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Lor M, Schaeffer NC, Brown R. Initial Psychometric Testing of a Pain Quality Pictogram Tool Among Hmong Limited English Proficient and Bilingual Community Members and Healthcare Practitioners. Pain Manag Nurs 2024; 25:e214-e222. [PMID: 38431504 DOI: 10.1016/j.pmn.2024.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 01/19/2024] [Accepted: 01/28/2024] [Indexed: 03/05/2024]
Abstract
PURPOSE To assess the matching and content validity of a pain quality pictogram tool with a Hmong community. DESIGN A Qualtrics survey was administered to two groups of participants. METHODS Sixty Hmong participants (n = 49 limited English proficiency and bilingual Hmong community members in group 1; n = 11 bilingual Hmong healthcare practitioners in group 2) participated in this study. Hmong community members in group 1 were asked to identify the pain pictogram that best matched a pre-recorded Hmong pain quality phrase. The practitioners in group 2 were asked to evaluate how well each pain pictogram represented the pre-recorded Hmong pain quality phrase it intended to measure. To assess the matching, we assessed agreement between the pain concept in the phrase and the pictogram intended to represent it, using group 1. A content validity index (CVI) was calculated to assess the content validity of the tool using group 2. RESULTS Among the community participants, 8 of the 15 pictograms were matched with the intended phrase almost perfectly, and 3 were matched by a substantial majority. There were no differences in matching by patient gender and language proficiency. Among practitioners, 11 of 15 pain pictograms met the CVI threshold of 0.70 for all three dimensions (i.e., representativeness, relevance, and comprehension). CONCLUSION Findings support including most of the pain pictograms in the tool but suggest specific areas for improvement. CLINICAL IMPLICATIONS Findings provide insights for redesigning the selected pain pictogram tool to be used in clinical settings with LEP Hmong patients.
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Affiliation(s)
- Maichou Lor
- University of Wisconsin-Madison, School of Nursing, Madison, Wisconsin.
| | - Nora Cate Schaeffer
- University of Wisconsin-Madison, Department of Sociology, Madison, Wisconsin
| | - Roger Brown
- University of Wisconsin-Madison, School of Nursing, Madison, Wisconsin
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Plummer KJ, McCarthy MC, Newall FH, Manias E. "Their Bodies Just Give It Away": A Qualitative Study of Pain Assessment in the Context of Pediatric Hematopoietic Stem Cell Transplantation Therapy. Cancer Nurs 2024; 47:151-162. [PMID: 36728173 DOI: 10.1097/ncc.0000000000001199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Children undergoing hematopoietic stem cell transplantation (HSCT) are vulnerable to pain. OBJECTIVE This study aimed to examine how healthcare providers and parents assessed pain and what contextual factors influenced their pain assessment practices for children hospitalized after allogeneic HSCT therapy. METHODS A qualitative case study was conducted in a tertiary level pediatric HSCT unit in 2 phases. Semistructured interviews with parents were conducted at 30 and 90 days after HSCT therapy. Healthcare providers participated in naturalistic observations of pain-related care provided to children during their hospitalization for HSCT therapy and a semistructured interview. RESULTS The assessment of pain after transplantation by healthcare providers and parents was predominantly reliant on the observation of children for behaviors indicative of pain, rather than the application of validated pain assessment tools. Without formal measures of the pain experience, judgments regarding the severity of children's pain were influenced by the context of high acuity of care posttransplantation and the emotional responses of healthcare providers and parents from bearing witness to children's pain. CONCLUSION Pain assessments mostly reflected children's ability to tolerate pain, rather than a genuine measurement of how significantly pain impacted the child. IMPLICATION FOR PRACTICE This study has emphasized how the assessment of pain for children hospitalized during HSCT therapy is limited by the complexity of the clinical environment. It is recommended that validated methods of assessing pain by healthcare providers and parents be implemented into clinical practice to ensure children's pain is visible.
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Affiliation(s)
- Karin J Plummer
- Author Affiliations: Department of Nursing, Melbourne School of Health Sciences, University of Melbourne (Drs Plummer, Newall, and Manias), Australia; Children's Cancer Centre, Royal Children's Hospital (Drs Plummer and McCarthy), Melbourne, Australia; Clinical Sciences, Murdoch Children's Research Institute (Drs Plummer, McCarthy, and Newall), Melbourne, Australia; Department of Pediatrics, Melbourne Medical School, University of Melbourne (Drs Plummer, McCarthy, and Newall), Australia; Department of Nursing Research, Royal Children's Hospital (Dr Newall), Melbourne, Australia; School of Nursing and Midwifery, Monash University (Dr Manias), School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Institute for Health Transformation (Dr Manias), Melbourne, Australia; and Department of Medicine, Royal Melbourne Hospital, University of Melbourne (Dr Manias), Australia
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Robinson OC, Pini S, Flemming K, Campling N, Fallon M, Richards SH, Mayland CR, Boland E, Swinson D, Hurlow A, Hartup S, Mulvey MR. Exploration of pain assessment and management processes in oncology outpatient services with healthcare professionals: a qualitative study. BMJ Open 2023; 13:e078619. [PMID: 38151273 PMCID: PMC10753735 DOI: 10.1136/bmjopen-2023-078619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 10/17/2023] [Indexed: 12/29/2023] Open
Abstract
OBJECTIVES This study explored cancer pain management practices and clinical care pathways used by healthcare professionals (HCPs) to understand the barriers and facilitators for standardised pain management in oncology outpatient services (OS). DESIGN Data were collected using semistructured interviews that were audio-recorded and transcribed. The data were analysed using thematic analysis. SETTING Three NHS trusts with oncology OS in Northern England. PARTICIPANTS Twenty HCPs with varied roles (eg, oncologist and nurse) and experiences (eg, registrar and consultant) from different cancer site clinics (eg, breast and lung). Data were analysed using thematic analysis. RESULTS HCPs discussed cancer pain management practices during consultation and supporting continuity of care beyond consultation. Key findings included : (1) HCPs' level of clinical experience influenced pain assessments; (2) remote consulting impeded experienced HCPs to do detailed pain assessments; (3) diffusion of HCP responsibility to manage cancer pain; (4) nurses facilitated pain management support with patients and (5) continuity of care for pain management was constrained by the integration of multidisciplinary teams. CONCLUSIONS These data demonstrate HCP cancer pain management practices varied and were unstructured. Recommendations are made for a standardised cancer pain management intervention: (1) detailed evaluation of pain with a tailored self-management strategy; (2) implementation of a structured pain assessment that supports remote consultations, (3) pain assessment tool that can support both experienced and less experienced clinicians. These findings will inform the development of a cancer pain management tool to integrate within routine oncology OS.
