed a high success rate of the procedure with only minor complications. There were no serious adverse events or recurrences observed during the 1-year follow-up period.

Conclusion: The study concludes that comprehensive and high-quality nursing care is essential for the success of CTguided percutaneous balloon compression for trigeminal neuralgia.

Clinical implications: This method is a accurate and costeffective alternative to traditional approaches. However, its successful implementation hinges on higher standards of nursing care, which include meticulous preoperative preparation, vigilant intraoperative monitoring, and thorough postoperative management.

Objectives: To synthesize the current evidence on perioperative pain management in older adults with hip fractures and to provide an evidence-based reference to support clinical decision-making by healthcare professionals.

Methods: This review was conducted in accordance with the evidence synthesis methodology developed by the Joanna Briggs Institute (JBI). Guided by the "6S" evidence hierarchy model, a top-down search strategy was employed to identify evidence related to pain management in older adults with hip fractures. The evidence sources included clinical decision support tools, recommended practices, clinical guidelines, best practice statements, evidence summaries, systematic reviews, and expert consensus statements. The search covered literature from database inception to November 30, 2023. Two reviewers independently screened and appraised the literature, followed by data extraction and synthesis based on the JBI Levels of Evidence and Grades of Recommendation.

Results: A total of 14 papers were included in the analysis, including one clinical decision, one recommended practice, seven guidelines, two expert consensus, one evidence summary, and two systematic reviews. Based on the synthesis and integration of the extracted evidence, five thematic domains were identified: pain assessment, nonpharmacological interventions, pharmacologic interventions, Traditional Chinese Medicine, and health education. A total of 25 best evidence statements were ultimately formulated.

Conclusions: This study summarizes the best evidence for perioperative pain management in elderly patients with hip fractures. The evidence covers key aspects such as optimal timing of pain assessment, appropriate tool selection, and consideration of individualized factors during evaluation. It also addresses nonpharmacological and pharmacological interventions across the preoperative, intraoperative, and postoperative phases. These findings provide a scientific and practical foundation for healthcare professionals to implement systematic and evidence-based pain management strategies in this patient population.

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.