Pain Management Nursing最新文献

Objectives: Evaluate the effectiveness of adding health education programs to a fibromyalgia intervention, focusing on pain intensity and the impact of fibromyalgia on quality of life.

Design: Systematic review and meta-analysis of randomized controlled trials.

Data sources: Databases: Web of Science, Medline, Scopus, Cumulative Index to Nursing and Allied Health Literature, Latin American and Caribbean Health Sciences Literature and PsycINFO.

Review/analysis methods: Literature from 2005-2025 was reviewed. Risk of bias was assessed by two researchers using the Cochrane Collaboration's tool. Quality of evidence was measured using the Grading of Recommendations, Assessment, Development, and Evaluation tool.

Results: The systematic review included 7 randomized controlled trials. 6 studies were included in the meta-analysis of the impact of fibromyalgia on quality of life, and five in the pain intensity meta-analysis. Meta-analysis results showed that health education significantly reduced pain intensity (MD=-13.10; 95% CI [-22.06, - 4.14], p=0.004) and improved the impact of fibromyalgia on quality of life (SMD=-0.39; 95% CI [-0.55, -0.23], p<.001). Subgroup analyses showed that adding education to usual care led to clinically relevant reduction in pain intensity (MD=-19.53; 95% CI [-31.68, -7.39], p=0.002) and statistically significant improvement in the impacf of fibromyalgia on quality of life (SMD=-0.46; 95% CI [-0.66, -0.26], p < .001).

Conclusions: Health education programs are effective in improving pain intensity and reducing the impact of fibromyalgia on quality of life. Further research is needed to support findings.

Nursing practice implications: By implementing health education for fibromyalgia patients, nurses can improve outcomes, enhancing the quality of care provided.

Background: A majority of adults undergoing heart surgery involving cardiopulmonary bypass (CPB) will experience acute pain.

Aims: To explore the effects of nursing interventions based on behavior change theory (BCT) on pain severity, pain interference, sleep quality, perceived control, quality of life, and self-care abilities.

Methods: A total of 53 patients undergoing CPB heart surgery in one hospital were enrolled. The patients were divided into Behavior Change Theory (BCT) group (n = 33) and Usual Care (UC) group (n = 20), among whom patients in the UC group received routine nursing intervention, while patients in the BCT group received nursing intervention based on BCT. Patients were evaluated for pain, sleep, perceived control, quality of life, self-care abilities, Hamilton Anxiety Scale (HAMA), and Hamilton Depression Scale (HAMD) questionnaires at baseline and after the intervention.

Results: Individuals in the BCT group demonstrated reduced pain levels, improved quality of life, enhanced self-care abilities, and lower scores of the HAMA and HAMD scales compared to those in the UC group (all p < .05). Implementation of BCT resulted in improvements in perceptual control (p < .001), reductions in pain interference (p = .02), and pain severity (p = .03). Group effects remained significant in terms of perceived control and pain interference (both p < .05), with trends observed in pain severity after adjusting baseline difference variables (p < .10). Sleep quality, assessed by PSQI, did not differ significantly between groups (p = .288).

Conclusion: Nursing interventions rooted in BCT holds the potential to augment patients' perception of control, elevate quality of life, enhance self-care abilities, and alleviate pain after CPB heart surgery.

Background: Physicians and nurses experience a high prevalence of non-specific neck-shoulder pain (NNSP) and are exposed to multiple risk factors. However, no targeted tools comprehensively assess these risk factors.

Objective: This study aimed to develop assessment indicators for evaluating risk factors contributing to NNSP among physicians and nurses.

Design: A systematic literature review and Delphi method, guided by a theoretical framework, were employed to develop the index system.

Methods: This study utilized a theoretical framework based on ergonomics and the biopsychosocial pain model to collect multi-source data for developing a risk assessment index system. Initially, candidate indicators were identified through literature reviews, theoretical analysis, expert interviews, and consultations. Three rounds of the e-Delphi technique were conducted to identify indices potentially affecting neck-shoulder pain. Finally, the analytic hierarchy process (AHP) method was employed to calculate the relative weight of each indicator.

