Healthcare Providers’ Knowledge and Current Practice of Pain Assessment and Management: How Much Progress Have We Made?

Context. Despite improvement in pain management and availability of clinical treatment guidelines, patients in Jordan are still suffering from pain. Negative consequences of undertreated pain are being recognized as a reason for further illnesses and poor quality of life. Healthcare providers (HCPs) are responsible for relieving pain of their patients.Objective. To evaluate the knowledge and attitudes of HCPs toward pain management in Jordan.Methods. A 16-item questionnaire with agree or disagree options was given to 662 HCPs in seven hospitals in Jordan who volunteered to participate in the study. Following data collection, the responses were coded and entered into SPSS.Results. There was a statistically significant difference (p<0.004) in percentage scores between physicians (36%) and pharmacists (36%) versus nurses (24%). The level of knowledge was the best among physicians, followed by pharmacists specifically in the area of cancer pain management. Nurses scored the lowest for knowledge of pain assessment and management among HCPs. However, HCPs overall scores indicated insufficient knowledge specifically in relation to pain assessment and management among children.

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Pain Assessment: Benefits of Using Pain Scales for Surgical Patients in South Bohemian Hospitals

Healthcare ◽

10.3390/healthcare9020171 ◽

2021 ◽

Vol 9 (2) ◽

pp. 171

Author(s):

Vera Olisarova ◽

Valerie Tothova ◽

Martin Cerveny ◽

Vendula Dvorakova ◽

Petr Sadilek

Keyword(s):

Quality Of Life ◽

Pain Management ◽

Pain Assessment ◽

Exploratory Study ◽

Surgical Patients ◽

The South ◽

Pain Scales ◽

Emotional Component ◽

Attention To Pain

Pain is a medical and nursing problem that is common in surgical departments. Inadequate pain management can lead to patient distress, as well as extending the period in which the patient’s quality of life is reduced. The standardized SF-MPQ-2 questionnaire provides nurses with the opportunity to assess pain within a broader context. The aim of this descriptive and exploratory study was to describe the state of pain assessment in surgical patients in the South Bohemian Region and to highlight the benefits of using a standardized tool for proper pain assessment. The research was carried out using a quantitative survey within the South Bohemian Region (Czech Republic). The participants in the study were nurses working in surgical departments in hospitals in the region as well as hospitalized patients. The results show that nurses pay slightly more attention to pain assessments than doctors. We know that, generally, pain decreases with time after surgery. Nonetheless, returning pain, as well as continuous pain, can occur, both of which have an emotional component. The results of this study are directed at nurses and include a call for more effective pain management through improved assessment.

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Quality of care in the free maternal healthcare era in sub-Saharan Africa: a scoping review of providers’ and managers’ perceptions

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-03701-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Monica Ansu-Mensah ◽

Frederick Inkum Danquah ◽

Vitalis Bawontuo ◽

Peter Ansu-Mensah ◽

Tahiru Mohammed ◽

...

Keyword(s):

Quality Of Care ◽

Research Question ◽

Healthcare Providers ◽

Poor Quality ◽

Sub Saharan Africa ◽

Healthcare Financing ◽

Maternal Healthcare ◽

Sub Saharan ◽

The Impact

Abstract Background Free maternal healthcare financing schemes play an essential role in the quality of services rendered to clients during antenatal care in sub-Saharan Africa (SSA). However, healthcare managers’ and providers’ perceptions of the healthcare financing scheme may influence the quality of care. This scoping review mapped evidence on managers’ and providers’ perspectives of free maternal healthcare and the quality of care in SSA. Methods We used Askey and O’Malley’s framework as a guide to conduct this review. To address the research question, we searched PubMed, CINAHL through EBSCOhost, ScienceDirect, Web of Science, and Google Scholar with no date limitation to May 2019 using keywords, Boolean terms, and Medical Subject Heading terms to retrieve relevant articles. Both abstract and full articles screening were conducted independently by two reviewers using the inclusion and exclusion criteria as a guide. All significant data were extracted, organized into themes, and a summary of the findings reported narratively. Results In all, 15 out of 390 articles met the inclusion criteria. These 15 studies were conducted in nine countries. That is, Ghana (4), Kenya (3), and Nigeria (2), Burkina Faso (1), Burundi (1), Niger (1), Sierra Leone (1), Tanzania (1), and Uganda (1). Of the 15 included studies, 14 reported poor quality of maternal healthcare from managers’ and providers’ perspectives. Factors contributing to the perception of poor maternal healthcare included: late reimbursement of funds, heavy workload of providers, lack of essential drugs and stock-out of medical supplies, lack of policy definition, out-of-pocket payment, and inequitable distribution of staff. Conclusion This study established evidence of existing literature on the quality of care based on healthcare providers’ and managers’ perspectives though very limited. This study indicates healthcare providers and managers perceive the quality of maternal healthcare under the free financing policy as poor. Nonetheless, the free maternal care policy is very much needed towards achieving universal health, and all efforts to sustain and improve the quality of care under it must be encouraged. Therefore, more research is needed to better understand the impact of their perceived poor quality of care on maternal health outcomes.

