Pain Management in Pediatric Nursing

Children often experience pain in different stage of life. After birth, newborns are exposed to many painful attempts and their anxiety levels increase with it. These painful attempts lead to metabolic or physiological problems in newborns. Excessive protein expenditure when exposed to pain for a long time, electrolyte inhalation, weakening of the immune system. Even repetitive painful procedures increase mortality and morbidity. Children experience pain due to acute onset diseases such as otitis media or pharyngitis and also in different medical interventions such vaccination, blood transfusion, vascular access, dressing change, lumber punching, or sickle cell anemia. Appropriate assessment scales should be used to treat pain effectively and adequately. Pharmacological treatment as well as non-pharmacological treatment methods has been found to be effective in the treatment of pain. Non-pharmacological methods allow your body to release natural endorphins and help to lift the pain to a minimum level or completely. In this study, current approaches and studies about pain in children will be presented. Non-pharmacological methods will be examined in more detail. Every child has right to live a painless life. It is one of the main purposes of nursing care to relieve children’s pain and improve their life quality.

Postoperative pain assessment and management among nurses in selected hospitals in Benin City,Edo State,Nigeria

Objective:This study was designed to determine the nurse assessment of postoperative pain and its management in selected hospitals,Benin City,Edo State,Nigeria.Materials and Methods:A descriptive cross-sectional survey was adopted.The target population consist of 222 purposely nurses who are in the cadre of nursing officer II to chief nursing officer who works in the various surgical wards/units of the selected health facilities.The data were collected from the participants using the pretested structured questionnaire developed by the researcher.Results:Results showed that 66.2%of nurses had a poor level of knowledge on postoperative pain assessment.The McGill Pain Questionnaire was the most used pain assessment tool with a mean score of 2.84 whereas the Dallas Pain Questionnaire was the least used with a mean score of 1.90.“Providing clean,calm,and well-ventilated ward environment”(3.69±0.61)was the most used nonpharmacological method for postoperative pain management,followed by“distraction,relaxation,and guided imagery”(3.52±0.50),“dressing,bandage,splint,and reinforce wound sites postoperatively”(3.39±0.54),and“early ambulation/exercise”(3.20±0.62).The most used pharmacological interventions were“acetaminophen”(3.63±0.55),“topical anesthetic”(2.92±0.62),“nonselective nonsteroidal anti-inflammatory drugs”(2.87±0.43),and“mixed opioid agonist-antagonist”(2.56±0.56).Conclusion:There is a poor level of knowledge on postoperative pain assessment among nurses in this study setting.It is,therefore,pertinent for hospitals to organize continuous in-service training for postoperative pain assessment and management,especially on nonpharmacological approaches among nurses.

Nonpharmacological pain management practices among nurses working in multiple centers in Saudi Arabia: A cross-sectional study

Objective:The aim of the study was to investigate the prevalence,and determinants,of nonpharmacological pain management practices among nurses in multiple settings.Materials and Methods:A cross-sectional examination was conducted involving 324 nurses from 16 hospitals in Hai’l,Saudi Arabia.Participants completed a self-reported survey utilizing established tools to assess the frequency of nonpharmacological pain management interventions utilization and identify associated barriers.Data analysis was performed using SPSS version 29.0.Results:Nonpharmacological pain management practices were found to be utilized“sometimes,”with a score of 2.89±0.48.Commonly employed techniques included placing patients in comfortable positions and providing a tranquil environment.Gender was the sole demographic factor significantly affecting the use of these techniques(P<0.001),with female nurses demonstrating higher utilization.Barriers to implementation varied based on the hours of recent pain management education(P=0.004),with prevalent barriers including nurse shortages,multiple responsibilities,heavy workloads,and nurse fatigue.Conclusion:The study reveals moderate utilization of nonpharmacological pain management approaches,primarily focusing on patient positioning and creating a calm environment.Female nurses exhibited higher adoption rates of these techniques.Barriers to implementation,such as nurse shortages and heavy workloads,were influenced by recent pain management education.Consequently,enhancing education and fostering supportive work environments are crucial for surmounting these barriers and promoting pain management awareness among nurses.

