scholarly journals ABOUT THE PAIN IN CHILDREN

2019 ◽  
Vol 32 (2) ◽  
pp. 281-284
Author(s):  
Svetla Ivanova
Keyword(s):  
Pain Management ◽  
Pain Assessment ◽  
Pain Treatment ◽  
Emotional Experience ◽  
Behavioral Assessment ◽  
Age Groups ◽  
Diagnostic Procedures ◽  
Self Report ◽  
Pediatric Care ◽  
First Pain

Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage. Pain for pediatric patients is more difficult to evaluate and treat than in adults. Its assessment and management are key components of pediatric care which aim to reduce subjective sensation and to improve the satisfaction of medical specialists and parents. The assessment of pain depends on the cognitive development of the child , the clinical context and the type of pain. Pain management in children improves physiological, behavioral and hormonal results, leads to faster recovery, less complications, and reduced healthcare resources. Ineffective and untimely treatment of pain in children can cause long-lasting physical and psychological consequences. This article aims to determine the importance of adequate pain control in children. For children over the age of 6, pain assessment is based on self-assessment, whereas children under the age of 6 require behavioral scales for pain assessment. Behavioral assessment scales include child monitoring as well as basic characteristics of pain such as intensity, location, duration. The nurses are in a position to meet the child's first pain caused by fear and anxiety in the hospital, but parents who take care of the child are an important assistant in assessing, especially in children with special needs. Some children may find it difficult to do a distinction between pain, anxiety and stress. Effective pain assessment leads to more satisfied children and families. Prolonged inadequate treatment of pain in children may be due to the lack of knowledge and failure of nurses to appreciate and manage pain effectively. Medical specialist should be able to detect the symptoms and signs of pain in different age groups and determine whether these symptoms are caused by pain or other factors. The methods used for pain assessment have proven clinical efficacy, reliability and usability, making them an integral part of the treatment and management of pain. Three are the ways to measure it in children: self-report, behavioral evidence, and physiological-clinical observations. After processing the collected information, the data are entered into the required documentation which provides continuous ,safe and qualified care. Documentation of the children’s pain is a key factor in pain managing. Low level of nurses’ knowledge of assessing pain, inappropriate use of pain scales or lack of documentation could affect pain treatment. Assessment is performed if a child complains of pain, after surgery, if a procedure would cause discomfort or at least once a shift to check if children have any pain. The main subject of pain management strategy is pain prevention and modification of techniques used for diagnostic procedures for infant.

scholarly journals Pain assessment and registration in medical oncology clinics: operationalised through the lens of health care professionals and patients

2021 ◽  
Vol 4 ◽  
pp. 86
Author(s):  
Laserina O'Connor ◽  
Aileen Hassett ◽  
Noeleen Sheridan
Keyword(s):  
Pain Management ◽  
Cancer Pain ◽  
Cancer Treatment ◽  
Pain Assessment ◽  
Health Care Professionals ◽  
Healthcare Professionals ◽  
Medical Oncology ◽  
Pain Treatment ◽  
Self Report ◽  
Common Symptom

Background: Pain is a common symptom in patients who survive cancer and in those who live with progressive advanced disease. Systematic screening and documentation of pain are necessary to improve the quality of cancer pain treatment, because a key pain-related barrier is that patients are reluctant to discuss pain, due to fear that reporting pain will distract the healthcare professional from their cancer treatment. Methods: This study adopted an explanatory sequential mixed-methods design. Data collection incorporated three strands. The first strand involved a quantitative enquiry in which medical chart reviews of patients (n=100) attending the medical oncology outpatient clinic were examined. The second qualitative strand comprised of semi-structured interviews with patients (n=10) attending that service. The third strand was qualitative and consisted of focus group discussions with healthcare professionals (n=12). Results: All 100 patients had cancer. The quantitative findings confirmed the suboptimum assessment and subsequent recording of patient’s pain, that seemed to afford a reality check for all healthcare professionals. For patients, the outcomes of the anti-cancer treatment were their priority, and pain was perceived as inevitable, being associated with a cancer diagnosis. There were multifaceted complexities voiced amongst healthcare professionals associated with balancing the benefits and harms aligned with treating cancer pain. Conclusions: Pain assessment in medical records was not systematically recorded by healthcare professionals. Patients were reluctant to self-report pain during their medical oncology outpatient review. The expectation that patients will self-report pain can be accommodated by healthcare professionals if a personalized pain goal is part of the cancer pain management plan during each clinical encounter. Healthcare professionals reported a need to take distinct responsibility for supplementing their dearth of knowledge, skills and beliefs regarding assessing and managing patients’ cancer pain. Optimal pain management stems from an interprofessional approach that was applied in this study design.

