| 1. |
- Andersen, R. D., et al.
(författare)
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The Complexities of Nurses’ Pain Assessment in Hospitalized Preverbal Children
- 2019
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Ingår i: Pain Management Nursing. - : Elsevier. - 1524-9042 .- 1532-8635. ; 20:4, s. 337-344
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Tidskriftsartikel (refereegranskat)abstract
- Background: Preverbal children are at increased risk for underassessment of pain. Pain is a social transaction involving the child in pain and the nurse assessor. However, our understanding of the nurse's part in this transaction is limited. Aims: The aim of this study was to explore nurses’ assessment of pain in hospitalized preverbal children based on self-selected clinical examples. Design: Qualitative, descriptive design. Settings: Five different hospital units in Canada and Norway. All units had an observational pain scale for preverbal children available for use. Participants/Subjects: Nurses (N = 22) with ≥1 year experience caring for preverbal children. Methods: Individual, semistructured interviews. Data were analyzed using inductive thematic analysis. Results: Nurses' assessment of pain in hospitalized preverbal children emerged as a nonlinear complex process incorporating different actions and reflections in response to the child's situation and expression of distress. Information from parents was routinely included in the assessment, although further parental involvement varied considerably. Although each assessment was personalized to the individual child, the nurse used previous experiences to interpret observations of and information from the child and the parents. Few nurses described using structured pain scales, but when used, these scales were included as only one aspect of their overall assessment. Conclusions: Nurses preferred pain assessment based on clinical judgment and tailored to the individual child. Implementation strategies that aim to integrate structured pain scales with clinical judgment to assess pain may be more likely to succed. Further examination of this approach is warranted.
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| 3. |
- Bjerså, Kristofer, et al.
(författare)
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Adjunct High Frequency Transcutaneous Electric Stimulation (TENS) for Postoperative Pain Management during Weaning from Epidural Analgesia Following Colon Surgery: Results from a Controlled Pilot Study.
- 2015
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Ingår i: Pain management nursing : official journal of the American Society of Pain Management Nurses. - : Elsevier BV. - 1532-8635 .- 1524-9042. ; 16:6, s. 944-950
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Tidskriftsartikel (refereegranskat)abstract
- The potential benefit of nonpharmacological adjunctive therapy is not well-studied following major abdominal surgery. The aim of the present study was to investigate transcutaneous electrical nerve stimulation (TENS) as a complementary nonpharmacological analgesia intervention during weaning from epidural analgesia (EDA) after open lower abdominal surgery. Patients were randomized to TENS and sham TENS during weaning from EDA. The effects on pain at rest, following short walk, and after deep breath were assessed by visual analog scale (VAS) grading. Number of patients assessed was lower than calculated because of change in clinical routine. Pain scores overall were low. A trend of lower pain scores was observed in the active TENS group of patients; a statistical significance between the groups was found for the pain lying prone in bed (p<.05). This controlled pilot study indicate benefits of TENS use in postoperative pain management during weaning from EDA after open colon surgery. Further studies are warranted in order to verify the potential beneficial effects from TENS during weaning from EDA after open, lower abdominal surgery.
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| 4. |
- Brorson, Hanna, et al.
(författare)
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Pain Relief at the End of Life: Nurses' Experiences Regarding End-of-Life Pain Relief in Patients with Dementia.
- 2013
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Ingår i: Pain Management Nursing. - : Elsevier BV. - 1532-8635 .- 1524-9042.
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Tidskriftsartikel (refereegranskat)abstract
- Patients with dementia receive suboptimal palliative care, and this patient group is at risk to have pain at the end of life. Because communicative impairments are common in this patient group, nurses play an important caregiver role in identifying, assessing, and relieving patients' pain. This study aimed to describe nurses' experiences regarding end-of-life pain relief in patients with dementia. This descriptive exploratory qualitative study was based on seven semistructured interviews. Burnard's content analysis inspired the data analysis. Two main categories were identified: (1) nurses' experience of difficulties concerning pain relief and (2) nurses' experience of resources concerning pain relief. Nurses experienced difficulties, such as feeling of powerlessness because of difficulties in obtaining adequate prescriptions for analgesics, ethical dilemmas, feeling of inadequacy because analgesia did not have the desired effect, and a feeling of not being able to connect with the patient. Factors, including knowledge about the patient, professional experience, utilization of pain assessment tools, interpersonal relationships, and interprofessional cooperation, served as resources and enabled end-of-life pain relief. The results of this study highlight the complexity of pain relief in patients with dementia at the end of life from a nursing perspective. The inability of patients with dementia to verbally communicate their pain makes them a vulnerable patient group, dependent on their caregivers. Knowing the life story of the patient, professional experience, teamwork based on good communication, and use of a pain assessment tool were reported by the nurses to improve pain relief at the end of life for patients with dementia.
