Pain Management Nursing最新文献

Purpose: This study aimed to examine the effects of auricular acupressure (AA) on neck pain and stress in nursing students with neck pain.

Methods: This single-blind, randomized, and placebo-controlled comparative pretest-posttest study involved administering AA for four weeks. The subjects included nursing students experiencing neck pain. The experimental group comprised 17 subjects, and the control group comprised 14 subjects. In the experimental group, AA was applied to the Shenmen, cervical vertebrae, shoulder, and liver areas to improve neck pain and reduce stress. In the control group, AA was applied to the anus, rectum, urethra, and external genitalia areas, which are not associated with neck pain and stress. To assess the intervention effects, NRS (Numeric Rating Scale), NDI (Neck Disability Index), and PSS (Perceived Stress Scale) scores were measured.

Results: The NRS scores in the experimental group with AA significantly decreased over time (F = 7.463, p < .001). The between group and group-by-time interaction results were F = 8.564, p = .007 and F = 3.252, p = .025, respectively. The NDI scores in the experimental group showed a statistically significant difference between the groups (F = 13.762, p = .001); however, there were no significant differences over time or in the group-by-time interaction (F = 1.086, p = .347) (F = .301, p = .757). The PSS scores in the experimental group decreased significantly over time (F = 5.557, p = .013), but there were no significant differences between the groups (F = .636, p = .432) or in the group-by-time interaction (F = .063, p = .891).

Conclusion: AA applied for four weeks was found to be safe, noninvasive, and effective in reducing neck pain in nursing students with cervical pain.

Purpose, and design: Knee osteoarthritis (OA) is one of the most common and debilitating diseases, especially in the elderly. Hemp seed oil is a plant product that has been used as a food or drug since ancient times because of its anti-inflammatory and analgesic properties.

Methods: A double-blind, active, placebo-controlled trial was done to assess the efficacy of hemp seed oil on knee OA. Ninety patients were randomly allocated to three groups; hemp seed oil, diclofenac gel, and placebo via a blocked randomization method, and were asked to apply the topical treatment daily for 2 months. The study participant underwent assessments before, and four and 8 weeks after the intervention. Evaluation included measurements of the heel-to-thigh distance, utilization of Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and application of visual analog scale (VAS). Data analysis was performed using SPSS.24 and the significance level was considered as p < .05.

Results: All parameters, except heel-to-thigh distance, improved significantly in the hemp seed oil group compared to placebo group. Improvements in VAS and WOMAC parameters were not different comparing the hemp seed oil and diclofenac gel groups. Heel-to-thigh distance decreased significantly within all groups during the study. There were no significant differences in improvements in heel-to-thigh distance comparing the three groups.

Conclusion, and clinical implications: Hemp seed oil led to greater improvements in VAS pain score and WOMAC parameters, but not knee flexion range, compared to placebo. There were no differences in measured outcomes comparing hemp seed oil and diclofenac gel.

Purpose: To compare trunk flexor, extensor, and lateral flexor muscle endurance between women with moderate to severe disability due to chronic neck pain (CNP) and asymptomatic women.

Design: Observational case-control study.

Methods: Thirty women with CNP and Neck Disability Index scores ranging from 30% to 70% and 28 asymptomatic women were included. The visual analog scale was used to assess neck pain intensity at rest and during activity. To assess trunk muscles endurance, trunk flexor endurance test, Sorensen test, and side bridge endurance test were performed.

Results: Analysis of covariance indicated that neck pain group had lower body mass index-adjusted endurance times of trunk flexor, extensor, and lateral flexor muscles with large effect sizes (p < .001, η² = 0.378-0.696). Trunk flexor endurance time showed a moderately negative correlation with neck pain intensity at rest and a weakly negative correlation with neck disability score (r = -460 and -365, p < .05).

Conclusions: Women with moderate to severe disability due to CNP exhibited decreased trunk muscle endurance, which may be a predisposing factor for low back pain. Also, trunk flexor endurance was related to neck pain complaints. A holistic approach, addressing the entire spine rather than focusing solely on the cervical region, might be useful for managing CNP.

Clinical implications: The findings of reduced endurance in trunk muscles should consider incorporating interventions in the management of CNP to effectively address pain and disability.

Purpose: The most important cause of death among cardiovascular diseases is Coronary artery disease (CAD). Pain and insomnia symptoms are the most common symptoms in CAD patients. Acupressure is used in patients with CAD as one of the energy-based complementary and alternative methods. This study was conducted to investigate the effects of self-acupressure on pain and sleep quality in patients with coronary artery disease.

Design: This is a randomised controlled trial.

Methods: This study was conducted between June and August 2021 with a total of 80 participants, 40 in the intervention and 40 in the control group. The participants in the intervention group were asked to perform a total of 16 sessions for 4 weeks, 2 days a week in the morning and afternoon, for a total of 23 minutes, depending on the preparation and compression time to be performed on 5 points. The control group did not receive any intervention during the study. Data were collected by using Descriptive Information Form, Visual Analogue Scale (VAS) and Pittsburgh Sleep Quality Index (PSQI).

Results: After self-acupressure, the VAS total score of the intervention group decreased significantly compared to the control group (t=-11.861; p<.05). After intervention PSQI total and subscale mean scores of the intervention group decreased significantly compared to the control group (t=-7.767; p<.05). It can be seen that self-acupressure application has a negative and significant effect on PSQI total mean scores and VAS total mean score of patients (p<.05).

Conclusion: The results of this study showed that self-acupressure was effective in improving the pain and sleep quality of patients with coronary artery disease.

