Pain Management Nursing最新文献

Purpose: The Activity-Based Checks of Pain (ABCs) is a pain assessment tool incorporating activities of daily living and instrumental activities of daily living. This instrument is designed to focus on functional capabilities and limitations due to pain. This study was designed to validate the factorial structure of the ABCs and assess its use in participants with chronic pain.

Methods: Participants were recruited in two phases. Phase one optimized the design of the ABCs, with 297 subjects selecting their preferred icon for each function and rating its understandability. The most preferred and understandable icons were then used in phase two, where 304 participants with chronic pain completed the ABCs, the Patient-Reported Outcomes Measurement Information System (PROMIS) with additional PROMIS items that were analogous to the ABCs functions but not represented in the PROMIS-29, and the Brief Pain Inventory (BPI). Data were analyzed using exploratory factor analysis and confirmatory factor analysis.

Results: Four factor loadings resulted in: multiplanar activities, sitting and/or hip flexor pain, walking and/or ambulation, and pain interference with lightweight unilateral activities. High internal consistency was demonstrated for all four factor loadings (0.623-0.879, 0.577-0.824, 0.512-0.841, 0.519-0.817, respectively). Correlations between items in the ABCs, PROMIS, and BPI resulted in moderate to strong correlations. Test-retest reliability was moderate to strong (intraclass correlation coefficient: 0.74).

Conclusions: The results confirm the ABCs as a valid and reliable tool for assessing the impact of pain on function in patients with chronic pain.

Purpose: To explore associations between arthritis-related joint pain and walking duration as a primary physical activity among older adults with arthritis.

Design: Cross-sectional secondary data analysis.

Method: This study used data from the 2019 Behavioral Risk Factor Surveillance System (BRFSS), focusing on respondents aged 50 and older who self-reported a physician diagnosis of arthritis (N = 31,067). Weekly walking duration and joint pain level (none, mild, moderate, severe) were self-reported. A multinomial logistic regression model was applied to examine associations between walking duration and joint pain levels, controlling for age, gender education, income, and race/ethnicity.

Results: Walking ≥ 151 min/week was associated with a 15%-28% reduction in the odds of experiencing moderate joint pain and a 23%-30% reduction in the odds of experiencing severe joint pain compared with walking < 150 min/week (all p < .05).

Conclusion: Although causality could not be inferred due to the cross-sectional design, moderate increases in weekly walking were significantly associated with lower levels of joint pain. Walking for 301-450 minutes per week (43-64 minutes per day) was linked to substantial pain reduction.

Clinical implication: These findings support the role of cumulative daily walking as a therapeutic strategy for managing joint pain in older adults with arthritis. Barriers to walking should be addressed in clinical assessments and nursing interventions to enhance effectiveness.

Background: Pain management in people with dementia is challenging, and there is a knowledge-practice gap in this area.

Objective: The purpose of this study was to comprehensively analyze and synthesize the current evidence on healthcare personnel's knowledge, attitudes, and practices regarding pain management for people with dementia.

Methods: An integrative review was conducted. Six electronic databases, including PubMed, CINAHL, Web of Science, PsycINFO, Cochrane Library, and EMBASE, were searched to identify qualified articles. After removing the duplicates, the search results underwent title screening, abstract screening, and full-text review. The 2018 Mixed-Methods Appraisal Tool was used to evaluate the quality of the included articles. Data analysis incorporated data reduction, display, comparison, conclusion drawing, and verification.

Results: A total of 32 full-text articles were included, and five themes were summarized based on the knowledge-attitude-practice (KAP) model as (1) inadequate knowledge; (2) mixed negative and positive attitudes towards pain management; (3) challenges in pain identification; (4) challenges and barriers to comprehensive pain assessment; and (5) undertreated and poorly documented pain.

Conclusion: Initiatives that prioritize improving healthcare personnel's knowledge, fostering positive attitudes, and promoting the adoption of effective assessment and management methods in pain management for individuals with dementia are essential.

Clinical implications: Nurses should participate in comprehensive training and education on dementia-specific pain assessment, proactively collaborate with interdisciplinary healthcare personnel, and ensure timely communication with family caregivers. Additionally, integrating structured pain assessment tools into electronic health records and standardizing documentation protocols could enhance care coordination and quality.

Purpose: To investigate the effectiveness of integrating respiratory exercises with core stability training compared to core stability training alone in improving outcomes for males with chronic non-specific low back pain (CNLBP).

Design: A randomized controlled trial was conducted with 28 male participants aged 35-55 years over an eight-week period.