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| 6. |
- Eriksson, Kerstin, et al.
(författare)
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Predictors for Early Physical Recovery for General and Orthopedic Patients after Major Surgery: Structural Equational Model Analyses
- 2020
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Ingår i: Pain Management Nursing. - : ELSEVIER SCIENCE INC. - 1524-9042 .- 1532-8635. ; 21:4, s. 371-378
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Tidskriftsartikel (refereegranskat)abstract
- Background: Attention to factors that may affect patients ability to experience enhanced recovery after surgery is essential in planning for postoperative care. Aims: To create models of predefined pre,- peri-, and postoperative variables in order to analyze their impact on patients physical recovery on postoperative days 1 and 2 after major orthopedic and general surgery. Design: An exploratory design with repeated measures was used, including 479 patients who had undergone orthopedic (289) or general surgery (190) at three hospitals. Methods: Pain, nausea, and level of physical ability were measured preoperatively and on postoperative days 1 and 2 by using the Numerical Rating Scale and items from the Postoperative Recovery Profile. Structural equation modeling was used to explore the impact of the predefined variables on patients physical recovery. Results: The orthopedic group contained significantly more women and significantly more patients with pain and opioid use. Although the models showed good fit, "traditional" preoperative (pain, nausea, physical abilities, chronic pain, opioid use) and perioperative variables (anesthesia, length of surgery) constituted few (orthopedic) or no (general surgery) predictive properties for physical recovery. Postoperative average pain intensity, average nausea intensity, and physical ability explained physical recovery on day 1, and physical recovery on day 1 predicted physical recovery on day 2. Conclusions: "Traditional" predictors had little effect on patients postoperative physical recovery, while associations with common postoperative symptoms were shown. Further research is needed to explore additional variables affecting early physical recovery and to understand how soon patients are physically ready to return home. (C) 2019 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.
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| 7. |
- Hanberger, Lena, et al.
(författare)
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Needle-Related Pain, Affective Reactions, Fear, and Emotional Coping in Children and Adolescents With Type 1 Diabetes : A Cross-Sectional Study
- 2021
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Ingår i: Pain Management Nursing. - : Elsevier. - 1524-9042 .- 1532-8635. ; 22:4, s. 516-521
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Tidskriftsartikel (refereegranskat)abstract
- Background: The self-care of type 1 diabetes (T1D) includes undergoing procedures with needles several times daily, which may cause pain and fear.Aims: The aim was to identify the degree of perceived pain, affective reactions, fear, and emotional coping among children and adolescents with T1D.Design: A cross-sectional survey was performed.Methods: Children and adolescents 7-18 years of age (n = 197) and their parents (n = 123) completed the Coloured Analogue Scale (CAS), the Facial Affective Scale (FAS), the Diabetes Fear of Injection Questionnaire (D-FISQ), and the Faces Emotional Coping Scale (FECS) in relation to needle procedures.Results: The higher the values of the CAS, FAS and D-FISQ scores, the lower values for coping were reported by children and adolescents regarding treatment with insulin pen or pump, blood glucose test, and venipuncture (p < .001). Patients reported strong negative affect regarding insulin injections (35%) and blood glucose tests (32%), as well as negative affect (48%, 69%) and substantial pain (27%, 50%) for inserting a pump needle and venipuncture, respectively. Parents reported significantly higher values than children on all scales and procedures except D-FISQ (blood glucose tests) and FECS (venipuncture).Conclusions: Children and adolescents who perceive greater pain during needle-related procedures have poorer coping ability. Pediatric diabetes teams need to identify those in need of extra support to develop pain coping strategies.
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