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What is the knowledge of tubercular patients about risk factors contributing to development of their disease

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh06s2122i ◽

2006 ◽

Vol 134 (Suppl. 2) ◽

pp. 122-127 ◽

Cited By ~ 1

Author(s):

Miroslav Ilic

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Main Risk Factor ◽

Active Pulmonary Tuberculosis ◽

Anonymous Questionnaire ◽

Number Of Patients ◽

Significant Difference ◽

Level Of Knowledge ◽

Basic Characteristics

INTRODUCTION. Present knowledge of population on basic characteristics of tuberculosis is a significant issue of prevention of tuberculosis. OBJECTIVE. The objective of our study was to determine the level of knowledge on risk factors of tuberculosis among tubercular patients. METHOD. A total of 115 new patients with the active pulmonary tuberculosis were interviewed by means of anonymous questionnaire, who has been treated at the Institute of Pulmonary Diseases, Sremska Kamenica during six-month period (October 2003-March 2004). RESULTS. The patients fulfilled the questionnaire; 37.6 % had no or finished only elementary school, and 58.6 % considered genetics the main risk factor of tuberculosis. Every second patient believed that he could not catch tuberculosis if he suffered from diabetes mellitus or any kind of tumor. 8.7 % of patients who suffered from diabetes mellitus had been informed by their physicians that could catch tuberculosis one day. Every third patient did not possess sewage system and nearly 20% lived in moist flats. Around 85% had no regular salaries or these were significantly under the average Serbian income per capita in this period (12820 dinars-CSD). Leading risk factors that can contribute to development of tuberculosis were as follows: irregular nutrition (91.4 %), smoking (74.2 %), alcohol consumption (65.5%) and associated diseases (diabetes mellitus, tumors). Only 15% of them believed that all these risk factors (smoking, alcohol, irregular diet) could participate together in development of tuberculosis, and not as individual factors. Analyzing the patients? knowledge on risk factors of tuberculosis, in relation to their educational level and alcohol and cigarettes consumption, there was no significant difference (p<0.05). Nevertheless, analyzing the quality of life in patients? houses, in relation to salary and bad habits (alcohol, cigarettes) as risk factors of tuberculosis, significant statistical difference was found (p>0.05). CONCLUSION. Intensive and permanent education of population is necessary primarily considering the knowledge on tuberculosis that would be the basis of reducing the number of patients and leading to possible eradication of this disease.

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The revised FLACC score: Reliability and validation for pain assessment in children with cerebral palsy

Scandinavian Journal of Pain ◽

10.1016/j.sjpain.2015.06.007 ◽

2015 ◽

Vol 9 (1) ◽

pp. 57-61 ◽

Cited By ~ 9

Author(s):

Line Kjeldgaard Pedersen ◽

Ole Rahbek ◽

Lone Nikolajsen ◽

Bjarne Møller-Madsen

Keyword(s):

