Pain management by health care professionals: Impact on the hospitalized patient

Abstract Background Pain affects a person’s physical and psychological well-being, work performance and productivity. Working population bear their pain and continue to work which may contribute to the worsening of their pain condition. However, their pain situation was not well-examined. Objective The aim of the study was to explore the prevalence of acute and chronic pain in the working population in Hong Kong, understand their pain management strategies and determine their preferences with regard to the use of electronic pain management materials. Methods This was an exploratory online survey. The participants’ pain history, their preferences in methods of pain management, the source of the pain management education that they had received, sources and preferences in relation to the use of the Internet for pain education, and the participants’ demographic characteristics were collected. Results A total of 210 participants joined the study, 67% of whom were experiencing pain. Of the group in pain, 71.6% were in chronic pain that has persisted for 3 months or more. Pain intensities ranged from 2.82 to 3.82 on a 10-point numeric scale. Of the participants, 85.7% reported not receiving adequate pain management education, and 91.4% of those agreed pain services were inadequate. Websites and health care professionals were the sources from which they obtained their pain management education. Conclusions The high prevalence of pain in the working population requires special attention. Health care professionals should be proactive and an online pain management programme can be a solution to address the critical problem of pain in the working population.

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Health-Care Professionals Perceived Barriers to Effective Cancer Pain Management in the Home Hospice Setting: Is Dying at Home Really Best?

OMEGA - Journal of Death and Dying ◽

10.1177/0030222819857871 ◽

2019 ◽

pp. 003022281985787

Author(s):

Lee A. Johnson ◽

Cynthia J. Bell ◽

Sheila Ridner ◽

Barbara Murphy

Keyword(s):

Health Care ◽

Pain Management ◽

Cancer Pain ◽

Health Care Professionals ◽

Cultural Beliefs ◽

Comparative Approach ◽

Unexpected Finding ◽

Convenience Sample ◽

Alternative Placement ◽

Patients At Risk

Hospice health-care professionals (HCP) evaluate and manage cancer pain in patient homes. This study explores HCP’s perceptions of barriers that affect pain management for home hospice cancer patients. A convenience sample of 20 experienced hospice HCP were recruited from a regional hospice agency. Data were collected through two focus groups using semistructured interviews and analyzed using a constant comparative approach to generate themes. An unexpected finding revealed patient’s religious and cultural beliefs about suffering and family caregiver’s beliefs that patients deserve to suffer due to past actions are barriers to pain management in home hospice. Hospice HCP can identify patients at risk for suffering at the end of life. Interventions targeting spiritual suffering and needs are needed. Home hospice HCP have an ethical obligation to address undue suffering through family’s withholding of necessary pain medications and should consider alternative placement when home is not suitable for a peaceful death.

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Interpreting the Meaning of Pain Severity Scores

Pain Research and Management ◽

10.1155/2002/971935 ◽

2002 ◽

Vol 7 (4) ◽

pp. 192-198 ◽

Cited By ~ 29

Author(s):

Marilyn J Hodgins

Keyword(s):

Health Care ◽

Pain Management ◽

Health Care Professionals ◽

Pain Measurement ◽

Management Practices ◽

Care Organization ◽

Treatment Goals ◽

Severity Scores ◽

Measurement Tools ◽

The Impact

Poor pain management practices are generally discussed in terms of barriers associated with the patient, clinician and/or health care organization. The impact of deficiencies in the tools that are used to measure pain are seldom addressed. Three factors are discussed that complicate the measurement of pain: the nature of pain, the lack of meaning associated with scores generated by pain scales, and treatment goals that lack specificity and are not linked to patients' pain scores. The major premise presented in the present article is that the utility of pain measurement is limited because health care professionals do not have a common understanding of the meaning of scores generated by pain measurement tools, especially within the acute care setting. To address this issue, approaches to establishing instrument validity need to be broadened to include the examination of the meaning and consequences of these measurements within a specific context. Substantive improvements in pain management are unlikely to occur until criteria are identified to link explicitly the scores generated by pain measurement tools to treatment goals.