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Affiliation(s)
| | - Simon Pini
- Psychological and Social Medicine, University of Leeds, Leeds, UK
| | | | - Natasha Campling
- School of Health Sciences, University of Southampton, Southampton, Hampshire, UK
| | - Marie Fallon
- MRC Institute of Genetics & Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | | | - Catriona R Mayland
- Department of Oncology and Metabolism, The University of Sheffield, Sheffield, UK
- Divison of Clinical Medicine, University of Sheffield, Sheffield, UK
| | - Elaine Boland
- Palliative Medicine, Hull University Teaching Hospitals NHS Trust, Hull, UK
| | - Daniel Swinson
- St. James's University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Adam Hurlow
- Palliative Care Team, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Sue Hartup
- St. James's University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Matthew R Mulvey
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
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Corradi‐Dell'Acqua C, Hofstetter C, Sharvit G, Hugli O, Vuilleumier P. Healthcare experience affects pain-specific responses to others' suffering in the anterior insula. Hum Brain Mapp 2023; 44:5655-5671. [PMID: 37608624 PMCID: PMC10619377 DOI: 10.1002/hbm.26468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 07/13/2023] [Accepted: 07/22/2023] [Indexed: 08/24/2023] Open
Abstract
Medical students and professional healthcare providers often underestimate patients' pain, together with decreased neural responses to pain information in the anterior insula (AI), a brain region implicated in self-pain processing and negative affect. However, the functional significance and specificity of these neural changes remains debated. Across two experiments, we recruited university medical students and emergency nurses to test the role of healthcare experience on the brain reactivity to other's pain, emotions, and beliefs, using both pictorial and verbal cues. Brain responses to self-pain was also assessed and compared with those to observed pain. Our results confirmed that healthcare experience decreased the activity in AI in response to others' suffering. This effect was independent from stimulus modality (pictures or texts), but specific for pain, as it did not generalize to inferences about other mental or affective states. Furthermore, representational similarity and multivariate pattern analysis revealed that healthcare experience impacted specifically a component of the neural representation of others' pain that is shared with that of first-hand nociception, and related more to AI than to other pain-responsive regions. Taken together, our study suggests a decreased propensity to appraise others' suffering as one's own, associated with a reduced recruitment of pain-specific information in AI. These findings provide new insights into neural mechanisms leading to pain underestimation by caregivers in clinical settings.
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Affiliation(s)
- Corrado Corradi‐Dell'Acqua
- Theory of Pain Laboratory, Department of Psychology, Faculty of Psychology and Educational Sciences (FPSE)University of GenevaGenevaSwitzerland
- Geneva Neuroscience CenterUniversity of GenevaGenevaSwitzerland
- Laboratory of Behavioural Neurology and Imaging of Cognition, Department of NeuroscienceUniversity Medical Center, University of GenevaGenevaSwitzerland
| | - Christoph Hofstetter
- Laboratory of Behavioural Neurology and Imaging of Cognition, Department of NeuroscienceUniversity Medical Center, University of GenevaGenevaSwitzerland
| | - Gil Sharvit
- Laboratory of Behavioural Neurology and Imaging of Cognition, Department of NeuroscienceUniversity Medical Center, University of GenevaGenevaSwitzerland
- Swiss Center for Affective Sciences, University of GenevaGenevaSwitzerland
- Balgrist University Hospital and University of ZurichZurichSwitzerland
| | - Olivier Hugli
- Emergency Department, University Hospital of Lausanne (UHL)LausanneSwitzerland
| | - Patrik Vuilleumier
- Geneva Neuroscience CenterUniversity of GenevaGenevaSwitzerland
- Laboratory of Behavioural Neurology and Imaging of Cognition, Department of NeuroscienceUniversity Medical Center, University of GenevaGenevaSwitzerland
- Swiss Center for Affective Sciences, University of GenevaGenevaSwitzerland
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Schmidt L, Zabelberg S, Schlatter S, Adams I, Douplat M, Perchet C, Lilot M, Rey AE, Mazza S. The impact of shift work on pain recognition, a robust ability among intensive care nurses. Eur J Pain 2023; 27:1203-1215. [PMID: 37434490 DOI: 10.1002/ejp.2150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 06/07/2023] [Accepted: 06/10/2023] [Indexed: 07/13/2023]
Abstract
BACKGROUND Pain empathy is essential for high-quality of care. The cognitive ability to identify and understand the pain in others remains underexplored in the context of hospital shift work. This study aimed to observe the early subliminal ability to detect pain in other faces and to investigate pain intensity evaluations during day and night shifts. METHODS Twenty-one nurses (31 ± 7 years, 20 women) from cardio-paediatric intensive care participated in this study. Eighteen nurses completed all testing in the morning and evening hours, before and after the 12-hour day and night shift. In the first test, the nurses had to decide if facial stimuli presented subliminally showed pain or not. During the second test, they consciously determined the intensity of the painful faces on a numerical scale. Sleep, sleepiness and empathy were also measured. RESULTS Recognition accuracy and pain sensitivity remained stable over time, only sensitivity increased following the work shift (F(1,15) = 7.10, p = 0.018). Intensity ratings remained stable. Sleepiness at the end of the night shift was negatively correlated with accuracy (ρ = -0.51, p = 0.018) and positively correlated with prior night shifts (ρ = -0.50, p = 0.022). CONCLUSION The judgement of facial pain expressions seems robust across shift types, only individual factors such as sleepiness interfere with pain recognition. Pain sensitivity may be enhanced during working hours. SIGNIFICANCE STATEMENT Some professions need to know how to assess pain 24/7 and a lack of sleep can disrupt the cognitive processes necessary for this assessment. Night shifts provoke a bias in pain management, and sleep deprivation, a decrease in pain evaluation. By conducting a repeated measure study in the field that applied a different paradigm (subliminal recognition of facial cues) we add evidence to the understanding of pain recognition and the impact of sleep deprivation on the early processing of pain in others.