Effects of comprehensive nursing with cognitive behavioral therapy in orthodontic osteodilated arch treatment

BACKGROUND This work explored the effects of cognitive behavior therapy(CBT)-based comprehensive nursing intervention(CNI)mode in arch expansion to treat patients with orthodontic osteodilated arch(OOA).AIM To explore the application effect of CBT-based CNI model in orthodontic expansion arch treatment.METHODS Using convenient sampling method,81 patients with OOA were selected and rolled into a control group(Ctrl group,40 cases)and an observation group(Obs group,41 cases).During the treatment,patients in the Ctrl group received routine nursing intervention mode,and the those in the Obs group received CBT mode on the basis of this.Before and after intervention,the incidence of oral mucositis,the mastery rate of correct arch expansion method,self-rating anxiety scale score,soft scale index,and plaque index were compared for patients in different groups.In addition,satisfaction and complications were comparatively analyzed.RESULTS Incidence of oral mucositis in the Obs group was lower(14.6%vs 38.5%),and the mastery rate of correct arch expansion method was obviously higher(90.2%vs 55.0%)was obviously higher(all P<0.05).Meanwhile,the soft scale index and plaque index in the Obs group were much lower(P<0.05).The compliance(90.24%)and satisfaction(95.12%)in the Obs group were greatly higher(P<0.05).CONCLUSION The CBT-based CNI mode greatly improved the mastery rate of correct arch expansion method during arch expansion in treating patients with OOA and enhanced the therapeutic effect of arch expansion and the oral health of patients,improving the patient compliance.

Effect analysis of applying high-quality service model to surgical nursing

BACKGROUND Surgical care of the hand plays a crucial role in the medical field,as problems with the hand can profoundly affect a patient's quality of life and function.In order to meet the needs of patients,improve patient satisfaction and improve treatment outcomes,high-quality service models have been introduced in the field of nursing.AIM To explore the effect analysis of applying high-quality service model to surgical nursing.METHODS We conducted a retrospective study of patients who underwent hand surgery at our hospital between 2019 and 2022,using a quality service model that included improved patient education,pain management,care team collaboration,and effective communication.Another group of patients received traditional care as a control group.We compared postoperative recovery,satisfaction,complication rate,and length of hospital stay between the two groups.Inferential statistics were used to compare the difference between the two groups by independent sample t test,Chi-square test and other methods to evaluate the effect of intervention measures.RESULTS Postoperative recovery time decreased from 17.8±2.3 d to 14.5±2.1 d,pain score decreased from 4.7±1.9 to 3.2±1.4,and hand function score increased from 78.4±7.1 to 88.5±6.2.In terms of patient satisfaction,the quality service model group scored 87.3±5.6 points,which was significantly higher than that of the traditional care group(74.6±6.3 points).At the same time,patients'understanding of medical information also improved from 6.9±1.4 to 8.6±1.2.In terms of postoperative complications,the application of the quality service model reduced the incidence of postoperative complications from 26%to 10%,the incidence of infection from 12%to 5%,and the incidence of bleeding from 10%to 3%.The reduction in these data indicates that the quality service model plays a positive role in reducing the risk of complications.In addition,the average hospital stay of patients in the quality service model group was shortened from 6.8±1.5 d to 5.2±1.3 d,and the hospitalization cost was also reduced from 2800±600 yuan to 2500±500 yuan.CONCLUSION Applying a quality service model to hand surgery care can significantly improve patient clinical outcomes,including faster recovery,less pain,greater satisfaction,and reduced complication rates.

Implementation and evaluation of a pain management core competency education program for surgical nurses