Cerebral Palsy ◽

Pain Management ◽

Postoperative Pain ◽

Pain Score ◽

Pain Assessment ◽

Reliability And Validity ◽

Measurement Properties ◽

Cosmin Checklist ◽

Children With Cerebral Palsy

AbstractBackground and aimsPain in children with cerebral palsy (CP) is difficult to assess and is therefore not sufficiently recognized and treated. Children with severe cognitive impairments have an increased risk of neglected postoperative, procedural and chronic pain resulting in decreased quality of life. The r-FLACC (revised Face, Legs, Activity, Cry and Consol ability) pain score is an internationally acclaimed tool for assessing pain in children with CP because of its ease to use and its use of core pain behaviours. In addition the r-FLACC pain score may be superior to other pain assessment tools since it includes an open- ended descriptor for incorporation of individual pain behaviours. The COSMIN group has set up three quality domains, which describe the quality of Health-Related Patient-Reported Outcomes (HR-PROs). These are reliability (internal consistency, reliability and measurement error), validity (content validity, construct validity and criterion validity) and responsiveness. The r-FLACC score has only been assessed for reliability and validity in the original English version by the developers of the score. The aim of this study is to assess reliability and validity of the r-FLACC pain score for use in Danish children with CP.MethodsTwenty-seven children aged 3–15 years old with CP were included after orthopaedic surgery. Two methods for assessment of postoperative pain were used. Pain intensity was assessed by r-FLACC, with a 2 min standardized video recording of the child, and the Observational Visual Analogue Score (VAS-OBS) assessed by the parents. The COSMIN checklist was used as a guideline in the reliability and validity testing of the r-FLACC score.ResultsReliability was supported by three measurement properties. Internal consistency was excellent with a Cronbachs alpha of 0.9023 and 0.9758 (two raters). A factor analysis of the subgroups in the r-FLACC score showed unidimensionality. A test-retest showed excellent intra-rater reliability with an intraclass correlation (ICC) of 0.97530. Inter-rater reliability was acceptable with an ICC of 0.74576. Validity was supported by three measurement properties. Content validity was tested by the originators of the r-FLACC. Construct validity was supported by a significant increase in r-FLACC scores following surgery (n = 17; difference 2.23; p = 0.0397). Criterion validity was acceptable with Pearson’s correlation coefficients of 0.76 and 0.59 when comparing r-FLACC scores and VAS-OBS scores.Conclusions and implicationsThis study benefits from a systematical approach to the validation and reliability parameters by using the COSMIN checklist as a guideline. It is evident that the r-FLACC pain score maintains its psychometric properties after translation. In conclusion, the r-FLACC pain score is valid and reliable in assessing postoperative pain in children with CP not able to self-report pain. With the r-FLACC pain score clinicians have a valid tool for assessing postoperative pain, hence increasing the quality of pain management in children with CP. In addition the validated r-FLACC score has the potential for use in interventional research regarding pain management in this vulnerable group of patients. Future perspectives include validation of the r-FLACC score for procedural and chronic everyday pain and implementation into daily practice.

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Paradigm 8: Community Care Is Destigmatizing

10.1093/med/9780199797639.003.0009 ◽

2013 ◽

Author(s):

Heather Stuart ◽

Julio Arboleda-Flórez ◽

Norman Sartorius

Keyword(s):

Mental Illness ◽

Community Care ◽

Social Stigma ◽

Safety Net ◽

Poor Quality ◽

Community Services ◽

Negative Consequences ◽

Health Movement ◽

Community Mental Health Movement

Chapter 9 addresses how there have been many negative consequences for people with a mental illness as a result of the rapid deinstitutionalization of mental hospitals without appropriate community services to provide a safety net. These have included criminalization, increased stigmatization, social exclusion, poor quality of care, and poorer health outcomes. It covers how these problems challenge the notion that the community mental health movement has been a destigmatizing force leading to greater social participation for people with a mental illness. Because they are now more visible, and often less supported by treatment systems, people with a mental illness living in the community may be at greater risk of experiencing social stigma.

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Group Interprofessional Chronic Pain Management in the Primary Care Setting: A Pilot Study of Feasibility and Effectiveness in a Family Health Team in Ontario

Pain Research and Management ◽

10.1155/2013/491279 ◽

2013 ◽

Vol 18 (5) ◽

pp. 237-242 ◽

Cited By ~ 3

Author(s):

Ricardo N Angeles ◽

Dale Guenter ◽

Lisa McCarthy ◽

Martha Bauer ◽

Miriam Wolfson ◽

...

Keyword(s):

Quality Of Life ◽

Primary Care ◽

Chronic Pain ◽

Pain Management ◽

Resource Utilization ◽

Health Resource ◽

Health Resource Utilization ◽

Significant Difference ◽

The Mean

BACKGROUND: Approximately 18.9% of Canadians live with chronic pain. Primary care reform in Ontario presents unique opportunities to assess approaches to help these patients.OBJECTIVE: To assess the feasibility of an interprofessional primary care-based program for patients living with chronic pain, and to examine the potential impact of such a program on quality of life and health resource utilization.METHODS: >An embedded mixed-methods evaluation (randomized controlled trial with waiting list control and semistructured interviews) of an eight-week series of small group sessions exploring multifactoral aspects of pain management was performed. Participants were randomly assigned to early intervention (EI) or delayed intervention (DI) groups. All participants received the intervention; the DI group served as a control group for comparison with the EI group. Outcomes included the Short Form-36 Health Survey version 2 (SF-36v2), medication use and health care utilization. Qualitative interviews were conducted to identify areas for program improvement.RESULTS: A total of 240 patients were recruited and 63 agreed to participate. The mean (± SD) age of the participants was 55±14.1 years and 62.3% were female. There was no significant difference in the mean change in SF-36v2 summary scores between the EI and DI groups. However, the SF-36v2 subscale score for bodily pain was significantly improved in the EI group compared with the DI group after six months of observation (mean difference = 13.1 points; P<0.05). There was also significant improvement in this score when both groups were pooled and aggregate preintervention and postintervention scores were compared. There was a significant decrease in the mean number of clinic visits in the six-month period following the intervention compared with the six-month period before the intervention (P=0.043).CONCLUSION: An interprofessional program in primary care for patients living with chronic pain may lead to improvements in quality of life and health resource utilization. The challenges to the feasibility of the program and its evaluation are recruitment and retention of patients, leading to the conclusion that the program, as it was conducted in the present study, is not appropriate for this setting.

