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Piyakhachornrot C, Youngcharoen P. Pain management education needs for nurses caring for older adults undergoing total knee replacement. Int J Orthop Trauma Nurs 2024; 52:101037. [PMID: 37438242 DOI: 10.1016/j.ijotn.2023.101037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 06/29/2023] [Accepted: 07/01/2023] [Indexed: 07/14/2023]
Abstract
INTRODUCTION Effective postoperative pain management is necessary to improve the outcomes of older adults undergoing total knee replacement (TKR). Discovering what registered nurses (RNs) need to know about pain management may be beneficial to improving the quality of care. AIM The study aimed to identify the information needed to develop pain management education for RNs caring for older adults undergoing TKR. METHODS A qualitative descriptive design was used in this study. Three focus groups were conducted with 22 staff RNs with experience caring for older adults undergoing TKR at a supra-tertiary care hospital in Bangkok, Thailand; one focus group was conducted with five members of the hospital's nursing pain management committee. Data were analyzed using content analysis. RESULTS Two themes relevant to pain assessment education were pain assessment and pain management. Subthemes of pain assessment included challenges in cognitively impaired older adults, inadequate knowledge and misconceptions, and re-assessing pain. Three subthemes of pain management were created, including knowledge of pain medication, new trends in pharmacological pain management and devices, and non-pharmacological pain management using cold compression. CONCLUSIONS RNs require current information about pain management to provide effective postoperative care for older adults undergoing TKR. The findings may be used in pain management education to update RNs' knowledge of pain management.
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Affiliation(s)
- Chayada Piyakhachornrot
- Nursing Department, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Phichpraorn Youngcharoen
- Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
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Fekede L, Temesgen WA, Gedamu H, Kindie S, Bekele TG, Abebaw A, Baymot A, Difer M. Nurses' pain management practices for admitted patients at the Comprehensive specialized hospitals and its associated factors, a multi-center study. BMC Nurs 2023; 22:366. [PMID: 37803315 PMCID: PMC10559436 DOI: 10.1186/s12912-023-01528-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 09/22/2023] [Indexed: 10/08/2023] Open
Abstract
BACKGROUND Pain is the most common challenge that most hospitalized patients complain of and is influenced by several patients, nurses, and institutional-related factors. Most studies in Ethiopia on pain were focused on surgical illnesses only. OBJECTIVE To assess nurses' pain management practice and associated factors for admitted patients at Comprehensive Specialized Hospitals. METHODS AND MATERIALS A multi-center institution-based cross-sectional study was conducted at the five randomly selected Comprehensive Specialized Hospitals of the Amhara region from May 01 to June 01, 2022. A multi-stage sampling method was employed to select a total of 430 nurses and patients for whom the nurses were responsible. Data were collected using standard self-administered, structured, and checklist questionnaires from nurses, patients, and patients' charts respectively. The modified Bloom's criteria categorized the overall practice as good, moderate, and poor. Data were checked, coded, and entered into Epi-Data version 4.6 and exported to SPSS version 25. An ordinal logistic regression model was applied, and variables with a p-value < 0.05 with a 95% CI in the multivariable analysis were considered significant. RESULTS The study evaluated the pain management practices of 430 nurses and only a quarter had good pain management practices. Those nurses with first degrees and above education level (AOR = 2.282) and who attended in-service training (AOR = 2.465) were found to have significantly higher pain management practice. Expected though patients with painful procedures (AOR = 5.648) and who had severe pain (AOR = 2.573) were receiving better pain management practices from their nurse care provider. Nurses working in the institutions with a pain-free initiative focal person (AOR = 6.339) had higher pain management practices. CONCLUSION AND RECOMMENDATION Overall, the majority of nurses had poor pain management practices. Higher educational levels, in-service training, and assigning a pain-free focal person had an impact on pain management services. Patients with higher pain levels and painful procedures were getting better attention. Hospital administrations need to provide due attention to the pain management of hospitalized patients by providing in-service training and educational opportunities to improve the capacity of nurses. Patients would be benefited considerably if hospitals focus on assigning focal persons for advocating regular pain management for admitted patients regardless of their pain level.