Methods: Participants with CNLBP were recruited at the Sport Science Laboratory of Bu-Ali Sina University between September 2021 and October 2022. They were randomly assigned to either a combined core stability and respiratory exercise (CCSRE) group (n=14) or a core stability exercise (CSE) group (n=14). Outcome measures included the Visual Analog Scale (VAS) for pain, Roland-Morris Disability Questionnaire (RMDQ) for functional disability, and Y-Balance Test (YBT) for dynamic balance, assessed 1-3 days before and after the intervention. Repeated measures analysis of variance was used to evaluate group-by-time interactions (p<0.05).

Results: Significant group-by-time interactions were observed for pain (F = 22.17, p = 0.001, η² = 0.460), dynamic balance (F = 10.74, p = 0.003, η² = 0.292), and functional disability (F = 18.58, p = 0.001, η² = 0.417). The CCSRE group demonstrated greater reductions in pain and functional disability and larger improvements in dynamic balance compared to the CSE group.

Conclusion: The integration of respiratory exercises with core stability training significantly reduces pain and functional disability while enhancing dynamic balance in males with CNLBP compared to core stability training alone.

Clinical implications: Incorporating respiratory exercises into core stability training can enhance therapeutic outcomes for males with CNLBP, offering a more effective rehabilitation strategy to reduce pain and improve functional capacity.

Purpose: To compare the effects of nonpharmacological interventions on pain, fear, satisfaction, and duration of peripheral intravenous catheterization (PIC) in children.

Design: A randomized controlled trial.

Materials and methods: The study was conducted in a training and research hospital in northwest Türkiye between October 2023 and March 2024 with 90 patients, ages 5-12. Children were divided into three groups using a simple randomization method: (1) palm stimulator (n = 30), (2) cartoon (n = 30), and (3) control (n = 30). The child, parent, and observer assessed the children's pain and fear levels before, during, and after PIC. After PIC, the children's and parents' satisfaction was evaluated.

Results: The average age of the children was 7.81 ± 2.62. The pain scores recorded for the intervention groups before, during, and one minute after the PIC were significantly lower than those of the control group. The fear scores reported by the children during the PIC were as follows: 1.26 ± 1.50 in the palm stimulator group, 1.33 ± 1.32 in the cartoon group, and 2.76 ± 1.38 in the control group, indicating a statistically significant difference between the groups. However, there was no significant difference in the satisfaction scores of children and parents across the groups. Additionally, the duration of the PIC was the shortest in the control group.

Conclusions: The use of palm stimulators and cartoons as nonpharmacological methods in pain intervention for children significantly reduced pain levels before, during, and after procedures. This study, which included evaluations by children, parents, and observer, found that the palm stimulator impacted pain and fear levels comparable to watching a familiar cartoon. Although there was no difference in overall procedure satisfaction between the groups, the satisfaction score for the palm stimulator was notably higher.

Clinical implications: The palm stimulator and cartoon film methods can reduce pain and fear during PIC in children. These methods significantly reduced the pain and fear of our participants during PIC.

The clinical trial registration number: NCT06772259.

Purpose: To investigate the relationships among shoulder pain, functional disability, perceived stress, and health-related quality of life (HRQOL), as well as to assess the educational needs related to shoulder pain prevention among middle-aged Korean women.

Design: Cross-sectional study.

Methods: This study included middle-aged Korean women recruited between November 27 and December 28, 2022. Data were collected using the Shoulder Pain and Disability Index (SPADI), the 12-item Short-Form Health Survey (SF-12) for HRQOL, the Perceived Stress Scale, and a structured questionnaire assessing educational needs related to shoulder pain prevention. Descriptive and frequency analyses were conducted to examine the general characteristics of participants. Chi-square tests were conducted to compare sociodemographic and behavioral variables by SPADI severity. Differences in HRQOL, shoulder pain, disability, and perceived stress based on educational needs were analyzed. Pearson's correlation analysis was conducted to examine the relationships among variables, and stepwise multiple regression was employed to identify factors influencing HRQOL.

Results: Participants with moderate-to-severe shoulder pain (SPADI ≥30) reported significantly higher levels of work-related physical burden, lower educational attainment, and greater willingness to participate in shoulder pain prevention education than those with milder symptoms. Perceived stress levels were also significantly higher among participants in the moderate-to-severe SPADI group compared to those with lower scores. Additionally, significant differences in physical and mental health were observed based on the educational demand for cause and symptom management of participants. Mental health and perceived stress also differed significantly according to demand for posture education. Stress levels varied significantly by demand in indoor home training and proper desk and chair positioning for shoulder pain prevention. Increased shoulder pain was positively correlated with greater disability and perceived stress, alongside declines in physical and mental HRQOL.