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Slow Release Metformin Effect in Weight Loss and Total Calorie Intake in Obese Volunteers

Journal of Agromedicine and Medical Sciences ◽

10.19184/ams.v3i1.4098 ◽

2017 ◽

Vol 3 (1) ◽

pp. 50

Author(s):

Cholis Abrori ◽

Lucky Tiya ◽

Deti Rosalina

Keyword(s):

Weight Loss ◽

Slow Release ◽

Poor Quality ◽

The Body ◽

Calorie Intake ◽

Measured Weight ◽

Significant Difference ◽

Total Calorie ◽

Alternative Drug

Obesity can cause serious problems that will lead to poor quality of life, increased morbidity and mortality rate. Slow-release metformin will work longer in the body with a single dose everyday be an alternative drug for weight loss. The purpose of this study was to compare the effectiveness of slow-release metformin compared to metformin regular to body weight and calorie intake in volunteers with obesity. The study was conducted on 16 volunteers who were divided into two groups in pairs. Volunteers will be measured weight and calorie intake with a 24-hour food recall method, data was taken at the time before the intervention, the end of week 1st, 2nd, 3rd, and 4th. The result obtained weight loss better in the group receiving slow-release metformin by 5.08% compared to the group receiving regular metformin by 2,60%, but there was no significant difference between the groups in terms of calorie intake during the study. The conclusion of this study is a slow-release metformin is greater in weight loss than regular metformin, but does not affect the amount of calorie intake.Keywords: Metformin, slow-release, weight loss, calorie intake, obesity

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P645 Mental health, work presenteeism and exercise in IBD patients

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjab076.765 ◽

2021 ◽

Vol 15 (Supplement_1) ◽

pp. S577-S577

Author(s):

M Sciberras ◽

C Nascimento ◽

T Tabone ◽

K Karmiris ◽

P Nikolaou ◽

...

Keyword(s):

Quality Of Life ◽

Demographic Data ◽

International Study ◽

Poor Quality ◽

Psychiatric Medication ◽

Active Involvement ◽

Significant Difference ◽

Previous Medication ◽

History Of

Abstract Background IBD has been shown to increase the rates of anxiety and depression amongst diagnosed individuals, with a prevalence rate of approximately 15- 20%. Chronic diseases such as IBD can have a significant impact on productivity at work (presenteeism). This can lead to emotional distress, poor quality of life and cost effects on employers. The primary aim of the study was to assess the prevalence of psychological problems, exercise levels and presenteeism at work among IBD patients. Methods This was a multicentre international study whereby IBD patients (>18 years) in clinical remission over the last year, were asked to answer an anonymous questionnaire. Demographic data, type of IBD, current and previous medication, admissions to hospital, history of psychiatric referrals, Stanford Presenteeism Scale (SPS-6), Godin Score (exercise related score) were collected. Exclusion criteria included patients with IBD flares requiring corticosteroids in the previous 12 months. Results 573 patients (CD: n=318) from 8 European Centres and Israel participated in the study. The mean patient age was 39.9 years (SD+/- 13.0). 21.6% were smokers and 48.5% were non-smokers. The rest were ex-smokers. 10.9% of patients had a diagnosis of depression/anxiety prior to the diagnosis of IBD, whereas this increased to 20.6% post-IBD diagnosis, this being significantly commoner in the CD cohort (23.0%, p<0.05) and in females (55.8%, p<0.05). 37.7% of patients had been to a psychiatrist or a psychologist (41% of CD, p<0.05) with 11.7% of patients being on psychiatric medication (14.5% of CD, p<0.05). Low presenteeism at work was evident in 34.7%, with no statistically significant difference between UC and CD patients (p=0.5). 39.9% had a Godin Exercise Score being in the active range, 38.8% had a sedentary/insufficient exercise score. The rest were moderately active. Patients diagnosed with depression/anxiety had a more sedentary lifestyle. Conclusion In our study 37.7% of patients were referred for psychological help. This can have several effects including poor presenteeism at work (34.7%) and reduced efficiency. These issues are commoner in patients with CD than in UC. Active involvement of a psychologist/ psychiatrist as part of the IBD team should be routine as to improve the patient’s quality of life.