scholarly journals Evaluasi Kepatuhan Pelaksanaan Standar Prosedur Operasional Manajemen Nyeri pada Pasien Luka Bakar di RSUP Dr. Hasan Sadikin Bandung

2019 ◽  
Vol 7 (2) ◽  
pp. 92-99
Author(s):  
Yudhanarko Yudhanarko ◽  
Suwarman Suwarman ◽  
Ricky Aditya
Keyword(s):  
Pain Management ◽  
General Hospital ◽  
Pain Assessment ◽  
Rating Scale ◽  
Emotional Experience ◽  
Numeric Rating Scale ◽  
Pain Scale ◽  
Standard Operating ◽  
Numeric Rating

Nyeri didefinisikan sebagai pengalaman sensorik dan emosional yang tidak menyenangkan terkait dengan kerusakan jaringan aktual atau potensial. Manajemen nyeri pada luka bakar merupakan bagian yang tidak terpisahkan dari terapi luka bakar. Nyeri pada luka bakar merupakan nyeri akut, penanganan yang tidak baik akan menyebabkan komplikasi, salah satunya nyeri kronik. Rumah Sakit Umum Pusat (RSUP) Dr. Hasan Sadikin Bandung telah membuat Standar Prosedur Operasional (SPO) manajemen nyeri yang berguna untuk meningkatkan kepatuhan dalam pelaksanaan manajemen nyeri. Penelitian ini bertujuan mengevaluasi kesesuaian teknik pengkajian, tindak lanjut dan evaluasi ulang nyeri pada pasien luka bakar dengan SPO manajemen nyeri. Penelitian menggunakan metode deskriptif observasional retrospektif terhadap 99 rekam medis pasien luka bakar yang memenuhi kriteria inklusi di RSUP Dr. Hasan Sadikin Bandung pada tahun 2018. Hasil penelitian didapatkankan bahwa pengkajian nyeri yang dilakukan sesuai dengan SPO menggunakan numeric rating scale atau Wong Baker faces pain scale ditemukan pada 99 pasien (100%). Tindak lanjut hasil pengkajian nyeri luka bakar yang dilakukan sesuai dengan SPO sebanyak 71 pasien (72%). Evaluasi ulang setelah tindak lanjut pengkajian nyeri yang sesuai SPO pada 93 pasien (94%). Simpulan, pengkajian nyeri di RSUP Dr. Hasan Sadikin Bandung sudah sesuai dengan SPO manajemen nyeri, namun tindak lanjut dan evaluasi ulang pada nyeri luka bakar belum sesuai dengan SPO manajemen nyeri.Evaluation of Compliance to Standard Operating Procedures for Pain Management in Patients with Burns in Dr. Hasan Sadikin General Hospital BandungPain is defined as an unpleasant sensory and emotional experience related to actual or potential tissue damage. Pain management for burns is an integral part of burn therapy. Pain in burns is an acute pain and poor management will lead to health complications including chronic pain. Dr. Hasan Sadikin General Hospital Bandung has made a standard operating procedure (SOP) for pain management to improve compliance to pain management standard. This study aimed to evaluate the compliance to the standards in assessment techniques, follow-up, and re-evaluation of pain in patients with burn according to the applicable pain management SOP. This was a retrospective descriptive observational study on 99 medical records of burn patients who met the inclusion criteria in Dr. Hasan Sadikin General Hospital Bandung in 2018. The results of the study revealed that the pain assessment for these patient was carried out according to the SOP which refers to the use of a numeric rating scale or Wong Baker face pain scale in 99 patients (100%). In the follow-up, 71 were performed according to the SOP (72%) while the re-evaluation was performed in compliance with the SOP in 93 patients (94%). In conclusion, pain assessment in Dr. Hasan Sadikin General Hospital Bandung is performed in accordance with SOP on pain management but not all patients receive follow-up and re-evaluation of burn pain in accordance with the SOP on pain management. 