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Affiliation(s)
- Laura Schmidt
- Université Claude Bernard Lyon 1, Research on Healthcare Performance RESHAPE, INSERM U1290, Lyon, France
| | | | - Sophie Schlatter
- Université Claude Bernard Lyon 1, Research on Healthcare Performance RESHAPE, INSERM U1290, Lyon, France
- Université Claude Bernard Lyon 1, Centre Lyonnais d'enseignement par la simulation en Santé, CLESS, SimuLyon, Lyon, France
| | - Inga Adams
- Universität zu Köln, Psychologie, Cologne, Germany
| | - Marion Douplat
- Hospices Civils de Lyon, Département des Urgences, Hôpital Lyon Sud, Lyon, France
| | - Caroline Perchet
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, FORGETTING, F-69500, Bron, France
| | - Marc Lilot
- Université Claude Bernard Lyon 1, Research on Healthcare Performance RESHAPE, INSERM U1290, Lyon, France
- Université Claude Bernard Lyon 1, Centre Lyonnais d'enseignement par la simulation en Santé, CLESS, SimuLyon, Lyon, France
- Hospices Civils de Lyon, Département d'Anesthésie-Réanimation, Hôpital Louis Pradel, Groupement Hospitalier Est, Lyon, France
| | - Amandine Eve Rey
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, FORGETTING, F-69500, Bron, France
| | - Stéphanie Mazza
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, FORGETTING, F-69500, Bron, France
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Riontino L, Fournier R, Lapteva A, Silvestrini N, Schwartz S, Corradi-Dell'Acqua C. Cognitive exertion affects the appraisal of one's own and other people's pain. Sci Rep 2023; 13:8165. [PMID: 37208455 DOI: 10.1038/s41598-023-35103-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 05/12/2023] [Indexed: 05/21/2023] Open
Abstract
Correctly evaluating others' pain is a crucial prosocial ability. In both clinical and private settings, caregivers assess their other people's pain, sometimes under the effect of poor sleep and high workload and fatigue. However, the effect played by such cognitive strain in the appraisal of others' pain remains unclear. Fifty participants underwent one of two demanding tasks, involving either working memory (Experiment 1: N-Back task) or cognitive interference (Experiment 2: Stroop task). After each task, participants were exposed to painful laser stimulations at three intensity levels (low, medium, high), or video-clips of patients experiencing three intensity levels of pain (low, medium, high). Participants rated the intensity of each pain event on a visual analogue scale. We found that the two tasks influenced rating of both one's own and others' pain, by decreasing the sensitivity to medium and high events. This was observed either when comparing the demanding condition to a control (Stroop), or when modelling linearly the difficulty/performance of each depleting task (N-Back). We provide converging evidence that cognitive exertion affects the subsequent appraisal of one's own and likewise others' pain.
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Affiliation(s)
- Laura Riontino
- Department of Psychology, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland.
- Department of Neuroscience, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
- University of Geneva - Campus Biotech, Chemin Des Mines 9, 1211, Geneva, Switzerland.
| | - Raphaël Fournier
- Department of Neuroscience, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | | | - Nicolas Silvestrini
- Department of Psychology, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Sophie Schwartz
- Department of Neuroscience, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland
- Geneva Neuroscience Center, University of Geneva, Geneva, Switzerland
| | - Corrado Corradi-Dell'Acqua
- Department of Psychology, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
- Department of Neuroscience, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Geneva Neuroscience Center, University of Geneva, Geneva, Switzerland
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Women's perceptions of counselling on pain assessment and management during labour in Finland: A cross-sectional survey. Midwifery 2022; 114:103471. [DOI: 10.1016/j.midw.2022.103471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 08/12/2022] [Accepted: 08/26/2022] [Indexed: 11/19/2022]
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Robbertz AS, Shneider C, Cohen LL. The role of nursing student training status and anxiety in pediatric pain assessment. CHILDRENS HEALTH CARE 2022. [DOI: 10.1080/02739615.2022.2051512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
| | - Caitlin Shneider
- Department of Psychology, Georgia State University, Atlanta, GA, USA
| | - Lindsey L. Cohen
- Department of Psychology, Georgia State University, Atlanta, GA, USA
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Loued-Khenissi L, Martin-Brevet S, Schumacher L, Corradi-Dell'Acqua C. The Effect of Uncertainty on Pain Decisions for Self and Others. Eur J Pain 2022; 26:1163-1175. [PMID: 35290697 PMCID: PMC9322544 DOI: 10.1002/ejp.1940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Background Estimating others’ pain is a challenging inferential process, associated with a high degree of uncertainty. While much is known about uncertainty’s effect on self‐regarding actions, its impact on other‐regarding decisions for pain have yet to be characterized. Aim The present study exploited models of probabilistic decision‐making to investigate how uncertainty influences the valuation and assessment of another’s pain. Materials & Methods We engaged 63 dyads (43 strangers and 20 romantic couples) in a task where individual choices affected the pain delivered to either oneself (the agent) or the other member of the dyad. At each trial, agents were presented with cues predicting a given pain intensity with an associated probability of occurrence. Agents either chose a sure (mild decrease of pain) or risky (50% chance of avoiding pain altogether) management option, before bidding on their choice. A heat stimulation was then issued to the target (self or other). Decision‐makers were then asked to rate the pain administered to the target. Results We found that the higher the expected pain, the more risk‐averse agents became, in line with findings in value‐based decision‐making. Furthermore, agents gambled less on another individual’s pain (especially strangers) and placed higher bids on pain relief than they did for themselves. Most critically, the uncertainty associated with expected pain dampened ratings made for strangers’ pain. This contrasted with the effect on an agent’s own pain, for which risk had a marginal hyperalgesic effect. Discussion & Conclusion Overall, our results suggested that risk selectively affects decision‐making on a stranger’s suffering, both at the level of assessment and treatment selection, by (1) leading to underestimation, (2) privileging sure options and (3) altruistically allocating more money to insure the treatment’s success. Significance Uncertainty biases decision‐making but it is unclear if it affects choice behavior on pain for others. In examining this question, we found individuals were generally risk‐seeking when faced with looming pain, but more so for self; and assigned higher monetary values and subjective ratings on another’s pain. However, uncertainty dampened agents’ assessment of a stranger’s pain, suggesting latent variables may contradict overt altruism. This bias may underlie pain underestimation in clinical settings.
