Pain Management Nursing最新文献

Background: This study aimed to determine the tendency of older adults to present to the emergency department with pain complaints during the COVID-19 pandemic compared to the prepandemic period.

Methods: A cross-sectional, retrospective study design was used. Data were collected from the electronic medical records of older people who presented to emergency departments with pain before (March 2019-March 2020) and during the COVID-19 pandemic (April 2020-July 2021). We identified 10 pain diagnosis groups using ICD-10 codes. Patient data were grouped and cleaned using SQL scripts on the Oracle database.

Results: It was determined that 13.3% of 405,404 older people had presented to the emergency department with pain between March 2019 and July 2021. There was a 14.2% decrease in such admissions during the pandemic period. In the study, an increase was observed in the rates of older adults presenting to the emergency department with myalgia and joint pain. In contrast, the rates of those presenting with low back and neck pain, headache, eye pain, dysuria, and acute pain decreased during the pandemic. In the regression analysis, predictors for older adults' presentation to the emergency department with pain included age over 85 years (OR: 1.403), female gender (OR: 1.053), and myalgia (OR: 2.471).

Conclusions: During the COVID-19 pandemic, our study revealed fewer presentations to the emergency department for pain-related complaints. To prevent severe health problems from delayed care, we recommend expanding telemedicine, remote pain management, and home-based care. Further research is needed to examine the long-term effects of increased myalgia and joint pain.

Objectives: This study aimed to assess the efficacy of acupuncture in relieving postoperative pain.

Design: Systematic review and meta-analysis.

Data sources: The search strategy was designed according to the PICOS principle (population, intervention, comparison, outcome, and study). PubMed, Web of Science, Cochrane Library, and Embase were searched from the inception of databases to August 25th, 2022 to collect studies on acupuncture in the management of postoperative pain.

Review methods: Two researchers independently screened the searched studies using the EndNote X9 software. Relevant data were extracted, and the risk of bias in included studies was assessed. RevMan 5.4 software was used for data analysis, and the Grading of Recommendations, Assessment, Development, and Evaluation was used to assess the quality of evidence.

Results: A total of 25 studies were included. This meta-analysis showed statistically significant differences in the pain scores (SMD=-0.38, 95 %CI [-0.69, -0.07], p = .02) and the dosage of analgesics (SMD = -0.53, 95% CI [-0.99, -0.06], I² = 90 %, p < .00001] between the acupuncture group and the control group.

Conclusion: Acupuncture is effective for alleviating postoperative pain and reducing the dosage of analgesics. More well-designed, and large-scale prospective studies are needed to further validate the efficacy of acupuncture in relieving postoperative pain.

Nursing practice implications: Acupuncture is an acceptable choice for relieving postoperative pain since it is convenient, effective, and acceptable. Nurses can provide tailored guidance for patients to enhance their recovery and satisfaction.

Aim: This study was conducted to evaluate the effect of relaxation exercise with VR (Virtual Reality) glasses on pain severity, anxiety level, and vital signs in patients undergoing endoscopy.

Methods: This is a quasi-experimental study including a control group with a pretest/post-test applied. This study was conducted with a total of 100 patients, including 50 patients in the intervention and 50 patients in the control group. The data were collected by using Personal Information Form, Visual Analogue Scale (VAS), Visual Anxiety Scale, Vital Signs Form and Virtual Reality Glass Application Satisfaction Form.

Results: In the inter group evaluation, the mean systolic and diastolic blood pressure, heart rate and respiratory rate of the patients in the experimental group after endoscopy were found to be lower than the control group (p < .05). When the effect size value (Cohen d) of this finding was examined, it was found that the application of virtual reality glasses had a large effect on systolic and diastolic blood pressure and a moderate effect on respiration and heart rate. It was found that the mean VAS score of the patients in the control group after the endoscopy procedure was significantly higher than their mean values before the procedure (p = .001). There was no statistically significant difference in the mean VAS scores, anxiety scores and O2 saturation values of the patients in the experimental and control groups after the endoscopy. The mean virtual reality glasses satisfaction value of the patients was found to be 6.98.

Conclusion: Relaxation exercise performed with virtual reality glasses has positive effects on mean systolic and diastolic blood pressure values, heart rate and respiratory rate in patients undergoing endoscopy. In line with these results, it is recommended that the use of virtual reality glasses during endoscopy should be widespread by nurses.

Purpose: Headache is a prevalent and highly disabling neurological disorder. There are no data on its prevalence in and impact on hospitalized patients. The objective of this study was to describe the prevalence of headache in hospitalized patients, triggers associated with headaches in this population, and compliance with documentation in the electronic medical record system (EMRS).

Design: This was a prospective, descriptive, observational, cross-sectional study. Inpatients who agreed were included.

Methods: Demographic data, admission-related data, and headache data were collected. Data were obtained from the EMRS and direct interviews with patients. Data were collected at three time points in 2021 and 2022. Statistical analysis, comprising primary and secondary data analysis, was performed with R.

Results: Of the 403 admitted patients, 65.5% (264 of 403) participated. A total of 39% (103 of 264) had presented with headache during their hospitalization, of whom 48.5% (50 of 103) had experienced headache in the preceding 24 hours. Of these, 35.9% (37 of 103) identified stress and 26.2% (27 of 103) identified noise as the most frequent triggers and 24.3% (25 of 103) identified headache as a secondary symptom derived from the cause of admission. During the daily follow-up by the nurse, 95.5% (252 of 264) of patients indicated that they had been asked about pain in general and 11.4% (30 of 264) indicated that they had been asked specifically about headache. No records were obtained from the computer program because although some patients were asked about headache, answers were not recorded in the prespecified "headache" item in the EMRS.

