scholarly journals PEDIATRIC PROCEDURAL PAIN MANAGEMENT: A REVIEW OF THE LITERATURE

2012 ◽  
Vol 3 (4.1) ◽  
pp. 569 ◽  
Author(s):  
Kristy Petovello
Keyword(s):  
Health Care ◽  
Pain Management ◽  
Health Care Professionals ◽  
Complex Nature ◽  
Pediatric Pain ◽  
Health Seeking ◽  
Health Care Experiences ◽  
Values And Beliefs ◽  
Early Health ◽  
Children's Pain

<p>Research in the last two decades has revealed the complex nature of pain and has thereby improved the understanding, treatment, and management of pediatric pain by health care practitioners. However, a significant gap between knowledge and practice still exists. Pediatric pain remains under-managed. Several themes emerged in this literature review as factors influencing adequate pain management. These include: outdated beliefs about pain management; inconsistent use of evidence-based interventions; difficulties assessing children’s pain; and the role of the values and beliefs of caregivers and practitioners. The literature indicates a high risk of deleterious consequences of under-managed pediatric pain, linking early health care experiences to later health-seeking behaviours. Implications for practice are considerable. Recommendations include: an individualized “3-P” approach combining pharmacologic, physical and psychological strategies; collaborative approaches eliciting expertise from caregivers and health care professionals across multiple disciplines; and utilizing interventions before, during, and after procedures. <strong></strong></p>

scholarly journals Canadian Emergency Medicine Residents’ Perspectives on Pediatric Pain Management

CJEM ◽  
2015 ◽  
Vol 17 (5) ◽  
pp. 507-515 ◽  
Author(s):  
Huma Ali ◽  
Janeva Kircher ◽  
Christine Meyers ◽  
Joseph MacLellan ◽  
Samina Ali
Keyword(s):  
Emergency Medicine ◽  
Pain Management ◽  
Online Survey ◽  
Oral Morphine ◽  
Management Approach ◽  
Developmentally Delayed ◽  
Pediatric Pain ◽  
Graduate Curricula ◽  
Facilitators And Barriers ◽  
Children's Pain

AbstractBackgroundUnder-treatment of children’s pain in the emergency department (ED) can have many detrimental effects. Emergency medicine (EM) residents often manage pediatric pain, but their educational needs and perspectives have not been studied.MethodsA novel online survey was administered from May to June 2013 to 122 EM residents at three Canadian universities using a modified Dillman methodology. The survey instrument captured information on training received in pediatric acute pain management, approach to common painful presentations, level of comfort, perceived facilitators, and barriers and attitudes towards pediatric pain.Results56 residents participated (46%), 25 of whom (45%) indicated they had not received any training in pediatric pain assessment. All levels of residents reported they were uncomfortable with pain assessment in 0-2 year olds (p=0.07); level of comfort with assessment increased with years of training for patients aged 2-12 years (p=0.02). When assessing children with disabilities, 83% of respondents (45/54) indicated they were ‘extremely’ or ‘somewhat’ uncomfortable. Sixty-nine percent (38/55) had received training on how to treat pediatric pain. All residents reported they were more comfortable using pain medication for a 9 year old, as compared to a 1 year old (oral oxycodone p<0.001, oral morphine p<0.001, IV morphine p=0.004). The preferred methods to learn about children’s pain management were role-modeling (61%) and lectures (57%). The top challenges in pain management were with non-verbal, younger, or developmentally delayed patients.ConclusionCanadian EM residents report receiving inadequate training in pediatric pain management, and are particularly uneasy with younger or developmentally disabled children. Post-graduate curricula should be adjusted to correct these self-identified weaknesses in children’s pain management.

scholarly journals Acute and chronic musculoskeletal pain situations among the working population and their pain education needs: an exploratory study

2020 ◽  
Vol 37 (4) ◽  
pp. 445-452
Author(s):  
Shuk Kwan Tang ◽  
Mimi Mun Yee Tse ◽  
Sau Fong Leung ◽  
Theofanis Fotis
Keyword(s):  
Health Care ◽  
Chronic Pain ◽  
Pain Management ◽  
Health Care Professionals ◽  
Work Performance ◽  
Online Survey ◽  
Management Education ◽  
Well Being ◽  
Working Population ◽  
Pain Education

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.

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

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.

scholarly journals Interpreting the Meaning of Pain Severity Scores

2002 ◽  
Vol 7 (4) ◽  
pp. 192-198 ◽  
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.

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

2013 ◽  
Vol 24 ◽  
pp. e259
Author(s):  
J. Espírito Santo ◽  
A. Santos ◽  
C. Canha ◽  
J. Fonseca ◽  
R. Tenreiro ◽  
...  
Keyword(s):  
Health Care ◽  
Pain Management ◽  
Health Care Professionals ◽  
Hospitalized Patient

scholarly journals Recommendations From the Twitter Hashtag #DoctorsAreDickheads: Qualitative Analysis

10.2196/17595 ◽  
2020 ◽  
Vol 22 (10) ◽  
pp. e17595
Author(s):  
Anjana Estelle Sharma ◽  
Ziva Mann ◽  
Roy Cherian ◽  
Jan Bing Del Rosario ◽  
Janine Yang ◽  
...  
Keyword(s):  
Health Care ◽  
Qualitative Analysis ◽  
Health Care Professionals ◽  
User Profile ◽  
Ehlers Danlos Syndrome ◽  
Health Care Experiences ◽  
Final Sample ◽  
Patient Advocates ◽  
Twitter Users ◽  
Clinical Conditions

