Pain management nursing : official journal of the American Society of Pain Management Nurses
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It is very important for nurses to have a clear understanding of the patient's pain experience and of management strategies. However, a review of the nursing literature shows that one of the main barriers to proper pain management practice is lack of knowledge. ⋯ The purpose of this article is to discuss the role of computer-based simulations as a reliable educational technology strategy that can enhance the learning experience of nursing students acquiring pain management knowledge and practice. Computer-based simulations provide a significant number of learning affordances that can help change nursing students' attitudes and behaviors toward and practice of pain assessment and management.
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Randomized Controlled Trial
Nonpharmacologic Pain Management Interventions in German Nursing Homes: A Cluster Randomized Trial.
The reported prevalence of pain among nursing home residents (NHRs) is high. Insufficient use of analgesics, the conventional pain management strategy, is often reported. Whether and to what extent nonpharmacologic therapies (NPTs) are used to manage the pain of NHRs in Germany is largely unknown. ⋯ Given the prevalence of pain in NHRs, there is a clear need to improve pain management in this population. Extended use of NPT offers a promising approach. We recommend that nurses provide residents with education on pain-management techniques to support them in taking a proactive role in managing their pain.
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Randomized Controlled Trial Pragmatic Clinical Trial
Effects of Natural Sounds on Pain: A Randomized Controlled Trial with Patients Receiving Mechanical Ventilation Support.
Nonpharmacologic pain management in patients receiving mechanical ventilation support in critical care units is under investigated. Natural sounds may help reduce the potentially harmful effects of anxiety and pain in hospitalized patients. The aim of this study was to examine the effect of pleasant, natural sounds on self-reported pain in patients receiving mechanical ventilation support, using a pragmatic parallel-arm, randomized controlled trial. ⋯ The trial arms were similar at baseline. Pain scores in the intervention arm fell and were significantly lower than in the control arm at each time point (p < .05). Administration of pleasant, natural sounds via headphones is a simple, safe, nonpharmacologic nursing intervention that may be used to allay pain for up to 120 minutes in patients receiving mechanical ventilation support.
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Pain management trajectory data that includes previous pain treatments, timing, changes, and outcomes provide crucial data for patients with chronic pain and their practitioners to use when discussing ways to optimize pain management regimens. The aim of this study was to test the use of the life history calendar method to identify pain treatments, treatment regimens, timing, and outcomes of the pain management trajectory of individuals with chronic pain, and to examine feasibility. A pilot, descriptive, methodological design was used. ⋯ Participants identified pain treatments, discriminate between treatments and between OA and other conditions, and identified treatment effects. Treatment sequence was identified, but more precise timing was generally not reported. Pain management trajectories could provide a helpful way for practitioners to discuss safe, efficacious pain management options with patients.
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Pain assessment in older individuals with cognitive impairment is challenging. Evidence on the performance of pain assessment tools in this population remains limited. The aim of this study was to evaluate the performance of self-reported pain, nurse-reported pain, and observational pain tools among older patients with cognitive impairment using a prospective observational design. ⋯ There was statistically significant correlation between SRP and GDS-15 (r = 0.382, p < .001) but not between SRP and MMSE (r = 0.018, p = .824). These results suggest that the use of an observational pain scale would be helpful in pain assessment among older individuals when the ability to report pain is not possible. However, self-reported assessments should be attempted first for cognitively impaired patients.