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Affiliation(s)
- Leyla Loued-Khenissi
- Theory of Pain Laboratory, Department of Psychology, Faculty of Psychology and Educational Sciences (FPSE), University of Geneva, Geneva, Switzerland.,Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland
| | | | - Luis Schumacher
- Theory of Pain Laboratory, Department of Psychology, Faculty of Psychology and Educational Sciences (FPSE), University of Geneva, Geneva, Switzerland
| | - Corrado Corradi-Dell'Acqua
- Theory of Pain Laboratory, Department of Psychology, Faculty of Psychology and Educational Sciences (FPSE), University of Geneva, Geneva, Switzerland.,Geneva Neuroscience Center, University of Geneva, Geneva, Switzerland
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Vigier M, Thorson KR, Andritsch E, Stoeger H, Suerth L, Farkas C, Schwerdtfeger AR. Physiological linkage during interactions between doctors and cancer patients. Soc Sci Med 2021; 284:114220. [PMID: 34273870 DOI: 10.1016/j.socscimed.2021.114220] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 07/03/2021] [Accepted: 07/09/2021] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Doctors and patients influence each other when interacting and, as a result, can become similar to each other in affect and behavior. In the current work, we examine whether they also become similar to each other on a moment-to-moment basis in their physiological responses. Specifically, we examine physiological linkage-how much a doctor's (or patient's) physiological response predicts a patient's (or doctor's) response at a subsequent time interval-and whether this changes over the course of doctor-patient relationships (measured as the number of consultations held for each unique doctor-patient dyad). METHODS We collected interbeat interval responses (IBI) continuously during consultations between oncologists and patients undergoing cancer treatment (N = 102 unique doctor-patient interactions) at a hospital in Austria. RESULTS Physiological linkage varied by an interaction between role (doctor vs. patient) and relationship length (in a non-linear, quadratic pattern). Patients showed significant positive linkage to their doctors (i.e., doctors' physiological responses positively, significantly predicted patients' responses) in relationships that spanned three to eight consultations together. Patients were not linked to their doctors in shorter or longer relationships. Doctors were never significantly linked to their patients, meaning that patients' physiological responses never predicted doctors' responses. CONCLUSION These results reveal that, by influencing patients' physiological responses on a moment-to-moment basis, doctors may have even more influence over patients' physiology than previously known.
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Affiliation(s)
- Marta Vigier
- Division of Oncology, Medical University of Graz, Graz, Austria; Department of Psychology, University of Graz, Graz, Austria.
| | - Katherine R Thorson
- Department of Psychology, Barnard College of Columbia University, New York, USA.
| | | | - Herbert Stoeger
- Division of Oncology, Medical University of Graz, Graz, Austria
| | - Leonie Suerth
- Department of Psychology, University of Graz, Graz, Austria
| | - Clemens Farkas
- Division of Oncology, Medical University of Graz, Graz, Austria
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AKPOLAT R, ŞİŞMAN H, ALPTEKİN D, GÖKÇE E, GEZER D, ARSLAN S. Ameliyat sonrasi ağrıya yaklaşımların değerlendirilmesi. CUKUROVA MEDICAL JOURNAL 2021. [DOI: 10.17826/cumj.898769] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
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A Scoping Review of Pain Management Education Programs (PMEPs): Do They Prepare Nurses to Deal with Patients' Postoperative Pain? Pain Res Manag 2020; 2020:4062493. [PMID: 33123303 PMCID: PMC7584952 DOI: 10.1155/2020/4062493] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 07/11/2020] [Accepted: 10/04/2020] [Indexed: 11/18/2022]
Abstract
This is a report of a scoping review undertaken to obtain an overview of studies conducted on pain management education programs (PMEPs). The aim of this review was to describe existing research publications relating to PMEP to map how pain management practice training might directly influence surgical nurses in contributing to successful pain outcomes in patients. The initial search of electronic databases identified 40 articles according to the inclusion criteria and search strategy, which applied the following terms: (“Pain management education program”) AND∗ OR∗ (“Nurses”) AND∗ OR∗ (“Patient outcomes”) AND∗ (“Mixed methods”). Titles, abstracts, and keywords were also searched for the term “Nurse education.” After applying exclusion criteria, five relevant peer-reviewed articles were eventually selected for the final charting of the data. The search included articles published between January 2015 and March 2019. The results show that PMEPs employ a variety of computer-based simulation, web-based facilitation, and video materials based on an evidence-based approach in their syllabuses. PMEPs were shown to enhance practice by promoting improved skills in critical thinking, leadership, patient management, and health promotion. Additionally, these programs promote an ability to practice across a variety of inpatient and outpatient settings, wherein nurses' engagement in managing patients' pain increased after completing the PMEP. Research within PMEP indicates that these programs may contribute to promoting opportunities for new collaborations within multidisciplinary team projects. Additionally, further research initiatives are needed to explore various aspects of these programs to enhance the nursing skills required for effective pain management, such as computer-based simulation, web-based facilitation, and video materials. Moreover, research relating to PMEPs in low- and middle-income countries is scarce and warrants further study.
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Mizuma K, Amitani M, Mizuma M, Kawazu S, Sloan RA, Ibusuki R, Takezaki T, Owaki T. Clarifying differences in viewpoints between multiple healthcare professionals during discharge planning assessments when discharging patients from a long-term care hospital to home. EVALUATION AND PROGRAM PLANNING 2020; 82:101848. [PMID: 32652436 DOI: 10.1016/j.evalprogplan.2020.101848] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Revised: 05/25/2020] [Accepted: 06/26/2020] [Indexed: 06/11/2023]
Abstract
Comprehensive discharge planning provided by interprofessional collaboration is critical for discharging patients from hospitals to home. For effective interprofessional discharge planning, the evaluation that clarifies the differences in assessment viewpoints between various healthcare professionals is needed. This study aimed to clarify the assessment viewpoints of multiple healthcare professional groups when discharging patients from a long-term care hospital (LTCH) to home. We reviewed 102 medical records from an LTCH in Japan, extracted descriptions of discharge planning assessments written by 3 doctors, 13 nurses, 3 physical therapists, 13 care workers, and 2 social workers, linked these to the International Classification of Functioning, Disability and Health, and conducted the statistical analysis. Doctors and nurses significantly focused on "Body Functions". Physical therapists and care workers significantly focused on "Activities and Participation". Social workers significantly focused on "Environmental Factors". We also identified the factors less or missing from assessments in the clinical field of the LTCH. Our findings could be contributed as a base of knowledge to foster a better understanding of different healthcare professionals' assessment viewpoints. The further development of comprehensive discharge planning assessment tools, service programs, and research on discharge planning methods that could contribute to effective interprofessional discharge planning is needed.