Conclusions: Headache is a prevalent symptom in hospitalized patients. Health care professionals should ask, register, and care about headache routinely to improve patients' well-being.

Purpose: A current challenge that may exacerbate symptoms of compassion fatigue and compromise the ability to experience compassion satisfaction among nurses is pain management. This study examined the associations between nurses' comfort with administering pain management, confidence in providers' prescribing patterns and reported compassion satisfaction and compassion fatigue (measured as burnout and secondary traumatic stress).

Design: This exploratory study used a survey design to gather primary data from nurses via a convenience sampling method.

Methods: A survey was created and disseminated electronically to registered nurses from September to November 2019. The survey asked about nurses' comfort administering pain medications, confidence in providers' prescribing patterns, and the Professional Quality of Life Scale (ProQOL).

Results: While nurses reported comfort treating patients with pain and managing pain, they were less confident that providers opioid prescribing patterns. Confidence in provider prescribing was positively correlated with compassion satisfaction and negatively correlated with burnout.

Conclusions: Organizations should focus on continuing education of pain management, creating a culture of evidence-based pain management, and promoting effective communication.

Purpose: Conditioned Pain Modulation (CPM) is a useful tool for testing the functionality of endogenous pain modulation. However, inconsistent results have been obtained in clinical populations, possibly due to the wide variety of CPM protocols used and the influence of demographic and psychological characteristics of the individuals assessed.

Methods: We tested the sensitivity and reliability of four commonly used CPM paradigms in a sample of 58 healthy participants. We also checked how these measures were related to Temporal Summation of Second Pain (TSSP), sociodemographic (age and sex) and psychological variables (anxiety and stress).

Results: CPM results were influenced by the test stimulus used, with tests using pain pressure threshold (PPT) obtaining a greater number of responders (over 65%) and being the most sensitive (higher size effect: Cohen's d > 0.5). However, all measures showed excellent intrasession reliability, with strong agreement between the CPM magnitudes. CPM indices were not correlated with TSSP, age or sex, and the psychological scales did not differentiate CPM responders and non-responders.

Conclusions: Although the CPM indices showed good reliability, construction of a large database with standardized values for healthy individuals seems necessary for the use of CPM in clinical settings.

Background: Severe pain after foot/ankle surgeries is often underestimated because these procedures are perceived as less extensive than other orthopedic surgeries. However, surgeries involving the bones and joints in the foot and ankle can result in intense pain.

Aims: This study aimed to identify the incidence and risk factors associated with postoperative moderate to severe pain.

Design: We reviewed the medical records of 334 patients undergoing foot/ankle surgery under spinal anesthesia. The maximum numeric rating scale (NRS) pain scores were recorded at 12-hour intervals for 48 hours postsurgery, and the incidence of postoperative pain was calculated. Patients were then classified into two groups based on their maximum NRS score from the first postoperative day: those with no or mild pain (NRS score of 0-3) and those with moderate to severe pain (NRS score of 4-10). We collected variables related to the patient, surgery, and anesthesia and used logistic regression analysis to identify the factors associated with moderate to severe pain.

Results: Approximately 67% of patients experienced moderate to severe pain on the first day after foot/ankle surgery, with the peak severity occurring during the initial 12 hours. Performing spinal anesthesia alone (adjusted risk ratio [ARR], 1.44; 95% confidence interval [CI], 1.21-1.71; p < .001) and hindfoot/ankle surgery (ARR, 1.22; 95% CI, 1.03-1.44; p = .020) were identified as independent risk factors for moderate to severe pain.

Conclusions: Due to the high incidence of severe pain following foot/ankle surgery, patients who had spinal anesthetic alone or underwent hindfoot/ankle surgery are more likely to experience moderate to severe pain. Improved pain management measures are crucial for these patients to achieve better outcomes.

Purpose: The pain experience of patients with sickle cell disease (SCD) frequently consists of episodes of acute exacerbation. However, recent studies suggest that many patients who suffer from SCD have symptoms of chronic neuropathic pain. Additional research is needed to determine what role genotype plays in the patient's pain phenotype experience in SCD. The purpose of our project was to determine whether a catechol-O-methyltransferase (COMT) single nucleotide polymorphism (SNP), rs4680, was associated with the experience of chronic neuropathic pain in patients with SCD.

Design: Cross sectional study.

Method: In our study, 184 patients (98% African American, mean age 36.5 ± 11.6 years, 63% female) completed the Self-Reported Leeds Assessment of Neuropathic Symptoms and Signs (S-LANNS) and the Neuropathic Pain Symptom Inventory (NPSI) and provided blood samples for genotyping of the rs4680 SNP. We conducted a cross-sectional association study using a likelihood ratio test that compared a model with and without genotype as a predictor. We also used linear regression model to determine whether the Met allele was associated with pain in an additive model.

Result: 50% of the study participants had a Val/Val genotype, 41% had a Val/Met, and 9% had a MET/MET. Between the three rs4680 genotypes, the differences in the mean S-LANNS or NPSI scores were not statistically significant. The Met allele was also not significantly associated with neuropathic pain (S-LANNS p = .23; NPSI p = .73) in an additive SNP model.

Conclusion: Further studies with larger samples are needed to determine if the Met/Met genotype predisposes patients with SCD to neuropathic pain and if other polymorphisms in the COMT gene play a role in this process.