Results: After two rounds of expert consultation, the risk assessment index system reached a consensus, comprising six first-level indicators: workload factors, individual factors, work facilities and equipment factors, workspace and environment factors, organization management factors, and psychological factors. These were further divided into 14 second-level indicators and 82 third-level indicators. Among these, workload factors had the highest weight (0.2484), while psychological factors had the lowest (0.1019).

Conclusion: The risk assessment index system achieved expert consensus, confirming its scientific validity and practical applicability. It provides a structured approach to identifying risk factors and high-risk individuals for neck-shoulder pain among physicians and nurses.

Purpose: To identify the pain experiences of cancer patients and the expectations of patients and caregivers in relation to pain management.

Design: Phenomenological qualitative study.

Methods: We used convenience sampling to recruit patients who had experienced pain level ≥4 according to the Numeric Rating Scale and their caregivers. The interview script was developed from the Nursing Outcomes Classification. We conducted a narrative analysis of the content.

Results: Eleven participants (eight patients and three caregivers) were included. The results were grouped into three main themes: 1) the experience of pain: the description and consequences of pain on participants' lives, and the meaning it has for patients and caregivers; 2) pain management: pharmacological and non-pharmacological pain management, the support of friends and family, and the lack of references and empowerment in pain management), and 3) expectations: communication with professionals, care by nurses, and pain relief and support.

Conclusions: The participants' oncological pain was intense, persistent and complex. Outpatient management of pain was difficult and was conditioned by the knowledge of patients and caregivers, but also by the professional's degree of experience. Nurses should be trained in the evaluation and management of oncological pain, so that they can educate patients and caregivers.

Objectives: Current guidelines for the treatment of fibromyalgia support a multicomponent approach combining pharmacological and nonpharmacological interventions. The potential effectiveness of a nonpharmacological multicomponent pilot program combining psychosocial education, water-based therapy, and relaxation was assessed.

Methods: Participants with fibromyalgia attended 3-to-4-hour weekly sessions for 8 weeks. The sessions were held in groups of eight to nine patients and included physical and educational components. The physical component included a 1-hour balneotherapy followed by a 1-hour relaxation. The educational component included eight 1-to-2-hour sessions with pain specialists, trained nurses, a sleep specialist, a nutritionist, a psychologist, and a psychometrician. The program staff recorded self-reported symptoms at the start (T0), the end (week 8 [W8]), and 6 months after the end (month 6 [M6]) of the program, using the Fibromyalgia Impact Questionnaire (FIQ) and the Hospital Anxiety and Depression Scale (HADS) questionnaire.

Results: Sixty-eight patients (66 females, mean age 49 years) participated in the program and gave informed consent for the analysis. Fifty-six had data available for all questionnaires at all time points (T0, W8, and M6). Patients with a T0 FIQ score of ≥59 had higher mean T0 anxiety and T0 depression scores compared with other patients (anxiety: 15.1 [SD 4.43] v 12.2 [SD 2.63], p = .0014; depression: 11.7 [SD 3.68] v 10.1 [SD 3.63], p = .049). Compared to T0 values, the anxiety and depression scores significantly decreased at W8 (anxiety T0: 13.7 [SD 3.95] v. W8 12.3 [SD 4.04], p = .0009; depression T0: 11.0 [SD 3.71] v W8: 9.4 [SD 3.81], p = .0019); and the FIQ score significantly decreased at W8 in the group of patients with a T0 FIQ score ≥59 (T0 FIQ 69 [SD 7.82] v W8 FIQ 59.9 [SD 9.6], p = .0004).