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Affiliation(s)
- Kimiko Mizuma
- Department of Community-Based Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, Japan.
| | - Marie Amitani
- Department of Community-Based Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, Japan.
| | - Midori Mizuma
- Medical Corporation Hakuyoukai, 2125 Hishikarimaeme, Kagoshima, Japan.
| | - Suguru Kawazu
- Department of Psychosomatic Internal Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, Japan.
| | - Robert A Sloan
- Department of Psychosomatic Internal Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, Japan.
| | - Rie Ibusuki
- Department of International Island and Community Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, Japan.
| | - Toshiro Takezaki
- Department of International Island and Community Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, Japan.
| | - Tetsuhiro Owaki
- Department of Community-Based Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, Japan.
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Rezaei H, Saeed AFM, Abdi K, Ebadi A, Ghanei Gheshlagh R, Kurdi A. Translation and Validation of the Farsi Version of the Pain Management Self-Efficacy Questionnaire. J Pain Res 2020; 13:719-727. [PMID: 32308471 PMCID: PMC7152734 DOI: 10.2147/jpr.s246077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 03/24/2020] [Indexed: 11/23/2022] Open
Abstract
Introduction Pain management is a complex process that is managed through a multi-disciplinary team in which nurses have a significant role. The present study aimed at translating and examining the psychometric properties of the Pain Management Self-Efficacy Questionnaire (PMSEQ) among Iranian nurses. Methods This was a cross-sectional, methodological study conducted in 2019 among nurses working in two teaching hospitals in Sanandaj (Tohid and Kosar). The participants were selected using a convenience sampling method. Responsiveness; interpretability; and face, content, and construct validities were examined using exploratory and confirmatory factor analyses. In addition, internal consistency and stability were examined using the Cronbach’s alpha and test-retest, respectively. Results Overall, 410 nurses (210 for the EFA and 200 for the CFA) were included in the sample. In the exploratory factor analysis, two factors of comprehensive pain assessment and pain management with eigenvalues of 6.36 and 1.91, respectively, were extracted. The two factors together explained 56.64% of the variance of nurses’ pain management self-efficacy. The confirmatory factor analysis indicated that the model had a moderate fit to the data (RMSEA: 0.12; NFI: 0.84; NNFI: 0.86; CFI: 0.88; IFI: 0.88; RFI: 0.81; GFI: 0.76; AGFI: 0.69; PGFI: 0.59; RMR: 0.09; standardized RMR: 0.09). Total questionnaire and the two factors (i.e. comprehensive pain assessment and pain management) had internal consistency coefficients of 0.891, 0.876, and 0.803, respectively. Conclusion The Farsi version of PMSEQ had good internal consistency and reliability, as well as content and construct validity, and can be used in future studies.
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Affiliation(s)
- Hayedeh Rezaei
- Department of Nursing, Faculty of Nursing and Midwifery, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Ali Faiek M Saeed
- Department of Management, College of Business Administration and Economic, Bayan University, Erbil, Kurdistan, Iraq
| | - Kamel Abdi
- Nursing Department, Faculty of Medicine, Komar University of Science and Technology, Sulimaniya City, Kurdistan Region, Iraq
| | - Abbas Ebadi
- Behavioral Sciences Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Reza Ghanei Gheshlagh
- Department of Nursing, Faculty of Nursing and Midwifery, Kurdistan University of Medical Sciences, Sanandaj, Iran, Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Amanj Kurdi
- Pharmacoepidemiology and Pharmacy Practice, Strathclyde Institute of Pharmacy and Biomedical Science, University of Strathclyde, Glasgow, UK, Department of Pharmacology, College of Pharmacy, Hawler Medical University, Erbil, Iraq
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Miron-Shatz T, Ormianer M, Rabinowitz J, Hanoch Y, Tsafrir A. Physician experience is associated with greater underestimation of patient pain. PATIENT EDUCATION AND COUNSELING 2020; 103:405-409. [PMID: 31526533 DOI: 10.1016/j.pec.2019.08.040] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 08/27/2019] [Accepted: 08/29/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE Procedural pain is unique in that physicians simultaneously cause and assess it. Experienced male physicians are known to underestimate their female patients' pain more than other physicians. However, it is unknown whether this also occurs in obstetrics/gynecology, where all patients are females. This study addresses the gap in literature on procedural pain assessment accuracy. METHODS The present research compares paired pain evaluations from 20 obstetricians/gynecologists and their 92 female patients. RESULTS Our data demonstrate that patients' reported pain levels (M = 5.53, SD = 2.7) were significantly higher than their physicians' pain estimates (M = 4.89, SD = 2.19), t = 2.64, p < 0.005. The gap between patients' and physicians' pain estimates was greatest among physicians with the greatest procedural experience (M = 1.49, SD = 2.24), f = 5.72, p < 0.005. Male physicians underestimated their patients' pain significantly more than female physicians do, t = 2.27, p < 0.05. CONCLUSION Our results shed light on systematic underestimation of procedural pain and highlight the significance of experience and sex differences in pain evaluation. PRACTICE IMPLICATIONS Physicians' experience influences their perception of patient pain while performing procedures. Experienced male physicians, even those who exclusively treat female patients, need to be aware of this ubiquitous bias in assessing their female patients' procedural pain.