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Dental pain management with prescription opioids by nondental health care professionals in a health care system network

Oral Surgery Oral Medicine Oral Pathology and Oral Radiology ◽

10.1016/j.oooo.2019.07.025 ◽

2020 ◽

Vol 129 (1) ◽

pp. e184-e185

Author(s):

Jillian M. Rigert ◽

Joel J. Napenas ◽

Meghan Wally ◽

Michael Runyon ◽

Joseph R. Hsu ◽

...

Keyword(s):

Health Care ◽

Pain Management ◽

Health Care System ◽

Health Care Professionals ◽

Dental Pain ◽

Prescription Opioids ◽

Care System

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Painful Reality: Inappropriate Provider Management of Pain as a Determinant of Health Care Avoidance

Creative Nursing ◽

10.1891/1078-4535.22.3.151 ◽

2016 ◽

Vol 22 (3) ◽

pp. 151-160

Author(s):

Nancy L. Baenziger

Keyword(s):

Health Care ◽

Pain Management ◽

Health Care System ◽

Health Care Professionals ◽

Biomedical Knowledge ◽

Pain Mechanisms ◽

Patient Pain ◽

Repeated Pain ◽

Pain Experiences ◽

Care System

Although pain is often characterized as a subjective, highly individualized phenomenon, in fact, numerous elements which are simply biological in nature underlie interpersonal differences in pain experience that influence the effectiveness of provider pain management. Elements acting at the level of tissues and cells include signal-transmitting molecules in pain pathways; elements acting at the level of the whole person comprise entire brain networks and anatomic elements fostering pain vulnerability. However, knowledge of these elements and translation of such knowledge into practical means for relieving patient pain is dismayingly sparse across the total spectrum of health care professionals. A serious consequence of this knowledge and action gap is that isolated, or worse yet, repeated, pain experiences may lead to profound mistrust of the health care system and its providers and to health care avoidance (e.g., mammography). This article outlines a biologic knowledge base and proposed remedies to improve pain management across the entire domain of health care. Key components of this approach include enhanced education for providers and informational outreach to health care consumers, clarifying pain mechanisms to both constituencies. Moreover, increased accountability within the health care system is needed, both in knowing and applying well-established biomedical knowledge and in best using technical and interpersonal skills necessary for effective pain management.

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Pharmacist’s Role in Dispensing Opioids for Acute and Chronic Pain

Journal of Pharmacy Practice ◽

10.1177/0897190010379710 ◽

2011 ◽

Vol 25 (5) ◽

pp. 497-502 ◽

Cited By ~ 14

Author(s):

Karen F. Marlowe ◽

Richard Geiler

Keyword(s):

Health Care ◽

Chronic Pain ◽

Pain Management ◽

Health Care Providers ◽

Family Relationships ◽

Health Care Professionals ◽

The United States ◽

Care Providers ◽

Economic Productivity ◽

The Impact

Pain continues to be a serious health care concern in the United States. Patients with chronic pain experience the impact of the disease throughout their lives including their social interactions, family relationships, and in many cases economic productivity. Multiple surveys have found that many pharmacists hold misconceptions regarding opioids, pain disease states, and their understandings of current regulations. Multiple barriers affect the ability of pharmacists to deliver care to patients' prescribed opioid therapy. Inadequate communication between health care professionals and patients is one of the hurdles, which prevents quality care. Increased communication between health care providers including access to health information is one step, which is crucial to improving provision of pharmacotherapy. Finally, the quality of educational opportunities relative to opioids and pain management specifically for pharmacists needs to be increased, and consideration needs to be given for making appropriate pain management education mandatory.

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Pain Assessment in a Geriatric Psychiatry Program

Pain Research and Management ◽

10.1155/2007/975282 ◽

2007 ◽

Vol 12 (4) ◽

pp. 273-280 ◽

Cited By ~ 4

Author(s):

Paul Stolee ◽

Loretta M Hillier ◽

Jacquelin Esbaugh ◽

Nancy Bol ◽

Laurie McKellar ◽

...

