Pain management nursing : official journal of the American Society of Pain Management Nurses
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Patients with chronic pain and/or spasticity who have an intrathecal targeted drug delivery (TDD) pump require frequent needle access procedures to refill the pump's medication reservoir. Some patients find the access procedure painful and/or anxiety provoking. The purpose of this study was to determine if a nursing intervention of providing a distraction with a music relaxation video during the pump access procedure would reduce patients' pain and state anxiety. ⋯ The music video was effective in producing a sustained reduction over time of participants' pain during the pump refill procedures; it was most effective in initially reducing participants' state anxiety at the initial intervention visit; however, it did not demonstrate a progressively sustained effect. Participants' opinions about the music video experience were positive.
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Emotion regulation is a regulatory process to modify emotional activation in a wide range of situations and shows potential effects to reduce pain and emotional distress. The purpose of this review was to enhance an understanding of the role of emotion regulation strategies and their outcomes in reducing women's pain from labor to 3 months postpartum. ⋯ Both mindfulness and distraction would be offered to pregnant women as part of alternative self-pain management strategies to prepare them for dealing with pain and other discomforts. Future research needs to test the effects of the intervention beyond childbirth.
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It is morally distressing when a healthcare provider sees patients with undertreated pain but is unable to provide adequate relief because of a surrogate's refusal of such treatment. This issue might occur when there is no clear advanced directive that represents patients' wishes for treatment, and can be further complicated when patients are of minority cultural backgrounds. ⋯ This case highlights the ethical dilemma of withholding opioid treatment in a patient with advanced cancer. We conclude that the obligation to treat pain should be understood beyond the authority of surrogate refusal, in favor of patient quality of life, when an advance directive is not in place.
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Review Meta Analysis
The impact of Nonpharmacological Interventions on Cortisol During Heel Lance Procedures on Preterm Infants: A Meta-Analysis Of RCTs.
Current research suggests a need to implement environmental, behavioral, and even nutritional interventions, with the objective of improving the comfort and stability of preterm newborn infants, as well as reducing their stress and pain levels. Several studies have used the salivary reactivity of cortisol to assess stress or pain in preterm infants. The aim of this study was to analyze the results of published randomized controlled trials that tested the effects of nonpharmacological interventions on cortisol as a treatment for heel lance pain/stress in preterm infants. ⋯ Future studies should be performed on nonpainful interventions in order to gain more knowledge about the regulation of cortisol in saliva in preterm infants with involving control group and larger sample sizes.
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It is common practice to use pain quality indicators (QI) to accurately assess the medical care situation of patients. This literature review identifies the status quo of acute pain QI among adult inpatients. ⋯ European studies comprehensively comparing acute pain management results are currently missing. Thus, this report highlights the need to develop consensus-based quality indicators in management of acute pain, which take into account both the methodologic quality and the relevance to clinical practice.