Conclusions: This pilot analysis suggests that this multicomponent intervention has the potential to alleviate anxiety and depression symptoms and improve the quality of life of patients with fibromyalgia. Further randomized trials should assess the short- and long-term effectiveness of this intervention.

Introduction: One of the most common chronic musculoskeletal pain disorders is myofascial pain syndrome (MPS). A previous study showed that the levels of inflammatory mediators and growth factors were elevated in MPS. The objective of the current study was to examine sex differences in inflammatory mediators in patients with acute MPS and asymptomatic controls.

Methods: This cross-sectional study included a total of 57 patients (33 females; 24 males) clinically diagnosed with acute MPS who were consecutively recruited from the hospital emergency department, and 31 healthy subjects (12 females; 19 males) who were recruited via advertisements in the hospital and community. Serum inflammatory mediators and growth factors were measured in patients with MPS within 24 hours of symptoms and in healthy controls, using antibody-immobilized beads on a Luminex analyzer.

Results: The levels of inflammatory mediators and growth factors were significantly higher in patients with MPS compared with healthy controls. No significant sex differences were observed in the MPS group in the levels of tumor necrosis factor-α (TNF-α), monocyte chemoattractant protein-1 (MCP-1), interleukin-8 (IL-8), macrophage inflammatory protein-1α (MIP-1α), interleukin-1α (IL-1α), fibroblast growth factor-2 (FGF-2), or platelet-derived growth factor (PDGF). Similarly, in healthy controls, no sex differences were found in TNF-α, MCP-1, IL-8, MIP-1α, MIP-1β, IL-1α, granulocyte-macrophage colony-stimulating factor (GM-CSF), or PDGF levels. Median G-CSF levels were significantly higher in males with MPS 103.0 (48.0-211.5) compared with females 51.7 (31.0-77.8) with MPS (χ(3) = 16.02, p < .05), while no sex differences were found in healthy controls. In males compared with females with MPS, there was a trend of higher median levels of GM-CSF, MIP-1β, and vascular endothelial growth factor. In healthy males compared with female controls, the levels of FGF-2 (105.2 [56.1-137.6] vs. 59.5 [38.8-80.7], χ(3) = 20.14, p = .04) and GM-CSF (19.9 [9.1-47.6] vs. 8.3 [4.2-11.9], χ(3) = 16.02, p = .03) were significantly higher.

Conclusion: The levels of several of the inflammatory mediators assessed in this study were elevated to a similar extent in both healthy males and females and those with acute MPS.

Purpose: This study aimed to evaluate the effectiveness of Progressive Muscle Relaxation (PMR) on postoperative pain level and sleep quality in patients undergoing open heart surgery.

Design: A single center, two-group, single-blind randomized controlled trial.

Methods: This study comprised 60 patients who were admitted to the cardiovascular surgery department and undergoing open heart surgery between January 2023 and April 2024. Patients were randomized into 30 in the experimental group and 30 in the control group. Data were collected using Patient Identification Form, Short-form of McGill's Pain Questionnaire (SF-MPQ) and Richard-Campbell Sleep Questionnaire (RCSQ). PMR were applied twice a day, morning and evening, on the post-operative days 1st, 2nd, and 3rd days to experimental group. Before and after PMR, the patients' pain level and sleep quality were evaluated. The control group received usual care and treatment.

Results: In the experimental group, pain level decreased significantly from 9.36 points on the 1st day to 1.50 points on the 3rd day in the post-operative service (p0.001). In the control group, pain level decreased only to 6.13 points on the 3rd day. It was determined that sleep quality gradually increased in the experimental group and reached 545.83 points on the 3rd day in the post-operative service. In the control group, it increased only to 330.16 points. A significant difference was found pain level and sleep quality in all measurements between the experimental and control groups.

Conclusions: In this study, it was suggested that progressive muscle relaxation reduces pain and improves sleep quality in patients undergoing open heart surgery. It is recommended that nurses include progressive muscle relaxation in postoperative pain control and sleep management in usual care.