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Affiliation(s)
- Talya Miron-Shatz
- Winton Centre for Risk and Evidence Communication, Cambridge University, England, United Kingdom; Faculty of Business Administration, Ono Academic College, Kiryat Ono, Israel.
| | - Maayan Ormianer
- Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Jonina Rabinowitz
- Faculty of Business Administration, Ono Academic College, Kiryat Ono, Israel
| | - Yaniv Hanoch
- Southampton Business School, University of Southampton, University Road, Southampton SO17 1BJ, United Kingdom
| | - Avi Tsafrir
- Shaare-Zedek Department of Obstetrics & Gynecology, Hebrew University School of Medicine, Jerusalem, Israel
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Schuster J, Hoyer C, Ebert A, Alonso A. Use of analgesics in acute stroke patients with inability to self-report pain: a retrospective cohort study. BMC Neurol 2020; 20:18. [PMID: 31937259 PMCID: PMC6961294 DOI: 10.1186/s12883-020-1606-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 01/08/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Pain is a common and burdensome complication in patients with acute stroke. We assessed the impact of impaired communication in stroke patients on pain assessment and treatment. METHODS We included 909 (507 male, mean age 71.8 years) patients admitted to our stroke unit from 01/2015 to 12/2015 in the analysis. Patients were assigned to four groups: able to communicate (AC), not able to communicate prior to index stroke (P-NAC), due to focal symptoms of index stroke (S-NAC), due to a reduced level of consciousness (C-NAC). Pain prevalence, documentation of pain and use of analgesics were evaluated. C-NAC patients were excluded from analyses regarding analgesic treatment due to relevant differences in patient characteristics. RESULTS 746 patients (82.1%) were classified as AC, 25 (2.8%) as P-NAC, 90 (9.9%) as S-NAC and 48 (5.3%) as C-NAC. Pain was documented on the Numeric Rating Scale and in form of free text by nurses and physicians. Nurses documented pain more frequently than physicians (p < 0.001). Pain prevalence was 47.0% (n.s. between groups). The use of analgesic medication increased from 48.7% in the AC group, to 76.0% in the P-NAC group, and 77.8% in the S-NAC group (p < 0.001). Opioid use was significantly more frequent in NAC patients (p < 0.001). The response to the treatment was poorly documented with significantly lowest rates in S-NAC patients (p < 0.001). CONCLUSIONS Our study suggests that post-stroke pain in patients with inability to communicate is not attended enough, not systematically assessed and therefore not sufficiently treated.
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Affiliation(s)
| | | | - A Ebert
- Department of Neurology, Medical Faculty of Mannheim, University of Heidelberg, Theodor Kutzer Ufer 1-3, 68167, Mannheim, Germany
| | - A Alonso
- Department of Neurology, Medical Faculty of Mannheim, University of Heidelberg, Theodor Kutzer Ufer 1-3, 68167, Mannheim, Germany.
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Compassionate and Clinical Behavior of Residents in a Simulated Informed Consent Encounter. Anesthesiology 2020; 132:159-169. [DOI: 10.1097/aln.0000000000002999] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Abstract
Editor’s Perspective
What We Already Know about This Topic
What This Article Tells Us That Is New
Background
Compassionate behavior in clinicians is described as seeking to understand patients’ psychosocial, physical and medical needs, timely attending to these needs, and involving patients as they desire. The goal of our study was to evaluate compassionate behavior in patient interactions, pain management, and the informed consent process of anesthesia residents in a simulated preoperative evaluation of a patient in pain scheduled for urgent surgery.
Methods
Forty-nine Clinical Anesthesia residents in year 1 and 16 Clinical Anesthesia residents in year 3 from three residency programs individually obtained informed consent for anesthesia for an urgent laparotomy from a standardized patient complaining of pain. Encounters were assessed for ordering pain medication, for patient-resident interactions by using the Empathic Communication Coding System to code responses to pain and nausea cues, and for the content of the informed consent discussion.
Results
Of the 65 residents, 56 (86%) ordered pain medication, at an average of 4.2 min (95% CI, 3.2 to 5.1) into the encounter; 9 (14%) did not order pain medication. Resident responses to the cues averaged between perfunctory recognition and implicit recognition (mean, 1.7 [95% CI, 1.6 to 1.9]) in the 0 (less empathic) to 6 (more empathic) system. Responses were lower for residents who did not order pain medication (mean, 1.2 [95% CI, 0.8 to 1.6]) and similar for those who ordered medication before informed consent signing (mean, 1.9 [95% CI, 1.6 to 2.1]) and after signing (mean, 1.9 [95% CI, 1.6 to 2.0]; F (2, 62) = 4.21; P = 0.019; partial η2 = 0.120). There were significant differences between residents who ordered pain medication before informed consent and those who did not order pain medication and between residents who ordered pain medication after informed consent signing and those who did not.
Conclusions
In a simulated preoperative evaluation, anesthesia residents have variable and, at times, flawed recognition of patient cues, responsiveness to patient cues, pain management, and patient interactions.
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The role of cognitive impairment in pain care in the emergency department for patients from residential aged care facilities: a retrospective, case-control study. Australas Emerg Care 2019; 23:114-118. [PMID: 31606333 DOI: 10.1016/j.auec.2019.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 09/12/2019] [Accepted: 09/16/2019] [Indexed: 11/21/2022]
Abstract
BACKGROUND Patients with cognitive impairment are at risk of substantial delays to analgesic medication when presenting to the emergency department in pain. AIM To identify if patients from residential aged care facilities with cognitive impairment experience the same delays to analgesic medication are reported in the general emergency department population. METHODS This study is a retrospective case-control review of patients presenting to one emergency department with pain as a presenting complaint from residential aged care, with and without cognitive impairment. RESULTS Patients without cognitive impairment experience delays in time to first analgesic medication (175min vs 98min, p=0.006) compared to cognitively impaired patients from residential aged care facilities. Both cohorts of patients waited more than three times the national benchmark for analgesic medication and 66% of all patients in this study did not have pain assessment completed. CONCLUSION Patients presenting from residential caged care facilities in this study without cogitative impairment wait longer for analgesia then patients who present with cogitative impairment, contrary to previously described relationships. Pain assessment and treatment are open to cogitative bias, and in the absence of pain assessment cogitative bias may prevail leading to poor pain care and discrepancies between patients with and without cogitative impairment.