Aspects of Pain, Its Assessment and Evaluation from An Acupuncture Perspective

2006 ◽  
Vol 24 (3) ◽  
pp. 109-117 ◽  
Author(s):  
Iréne Lund ◽  
Thomas Lundeberg
Keyword(s):  
Pain Assessment ◽  
Individual Variation ◽  
Rating Scales ◽  
Pain Treatment ◽  
Clinical Problem ◽  
Self Report ◽  
Assessment And Evaluation ◽  
Metric Properties ◽  
Perceived Pain ◽  
The Individual

Pain is a major clinical problem that causes great suffering for the individual and incurs costs for society. Accurate assessment and evaluation of perceived pain is necessary for diagnosis, for choice of treatment, and for the evaluation of treatment efficacy. The assessment of an individual's pain is a challenge since pain is a subjective, multidimensional experience, and assessment is based on the person's own self-report. The results are often varied, possibly due to inter-individual variation, but also in relation to gender and aetiology. A gold standard for pain assessment is still lacking, but rating scales, questionnaires, and methods derived from psychophysical concepts, such as threshold assessments and perceptual matching, are used. In the evaluation of pain and associated variables, both systematic and individual variation should be taken into account, as should pain-associated symptoms. Recommendations for pain treatment should be based on the patient's specific needs. Therefore, it is important to assess the level of perceived pain taking individual variation into account. The methods used should preferably have proved to be useful in randomised controlled trials, and analysis of pain assessment should consider its non-metric properties. In the future, the use of studies with a naturalistic protocol together with individual assessment of individual pain responses could increase the internal and external validity.

Pattern of Cumulative Treatment Hours on Pain Impact and PROMIS Outcomes

2021 ◽  
Author(s):  
Hongjin Li ◽  
Diane M Flynn ◽  
Krista B Highland ◽  
Larisa A Burke ◽  
Honor M Mcquinn ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Pain Management ◽  
Pain Treatment ◽  
Additive Models ◽  
Self Report ◽  
Interdisciplinary Treatment ◽  
Additional Patient ◽  
Impact Fatigue ◽  
Interdisciplinary Pain Treatment ◽  
Interdisciplinary Pain Management

ABSTRACT Introduction Participation in interdisciplinary treatments is associated with improvement in pain intensity, physical function, and additional pain-related outcome domains. However, the effect of cumulative treatment hours on outcomes remains unknown among military patients. The present analysis examined the relationship between cumulative interdisciplinary treatment hours and pain management outcomes at a single interdisciplinary pain management center (IPMC). Materials and Methods This is a retrospective observational study of data previously collected as standard of care at the Madigan Army Medical Center, approved by the Institutional Review Board. We included patients who received treatment at the IPMC and completed at least two self-report assessment batteries: one at baseline and at least one between 90 and 180 days after baseline (n = 882). The primary outcome was pain impact. Secondary outcomes included fatigue, depression, anxiety, and sleep-related impairment. Results Generalized additive models indicated that cumulative treatment hours were significantly associated with improvement in pain impact, fatigue, and depression. Patients who had higher baseline pain impact, who had mild or no depressive symptoms, and who were >40 years of age had greater improvements in pain impact following treatment, relative to those with lower pain impact, moderate-to-severe depressive symptoms, and were 40 years of age or younger, respectively. Additional research is needed to elucidate the effect of different therapies and additional patient factors in understanding the “therapeutic dose” of interdisciplinary pain management. Conclusions A higher number of cumulative treatment hours was associated with improvement of pain impact, fatigue, and depression among military personnel receiving interdisciplinary pain treatment. At least 30 hours of sustained interdisciplinary treatment appears to be the threshold for improvement in pain impact and related outcomes.