Objective:To investigate the effect of a pain management core competency education program on surgical nurses’pain knowledge and pain management nursing practice behaviors.Methods:An 8-h education program focused on pain management core competency was provided twice in two weeks including the multidimensional nature of pain,pain assessment,pharmacological and nonpharmacological management,and knowledge application was developed and implemented for surgical nurses by a multidisciplinary team.Multimodal teaching approaches such as didactic teaching and vignettes of cases for nurses to discuss were used.The Clinical Pain Knowledge Test(CPKT)was completed by 135 and 107 nurses from 17 surgical wards pre and post-program,respectively.Two hundred and three patients’medical records were randomly sampled according to the number of operations in each ward one week before and in the fifth week after the intervention,respectively.Documentation of patients’postoperative pain management nursing practice behaviors and pain intensity scores were collected.Results:After the intervention,the CPKT scores of nurses significantly increased from 45.6%±12.3%to 54.2%±10.2%(t=5.786,P<0.001).Nurses’postoperative pain management nursing practice improved,with proportion of pain assessment documentation increased from 59.6%(121/203)to 74.9%(152/203)(χ^(2)=10.746,P=0.001),those using pain intensity assessment tools increased from 81.8%(99/121)to 95.4%(145/152)(χ^(2)=13.079,P<0.001),and intramuscular injection of nonopioids decreased from 12.6%(13/103)to 2.7%(3/111)(χ^(2)=7.598,P=0.006).Patients’average worst pain score on the operation day significantly decreased(Z=-2.486,P=0.013),and scores from the first to the third postoperative day also decreased(Z=-2.172,P=0.030).Conclusions:Implementation of a pain management core competency education program for surgical nurses can increase their knowledge of core competencies of pain management,improve selected pain management practices,and decrease patients’postoperative pain intensity.

Nurses’ Knowledge and Attitudes towards Pain Management in Children Admitted in the Paediatric Department of Queen Elizabeth Central Hospital, Blantyre, Malawi

Background: Inadequate pain management is a problem in hospitalized children. Objectives: To explore knowledge and attitudes of nurses in management of pain in children. Methods: A descriptive design using qualitative methods was used to conduct the study. 17 nurses with prior pain management training were interviewed using a semi-structured interview guide. Ethical approval was obtained from College of Medicine Research and Ethics Committee. Data were analysed using thematic content analysis. Results: Nurses had some knowledge of pain assessment methods, treatment and use of morphine. Gaps, however, existed on how to use pain assessment scales, analgesics to use at each step of the WHO analgesic ladder, and how to effectively use morphine for pain relief. Although most nurses had positive attitudes towards children’s pain and use of morphine, negative attitudes were evident in some nurses regarding administration of morphine to neonates or acutely ill children. Conclusion and Implications: The study has revealed knowledge and attitude gaps which may reflect deficiencies in the pain education nurses received, non-availability of pain scales and lack of support for nurses to link theory with practice. Nurse leaders are challenged to provide repeated comprehensive education for nurses on pain assessment and management. Furthermore, user friendly pain scales should be developed, and nurses educated and demonstrated on their use. In addition, opportunities for supportive supervision with nurses in the clinical setting should be created for linkage of theory and practice.

Knowledge and Attitudes of Nurses Working at King Abdulaziz University Hospital toward Cancer Pain Management

Objective: This survey aims to identify the levels of knowledge and attitudes among nurses regarding cancer pain management. Methods: This cross-sectional survey was undertaken at King Abdulaziz University Hospital, Jeddah, between September 4 and September 27, 2015. The survey instrument was a pre-set questionnaire comprising 39 closed-ended format questions. Participants were asked questions to assess their knowledge and attitudes about cancer pain management and adherence to frequent misconceptions regarding opioid therapy. The chi-square test was used to compare differences between variables. Results: One hundred twenty-eight questionnaires were completed and analyzed. A mean sample score of 41.3% was achieved on pain-related knowledge questions. The average score on all 39 questions was 16.1 ± 4.6 (range, 0 - 24). Nurses on the male medical ward were most knowledgeable compared with those on other wards (p p p p p = 0.002). Conclusion: Optimization of inpatient supportive procedures should be a specific task at King Abdulaziz University Hospital until an oncology unit with nurses specialized in cancer care is established.

Pain assessment and management in the newborn:A systematized review

BACKGROUND Neonatal pain has been underdiagnosed due to several false beliefs.AIM To determine the status of neonatal pain in newborns who are admitted to intensive care units.METHODS Different databases were searched.Literature reviews and research reports conducted in newborns that were written in English,Spanish,or Portuguese,published between 2010 and 2020,and having free access to the full text were selected.A total of 135 articles were found,and 18 articles were finally reviewed.RESULTS Newborns are exposed to numerous painful procedures.In order to assess their pain levels,several scales have been used,although they are sometimes not correctly interpreted.In terms of pain management,the nursing team plays a very important role based mainly on both pharmacological and non-pharmacological approaches.CONCLUSION Nursing staff members must be well trained in order to identify pain and to interpret the scales correctly.Besides,they have an important role in performing non-pharmacological procedures for pain management.