Keyword(s):

Health Care ◽

Pain Management ◽

Pain Assessment ◽

Health Care Professionals ◽

Management Practice ◽

Group Discussion ◽

Geriatric Psychiatry ◽

Assessment Tools ◽

Pain Symptoms ◽

Consistent Approach

BACKGROUND: The assessment of pain in older persons with psychiatric illness is particularly challenging for health care professionals. There are few well-tested pain assessment tools for this population.OBJECTIVES: A study was conducted to explore pain assessment and management issues in geriatric psychiatry.METHODS: Seventy-four staff members of a geriatric psychiatry service at Regional Mental Health Care London, St Joseph’s Health Care London, London, Ontario completed a survey to assess current pain assessment and management practice for geriatric psychiatry patients, and to identify indicators used to assess pain in this population. The results of the survey were later shared with members of the program’s pain management team in a focus group discussion to explore opportunities on how to transfer these findings into clinical practice.RESULTS: The majority of survey respondents (91.8%) agreed that pain assessment and management could be improved for patients; only 14.9% reported that there was a consistent approach to pain management. Misconceptions and attitudes about pain, lack of easily administered pain tools, inconsistent monitoring of pain, and lack of documentation of pain symptoms and indicators were identified as significant barriers to optimal pain management for their patients. A number of behaviours indicative of pain were identified but emphasis was placed on recognition of changes from usual behaviour.CONCLUSIONS: The findings of the present study highlight the need for a comprehensive, practical and consistent approach to pain assessment and management, and provide insight into the critical components, including behavioural indicators, that could be incorporated into a pain protocol to be used with this population.

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Utilization of Non-Pharmacological Methods and the Perceived Barriers for Adult Postoperative Pain Management by the Nurses at Selected National Hospitals in Asmara, Eritrea

10.21203/rs.3.rs-39743/v1 ◽

2020 ◽

Author(s):

Betiel Yihdego Kidanemariam ◽

Traudl Elsholz ◽

Laban L. Simel ◽

Eyasu H. Tesfamariam ◽

Yonatan M. Andemeskel

Keyword(s):

Health Care ◽

Pain Management ◽

Postoperative Pain ◽

Pain Relief ◽

Health Care Professionals ◽

Work Experience ◽

Administrative Support ◽

Statistical Significance ◽

Demographic Data ◽

Perceived Barriers

Abstract Background Postoperative pain remains a concern to both patients and health care professionals. Non-pharmacological pain relief methods have the potential to complement pharmacological interventions and may offer alternative treatment options. The aim of the study was to assess nurses’ utilization of postoperative nurses’ non-pharmacological pain relief methods and the perceived barriers for their implementation in the National Hospitals. Methods Descriptive cross sectional study was conducted among 154 nurses working at the National Referral Hospitals and Sembel Private Hospital. A standardized five-point Likert-scale questionnaire which assesses nurses' utilization of selected non-pharmacological methods and the perceived barriers for the implementation of those methods were used to collect data. Descriptive statistics for the demographic data, independent samples t-test and one way ANOVA for the nurses’ utilization of the non-pharmacological methods and perceived barriers were used to analyze the data. Statistical significance level was set at P < 0.05. Results The study found that emotional support (45.5%), helping with daily activities (67.5%) and creating a comfortable environment (61%) were reported to be the most frequently used methods, whereas the cognitive-behavioral (5.9%) and physical methods (5.8%) were found with less frequency. The results also show that characteristics, such as the nurses' age (p = 0.013), education (p = 0.012), work experience (p = 0.001) and place of work (p = 0.001), were significantly related to the use of non-pharmacological methods. Among the various perceived barriers, health care system related barriers such as heavy work load (87.7%), shortage of time (84.4%), limited resources (82.5%), deficit in the guidelines for pain management (77.3%), lack of administrative support (76.6%) followed by patient related barriers such as patients uncooperative behavior (57.1%) were identified. Conclusion Only few of the non-pharmacological methods were found to be utilized by the nurses as pain relieving strategies and various perceived barriers are existing among the nurses towards the utilization of these methods. Nurses in these settings need training and education on non-pharmacological pain relief methods, particularly on methods that are utilized less often.