Dynamics on the field: A focused ethnographic study of pediatric pain management at four Ghanaian hospitals

2020 ◽  
Author(s):  
Abigail Kusi Amponsah ◽  
Evans Oduro ◽  
Victoria Bam ◽  
Joana Kyei-Dompim ◽  
Collins Kwadwo Ahoto ◽  
...  
Keyword(s):  
Pain Management ◽  
Pain Assessment ◽  
Management Practices ◽  
Participant Observation ◽  
Symbolic Capital ◽  
Ethnographic Study ◽  
Pediatric Care ◽  
Pediatric Pain ◽  
Improvement Programs ◽  
Children's Pain

Abstract BackgroundAs part of efforts to develop and implement a short course educational program on pediatric pain management, the current study sought to understand the culture and contextual factors that influence children’s pain management in order to improve the practice in pediatric care settings.MethodsGuided by Bourdieu’s theory of practice, a focused ethnographic study was conducted from October, 2018 to February, 2019. The study was contextualized at four Ghanaian hospitals among purposefully sampled nurses, physicians, hospitalized children and their families. During the 20-week study period, three ethnographers spent 144 hours conducting participant-observation sessions. Formal and informal interviews were held with participants in addition to review of hospital records. Results Analysis of the field data resulted in four themes. “Children’s pain expression and response of caregivers” described the disposition (habitus) of both children and caregivers to act in particular ways due to children’s incomplete health status (bodily capital) which caused them pain and also resulted in discomforting procedures. “Pharmacological pain management practices and attitudes” elucidated the use of analgesics as the mainstay disposition (habitus) in children’s pain management due to high level of respect (symbolic capital) given to such interventions on the pediatric units (field). “Managing pain without drugs” illustrated healthcare providers and family caregivers’ disposition (habitus) of using diverse nonpharmacological methods in managing children’s pain. “Communication and interaction between pain actors” depicted how children’s access to care givers (social capital) can serve as a powerful tool in influencing pediatric pain assessment and management disposition (habitus) on the pediatric units (field). ConclusionsThe habitus of pediatric pain actors toward pain assessment and management practices are influenced by various forms of capital (social, cultural, symbolic, bodily and economic) operating at different levels on the pediatric care field. Quality improvement programs that seek to enhance pediatric pain management should use the insights obtained in this study to guide the development, implementation and evaluation stages.

scholarly journals Dynamics on the field: a focused study on the culture and context of pediatric pain management at four Ghanaian hospitals

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Abigail Kusi Amponsah ◽  
Evans Oduro ◽  
Victoria Bam ◽  
Joana Kyei-Dompim ◽  
Collins Kwadwo Ahoto ◽  
...  
Keyword(s):  
Pain Management ◽  
Pain Assessment ◽  
Management Practices ◽  
Participant Observation ◽  
Symbolic Capital ◽  
Ethnographic Study ◽  
Pediatric Care ◽  
Pediatric Pain ◽  
Improvement Programs ◽  
Children's Pain

Abstract Background As part of efforts to develop and implement a short course educational program on pediatric pain management, the current study sought to understand the culture and contextual factors that influence children’s pain management in order to improve the practice in pediatric care settings. Methods Guided by Bourdieu’s theory of practice, a focused ethnographic study was conducted from October, 2018 to February, 2019. The study was contextualized at four Ghanaian hospitals among purposefully sampled nurses, physicians, hospitalized children and their families. During the 20-week study period, three ethnographers spent 144 h conducting participant-observation sessions. Formal and informal interviews were held with participants in addition to review of hospital records. Results Analysis of the field data resulted in four themes. “Children’s pain expression and response of caregivers” described the disposition (habitus) of both children and caregivers to act in particular ways due to children’s incomplete health status (bodily capital) which caused them pain and also resulted in discomforting procedures. “Pharmacological pain management practices and attitudes” elucidated the use of analgesics as the mainstay disposition (habitus) in children’s pain management due to high level of respect (symbolic capital) given to such interventions on the pediatric units (field). “Managing pain without drugs” illustrated healthcare providers and family caregivers’ disposition (habitus) of using diverse nonpharmacological methods in managing children’s pain. “Communication and interaction between pain actors” depicted how children’s access to care givers (social capital) can serve as a powerful tool in influencing pediatric pain assessment and management disposition (habitus) on the pediatric units (field). Conclusions The habitus of pediatric pain actors toward pain assessment and management practices are influenced by various forms of capital (social, cultural, symbolic, bodily and economic) operating at different levels on the pediatric care field. Quality improvement programs that seek to enhance pediatric pain management should use the insights obtained in this study to guide the development, implementation and evaluation stages.