Pain-Related Knowledge and Barriers among Jordanian Nurses: A National Study

The purpose of this study is to explore Jordanian nurses’ knowledge and attitudes regarding pain assessment, and barriers to intervention at different hospitals representing health care sectors in Jordan. A descriptive cross-sectional design was used in this study utilizing self-administered questionnaires to collect data from nurses working in public, University-affiliated, and private hospitals located on the north, mid, and south of Jordan using Nurses’ Knowledge and Attitudes Survey Regarding Pain, (n = 439). The mean of total correct answers on the 32 knowledge questions was 13.39 (SD = 4.31). Nurse-related barriers to effective pain management include patient history of alcohol abuse or drug addiction, and nursing staff reluctant to contact physician for analgesic order. Nurses working in surgical units, employed at private hospitals, holding a master degree, or who attended educational course or program scored significantly higher than other nurses. The results demonstrated knowledge deficit and attitude and that nurses underestimated and undertreated patients’ pain. Serious efforts should be taken in nursing schools and hospitals to prepare nurses and equip them with comprehensive knowledge tools to assess and manage pain appropriately.

Nurses' experiences with health care in pain clinics: A qualitative study

Background: Recent research has focused on the effectiveness of different treatment regimens in pain clinics,where a call for more multifaceted treatment has been highlighted.Less attention has been paid to improvements within pain clinics,and how registered nurses-who usually play a key role-perceive and experience the accessibility,treatment options and follow-up offers at public pain clinics.Objective: The overall aim was to explore and describe how nurses experience health care provided to patients with chronic non-cancer pain at pain clinics.Methods: We used 10 individual interviews with nurses working at 10 different public pain clinics in Norway.The interviews were analyzed using qualitative content analysis.Results: One theme was developed from the content analysis: "Nurses' striving to provide whole-person care in pain clinics." The nurses experienced allocation of limited resources as challenging,especially when the dilemma between accepting new patients from the waiting list and offering follow-up to existing patients became apparent.Multifaceted treatment was perceived as vital,although resources,priorities,and theoretical understanding of pain within the team were challenging.Conclusions: The needs for multifaceted and integrated treatments in chronic pain management were obvious,although this approach appeared to be too demanding of resources and time.Stronger cooperation between pain clinics in specialist care and health care providers in primary care to ensure better patient flow and treatment is required.Emphasis is placed on coherent theoretical approaches to pain management within the team in the pain clinics to ensure whole person care.

术后患者自控镇痛:北京协和医院30年临床管理经验

术后疼痛严重影响患者的康复进程,从而导致住院时间延长,照护成本增加。合理应用患者自控镇痛装置可有效缓解围术期急性疼痛。北京协和医院于1994年引入患者自控镇痛技术,并于2004年成立了急性疼痛服务工作组,以麻醉医生为指导、手术室疼痛专科护士为基础,联合实施基于患者自控镇痛的全流程、规范化管理,并不断改进和创新工作方法,为术后疼痛管理的发展奠定了坚实基础。本文从临床工作重点、护理管理经验、疼痛治疗理念的推广与传播、新形势下急性疼痛服务模式的发展等方面对该项工作进行系统回顾与总结,以期为全面加强患者诊疗过程中的疼痛管理、提升患者围术期镇痛服务满意度提供有价值的参考。

