Pain Management Nursing最新文献

Background: Pain following a cesarean section is a significantly stressful experience, impeding women's fast recovery. Interventions such as hand and foot massage have been employed for pain management after cesarean sections, but their effectiveness remains undetermined.

Objective: To comprehensively explore the effects of hand and foot massage on improving pain management after a cesarean section.

Methods: We searched PubMed, Cochrane Library, Web of Science, CINAHL, and China National Knowledge Internet (CNKI) for randomized controlled trials (RCTs) published from database inception to March 1, 2023 (updated to August 31, 2024), in English or Chinese. The meta-analysis was conducted in Review Manager 5.4, in which the embedded Cochrane risk-of-bias tool was employed to evaluate the quality of eligible studies. The results were pain and anxiety assessments following cesarean sections. Subgroup analysis and sensitivity analysis with a fixed-effects model and random-effects models were used to justify the pooled standard mean differences (SMDs).

Results: Seven RCTs involving 581 women after a cesarean section were included. The meta-analysis revealed that hand and foot massage could significantly reduce pain right after (SMD = -3.55, 95% CI [-3.90, -3.19], p < .001); 60 minutes (SMD = -2.44, 95% CI [-2.82, -2,06], p < .001); and 90 minutes (SMD = -1.10, 95% CI [-1.42, -0.78], p < .001) after cesarean section. Anxiety was also immediately improved when foot and hand massage was performed the first day after the cesarean section (SMD = -0.58, 95% CI [-0.95, -0.20], p = .003).

Conclusions: This meta-analysis indicated that hand and foot massage are beneficial for pain and anxiety management among women following a cesarean section. Appropriate implementation in clinical practice was suggested at an early stage.

Background: Millions of people live with dementia worldwide, relying heavily on family caregivers. Pain is common in both people living with Alzheimer's disease (PLWAD) and their caregivers, contributing to stress and burden. To our knowledge, this is the first study to examine the relationship between pain, stress, hair cortisol, and mental health in PLWAD and their caregivers and how these factors are linked to caregiver burden.

Methods: This exploratory pilot study included five PLWAD-caregiver dyads. Participants completed questionnaires on pain, mental health, and demographics. Hair samples were collected for cortisol analysis. Pearson correlation coefficients (r) were used to assess relationships between various factors of PLWAD and their caregivers.

Results: Contrary to expectations, pain and mental health measures for PLWAD displayed a trend toward negative correlation with their hair cortisol levels. Conversely, caregiver pain and mental health measures had a trend toward positive correlation with their hair cortisol levels. There was also a trend that higher pain in PLWAD was associated with higher caregiver burden.

Conclusion: This exploratory pilot study showed associational trends suggesting a complex relationship between pain, mental health, and stress in PLWAD-caregiver dyads. This preliminary work will inform future studies that can help advance targeted, tailored interventions.

Background: An increased interest has been observed in the wide use of intravenous patient-controlled analgesia (IV-PCA) to control acute postoperative pain in both China and Thailand. The safety and efficacy of IV-PCA in patient care requires competent and capable staff nurses. This study aimed to appraise the capabilities of Thai and Chinese registered nurses regarding IV-PCA as a guide to develop educational programs.

Method: A descriptive cross-sectional survey was conducted with 203 Chinese and 270 Thai registered nurses. An anonymous self-report questionnaire addressing 6 domains of capabilities toward IV-PCA was used to collect the data. Descriptive and inferential statistics were employed to analyze the data.

Results: The study found that the mean percentage scores (MPS) of the overall capability on IV-PCA of the Thai and Chinese nurse participants were 55.5 (mean [M] = 57.3, standard deviation [SD] = 4.9) and 62.6 (M = 58.7, SD = 13.0), respectively, which indicated very low and low levels. Barriers to the use and care of patients receiving IV-PCA after surgery according to the Thai and Chinese nurse participants included a lack of knowledge and systematic training regarding IV-PCA and a lack of first-hand experience in providing care for IV-PCA patients.

Conclusion: The study results call for intensive and effective training and education concerning all domains for registered nurses involved with patients receiving IV-PCA.

Background: Pain and altered hemodynamic variables are among the most common complications in patients undergoing hand laceration repair in an Emergency Department.