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Comparison of two doses of eCG for obtaining embryos in llama

SPERMOVA ◽

10.18548/aspe/0009.23 ◽

2021 ◽

Vol 11 (2) ◽

pp. 173-178

Author(s):

Cesar A Olaguivel ◽

◽

Jaime Ruiz ◽

Pedro Coila

Keyword(s):

Statistical Difference ◽

Poor Quality ◽

Dominant Follicle ◽

Linear Transducer ◽

Significant Difference ◽

National University ◽

Applied Dose ◽

T1 And T2 ◽

Ovulatory Follicles

The study was developed at the Pampa del Arco Experimental Center of the National University of San Cristóbal de Huamanga, the objective was to evaluate doses of 800 IU (T1) and doses of 1000 IU (T2) of eCG to obtain embryos. Eight adult female llamas were used, distributed four in each treatment (T1 and T2), with a body condition of 2.5, these were evaluated by ultrasound with a 7.5 MHz rectal linear transducer. Hormonal treatments began when the animals had a follicle> 7 mm. The application of eCG was 72 hours after the induction of ovulation of the dominant follicle with GnRH, on day 7 PGF2α was applied, natural mounting was performed plus GnRH (1ml), on day 15 the collection and evaluation of embryos was performed. The results obtained were the pre-ovarian stimulation follicular diameter of 8.3 mm and 9.1 mm for T1 and T2 respectively, the number of pre-ovulatory follicles was 6.33 and 5.50 for T1 and T2 respectively, the diameter of follicles pre-ovulatory was 11.2mm and 10.6 mm for T1 and T2 respectively, average of embryos recovered per donor was 4.66 ± 0.81 and 3.50 ± 0.54 embryos for T1 and T2 respectively, with a significant difference (p <0.05) and the quality of embryos had 35.7% and 38.1% of embryos of excellent quality, 28.6% and 33.3% of good quality, 10.7% and 9 , 5% of regular quality, 10.7% and 0% of poor quality, for T1 and T2 respectively and 14.3% and 19.0% of non-transferable embryos for T1 and T2 respectively, with no statistical difference (p≥0, 05). It is concluded that the number of embryos recovered with a dose of 800 IU of eCG is higher compared to the dose of 1000 IU of eCG (p <0.05) and that there is no association between the applied dose of eCG and the quality of the llama embryos (p≥0.05)

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Psychiatric morbidity, quality of life and marital satisfaction among spouse of men with opioid dependence syndrome: a study from North India

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20171060 ◽

2017 ◽

Vol 4 (2) ◽

pp. 556

Author(s):

Ruchi Soni ◽

Ritesh Upadhyay ◽

Parth Singh Meena ◽

Mahendra Jain

Keyword(s):

Quality Of Life ◽

Marital Satisfaction ◽

Psychiatric Disorder ◽

Opioid Dependence ◽

Short Form ◽

Psychiatric Morbidity ◽

Poor Quality ◽

North India ◽

Significant Difference

Background: Opioid dependence syndrome has deleterious consequences not only on addict but also on the members of family especially his spouse who is most vulnerable to develop significant psychiatric disorder given the intimate nature of their relationship. Addressing these issues will be beneficial as spouses are important source of moral support and assistance to the substance user’s quest toward abstinence.Methods: For psychiatric morbidity, 100 spouses of men with opioid dependence syndrome were evaluated. Severity of opioid dependence in the husbands was assessed using severity of opioid dependence questioner (SODQ). Quality of life and marital satisfaction was assessed using short form health survey 36 (SF 36) and marital satisfaction scale (MSS) respectively.Results: Data analysis reveals that 33% of spouses had a psychiatric disorder. Primarily mood and anxiety disorder was present in 22% and 9% of subjects respectively. Highly significant difference existed between cases and controls in terms of marital satisfaction (p = 0.0001) and quality of life (p≤0.05) indicating low marital satisfaction and poor quality of life in spouses of opioid dependent individuals.Conclusions: Psychological distress and psychiatric morbidity in spouses of opioid dependent men is high, with poor quality of marital life and marital satisfaction being low. Hence, interventions that aim at allaying their distress and improving their mental health can improve the condition of the substance user and contribute to a better outcome of substance abuse treatment.

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