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Affiliation(s)
- Legese Fekede
- Department of Nursing, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia.
| | - Worku Animaw Temesgen
- Department of Nursing, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Haileyesus Gedamu
- Department of Nursing, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Selamsew Kindie
- Department of Nursing, College of Medicine and Health Sciences, Mada Wulabu University, Bale Robe, Ethiopia
| | | | - Ambaw Abebaw
- Department of Nursing, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Aemiro Baymot
- Department of Nursing, College of Medicine and Health Sciences, Addia Ababa University, Addis Ababa, Ethiopia
| | - Mesfin Difer
- Department of Nursing, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
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Bittencourt JV, de Souza PAC, Corrêa LA, Volotão AN, Mathieson S, Nogueira LAC. Health literacy, pain-related interference and pain-related distress of patients with musculoskeletal pain. Health Promot Int 2023; 38:daab183. [PMID: 34718561 DOI: 10.1093/heapro/daab183] [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] [Indexed: 11/14/2022] Open
Abstract
The present study aimed to compare pain-related interference and pain-related distress in patients with musculoskeletal pain and differing levels of health literacy. A cross-sectional study was conducted among 243 patients with chronic musculoskeletal pain. Short Test of Functional Health Literacy in Adults classified the level of health literacy. Outcome measures included pain-related interference (pain intensity and functional limitation) and pain-related distress (psychosocial factors). Analysis of variance methods were used. One hundred twenty-three (50.62%) participants were classified as adequate, 24 (9.88%) as marginal and 96 (39.50%) as inadequate health literacy. Patients with inadequate health literacy had higher values of pain severity compared to the other groups, when controlled for age. The group adequate health literacy showed less kinesiophobia compared to their counterparts. Functional limitations and other psychosocial factors were similar among groups. Pain severity and kinesiophobia had disadvantageous findings in participants with inadequate health literacy. Still, the results of pain severity must be approached cautiously because the differences were observed when controlled for age solely.
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Affiliation(s)
- Juliana Valentim Bittencourt
- Rehabilitation Science Postgraduate Program at Augusto Motta University Centre (UNISUAM), Avenida Paris, 84, Bonsucesso, CEP 21041-020 Rio de Janeiro, Brazil
| | - Patrick Anderson Chaves de Souza
- Physiotherapy Department at Federal Institute of Rio de Janeiro (IFRJ), Rua Professor Carlos Wenceslau, 343, Realengo, CEP 21710-240 Rio de Janeiro, Brazil
| | - Leticia Amaral Corrêa
- Rehabilitation Science Postgraduate Program at Augusto Motta University Centre (UNISUAM), Avenida Paris, 84, Bonsucesso, CEP 21041-020 Rio de Janeiro, Brazil
| | - Andresa Narcizo Volotão
- Physiotherapy Department at Federal Institute of Rio de Janeiro (IFRJ), Rua Professor Carlos Wenceslau, 343, Realengo, CEP 21710-240 Rio de Janeiro, Brazil
| | - Stephanie Mathieson
- Institute for Musculoskeletal Health, Sydney School of Public Health, Edward Ford Building, A27 Fisher Rd, University of Sydney NSW 2006, Austrália
| | - Leandro Alberto Calazans Nogueira
- Rehabilitation Science Postgraduate Program at Augusto Motta University Centre (UNISUAM), Avenida Paris, 84, Bonsucesso, CEP 21041-020 Rio de Janeiro, Brazil
- Physiotherapy Department at Federal Institute of Rio de Janeiro (IFRJ), Rua Professor Carlos Wenceslau, 343, Realengo, CEP 21710-240 Rio de Janeiro, Brazil
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Peterson A, Schaller AS. How Hospital Patients Experience Pain the Previous 24 Hours-A Prevalence Assessment of Pain in Five Hospitals in Sweden. Pain Manag Nurs 2022; 23:878-884. [PMID: 36075787 DOI: 10.1016/j.pmn.2022.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 06/23/2022] [Accepted: 07/17/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND Previous studies show that pain is common among hospital inpatients. AIM This study measures the prevalence of pain and the impact of pain on sleep in patients admitted to five hospitals in Sweden. METHODS The patients were admitted to a surgical or a medical ward. They answered on a self-reported questionnaire about their average pain intensity and how much their pain interfered with their sleep the previous 24 hours, on a 010 numerical rating scale (NRS). RESULTS Of the 500 patients, 308 experienced pain (62%), (NRS ≥ 3) and 111 (22%) rated their pain as NRS ≥ 7. We found no difference between surgical and medical specialty regarding pain prevalence. The results suggest that roughly the same proportion of patients with pain also experienced poor sleep due to pain265 patients (53%) reported pain interference on sleep, NRS ≥ 3. CONCLUSIONS AND CLINICAL IMPLICATIONS This study shows that there is still an unacceptable high pain prevalence in inpatients and that patients experience pain as negatively impacting their sleep. Future pain care is likely to include a more comprehensive implementation strategy for the dissemination of knowledge, especially related to the complex context of today's healthcare system. That is, the possibility that anchoring new knowledge also benefits the patient is probably associated with optimization of the structural context. Future research should take this question further by examining how the organizational structure should be optimized for the dissemination of knowledge in healthcare professionals about pain and pain interference with sleep.