Clinical implications: Self-acupressure is an accessible and inexpensive method, it is recommended to be supported and maintained in the management of coronary artery disease in nursing practice.

Purpose: Patients in the intensive care unit suffer from pain caused by life-threatening illness or injury but also treatments such as surgery and nursing procedures such as venipuncture. Unconsciousness following head trauma or sedation stage complicates self-report, and both under- and over-management of pain can occur. Inadequate assessment and treatment might follow from unsuitable pain assessment practices. The aim of this study was to evaluate the effect of the implementation of a pain assessment tool on nurses` documentation of pain and the administration of analgesia and sedation.

Design: Quantitative pre-post design.

Methods: The study was conducted at one intensive care unit at a university hospital and involved 60 patient records and 30 pre-implementations and 30 post-implementations of the Critical-Care Pain Observation Tool (CPOT).

Results: After implementation, a 38% adherence rate was found. The frequency of nurses' pain evaluations increased significantly from 1.3 to 2.3 per nursing shift. The implementation of CPOT also improved how often nurses identified pain by use of facial expressions, muscle tension, and cooperation with the mechanical ventilator, whereas focus on vital signs dropped (p = .014). A larger proportion of patients (17%) received paracetamol after the CPOT implementation compared with before (8%). Findings were statistically significant at p < .01.

Conclusions: Implementation of CPOT increased the frequency of pain evaluations, and the observable patient behavior was more often interpreted as pain-related. Nurses' adherence rate to sustained patient behavior focus being modest highlights the essential need for ongoing improvements in practice. Implementation of a new tool must be followed by non-pharmacological and pharmacological pain management steps.

Clinical implications: Implementing the CPOT as a pain assessment tool has the potential to enhance assessment practices. However, it is important to note that simply increasing assessment frequency does not guarantee nursing interventions to alleviate pain. This indicates the need for additional steps to be taken in order for nurses to complete the pain assessment cycle and effectively address interventions and reassessments.

Purpose: Explore factors influencing pain management among female breast cancer survivors aged 65+ years with moderate to severe pain based on a score of 4 or greater on the 0-10 numeric rating scale.

Design: Qualitative descriptive study.

Methods: We interviewed 21 purposefully sampled women aged 65+ years who experienced moderate to severe pain. Researchers coded interview transcripts for factors affecting study participants' pain management experiences.

Results: Pain management facilitators included patient-centered interactions with care teams and reliance on psychosocial assets. Challenges included ineffective care team interactions and participants' negative perceptions of opioid analgesia. Other factors included pain attributed to cancer treatment, pain management plan adherence, and psychosocial influencers.

Conclusions: With regard to this sample, patient-centered communication and pain management education help female breast cancer survivors aged 65+ years manage their pain. Mitigation of opioid stigma and undermanaged painful comorbid conditions could further optimize pain management. Further research on the effects of breast cancer treatment, level of adherence to pain management recommendations, and psychosocial influences on pain management is needed.

Clinical implications: Providing contact information for care team members during and after clinic hours facilitates open communication, including timely reporting of new and undertreated pain. Collaborating with the patient and care team on a clear pain management plan and establishing parameters for when to notify the care team empower patients to optimize management of their pain. Verifying patients' understanding of prescribed analgesia and management of side effects and providing education as needed may reduce negative perceptions of opioid analgesia.

Purpose: This study was conducted as a descriptive study to determine the pain fears of patients undergoing surgery in the neurosurgery clinic.

Material and method: The study was conducted with 151 patients hospitalized in the neurosurgery clinic who met the inclusion criteria. Data were collected with the patient information form and the fear of pain scale-III. Ethics committee approval, institutional permission, and written consent from individuals were obtained before the study.

Results: It was determined that the mean fear of pain score was 64.59 ± 18.43, 41.7% of the patient were fear of surgical incisional pain. Fear of surgical incisional pain is responsible for 22.0% and female gender is responsible for 29% of the change in fear of pain scores.

Conclusion: As a result, it was determined that the pain fear level of the patients in the pre-operative period was moderate. Increasing the practices to reduce the patients' fear of pain should be recommended.

Purpose: Opioid medications are necessary in the treatment of critically ill infants; however. prolonged use may lead to withdrawal syndrome. The purpose of this study was to assess feasibility of delivering an acupressure protocol for the treatment of iatrogenic withdrawal in a pediatric cardiac intensive care unit as well as impact and acceptance of acupressure as an adjunct treatment.

Design: Randomized pilot feasibility trial.

Methods: Acupressure stickers were applied and rotated to one ear every 1-3 days until withdrawal symptoms improved.

Results: There were no serious adverse events, with only one reported incident of skin irritation. Recruiting benchmarks were exceeded. Weaning phases were significantly shorter in the acupressure group (medians 6.0 vs 22.0 respectively, p = .025, d = 0.90) and the control group used skin-to-skin contact as a comfort measure significantly more than the acupressure group (42.9% vs 6.3%, p = .18). Acupressure was accepted by parents, with an overall 96.2% rating their experience as positive, as measured by the Parent Client Satisfaction Questionnaire. The majority of health care providers (n = 19) were supportive, with 71.9% agreeing or completely agreeing acupressure is an acceptable adjunct for the treatment of withdrawal symptoms; 26.8% were neutral, as measured by the Acceptability of Intervention Measure, Intervention Appropriateness Measure, and Feasibility of Intervention Measure.

Conclusions: Acupressure was found to be safe, feasible, and accepted by health care providers in a pediatric cardiac intensive care setting.

Clinical implications: These findings support future research with larger sample sizes to improve clinical treatment of infants physically dependent on sedative medications.