Pain management nursing : official journal of the American Society of Pain Management Nurses
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Little is known about specific factors related to chronic pain that need to be considered to support successful transition from pediatric to adult health care settings. This is troubling because 1 in 5 adolescents may experience chronic pain and many will continue to live with pain into adulthood. This paper reviews what is known about successful transition processes for adolescents with various chronic conditions and the unique factors associated with chronic pain and includes a call for further research on transition. ⋯ Loss to follow-up and negative health outcomes are linked to poor transition processes. Despite studies examining factors associated with successful transition, not all of the findings are transferable to adolescents with chronic pain. We need to support adolescents, young adults, and their parents as they prepare for transition, engage pediatric and adult care providers in care, advocate for system change, and systematically examine the processes that support the successful health care transition of adolescents and young people with chronic pain.
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Behavioral scales allow for the pain assessment of vulnerable critically ill patients who are unable to self-report. However, validity of the use of such scales is limited in traumatic brain injury patients with an altered level of consciousness as a result of the different way that these patients express pain. Family participation is considered as an important component of pain assessment for those unable to self-report, but research in this area is minimal so far. ⋯ Several factors influenced how behaviors were interpreted by family, including personal medical beliefs and intimate knowledge of the patient's history. The pain behaviors determined by family caregivers can be useful in the pain assessment process of traumatic brain injury patients with an altered level of consciousness. Their input could also be helpful in further development of pain assessment tools.
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All nurses care for patients with pain, and pain management knowledge and attitude surveys for nurses have been around since 1987. However, no validated knowledge test exists to measure postlicensure clinicians' knowledge of the core competencies of pain management in current complex patient populations. To develop and test the psychometric properties of an instrument designed to measure pain management knowledge of postlicensure nurses. ⋯ A high decision consistency reliability was identified, with test cut-score of 75%. The final 23-item Clinical Pain Knowledge Test has acceptable discrimination, difficulty, decision consistency, reliability, and validity in the general clinical inpatient nurse population. This instrument will be useful in assessing pain management knowledge of clinical nurses to determine gaps in education, evaluate knowledge after pain management education, and measure research outcomes.