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Affiliation(s)
- Anna Peterson
- ain and Rehabilitation Center, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
| | - Anne Söderlund Schaller
- ain and Rehabilitation Center, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden; Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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Rangel T, Pham S, Senger B, Daratha K, Fitzgerald C, Mallo R, Daratha K. Pharmacologic Pain Management Trends among Adults Hospitalized with Cellulitis: An Evidence-Based Practice Project. Pain Manag Nurs 2022; 24:222-228. [PMID: 36220690 DOI: 10.1016/j.pmn.2022.09.003] [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: 09/07/2021] [Revised: 08/15/2022] [Accepted: 09/07/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Nurses commonly administer opioids, following "as needed" order sets, to patients hospitalized for acute pain conditions like cellulitis. Practice guidelines recommend limiting opioid administration for acute pain management. At two hospitals in the Pacific Northwest, an opioid stewardship committee was formed to align with best practice. AIMS The main objective was to describe changes to inpatient rates of opioid and non-opioid administration following implementation of evidence-based opioid stewardship efforts. DESIGN Observational, retrospective, evidence-based practice project. SETTINGS One 200-bed and one 680-bed hospital in Washington State. PARTICIPANTS/SUBJECTS Data were included from patients aged 18 years or older hospitalized for cellulitis. METHODS Demographic and pain-related data were extracted from the electronic health record (n = 4,523 encounters) guided by the symptom management framework. The proportion of patients receiving opioid or non-opioid medications before and after implementation of evidence-based practice opioid stewardship interventions was calculated descriptively. A logistic regression tested factors related to administration of an opioid medication. RESULTS The proportion of patients receiving an opioid decreased following opioid stewardship efforts while those receiving non-opioid analgesics remained stable. Factors significantly influencing inpatient opioid administration were: average inpatient pain score, pre-hospital opioid prescription, length of stay, and year of hospitalization. CONCLUSIONS Analgesic administration treating painful, acute cellulitis at two hospitals in the Pacific Northwest included opioid and non-opioid medications. The proportion of patients receiving opioids decreased following best practice opioid stewardship actions. Opportunities may exist for nurses to collaborate with providers to improve inpatient analgesic administration practices.
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Affiliation(s)
- Teresa Rangel
- Providence Health Care, Professional Development Department, Spokane, Washington.
