Effects of Localized Heating on Pain, Skin Perfusion, and Wound Healing After Lumbar Decompression

Factors Associated With Knowledge and Attitude Among Vietnamese Nursing Staff Regarding Pain Management in a Vietnam National Hospital

ABSTRACT

BACKGROUND: Nurses play an important role in providing holistic care and effective pain management, which is significantly associated with their knowledge and attitudes. Limited evidence is available from Vietnamese nursing studies evaluating the knowledge and attitudes of nurses toward pain management. The objectives of this study were to evaluate the knowledge and attitudes of Vietnamese nurses and identify factors associated with pain management. METHODS: This study used a descriptive and cross-sectional design and was conducted at a national hospital in Vietnam from May to June 2021. Nurses working in all clinical units were surveyed to collect demographic data and assessed using the structured Knowledge and Attitudes Survey Regarding Pain (KASRP) scale. Multiple linear regression analysis was conducted to identify factors associated with knowledge and attitudes. RESULTS: Two hundred seventy-nine nurses completed the survey, including 152 (54.5%) who read books or journals about pain, 25 (9.0%) who reported the use of unit-based pain guidelines, and 77 (27.6%) who used a numeric rating tool. The mean number of correct answers on the KASRP was 23.34 (mean KASRP correct percentage of 54.9%), and only 16 nurses (5.7%) had passing scores. Having a bachelor's degree or higher, reading books or journals about pain, using a numeric rating tool, and using unit-based pain guidelines were significantly associated with higher KASRP scores (P < .01) among nurses. CONCLUSIONS: The knowledge and attitudes of nurses regarding pain management were far from satisfactory. Regular pain management training, access to pain-related reading materials, and the frequent use of a numeric tool to assess pain intensity are recommended to enhance the quality of care for patients provided by clinical nurses.

Exploring the Face Validity of the Pain Numeric Rating Scale Among Healthcare Providers

ABSTRACT

BACKGROUND: Healthcare providers (HCPs) use the numeric rating scale (NRS) under the assumption that it provides reliable information from which to make decisions regarding analgesic administration. METHODS: We explored the face validity of the NRS using a prospective single-blinded observational design. Pre and post NRS scores were obtained from HCPs who submerged their hand in a bucket of ice water (pain stimulus). RESULTS: Despite a consistent similar pain source, individual HCPs rated their pain very differently (range, 2-10), and there was a significant difference in self-estimated pain tolerance (μ = 7.06 [SD, 1.43]) and actual pain scores (μ = 6.35 [SD, 2.2]; t = 4.08, P < .001). CONCLUSION: The findings indicate a limitation in the face validity of the NRS. The high variance in NRS scores reaffirms the subjectivity of pain perception and brings into question the utility of using NRS scores when determining analgesic dosages.

A Qualitative Study of Nurses' Perceptions of Narcotic Administration after Subarachnoid Hemorrhage

BACKGROUND

Nearly every patient admitted to a neuroscience intensive care unit (ICU) will experience pain and nurses are tasked with analgesic administration. Within the setting of the ongoing opioid epidemic it is not well understood how nurses meet the need to alleviate pain while individualizing analgesic administration.

AIMS

This qualitative study used a phenomenological approach to determine nurses' perceptions in pain management of patientswith subarachnoid hemorrhage (SAH).

DESIGN

Prospective qualitative inquiry using phenomenology SETTING: The study was conducted in a neuroscience intensive care unit at a university hospital.

PARTICIPANTS

Nine neuroscience intensive care unit nurses were enrolled using snowball sampling.

METHODS

Saturation was reached after nine individual nurse interviews. Hermeneutic cycling analysis was used throughout interviews and codes and themes were developed throughout the interview process. Rigor was established using triangulation, rich and thick descriptions, and member checks.

RESULTS

Emerging themes included discernment and hesitation. Discernment is supported by codes such as: "nursing judgement" and "follow the orders." Hesitation is supported by codes such as "clouded exam" and "over sedation." Eight nurses made references to hesitation of administering opioids due to the perception that it would cause a poorer neurological exam. All nurses described a reliance on education, experience, or intuition to guide their decision to administer opioids along with using approved pain scales. Themes were confirmed by member checks, which prompted slight modifications to coding.

CONCLUSIONS

Results of this study support that nurses do express apprehension in administering opioids to patients with (SAH). This apprehension leads to hesitation to administer the medication and a thought out discernment process.