Aim: This study aimed to evaluate the effects of using virtual reality (VR) technology on pain and hemodynamic variables in patients receiving hand laceration repair in an Emergency Department.

Method: This nonblinded randomized clinical trial included 160 patients undergoing laceration repair to their hands under local anesthetics from November 2020 to May 2021. The participants were randomly allocated to the experimental and control groups. Patients in the control group received routine care (such as ambient noise reduction, providing explanations about the surgery, and Lidocaine injection before the surgery). In the experimental group, a video containing natural landscapes and sounds was played using a semi-immersive VR headset during the surgery. Pain level and hemodynamic variables were measured immediately before and after the intervention. The pain was measured using the Critical Care Pain Observation Tool and Visual Analog Scale.

Results: Immediately after the intervention, systolic blood pressure (BP), respiration rate, and pain intensity were significantly lower in the intervention group compared with the control group (p < .05). There were no significant differences between the intervention and control groups regarding diastolic BP, mean BP, SPO2, heart rate, and muscular tension (p > .05).

Conclusions: Semi-immersive VR is effective in managing pain and hemodynamic variables during hand laceration repair. The nurses could use the semi-immersive VR to better control of pain and hemodynamic variables during hand laceration repair.

Purpose: Pain is a universal experience for hospitalized patients, with physical, psychological, spiritual, and cognitive implications. As hospitals seek to identify nonpharmaceutical options for managing acute pain, the role of chaplains has been overlooked. The purpose of this study was to evaluate the perceptions of nurses regarding chaplain involvement in pain management.

Methods: A survey was distributed to nurses to determine if they would request spiritual care services in various patient and family scenarios. Respondents were dichotomized into two groups based on self-report of whether they would contact a chaplain for patients with uncontrolled pain. Differences between groups were calculated using chi-square tests.

Results: Of 45 nurse respondents, 27 (60%) reported they would not contact a chaplain for patients with uncontrolled pain. Nurses who would consult the chaplain for pain management did not differ from nurses who would not consult the chaplain in terms of their own religious identification, knowledge of patient religious documentation in the medical record, or past experience with chaplain services.

Conclusions: Study findings suggest that nurses' perceptions of chaplain involvement in pain management must be addressed prior to implementing a new hospital pain management protocol.

Clinical implications: When developing and implementing new pain protocols based on holistic care of patients, hospitals should ensure that nursing staff are educated on when and how to incorporate chaplains as part of a holistic approach to managing acute pain.

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 must gather 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.

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.

Background: Cesarean section frequently is associated with different undesirable postoperative outcomes. Acute postoperative pain is one of the most frequently experienced adverse outcomes that occurs as the result of actual tissue damage. Previous studies have shown inconsistent results regarding the prevalence and predictors of acute postoperative pain. Therefore, this study aimed to assess the pooled prevalence and associated factors of postoperative pain after cesarean section.

Methods: This is a systematic review and meta-analysis study that was performed on the basis of studies published within the last 10 years on the prevalence and associated factors of postoperative pain after cesarean section. After PubMed, Google Scholar, HINAR, Scopus, Web of Sciences, Cochrane, EMBASE, and gray literature extensive search for primary studies, their quality was assessed and data was extracted. STATA^MP, version 17.0, was used for all possible analyses of the study.

Results: Twenty-eight studies were included in this systematic review and meta-analysis. The pooled prevalence of postoperative pain was 58% (95% confidence interval [CI] 48%, 67%) with heterogeneity (I² 99.33%). Incision length >10 centimeters (odds ratio [OR] 2.34 [95% CI 1.71, 2.97]); spinal anesthesia without adjuvant (OR 3.45 [95% CI 1.56, 5.33]); general type of anesthesia (OR 3.54 [95% CI 2.61, 4.48]); presence of preoperative anxiety (OR-1.73, 95% CI 1.12-2.35); and no peripheral nerve block (OR 3.23 [95% CI, 2.27-4.18]) were associated with the prevalence of postoperative pain significantly.

Conclusions: The pooled prevalence of acute postoperative pain after cesarean section was high (58%), which needs more strategies for pain management. Incision length >10 centimeters, spinal anesthesia without adjuvants, general type of anesthesia, preoperative anxiety, and no peripheral nerve block were significantly associated with this prevalence.

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.