| | - Sydney Pham
- Providence Sacred Heart Medical Center, Spokane, Washington
| | - Brenda Senger
- Gonzaga University, School of Human Physiology and Nursing, Spokane, Washington
| | - Kristopher Daratha
- Providence Health Care, Professional Development Department, Spokane, Washington
| | - Cynthia Fitzgerald
- Providence Health Care, Professional Development Department, Spokane, Washington
| | - Rebecca Mallo
- Providence Sacred Heart Medical Center, Spokane, Washington
| | - Kenneth Daratha
- Providence Health Care, Providence Medical Research Center, Spokane, Washington
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Hu JY, Roh YS. Psychometric Evaluation of the Nurses' Cancer Pain Management Competency Scale. Pain Manag Nurs 2022; 24:209-215. [PMID: 36171159 DOI: 10.1016/j.pmn.2022.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 07/25/2022] [Accepted: 08/16/2022] [Indexed: 10/14/2022]
Abstract
BACKGROUND There is lack of instruments for assessing nurses' comprehensive pain management competency. AIM This study aimed to assess the psychometric properties of the Nurses' Cancer Pain Management Competency Scale and to conduct a cursory survey of the pain management educational needs/resources of nurses caring for patients with cancer pain. METHOD A convenience sample of 230 Korean nurses who met the eligibility criteria completed the researcher developed the Nurses' Cancer Pain Management Competency Scale and a pain management educational needs/resources survey. The Nurses' Cancer Pain Management Competency Scale was based on the pain management core competencies identified by Fishman et al (2013). Internal consistency was assessed using Cronbach's alpha, and construct validity was examined using exploratory factor analysis with varimax rotation. RESULTS Cronbach's alpha of the scale was 0.89. Nurse cancer pain management competency includes four factors, which accounted for 68.44% of the variance: the context of pain management, pain assessment and measurement, management of pain, and multidimensional nature of pain. Approximately 42% of nurses had no available protocols related to cancer pain management. Nurses preferred multi-component educational modalities, including simulation-based learning. CONCLUSIONS Findings support internal consistency reliability and content and construct validity of the Nurses' Cancer Pain Management Competency Scale that can help examine pain management competency of nurses. Adopting an evidence-based clinical cancer pain management-related protocol and multi-component training programs are needed to achieve optimal cancer pain management competency in nurses.
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Affiliation(s)
- Jae Yeon Hu
- From the Graduate School of Nursing and Health Professions, Chung-Ang University, Seoul, Republic of Korea
| | - Young Sook Roh
- Red Cross College of Nursing, Chung-Ang University, Seoul, Republic of Korea.
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Kim K, Yang Y, Wang Z, Chen J, Barandouzi ZA, Hong H, Han HR, Starkweather A. A systematic review of the association between health literacy and pain self-management. PATIENT EDUCATION AND COUNSELING 2022; 105:1427-1440. [PMID: 34629232 DOI: 10.1016/j.pec.2021.09.037] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 08/03/2021] [Accepted: 09/28/2021] [Indexed: 05/24/2023]
Abstract
OBJECTIVE To synthesize the impact of health literacy on pain self-management contexts, processes, and outcomes. METHODS This systematic review employed a narrative synthesis. We used databases, including PubMed and PsycINFO, and handsearching of the reference lists to identify articles published before December 2020. Pain self-management variables were chosen based on the Individual and Family Self-Management Theory. Quality was assessed using the National Institute of Health quality assessment tool for observational and cross-sectional studies. RESULTS Twenty studies that included 6173 participants were used. Most studies measured functional domains of the health literacy concept. Twelve studies reported small to large associations between health literacy and pain knowledge, medication regimen adherence, or pain. Thirteen studies considered health literacy clinical risks in tailoring education, while seven viewed it as personal assets developed via education. CONCLUSIONS Limited information on the contribution of health literacy to pain self-management context factors and processes exists. Current evidence was limited by a lack of temporality, theoretical basis, and a priori sample estimation. PRACTICE IMPLICATIONS Using brief functional literacy scales in the clinical environment can be more practical. Identifying patients' literacy levels helps clinicians personalize education, which then promotes patients' knowledge of pain, medication regimen adherence, and pain control.
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Affiliation(s)
- Kyounghae Kim
- College of Nursing, Korea University, Seoul, South Korea; Institute of Nursing Research, Korea University, Seoul, South Korea; Transdisciplinary Major in Learning Health Systems, Department of Healthcare Sciences, Graduate School, Korea University, South Korea.
