Pain Management Nursing最新文献

Purpose: Healthcare education programs often provide limited training in contemporary pain neuroscience, leaving future professionals ill-prepared to address the pervasive and biopsychosocial problem of chronic pain. Exploration of the level of understanding of contemporary pain neuroscience and the attitudes toward people in pain among university students may help educators identify appropriate roles for students in pain-related interprofessional education. This study assessed and compared knowledge of contemporary pain neuroscience and attitudes and beliefs toward individuals experiencing pain among university students.

Design: Cross-sectional observational study.

Methods: 284 undergraduate and graduate, healthcare and non-healthcare students completed the revised Neurophysiology of Pain Questionnaire and the Health Care Providers' Pain and Impairment Relationship Scale.

Results: Findings revealed a widespread lack of contemporary pain neuroscience knowledge and misinformed attitudes and beliefs about individuals in pain across most groups. Physical Therapy students demonstrated significantly greater contemporary pain neuroscience knowledge and more informed attitudes and beliefs compared to all non-physical therapy healthcare and non-healthcare students. Surprisingly, non-healthcare students displayed comparable contemporary pain neuroscience to healthcare undergraduate and non-physical therapy graduate students, further highlighting gaps in healthcare curricula. Attitudes and beliefs toward individuals in pain were deficient among non-physical therapy healthcare majors and non-healthcare students alike.

Conclusions: These results underscore the need for comprehensive, contemporary pain neuroscience education across healthcare disciplines.

Clinical implications: All universities should consider incorporating contemporary Pain Neuroscience Education into healthcare curricula. Improved knowledge and attitudes among physical therapy students highlight the potential for meaningful contributions to interprofessional pain education through leadership, collaboration, and shared learning.

Objectives: To evaluate the correlation between opioid administration, pupillary changes measured by pupillometry, and patient-reported pain levels in nonprocedural settings, and to assess the utility of pupillometry as an objective tool for pain assessment and opioid efficacy.

Design: Systematic review of published literature.

Data sources: A literature search was conducted in February 2022 using PubMed, CINAHL, Web of Science, and EMBASE to identify studies examining the relationship between opioids, pupillary responses, and pain.

Review/analysis methods: A total of 160 articles were screened, and 14 studies met inclusion criteria for final analysis. Studies were evaluated for associations between opioid administration, pupillary measurements, and pain levels, as well as for reported confounding factors influencing pupillary response.

Results: Most studies demonstrated a significant association between opioid administration and pupillary constriction or altered pupillary reflexes. Several studies also identified correlations between pupillary responses and reported pain levels. Age, intraoperative medications, and individual physiological variability were found to influence pupillary measurements and may act as confounders.

Conclusions: Pupillometry shows promise as an objective indicator of opioid effect and pain response, particularly in settings where subjective pain reporting may be limited or unreliable. However, its interpretation must account for patient-specific and clinical confounding factors.

Nursing practice implications: Pupillary measurement may serve as a useful adjunct to traditional pain assessment tools in outpatient and postoperative settings. Incorporating pupillometry alongside routine vital signs-such as blood pressure, respiratory rate, and temperature-may enhance pain evaluation and support safer opioid prescribing and monitoring practices. Further research is needed to guide clinical implementation and establish standardized protocols.

Purpose: Chronic pain and cognitive impairment share similar biopsychosocial risk factors; however, little work has directly explored how these factors influence the relationship between chronic pain and cognitive impairment. This review aimed toexamine and integrate available evidence on biopsychosocial factors that influence the relationship between chronic pain and cognitive impairment in adults and develop a framework that will guide future research on this topic.

Design: Integrative review.

Method: Guided by the Whittemore and Knafl (2005) framework, we conducted a search using PubMed, Embase, and CINAHL to identify peer-reviewed, English-language articles published between 2015 and February 2025 with available full text that examined biopsychosocial factors associated with cognitive impairment in adults with chronic pain.

Results: Thirty-one articles were included, revealing four themes: 1) nature and type of chronic pain, 2) biological aging processes, 3) psychological disturbances, and 4) socioenvironmental factors.

Conclusion: Biopsychosocial factors influence the relationship between chronic pain and cognitive impairment through various pathways. Individuals with multifocal chronic pain, which is intense and of long duration, may be at the highest risk for cognitive impairment. Markers of brain aging and epigenetic aging may mediate the relationship between chronic pain and cognitive impairment. Psychological disturbances and the stress response may further mediate cognitive outcomes. Socioenvironmental factors may act as moderators in the relationship such that individuals with low socioeconomic status experience worse cognitive outcomes.