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Wikström L, Nilsson M, Broström A, Eriksson K. Patients’ self‐reported nausea: Validation of the Numerical Rating Scale and of a daily summary of repeated Numerical Rating Scale scores. J Clin Nurs 2018; 28:959-968. [DOI: 10.1111/jocn.14705] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 08/14/2018] [Accepted: 10/16/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Lotta Wikström
- School of Health and WelfareJönköping University Jönköping Sweden
- Department of Anesthesia and Intensive CareRyhov County Hospital Jönköping Sweden
| | - Mats Nilsson
- FuturumAcademy for Health and Care Region Jönköping County Sweden
| | - Anders Broström
- School of Health and WelfareJönköping University Jönköping Sweden
- Sweden Department of Clinical NeurophysiologyUniversity Hospital Linköping Sweden
| | - Kerstin Eriksson
- School of Health and WelfareJönköping University Jönköping Sweden
- Department of Anesthesia and Intensive CareRyhov County Hospital Jönköping Sweden
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Macindo JRB, Soriano CAF, Gonzales HRM, Simbulan PJT, Torres GCS, Que JC. Development and psychometric appraisal of the Pain Management Self-Efficacy Questionnaire. J Adv Nurs 2018; 74:1993-2004. [PMID: 29633327 DOI: 10.1111/jan.13582] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2018] [Indexed: 12/01/2022]
Abstract
AIM The aim of this study was to develop and psychometrically evaluate the Pain Management Self-Efficacy Questionnaire. BACKGROUND Pain management competence and confidence are important in rendering safe and effective patient care. However, there is a lack of psychometrically sound instruments measuring pain management self-efficacy. DESIGN Triphasic, prospective psychometric study. METHOD A 55-item Pain Management Self-Efficacy Questionnaire was initially developed after extensive theoretical and literature review. The questionnaire was evaluated by content experts for content validity and a consensus was achieved after two iterations. After pretesting, the Pain Management Self-Efficacy Questionnaire was distributed to 420 randomly selected pre-graduate student nurses and registered nurses from a nursing institution and a tertiary hospital. Data collection was conducted from January 2015 - 2016. Assessment parameters included basic item analysis, reliability analysis, floor and ceiling effects and construct validity using factor analysis and "known groups" technique. Replication analyses scrutinized two random halves of the sample. RESULTS The initial 55-item questionnaire was reduced to 42 items after two iterations of validation. After preliminary factor analyses, the Pain Management Self-Efficacy Questionnaire was reduced to 21 items. Final factor analysis produced a three-factor model: Comprehensive, Evaluative and Supplemental Pain Management Self-Efficacy. Construct validation using Kruskal-Wallis and Mann-Whitney tests showed group differences according to years of clinical experience and receipt of pain management training. CONCLUSION The 21-item Pain Management Self-Efficacy Questionnaire demonstrated satisfactory psychometric properties and can be used to measure pain management self-efficacy among nurses. Nevertheless, further psychometric validation is warranted accounting differences in culture and clinical practices.
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Affiliation(s)
| | | | | | | | | | - Jocelyn C Que
- Faculty of Medicine and Surgery, University of Santo Tomas, Manila, Philippines
- Pain Management and Palliative Care Unit, University of Santo Tomas Hospital, Manila, Philippines
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Ruben MA, Blanch-Hartigan D, Shipherd JC. To Know Another’s Pain: A Meta-analysis of Caregivers’ and Healthcare Providers’ Pain Assessment Accuracy. Ann Behav Med 2018; 52:662-685. [DOI: 10.1093/abm/kax036] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
- Mollie A Ruben
- School of Arts and Sciences, Massachusetts College of Pharmacy and Health Sciences University, Boston, MA
- Center for Healthcare Organization and Implementation Research, VA Boston Healthcare System, US Department of Veterans Affairs, Boston, MA
| | | | - Jillian C Shipherd
- National Center for PTSD, Women’s Health Sciences, VA Boston Healthcare System, Boston, MA
- Boston University School of Medicine, Boston, MA
- Lesbian, Gay, Bisexual, and Transgender (LGBT) Program, Veterans Health Administration, Washington, DC
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Menlah A, Garti I, Amoo SA, Atakro CA, Amponsah C, Agyare DF. Knowledge, Attitudes, and Practices of Postoperative Pain Management by Nurses in Selected District Hospitals in Ghana. SAGE Open Nurs 2018; 4:2377960818790383. [PMID: 33415201 PMCID: PMC7774443 DOI: 10.1177/2377960818790383] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 06/21/2018] [Accepted: 06/28/2018] [Indexed: 01/12/2023] Open
Abstract
INTRODUCTION There is documented evidence pointing to the fact that there are numerous challenges with postoperative pain (POP) management globally. However, these challenges with POP management are more profound in developing countries. PURPOSE The purpose of this study is to examine the knowledge, attitude, and practices of nurses concerning POP management in four selected district hospitals in Ghana. METHODOLOGY A descriptive, cross-sectional survey was employed to evaluate nurse's knowledge, attitude, and practices pertaining to POP management. Multistaged sampling was used to draw the respondents. An adapted version of the Nurses Knowledge and Attitudes Survey Regarding Pain instrument was used to test the knowledge, attitude, and practices of nurses and midwives. Descriptive statistics were used to analyze the data in order to present quantitative descriptions of variables in this study. RESULTS This study showed that nurses in the four district hospitals had knowledge deficits regarding POP management. Eighty-one representing 48% of nurses had low knowledge on POP management. An overwhelming majority of nurses (97.6%) relied on routinely rendered basic nursing skills to relieve POP and a few used pharmacological interventions. However, nurses had good attitudes toward POP management. CONCLUSIONS POP is ineffectively managed by nurses in district hospitals in Ghana. Nurses and midwives in Ghana need to adhere to best practices in POP management by increasing their theoretical and practical knowledge, so that there will be tangible positive change in POP management in Ghana. RECOMMENDATIONS Nurses must be empowered through continuous development programs to keep abreast with changing trends that pertain to POP management.
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Affiliation(s)
- Awube Menlah
- Department of Nursing, Valley View University, Adenta, Ghana
| | - Isabella Garti
- Department of Nursing, Valley View University, Adenta, Ghana
| | - Sarah Ama Amoo
- Intensive Care Unit, Cape Coast Teaching Hospital, Ghana
| | | | - Caleb Amponsah
- Department of Nursing, Valley View University, Adenta, Ghana
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Kim B, Miller CJ, Elwy AR, Holmes SK, Coldwell CM, Bauer MS. Staff perceptions implementing interprofessional team-based behavioural healthcare. J Interprof Care 2017; 31:360-367. [PMID: 28276840 DOI: 10.1080/13561820.2017.1283302] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The US Veterans Health Administration (VHA) in 2013 mandated a nationwide implementation of interprofessional team-based care in the general mental health setting and officially endorsed the collaborative care model in 2015 to guide the coordinated and anticipatory care to be delivered by these teams. Front-line clinic staff are major stakeholders whose practices are most directly affected by this implementation and may or may not view teams as useful or feasible for their practice. Our objective was to examine their perspectives on delivering team-to-patient care in order to understand what system-level efforts can best support the transition to such care from the more conventional provider-to-patient care. We conducted 14 semi-structured interviews with staff from general mental health clinics across three different VHA medical facilities. The interview questions focused on asking how care is organised and delivered at their clinic, their experiences in collaborating with other staff, and how the clinic handles changes. Four recurrent themes were identified: navigating workplace supervision, organisation, and role structures; continuing professional growth and relationships; delivering patient-focused care through education and connection to resources; and utilising information technology for communication and panel-based management. Quality improvement efforts were rarely discussed during the interviews. Our results indicate that staff's endorsement of the implementation of interprofessional care teams in general mental health settings may be strengthened through associated efforts targeted at enhancing their experiences aligned to these emergent themes.