| | - Yuxuan Yang
- School of Nursing, University of Connecticut, Storrs, CT, USA; Center for Advancement in Managing Pain, University of Connecticut, Storrs, CT, USA
| | - Zequan Wang
- School of Nursing, University of Connecticut, Storrs, CT, USA; Center for Advancement in Managing Pain, University of Connecticut, Storrs, CT, USA
| | - Jie Chen
- School of Nursing, University of Connecticut, Storrs, CT, USA; Center for Advancement in Managing Pain, University of Connecticut, Storrs, CT, USA
| | | | - Hyejeong Hong
- School of Nursing, University of Washington School of Nursing, Seattle, WA, USA
| | - Hae-Ra Han
- School of Nursing, Johns Hopkins University School of Nursing, Baltimore, MD, USA
| | - Angela Starkweather
- School of Nursing, University of Connecticut, Storrs, CT, USA; Center for Advancement in Managing Pain, University of Connecticut, Storrs, CT, USA
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Baik SY, Ryu GW, Lee H, Lee S, Choi M. Association Between Symptoms of Patients With Heart Failure and Patient Outcomes Based on Electronic Nursing Records. Comput Inform Nurs 2021; 39:1027-1034. [PMID: 34029266 PMCID: PMC8663513 DOI: 10.1097/cin.0000000000000763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We examined the association between symptoms (ie, dyspnea and pain) and patient outcomes (ie, length of stay, 30-day readmission, and death in hospital) among patients with heart failure using EMRs. This was a descriptive study that was conducted from July 1, 2014, to November 30, 2017. Participants were 754 hospitalized patients with heart failure (mean age, 70.62 ± 14.78 years; male-to-female ratio, 1:1.1). Data were analyzed using descriptive statistics, χ2 tests, and logistic regression analyses. Patients' average length of stay was 8.92 ± 13.12 days. Thirty-two patients (4.2%) were readmitted, and 100 patients (13.3%) died during hospitalization. Two-thirds (67.7%) experienced dyspnea, and 367 (48.7%) experienced pain. Symptoms and ICU admission were significantly related to patient outcomes. In the regression analyses, dyspnea, pain, and ICU admission were significantly related to higher-than-average lengths of stay. Dyspnea and ICU admission were related to death in hospital. Information regarding patients' symptoms, which was extracted from records, was a valuable resource in examining the relationship between symptoms and patient outcomes. The use of EMRs may be more advantageous than self-reported surveys when examining patients' symptom and utilizing big data.
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BMI influences relationships among health factors for adults with persistent pain who use prescription opioids. Nurs Outlook 2020; 68:440-448. [PMID: 32402394 DOI: 10.1016/j.outlook.2020.03.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 03/13/2020] [Accepted: 03/21/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Long-term use of prescription opioids for pain results in negative health outcomes. Overweight and pain are related, and adults with either condition commonly report poor sleep quality, high levels of depression, low levels of self-efficacy, and high pain interference and intensity. Insufficient research exists regarding how weight may influence pain outcomes in the context of common symptoms. PURPOSE To investigate how body mass index (BMI) influences relationships between health factors and pain outcomes among adults with pain prescribed opioids. METHODS The sample included 226 adults. Linear regression models tested relationships among variables and outcomes of pain intensity and pain interference. FINDINGS BMI significantly strengthened relationships between health factors and pain interference but not pain intensity. DISCUSSION Adults with persistent pain suffer worsened pain interference in the context of increased weight status. Nurses should consider addressing BMI as part of a holistic pain management care plan.
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Health literacy, pain intensity and pain perception in patients with chronic pain. Wien Klin Wochenschr 2018; 130:23-30. [PMID: 29322378 PMCID: PMC5772123 DOI: 10.1007/s00508-017-1309-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2017] [Accepted: 12/21/2017] [Indexed: 11/05/2022]
Abstract
Background Chronic pain poses a large burden for the healthcare system and the individuals concerned. The impact of health literacy (HL) on health status and health outcomes is receiving more and more attention. The aim of this study was to evaluate the association of HL with chronic pain intensity and pain perception. Methods A total of 121 outpatients suffering from chronic pain (pain duration >3 months) were evaluated. The HL was measured using the health literacy screening questions. Pain intensity was measured with a Visual Analogue Scale (VAS) and pain perception with the short-form McGill Pain Questionnaire (SF-MPQ). Results Individuals with low HL had significantly higher VAS values (Pearson correlation coefficient= −0.270, p = 0.003). Stepwise regression analysis showed that HL has a significant association with pain intensity (odds ratio [OR] = 2.31; 95% confidence interval [CI] 1.11–4.83), even after controlling for age and sex (OR = 2.27; 95% CI 1.07–4.82), but no longer after controlling for education (OR = 2.10; 95% CI 0.95–4.64). Conclusion Individuals with a higher HL showed less pain intensity, which seems to be caused by a better pain management; therefore, supporting the development of HL in patients with chronic pain could be seen as an important objective of integrated care.