Nursing practice implication: Cognitive assessments should be included in the routine care of individuals with chronic pain.

Purpose: High levels of stigma among patients with chronic pain contribute to negative psychological well-being. Existing measures have not focused on opioid stigma among individuals with chronic pain who may have legitimate need for opioid therapy.

Design: We developed a measure of opioid stigma that captures two constructs: perceived stigma (awareness of others' negative attitudes) and internalized stigma (application of stereotypes to oneself) among individuals with chronic pain.

Methods: We recruited 180 participants with chronic pain via the online platform CloudResearch to modify an existing stigma scale. We developed items related to perceived stigma (8 items) and internalized stigma (5 items). Concurrent and discriminant validity were evaluated using the Center for Epidemiologic Study Depression Scale-10, Rosenberg Self-Esteem and Brief Resilience Scales. Factor structure were based on Iterated principal factor analysis with Promax rotation.

Results: The final sample included 151 participants, primarily Caucasian (80%), between 30-39 years old (40%), with a history of opioid use (81%). A two-factor solution was identified (MSA = .90), representing perceived and internalized stigma (Eigenvalues 7.23, 2.53; inter-factor correlation = .45, alphas = .94, .94). Semi-partial item correlations ranged from .61-.78 for perceived stigma and .73-.82 for internalized stigma. Significant correlations were observed between perceived stigma and CESD-10 (0.19, p = 0.02), and internalized stigma and resilience (-0.26, p = .001).

Conclusion: The adapted 13-item measure demonstrates sound psychometric properties in evaluating awareness and agreement with stigmatizing attitudes, supporting its reliability and validity.

Clinical implications: Nurses are uniquely positioned to identify opioid stigma, develop interventions, and reduce its impact for individuals with chronic pain.

Background: Cancer-related pain is one of the most common and challenging symptoms affecting cancer patients, impacting their physical and mental health. The involvement of families in the management of cancer patients' symptoms has gradually become a trend.

Aims: The purpose of this study is to collect the real experiences of patients participating in family meetings focused on pain management from the patients' perspective.

Methods: A descriptive qualitative design was adopted, using phenomenological methods. Ten patients were interviewed using semi-structured interviews to clarify their real experiences of participating in family meetings focused on pain.

Results: The real experiences were divided into four major themes: obstacles in pain management, the effectiveness of family meetings in pain management, changes in participation in family meetings, and views on participating in family meetings. Specifically, family meetings can enable cancer patients to move from isolation to sharing, improving their self-management efficacy of pain.

Conclusions: Family meeting intervention is a positive experience. Family meetings enhance the knowledge and skills of patients and family members in pain management, increase their participation in pain care, and improve their emotional communication. When implementing pain management and family meeting intervention measures, the influence of different cultures should be considered.

Background: Since pain varies in patients with Parkinson's disease (PD), it is crucial to use an appropriate PD-specific pain scale to assess and manage pain. This study aimed to verify the reliability and validity of the Korean version of the King's Parkinson's Disease Pain Scale (KPPS).

Methods: Two hundred-thirty nine participants with Parkinson's Disease recruited from a tertiary medical center in Republic of Korea. Reliability was assessed through internal consistency and test-retest. For validity, the convergent and known-group validities were analyzed.

Results: Among the 239 PD participants, 205 (85.8%) experienced pain, measured by the Korean version of KPPS. For reliability, the Cronbach's α was .69, and test-retest reliability using intraclass correlation coefficient was .81. For convergent validity, the scale had statistically significant positive correlations with other pain characteristics, modified Hoehn and Yahr stage, activities of daily living, and nonmotor symptom. In addition, the scale was correlated with quality of life including EuroQol-5D and Parkinson's Disease Questionnaire-8. For known-group validity, the Korean version of the KPPS score was higher in women and in the group with higher modified Hoehn and Yahr stage. In addition, the scale was associated with motor fluctuation and dyskinesia.

Conclusion: The reliability and convergent and known-group validities of the Korean version of the KPPS were established. The use of this scale could contribute to the effective evaluation and management of pain in patients with PD in both research and clinical settings.

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.