以疼痛专科护士为主导的镇痛泵全程管理系统的构建及应用研究

目的构建以疼痛专科护士为主导的镇痛泵全程管理系统,并评价其应用效果。方法以疼痛专科护士为主导、病区护士为主体,构建集专科护士工作站模块和病区护士工作站模块为一体的智能化镇痛泵全程管理系统。于2021年7月—10月在某三级甲等综合性医院进行系统试运行,比较系统应用前后镇痛泵患者24 h内镇痛不全率、镇痛相关不良反应阳性探测率、患者满意度和护士工作耗时的差异。结果镇痛泵全程管理系统使用后,当日20:00镇痛不全发生率由12.9%下降至5.9%(χ^(2)=21.749,P<0.001);次日09:00镇痛不全发生率由20.1%下降至15.1%(χ^(2)=6.759,P=0.009);次日16:00镇痛不全发生率差异无统计学意义;镇痛相关不良反应阳性探测率上升,其中恶心呕吐探测率由9.2%上升到31.5%(χ^(2)=119.46,P<0.001),头晕阳性探测率由3.6%上升到8.1%(χ^(2)=13.96,P<0.001);患者满意度由(4.90±0.40)分提高到(4.96±0.25)分,疼痛专科护士随访前准备和随访后数据录入耗时由(93.85±11.14)min/d下降至<20 min/d,病区护士评估镇痛泵耗时由(29.72±8.80)s/次下降到2 s/次,差异均具有统计学意义(P<0.05)。结论疼痛专科护士主导的镇痛泵全程管理系统,能有效改善术后疼痛管理的质量和患者满意度,优化疼痛管理的工作流程和工作效率。

护士驱动多学科协作下食管癌根治术病人围术期疼痛管理方案的构建及应用

目的:构建护士驱动多学科协作下食管癌根治术病人围术期疼痛管理方案,并评价其应用效果。方法:将166例全身麻醉下行胸腔镜食管癌根治术病人按入院时间分为对照组81例及观察组85例。对照组行常规疼痛护理管理,观察组构建并实施护士驱动多学科协作下食管癌根治术病人围术期疼痛管理方案。比较两组病人术后疼痛评分、血压、疼痛对活动的影响及满意度。结果:观察组病人术后疼痛得分及收缩压、舒张压低于对照组(均P<0.05),术后疼痛对日常生活、情绪、步行能力、与他人的关系、睡眠及其他有助于康复活动的影响程度低于对照组(均P<0.05),病人对疼痛管理的满意度高于对照组(P<0.05)。结论:护士驱动多学科协作下食管癌根治术病人围术期疼痛管理方案应用于食管癌手术病人,可以有效减轻病人疼痛,控制血压,降低疼痛对术后活动的影响,提高病人满意度。

胸痛中心优化护理管理在急性心肌梗死患者中的应用效果

目的:观察胸痛中心优化护理管理在急性心肌梗死(ACI)患者中的应用效果。方法:回顾性分析2020年1月至2022年12月该院急诊科收治的80例ACI患者的临床资料,按照护理管理方法不同将其分为对照组和观察组各40例。对照组实施常规胸痛中心护理管理,观察组在对照组基础上实施胸痛中心优化护理管理。比较两组护理管理质量评分、急救相关指标(心电图完成时间、发病至首次医疗接触时间、心肌损伤标志物检测完成时间、导管室激活时间)水平、主要心血管不良事件发生率和急救满意度。结果:观察组护理管理质量评分高于对照组,差异有统计学意义(P<0.05);观察组心电图完成时间、发病至首次医疗接触时间、心肌损伤标志物检测完成时间、导管室激活时间均短于对照组,差异有统计学意义(P<0.05);观察组主要心血管不良事件发生率为2.50%(1/40),低于对照组的20.00%(8/40),差异有统计学意义(P<0.05);观察组急救满意度为100.00%(40/40),高于对照组的80.00%(32/40),差异有统计学意义(P<0.05)。结论:胸痛中心优化护理管理应用于ACI患者可提高护理管理质量评分和急救满意度,改善急救相关指标水平,降低主要心血管不良事件发生率,效果优于常规胸痛中心护理管理。

耳穴揿针疗法在急重症患者镇痛管理中的研究进展

疼痛是急重症患者的常见症状,其疼痛程度和住院环境、操作性诊疗等因素密切相关。镇痛管理是急重症患者治疗的重要组成部分。耳穴揿针疗法作为一种中医特色疗法,具有安全性高、无针感、实施简便等优势,临床应用越来越广泛,其实用性和疗效可持续性得到证实。本文通过查阅相关文献,从急重症患者的镇痛管理、耳穴揿针的作用机制及其应用方面进行综述,以期为后续研究提供参考。