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Affiliation(s)
- Bo Kim
- a VA Health Services Research & Development Center for Healthcare Organization and Implementation Research , Boston , Massachusetts , USA.,b Harvard Medical School , Boston , Massachusetts , USA
| | - Christopher J Miller
- a VA Health Services Research & Development Center for Healthcare Organization and Implementation Research , Boston , Massachusetts , USA.,b Harvard Medical School , Boston , Massachusetts , USA
| | - A Rani Elwy
- a VA Health Services Research & Development Center for Healthcare Organization and Implementation Research , Boston , Massachusetts , USA.,c Boston University School of Public Health , Boston , Massachusetts , USA
| | - Sally K Holmes
- a VA Health Services Research & Development Center for Healthcare Organization and Implementation Research , Boston , Massachusetts , USA.,c Boston University School of Public Health , Boston , Massachusetts , USA
| | - Craig M Coldwell
- d VA New England Healthcare System (Veterans Integrated Services Network 1) , Bedford , Massachusetts , USA.,e Boston University School of Medicine , Boston , Massachusetts , USA
| | - Mark S Bauer
- a VA Health Services Research & Development Center for Healthcare Organization and Implementation Research , Boston , Massachusetts , USA.,b Harvard Medical School , Boston , Massachusetts , USA
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Widerström-Noga E, Anderson KD, Perez S, Hunter JP, Martinez-Arizala A, Adcock JP, Escalona M. Living With Chronic Pain After Spinal Cord Injury: A Mixed-Methods Study. Arch Phys Med Rehabil 2016; 98:856-865. [PMID: 27894730 DOI: 10.1016/j.apmr.2016.10.018] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 10/20/2016] [Accepted: 10/25/2016] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To identify the relative importance of positive (facilitators) and negative (barriers) contributors to living with chronic pain after spinal cord injury (SCI). DESIGN Mixed-methods: (1) Qualitative (n=35): individual, semistructured, open-ended interviews identifying facilitator/barrier themes; (2) Quantitative (n=491): converting the most common themes into statements and quantifying agreement with these in an online survey to determine relative importance, underlying dimensions, and their associations with perceived difficulty in dealing with pain. SETTING University-based research setting and general community. PARTICIPANTS Volunteers (N=526) with SCI experiencing moderate to severe chronic pain. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Interview guides, facilitator/barrier statements, and pain inventories. RESULTS Exploratory factor analyses reduced agreement ratings into 4 facilitators (information regarding pain and treatments, resilience, coping, medication use) and 5 barriers (poor health care communication, pain impact and limitations, poor communication about pain, difficult nature of pain, treatment concerns). Greater "pain impact and limitations," "difficult nature of pain," "poor communication from provider," lower "resilience," greater "medication use," and younger age predicted greater difficulty in dealing with pain (r=.75; F=69.02; P<.001). CONCLUSIONS This study revealed multiple facilitators and barriers to living with chronic pain after SCI. The principal barrier, "poor health care communication," indicated that consumers do not receive adequate information from their health care providers regarding pain. "Information regarding pain and treatments" had greater agreement scores and factor loadings than all other facilitators, indicating that most participants view provider-patient communication and educational efforts regarding pain and pain management as priorities and critical needs. Further initiatives in these areas are important for improving pain management post-SCI.
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Affiliation(s)
- Eva Widerström-Noga
- The Miami Project to Cure Paralysis, University of Miami, Miami, FL; Department of Neurological Surgery, Miller School of Medicine, University of Miami, Miami, FL; Bruce W. Carter Veterans Affairs Medical Center, Miami, FL.
| | - Kimberly D Anderson
- The Miami Project to Cure Paralysis, University of Miami, Miami, FL; Department of Neurological Surgery, Miller School of Medicine, University of Miami, Miami, FL; Bruce W. Carter Veterans Affairs Medical Center, Miami, FL
| | - Salomé Perez
- Bruce W. Carter Veterans Affairs Medical Center, Miami, FL
| | - Judith P Hunter
- Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Alberto Martinez-Arizala
- The Miami Project to Cure Paralysis, University of Miami, Miami, FL; Department of Neurological Surgery, Miller School of Medicine, University of Miami, Miami, FL; Bruce W. Carter Veterans Affairs Medical Center, Miami, FL
| | - James P Adcock
- The Miami Project to Cure Paralysis, University of Miami, Miami, FL; Bruce W. Carter Veterans Affairs Medical Center, Miami, FL
| | - Maydelis Escalona
- The Miami Project to Cure Paralysis, University of Miami, Miami, FL; Bruce W. Carter Veterans Affairs Medical Center, Miami, FL
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Healthcare Providers’ Nonverbal Behavior can Lead Patients to Show Their Pain More Accurately: An Analogue Study. JOURNAL OF NONVERBAL BEHAVIOR 2016. [DOI: 10.1007/s10919-016-0230-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Cameron KA, De Haes HJC, Hulsman RL. Health communication in science, teaching and clinical practice: Selected papers from the Amsterdam EACH 2014 Conference. PATIENT EDUCATION AND COUNSELING 2015; 98:1169-1171. [PMID: 26319361 DOI: 10.1016/j.pec.2015.08.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- Kenzie A Cameron
- Division of General Internal Medicine and Geriatrics, Department of Medicine, Northwestern University, Feinberg School of Medicine, 750 N. Lake Shore Drive, 10th Floor, Chicago, IL 60611, United States
| | - Hanneke J C De Haes
- Department of Medical Psychology, Academic Medical Centre, University of Amsterdam, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands
| | - Robert L Hulsman
- Department of Medical Psychology, Academic Medical Centre, University of Amsterdam, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands.
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