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‘This won’t hurt a bit!’ – A descriptive review of health care professionals’ pharmacological management of pain in minor trauma

South African Family Practice ◽

10.4102/safp.v63i1.5249 ◽

2021 ◽

Vol 63 (1) ◽

Author(s):

Duncan M. Havenga ◽

Jaykumaran Govender ◽

Carolyn Lewis

Keyword(s):

Health Care ◽

Pain Management ◽

Health Care Professionals ◽

The Elderly ◽

Initial Contact ◽

Trauma Patients ◽

Minor Trauma ◽

Age Group ◽

Cross Sectional ◽

Prescribing Habits

Background: Emergency Centres (ECs) have a prominent trauma burden requiring effective pain management. This study aimed to review analgesia-prescribing habits in minor trauma, reviewing the patient demographics and diagnoses, analgesia-prescribing habits of health care professionals (HCPs) managing these cases, and differences in prescribing noted by patients’ age group, gender and triage code.Methods: A prospective, cross-sectional, descriptive study was conducted in a regional EC in KwaZulu-Natal. HCPs managing minor trauma patients completed a closed-ended questionnaire which indicated the patients’ demographics, diagnosis and analgesia prescribed.Results: The study comprised of 314 cases of which the demographic most represented were male patients aged between 20–30 years with soft tissue injuries. Simple analgesics and weak opioids (paracetamol, ibuprofen and tramadol) accounted for 87.9% of prescriptions. Referral clinics prescribed less analgesics than that provided in the EC. There were mostly no significant differences in prescription habits by patients’ age group, gender and triage code.Conclusion: Presenting complaints in our study were varied and likely to result in mild to moderate pain. Only a minority of patients received analgesics at initial contact. Standardised protocols providing treatment guidance for nurse-initiated pain management at initial contact is thus important. There were no significant differences in analgesics prescribed for adults and the elderly, which is worrisome given the potential negative side effects of analgesics in the elderly. Similar concerns in our paediatric population were not noted. Ensuring adequate analgesia with cognisance for safety at the extremes of age is of paramount importance.

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Health Care Professional’s Attitude Towards the Effective Management of Pain in the Critically Ill Neonate

The Journal of Critical Care Medicine ◽

10.1515/jccm-2015-0018 ◽

2015 ◽

Vol 1 (3) ◽

pp. 107-112 ◽

Cited By ~ 1

Author(s):

Laura Mihaela Suciu ◽

Manuela Cucerea ◽

Marta Simon ◽

Andreea Avasiloaiei ◽

Olimpia Petrescu ◽

...

Keyword(s):

Health Care ◽

Pain Management ◽

Health Care Professionals ◽

Newborn Infants ◽

Effective Management ◽

Older Children ◽

Parental Presence ◽

Pain Experience ◽

Pain Scales ◽

Important Barrier

Abstract Introduction: Over the past 25 years, caregiver’s knowledge of pain in newborn infants has advanced from the beliefs that newborn infants do not feel pain, to the knowledge that preterm infants experience more pain compare to older children and adults. However, caregivers know that pain exists in this population and research has supported that pain continues to be untreated up to 65% of the time. Aim of the study: The purpose of this study was to investigate the attitude and knowledge of health care professionals from the area of Neonatology in Romania regarding procedural pain management in newborn infants. Material and methods: The sample consisted of 85 physicians and nurses (110 invited) working in five Neonatal Care Centres. Data were collected using a self-completion, 17 items questionnaire designed for this study. Results: With a response rate of 77.27% which was similar in nurses and physicians, respondents in our study were aware about the pain experience during procedural interventions, recognized the items of pain scales assessment, and are not comfortable with the parental presence during painful procedures. Twenty-five percent of nurses versus 9% of physicians reported rushed care as an important barrier of adequate non-pharmacological pain management (95% IC, 0.319-0.003) Conclusions: The use of pain protocols for an effective management of pain during neonatal period is required.

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