Conclusions: Most participants sought education focused on shoulder pain causes, management, stress relief, and psychological support.

Clinical implications: A mobile app-based educational intervention is recommended to alleviate shoulder pain and stress while offering information on its causes, symptoms, and management.

Background: Pain is a barrier to gynecological procedure completion. Best practices recommend pharmacotherapy and assessment techniques (e.g., trauma-informed history) to manage pain. Non-pharmacological interventions, including distraction techniques (e.g., heat and breathing), demonstrate minor effectiveness, low side effects and low cost. However, there is a paucity of evidence exploring the implementation of pain management interventions into gynecological services. The purpose of this paper is to map a pain management intervention in order to increase our understanding of how to create environments supportive of pain management and patient safety for adults receiving gynecological procedures.

Methods: We applied Intervention Mapping to the development and implementation of a pain management intervention known as the Adult Comfort Promise. We used informant conversations with healthcare providers, identified as pain champions, to complete the six steps of Intervention Mapping. We completed the following Intervention Mapping steps: 1) conduct a needs assessment, 2) create change objectives, 3) select theory-based interventions, 4) design the intervention, 5) plan for adoption and implementation and 6) evaluation. This included a barriers and facilitators assessment, mapped to the Inside out socioecological model by Golden et al. We used member checking to confirm the accuracy of our findings.

Results: From August 2023 onwards, healthcare providers in an Ambulatory Care Clinic, within a tertiary-level healthcare center for women, youth, children and gender diverse individuals in the Maritime Canadian provinces, designed and implemented an intervention to improve the assessment, prevention and treatment of procedural pain for in-office gynecological procedures. Creating supportive environments for comfort and pain management required multiple factors, including policies, pain champions, ongoing monitoring, and support from leadership. Future research will evaluate the intervention's effectiveness, acceptability and fidelity.

Conclusion: Intervention Mapping was a valuable method for identifying opportunities for patient empowerment and implementation strategies for the Adult Comfort Promise. These findings may be transferable to other procedures or settings (e.g., primary care, student health, or community clinics). Intervention Mapping offers a guide to designing and implementing other pain management interventions to improve procedure completion. It may be useful for nurses as they implement pain management interventions into practice.

Purpose: This study aimed to examine the effects of virtual reality and music on pain, anxiety, itching, and vital signs of children during a skin prick test and evaluation.

Methods: This randomized controlled trial was divided into three groups: virtual reality (n = 30), music (n = 30), and control (n = 30). Anxiety, pain, vital signs, and itch were assessed.

Results: There was no significant difference between the groups in terms of sociodemographic characteristics; pain, anxiety levels and vital signs, except pre-procedural heart rate (p > .05). The mean age of the groups was similar (p = .946). The gender ratios were similar amongst the groups (p = .585), with 53% of the children in the VR group as female, 47% of the children in the music group as female, and 60% of the children in the control group as female. The pain scores and respiration rates of the children in the Virtual reality group were lower than those in the music and control groups during the skin prick test (p < .05). Children in the Virtual reality and music group indicated decreased levels of anxiety, respiration rates, and itching at 5, 10, and 15 minutes of the skin prick test evaluation compared to the control group (p < .05).

Conclusions: Virtual reality was found to be highly effective in reducing pain and respiratory rate during skin prick testing and in reducing heart rate after skin prick testing.

Purpose: This study aimed to compare the effect of auditory distraction and virtual reality (VR) on pain severity and physiological indicators during burn dressing changes among adult patients.

Design: A single-center, randomized controlled trial.

Methods: A total of 60 patients were randomly assigned to the auditory distraction (n = 20), VR (n = 20), and control (n = 20) groups. All patients in the three groups received intravenous morphine at a dose of 0.05 mg/kg body weight, 15 minutes prior to the dressing change. The auditory distraction group listened to music during the dressing, while the VR group used a headset to view nature images throughout the dressing procedure. Data collection tools were the numeric pain scale, a checklist form of the physiological Indicators, and a pulse oximetry device.

Result: Statistically significant differences in pain severity were observed among the VR, auditory distraction, and control groups during dressing changes (p < .05). Despite all patients receiving intravenous morphine (0.05 mg/kg), both interventions led to greater pain reduction. Oxygen saturation and respiratory rates also differed significantly across groups (p < .05), with posthoc analysis confirming that both interventions were equally effective and superior to standard care.

Conclusions: This study's findings demonstrated that auditory distraction was as effective as VR techniques in reducing fluctuations in physiological indicators and pain severity during dressing changes in adult patients.

Clinical implications: Nonpharmacological interventions can serve as effective adjuncts alongside pharmacological treatments in pain management nursing.