Background The social media site Twitter has 145 million daily active users worldwide and has become a popular forum for users to communicate their health care concerns and experiences as patients. In the fall of 2018, a hashtag titled #DoctorsAreDickheads emerged, with almost 40,000 posts calling attention to health care experiences. Objective This study aims to identify common health care conditions and conceptual themes represented within the phenomenon of this viral Twitter hashtag. Methods We analyzed a random sample of 5.67% (500/8818) available tweets for qualitative analysis between October 15 and December 31, 2018, when the hashtag was the most active. Team coders reviewed the same 20.0% (100/500) tweets and the remainder individually. We abstracted the user’s health care role and clinical conditions from the tweet and user profile, and used phenomenological content analysis to identify prevalent conceptual themes through sequential open coding, memoing, and discussion of concepts until an agreement was reached. Results Our final sample comprised 491 tweets and unique Twitter users. Of this sample, 50.5% (248/491) were from patients or patient advocates, 9.6% (47/491) from health care professionals, 4.3% (21/491) from caregivers, 3.7% (18/491) from academics or researchers, 1.0% (5/491) from journalists or media, and 31.6% (155/491) from non–health care individuals or other. The most commonly mentioned clinical conditions were chronic pain, mental health, and musculoskeletal conditions (mainly Ehlers-Danlos syndrome). We identified 3 major themes: disbelief in patients’ experience and knowledge that contributes to medical errors and harm, the power inequity between patients and providers, and metacommentary on the meaning and impact of the #DoctorsAreDickheads hashtag. Conclusions People publicly disclose personal and often troubling health care experiences on Twitter. This adds new accountability for the patient-provider interaction, highlights how harmful communication affects diagnostic safety, and shapes the public’s viewpoint of how clinicians behave. Hashtags such as this offer valuable opportunities to learn from patient experiences. Recommendations include developing best practices for providers to improve communication, supporting patients through challenging diagnoses, and promoting patient engagement.

scholarly journals The use of traditional medicine by caregivers for children under the age of five years as health seeking behaviour

2017 ◽  
Author(s):  
◽  
Shanitha Pillay
Keyword(s):  
Health Care ◽  
Traditional Medicine ◽  
Health Care Professionals ◽  
Conventional Medicine ◽  
Integrated Management ◽  
Total Sample ◽  
Traditional Healers ◽  
Health Seeking ◽  
Potential Threat ◽  
Sick Children

Child health has always been a global priority for decades; however, despite efforts to reduce the child mortality statistics, 5.9 million children under the age of five years have deceased in 2015. IMCI guidelines are used to assess, classify and treat sick children under the age of five years, however, despite the prevalent use of traditional medicine for this age group of children, the guidelines excludes the use of traditional medicine, hence the tendency exists to ignore such questions being asked. It is this gap in the history taking pertaining to sick children seeking health care at clinics that the researcher has identified, therefore, this study is intended to highlight the use of traditional medicine in children under the age of five years. The researcher’s methodology is a quantitative descriptive study by means of a self- developed structured questionnaire which was handed out to 183 caregivers attending a Gateway Clinic and 324 caregivers at Paediatric Out – Patient Department. The total sample size was 507 caregivers of children under the age of five years. Data was analysed using SPSS version 17. The data derived from this study indicated that although most caregivers would take their sick children to the clinic for first line treatment, there are a significant number who would rather use home remedies or seek care from traditional healers. The study reveals that 28.5% of caregivers were found to be administering traditional medicine with conventional medicine and 17.4% would do so concurrently. Evidence also revealed that 75.7% of the caregivers would disclose the use of traditional medicine for their children only if nurses enquired about it. Recommendations arising from the study findings are that the IMCI guidelines should incorporate a classification chart for use by health care professionals in order to identify children who were treated by traditional medicine preferably as “RED” - requiring urgent attention and possible admission to hospital, in view of the potential threat to life. Since the IMCI guidelines are also a teaching tool in nursing curricula, the assessment of sick children using traditional medicine will be incorporated into the formal teaching of nurses. Key words used were Integrated Management of Childhood Illnesses, effects and use of traditional medicine on children.

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

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

“We’re all in an abusive relationship with the health-care system”: Collective memories of transgender health care

2021 ◽  
pp. e20210013
Author(s):  
Charlie Davis ◽  
Corey W. Johnson ◽  
Ashley Flanagan ◽  
Washington Silk
Keyword(s):  
Health Care ◽  
Collective Memory ◽  
Health Care System ◽  
Health Care Professionals ◽  
Cultural Context ◽  
Positive Health ◽  
Memory Work ◽  
Health Care Experiences ◽  
Collective Memory Work ◽  
Care System

Collective memory work allows participants to recall, examine, and analyze their memories and experiences within a broader cultural context to see how their individual experiences link to collective, shared experiences of similar and/or different groups. This study utilized collective memory work to engage six trans participants in an examination of their individual experiences with health care. During a four-hour focus group, participants engaged in this process of discourse analysis and came to collective agreements about the meaning of their stories, the intentions of the author, and the intentions of others in their shared lived experience. In this paper, we will provide a thorough and rich description of the participants’ memories and their collective analysis, which highlights the interconnection between perceptions of oneself and their experiences with the health-care system. Our analysis revealed participants felt they had a toxic relationship with the health-care system. In particular, they discussed how health-care professionals left trans people tremulously asking for services, uncertain if they would receive care, what the quality of the care would be, and whether they would be treated respectfully. When discussing positive health-care experiences, participants highlighted when fears and anxieties were not realized, but all instances reflected some inappropriate actions. The results from this study will contribute to research on trans health care by providing a nuanced understanding of how health-care experiences impact trans communities collectively, as well as the ways in which health practices can be improved.

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