QIM19-116: Barriers and Trends in Cancer Patients’ referrals to Pain Management in Qatar: A Randomized Cohort Prospective Study

2019 ◽  
Vol 17 (3.5) ◽  
pp. QIM19-116
Author(s):  
Rehab Abdelwahab ◽  
Anas Hamad ◽  
Shereen El Azzaz ◽  
Randa Al Okka ◽  
Mohd A. Wahid ◽  
...  
Keyword(s):  
Pain Management ◽  
Pain Assessment ◽  
Pain Treatment ◽  
Pain Clinic ◽  
List Type ◽  
Patients With Cancer ◽  
Referral Criteria ◽  
Management Techniques ◽  
Primary Physicians

Background: Studies showed that 40%–50% of patients with cancer pain receive insufficient analgesia due to different factors (Beyeler et al, Support Care Cancer 2008; Salminen et al, Support Cancer Care 2008), beside the challenges to accurately assess pain, which might affect drug selection and pain control (Stewart, Ulster Med J 2014). In NCCCR, the treating primary physicians (PP) may prescribe analgesics to their patients or refer them to the Pain Management Team (PMT), based on evaluation or as requested by patients. This study will address the clinical concerns of PP, which may lead to refer the patients to PMT, moreover the clinical judgement of PMT on the referred cases whether they need to be refereed or not. Objectives: To determine the efficiency of the referral pathway to the pain clinic by PMT. Methods: PMT is going to assess the referred patient to their clinics according to pain assessment methods. Patients will be evaluated whether they have been appropriately referred or not, any unnecessary referral will be documented based on the following;• If the patient was referred by hematologist or oncologist• If the patient required specialized treatment• If the patient required urgent treatment/prescription or advanced pain management techniques• If the patient required further consultation by pain management• If the patient could be managed by PP Results: 195 patients were newly referred to the pain clinic during the period from March 8, 2018 to August 31, 2018. 12% (23/195) were deemed as unnecessary referrals based on PMT assessment; 43% (10/23) of them were hematology patients, while 57% (13/23) were oncology. The majority was for breast cancer and sickle cell disease patients with 35% for each. According to the PMT assessment, 61% (14/23) patients (95% CI, 40.79%–77.84%) considered unnecessary referrals due to improper basic pain assessment and management by PP, while 30% (7/23) patients (95%CI, 15.60%–50.87%) asked for refill medications. Conclusion: There is 12% unnecessary referrals to PMT, which need further improvement in the referral pathway, via the development of a definite referral criteria to PMT. PP should be encouraged to provide basic pain treatment and to consider multidisciplinary management with appropriate coordination for better improvements in patients’ quality of life.

Pain management

2007 ◽  
pp. 567-584
Keyword(s):  
Pain Management ◽  
Pain Assessment ◽  
Tissue Damage ◽  
Pain Control ◽  
International Association ◽  
Emotional Experience ◽  
Common Symptom ◽  
Pharmacological Interventions ◽  
Opioid Drugs ◽  
Analgesic Use

Introduction 568 Pain assessment 570 Principles of analgesic use 574 Classifications of pain 576 Use of opioid drugs 578 Use of syringe drivers in pain control 580 Non-pharmacological interventions for pain management 582 Pain is not an inevitable symptom of advanced cancer; however it is a common symptom when caring for people with advanced disease. Pain is defined by The International Association for the Study of Pain (IASP) as: ‘an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage’. In other well-known definitions, pain is described as being ‘whatever the experiencing person says it is, existing whenever he [she] says it does’...

