Pain management nursing : official journal of the American Society of Pain Management Nurses
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Review Practice Guideline Guideline
Pain management in sickle cell disease.
The unpredictable, recurrent, intense, and frequently persistent nature of pain associated with sickle cell disease poses a difficult challenge in terms of management. A wide variability exists in the way painful episodes are managed. Variations in practice reflect different views about the suitability of opioids, the efficacy of parenteral administration, and the risk of dependence on opioids. ⋯ The American Pain Society recognized that the undertreatment of pain and inappropriate management of pain in sickle cell disease seem to be common. A Clinical Practice Guideline was developed to provide evidence-based recommendations that could potentially improve pain management. The purpose of this report is to describe the pharmacologic strategies used to manage pain associated with sickle cell disease, examine issues and challenges related to pain management as well as concerns and fears related to addiction, and explain the administration of opioids as recommended by the American Pain Society.
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The decision to include a Spanish-speaking sample in a study of pain in children with leukemia necessitated translation of the data collection tools. Therefore, the Adolescent Pediatric Pain Tool (APPT) was translated by using the standard translation, back-translation procedure. The Spanish word list consists of 66 descriptors in the sensory, affective, evaluative, and temporal domains. ⋯ Two of these studies were completed with well children and adolescents, and one study that was part of a clinical research project focused on pain in children and adolescents with leukemia. Although content; construct, concurrent validity; and test-retest reliability were tested, further studies are necessary with larger populations of children and adolescents. This series of pilot studies supports the usefulness of the Spanish translation of the APPT word list, particularly for clinical or research situations in which multiple versions of a tool would counteract ease of use.
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Although sedation is acknowledged to be one of the most common side effects of opioid analgesics, the mechanisms and characteristics of this phenomenon remain elusive, and research in this area is extremely limited. This report integrates research findings on the mechanism of action of opioids with research findings on the phenomenon of consciousness to develop a model of how opioids may act in the central nervous system to produce sedation. Based on this integration, a definition of opioid-induced sedation is proposed to encourage dialogue and research on this perplexing and clinically significant phenomenon.
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Clinical Trial
An examination of critical care nurses' knowledge and attitudes regarding pain management in hospitalized patients.
The purpose of this study was to determine the effectiveness of an educational intervention focused on pain management. The sample consisted of 30 medical/surgical intensive care nurses (age range, 23 to 62 years) employed in a large metropolitan hospital in the southeastern United States. McCaffery and Ferrell's Nurses' Knowledge and Attitude Survey Regarding Pain was administered at 2 points in time: before and after the educational program. ⋯ These results support previous research findings related to the problem of inadequate pain management in the hospital setting. Further, the findings indicate that education regarding pain control is crucial for current nursing students as well as practicing nurses. The challenge for nurses is to be responsive to and integrate current pain management techniques in an effort to decrease the discomfort of hospitalized patients.