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Pain in hospitalized patients in a third-level health care institution. COLOMBIAN JOURNAL OF ANESTHESIOLOGY 2018. [DOI: 10.1097/cj9.0000000000000004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Medrzycka-Dabrowka W, Dąbrowski S, Gutysz-Wojnicka A, Gawroska-Krzemińska A, Ozga D. Barriers Perceived by Nurses in the Optimal Treatment of Postoperative Pain. Open Med (Wars) 2017; 12:239-246. [PMID: 28828405 PMCID: PMC5553189 DOI: 10.1515/med-2017-0037] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2014] [Accepted: 06/19/2017] [Indexed: 11/17/2022] Open
Abstract
It is currently estimated that the lack of adequate pain management affects 80% of the global population and the phenomenon poses a serious problem in more than 150 countries. On a national level, the greatest burden of inadequate treatment is borne, among others, by elderly patients. The purpose of the paper was to compare the prevalence of barriers to optimum post-operative pain management in elderly patients, observed by nurses in a clinical, provincial and municipal hospital in Poland. The research project was a multi-center one and took over a year. The study was questionnaire-based. It used the Polish version of the Nurses' Perceived Obstacles to Pain Assessment and Management Practices questionnaire. The study included a total of 1602 nurses working at a clinical, provincial and municipal hospital. In the university hospital, difficulties in pain assessment related to the healthcare system occurred statistically significantly more often.
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Affiliation(s)
| | - Sebastian Dąbrowski
- Anesthesiology and Intensive Care Unit, Specialistic HospitalGdańsk-Zaspa, Poland
| | | | | | - Dorota Ozga
- Department of Emergency Medicine, Faculty of Medicine, University of Rzeszow, RzeszowPoland
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Deschepper M, Vermeir P, Vogelaers D, Devulder J, Eeckloo K. Is pain at discharge a risk factor for unplanned hospital readmission? Acta Clin Belg 2017; 72:95-102. [PMID: 28229625 DOI: 10.1080/17843286.2017.1293311] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
INTRODUCTION Unplanned readmissions are associated with a high cost to health insurances and the incidence of preventable readmissions could be considered as a quality indicator for the initial hospital admission. We aimed to assess the predictive value for unplanned readmission of higher pain scores at discharge of the initial admission as well as of other pain and demographic characteristics. The documentation of significant associations would provide further support for a structured pain management policy. METHODS A retrospective analysis of a large single university hospital data-set of 33.122 admissions within a 13-month period allowed for the assessment of the predictive relationship of pain toward unplanned readmission at 7 and at 30 days after discharge through logistic regression, and of other characteristics through linear regression. RESULTS Pain scores at discharge of the initial admission were not significantly different (p > 0.05) with or without unplanned readmission and hence have no predictive value on the individual patient level. The prediction of the number of patients for each group, for example the number of patients that will be readmitted (size of the group), shows significance for pain at the moment of discharge (p_initial = 0.000), pain medication (p = 0.0044), and age (p = 0.0017). Pathology (p = 0.6151) and gender (p = 0.7029) have no significant predictive value. CONCLUSION Pain as dichotomous variable upon discharge cannot be used as single risk predictor for unplanned readmission. However, the pain score at discharge in combination with the use of pain medication and age is a risk factor for the number of short-term unplanned readmissions.
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Affiliation(s)
- Mieke Deschepper
- Ghent University Hospital, (Strategic) Policy Cell, Ghent, Belgium
| | - Peter Vermeir
- Department of General Internal Medicine, Ghent University Hospital, Ghent, Belgium
- Faculty of Medicine and Health Sciences, Department of Internal Medicine, Ghent University, Ghent, Belgium
| | - Dirk Vogelaers
- Department of General Internal Medicine, Ghent University Hospital, Ghent, Belgium
- Faculty of Medicine and Health Sciences, Department of Internal Medicine, Ghent University, Ghent, Belgium
| | - Jacques Devulder
- Ghent University Hospital, Centre Multidisciplinary Pain, Ghent, Belgium
- Faculty of Medicine and Health Sciences, Department of Anaesthesiology and Perioperative Medicine, Ghent University, Ghent, Belgium
| | - Kristof Eeckloo
- Ghent University Hospital, (Strategic) Policy Cell, Ghent, Belgium
- Faculty of Medicine and Health Sciences, Department of Public Health, Ghent University, Ghent, Belgium
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