scholarly journals Recommendations of the Polish Association of Anaesthesia and Intensive Care Nurses on pain monitoring in Intensive Care Units using a Polish version of the behavioural Pain Scale (bPS)

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Aleksandra Gutysz-Wojnicka ◽  
Ilona Rozalska ◽  
Aleksandra Pawlak ◽  
Katarzyna Czyż-Szypenbejl ◽  
Wiesława Grabska ◽  
...  
Keyword(s):  
Intensive Care ◽  
Pain Management ◽  
Intensive Care Units ◽  
Pain Assessment ◽  
Pain Treatment ◽  
Task Force ◽  
Pain Scale ◽  
Intensive Care Nurses ◽  
Polish Version ◽  
Behavioural Pain Scale

Abstract Introduction. In 2018, another update of the Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/ Sedation, Delirium, Immobilization and Sleep Disorders in Adult Patients Treated in Intensive Care Units (ICUs) was released. Aim. The study is aimed at presenting current recommendations concerning pain management in patients treated in ICU, and presenting the algorithm of pain assessment and monitoring in patients treated in ICU, using a Polish version of the BPS (Behavioural Pain Scale). The guidelines were prepared based on a systematic review of the literature published in the years 2013-2018. Material and methods. The search for scientific publications was carried out using electronic databases in English and Polish. The following keywords and their combinations were used in the searches: pain, assessment, monitoring, nurse, intensive care, adult patient, unable to communicate. Initially, 758 papers were identified with the use of keywords. After excluding duplicates and preliminary checking and selecting the titles of publications and abstracts, 85 papers were qualified for the analysis of full text. Conclusions. Access to effective pain treatment is a fundamental human right. Recommendations of the Polish Association of Anaesthesia and Intensive Care Nurses, concerning pain monitoring in ICU using a Polish version of the Behavioural Pain Scale (BPS), developed by the Task Force for Practice, are intended to provide a specific guideline for developing effective local pain management strategies in ICU.

scholarly journals Perioperative analgesia and assessment of pain in children (literature review)

2021 ◽  
Vol 25 (2) ◽  
pp. 329-335
Author(s):  
O. S. Goncharuk
Keyword(s):  
Pain Management ◽  
Postoperative Pain ◽  
Pain Assessment ◽  
Age Groups ◽  
Postoperative Pain Management ◽  
Assessment Tools ◽  
Cochrane Library ◽  
Perioperative Analgesia ◽  
Pain Scales ◽  
Nociceptive Responses

Annotation. Adequacy of postoperative analgesia and pain assessment remains a pressing issue in children. In order to provide effective pain management to this population, it is important to consider some specific features such as the age of a child, cognitive imparement, mechanisms of pain, and traumatic cimcumstances resulted in nociceptive responses. Therefore, it is essential for clinicians to be able to choose the appropriate tools for pain assessment in different age groups of children and clinical situations, and to interpret the obtained data correctly. Hence, our study aimed to systematize existing problematic aspects of postoperative pain assessment is children and to analyze the evidence on perioperative analgesia in the paediatic practice. For this purpose, we systematically searched MEDLINE, the Cochrane Library and Google Scholar for trials published between 2002-2020. We paid particular attention to the correct choice of pain assessment tools in children of different age groups, and proper interpretation of the data obtained. The study contains the updated recommendations for postoperative pain management in children. There is a special emphasis on priority of multimodal analgesia in children. Analysis of recent publications shows that newborns and children under 5 years of age should be assessed with comprehensive pain scales that include behavioral characteristics and physiological parameters. It is advisable to use self-assessment pain scales for children older than 5 years of age. In order to manage the acute pain effectively, it should be assessed at least every 4-6 hours. Sufficient perioperative analgesia promotes rapid rehabilitation and prevents children from postoperative homeostatic disruption.

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