骨关节炎病人非药物疼痛管理的最佳证据总结

目的:总结骨关节炎病人非药物疼痛管理最佳证据,为临床护理干预提供依据。方法:系统检索最佳临床实践数据库(BMJ)、英国国家卫生与临床优化研究所(NICE)、美国国立指南网(NGC)、乔安娜布里格斯研究所数据库(JBI)、美国风湿病学会(ACR)、国际骨关节炎研究协会(OARSI)、the Cochrane Library、Web of Science、EMbase、PubMed、中国知网、万方数据库等,检索时限为建库至2022年11月30日。由3名研究者采用JBI文献评价标准及证据分级系统,独立进行文献质量评价及证据级别评定。结果:共纳入14篇文献,包括9篇指南、4篇专家共识、1篇系统评价,共汇总31条证据,分别为多学科协作、疼痛评估、运动治疗、体重管理、心理和社会干预、健康教育与自我管理、随访7个方面的内容。结论:总结的骨关节炎病人非药物疼痛管理最佳证据,可为护理人员制订个性化护理方案提供循证依据。

规范化疼痛护理联合营养管理在晚期癌症患者中的应用

目的:探讨规范化疼痛护理联合营养管理在晚期癌症患者中的应用。方法:选取2020年1月—2022年1月于福建省泉州市第一医院放疗科进行姑息干预的晚期癌症患者100例作为研究对象,随机分为对照组、研究组,各50例。对照组实施常规护理,研究组则在常规护理的基础上进行规范化疼痛护理联合营养管理。对比两组数字分级评分法(NRS)评分、焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分,以及营养指标。结果:干预后,研究组NRS、SAS、SDS评分均明显低于对照组,差异均有统计学意义(P<0.05);干预后,研究组血红蛋白、白蛋白、血清总蛋白均明显高于对照组,差异均有统计学意义(P<0.05)。结论:在癌症晚期患者中进行规范化疼痛护理联合营养管理能够有效缓解癌性癌痛,缓解焦虑、抑郁情绪,提高患者营养指标水平。

云南省某三甲医院肿瘤专科组护士癌痛管理认知现状调查

通过调查云南省某三甲医院肿瘤专科组护士的癌痛管理认知水平及癌痛管理实践水平现状,为癌痛规范化管理培训与实践提供理论依据。采用方便采样法,选取云南省某三甲医院肿瘤专科组护理人员47名,发放自行设计的癌痛知识及癌痛管理问卷进行调查。调查结果显示,肿瘤专科组护士癌痛管理知识相关问卷平均正确率为54.73%;该专科组护士中具备开展癌痛管理健康讲座能力者占比61.70%,目前已开展癌痛管理健康教育者占比59.57%。研究发现,云南省某三甲医院肿瘤专科组护士癌痛规范化管理相关知识知晓率低、癌痛护理开展现状不容乐观。今后应针对肿瘤专科组护士进行更加全面、系统的癌痛知识培训,强化护理人员癌痛规范化管理意识,提升肿瘤专科组护士癌痛管理水平。

癌痛规范化干预流程对肺癌患者疼痛及睡眠质量的效果研究

目的:探究使用癌痛规范化干预流程对肺癌患者疼痛及睡眠质量的效果。方法:选取2023年1月至2024年1月厦门大学附属第一医院肿瘤内科收治的肺癌患者80例作为研究对象,按随机数字表法分为对照组和观察组,每组40例。对照组患者使用常规护理,观察组患者使用癌痛规范化干预流程,使用视觉模拟量表(VAS)、匹兹堡睡眠质量指数量表(PSQI)、焦虑自评量表(SAS)和抑郁自评量表(SDS)比较2组患者护理前后疼痛情况、睡眠质量以及焦虑抑郁情况。结果:干预后,观察组VAS评分、PSQI评分、SAS评分、SDS评分低于对照组患者(P<0.05)。结论:对肺癌患者使用癌痛规范化干预流程可以减少患者疼痛,提高睡眠质量,降低焦虑抑郁情绪,值得推广。