Educational Needs and Resources for Teachers Working with Students with Chronic Pain: Results of a Delphi Study

Children and adolescents spend most of their time at school. Therefore, teachers could be of help to improve the quality of life of students with chronic pain while they are at school. The aim of this study was to identify teachers’ educational needs and resources to help improve the adjustment to and function in the school of students with chronic pain. A Delphi survey including two rounds was conducted. Overall, 49 needs were identified in the first round. They were related to education, training, organization/logistics, and communication with the family and the health care center. Among the most important needs, based on the importance given and consensus reached, were (1) having information about the most appropriate attitudes and responses to a student with chronic pain, (2) how to reduce absenteeism, (3) how to ease the return to school after a long absence due to his or her pain problem, and (4) how to establish effective communication with the family. The results of this study provide new important data on the educational needs and resources which teachers would like to have to help their students with chronic pain at school, which could be used to develop educative programs for teachers.

Taking a headache history

The first tip is to take a full medical history. The trick is to interpret it. Around 400 bc Hippocrates described exertional and sex headaches with no aid other than a reed pen and papyrus or parchment. The second tip is to let patients tell the story in their own words as much as possible. The trick is to extract the salient features of the headache syndrome from what is often a cascade of irrelevancies while still trying to let the patient do most of the talking. This is a form of guided democracy. The final tip is to regard the headache as a pain problem to be analysed and hopefully solved by including a traditional pain history as taught in medical school. The trick is not to take shortcuts unless the patient is in extremis on being brought to the Emergency Department, when leaping straight to testing for neck rigidity and looking for signs of infection, a dilating pupil, and other warning signs is preferable.

Long-term effects of caesarean delivery on health and behavioural outcomes of the mother and child in Bangladesh

BackgroundIncreasing rate of unnecessary caesarean section (CS) is now reported worldwide that intensified the occurrence of adverse health outcomes for mother-child dyads. We investigated the association of CS with some basic health and behaviour outcomes of the mother-child dyads in Bangladesh.MethodsWe conducted a community based case-control study from May to August 2019. Total of 600 (300 had CS, and 300 had vaginal delivery (VD)) mother-child dyads were interviewed through a structured questionnaire. Method of delivery was the exposure variable classified as CS and VD. The outcome variables were a group of health and behaviour problems of the mothers and their children. A series of binary logistic regression models were carried out to examine the effects of the exposure variable on outcome variables. Mother’s socio-demographic and reproductive characteristics were adjusted in the models.ResultsThe mean maternal age (±SD) and weight were 25.1 (±5.2) years and 53.1 (±7.2) kilogram, respectively. Higher likelihood of headache, after delivery hip pain, problem of daily activities, and breastfeeding problem were reported among mother had CS in their last birth than VD. Children born through the CS were reported a higher likelihood of breathing problem and frequent illness and a lower likelihood of food demand and sleeping.ConclusionThe occurrence of CS increases the risk of health and behaviour problems among mothers and their children. This suggests the need for polices to avoid unnecessary CS and to increase awareness of adverse effects of CS. Frequent health checkup following CS is also important.

Sexual dysfunction and associated factors among patients with epilepsy at Amanuel Mental Specialty Hospital, Addis Ababa – Ethiopia

Background Many patients with chronic illness have sexual dysfunction that may be related to the condition itself, drug side effects, emotional sequel, or a combination of those factors. Patients with epilepsy are no exception. Men and women with epilepsy are frequently complaining sexual dysfunction and they appear to have a higher incidence of sexual dysfunction than peoples with other chronic neurologic illness. These problems can have a substantial impact on their sexuality thus; it needs careful study and evaluation. Methods Hospital based cross sectional study was conducted from January to July, 2016 among Patient with Epilepsy at Amanuel Mental Specialty Hospital. Interviewer administered Changes in Sexual Functioning Questionnaire (CSFQ-14) was used in order to assess the sexual problems. Finally, the data was analyzed by using Statistical Package for Social Science (SPSS) V-20. Descriptive statistics and logistic regression were used to describe the variables. Levels of significance of association determined at < 0.05. Results A total of 694 respondents participated, with response rate 99.14%. Among them 576 completed all items. The result showed that 363 subjects (63.9, 95%CI = 59.5–67.7) had global sexual dysfunction. Furthermore, the rate of sexual dysfunction was reported as 55.6% (95%CI = 49.1–62.6) and 67.4% (95%CI = 62.8–72.1) in female and male participants, respectively. Among domains of sexual dysfunction; sexual arousal problem (97.8% (95%CI = 95.8–98.3)) and sexual pain problem (11.3% (95%CI = 8.8–13.9)) were the most and the least prevalent sexual dysfunctions respectively. Concerning associated factors; age grouped > 51, depression, being out of relationship or not satisfied with non-sexual aspect of relationship, being jobless and khat use has positive association with sexual dysfunction. By the other side alcohol use, level of education & age groups 18–21 years associated negatively. Conclusions The prevalence of sexual dysfunction among patients with epilepsy is very high; its prevalence is more among males than females. Sexual arousal problem and sexual pain problem were the most and the least prevalent sexual dysfunctions respectively.

Developing the Network Pain Rehabilitation Limburg: a feasibility study protocol

IntroductionPatients having chronic musculoskeletal pain (CMP) face challenges as mismatches often exist between the complexity of patient’s pain problem and the rehabilitation treatment offered. This can result in less efficient care for the patient and increased medical shopping. The Network Pain Rehabilitation Limburg (NPRL), a transmural integrated healthcare network, will be designed to improve daily care for patients with CMP. NPRL focusses on improving patient’s level of functioning despite pain by stimulating a biopsychosocial approach given by all involved healthcare professionals. A feasibility study will be performed which will give insight into the barriers and facilitators, perceived value, acceptability and implementation strategies for NPRL.Methods and analysisThis study has a three-phase iterative and incremental design, based on key principles of a user-centred design. Mixed methods will be used in which healthcare professionals and patients involved in NPRL will participate. In phase 1, NPRL will be developed and healthcare professionals educated. Phase 2 focusses on the implementation and phase 3 on the transferability of NPRL. In addition, preliminary data on patient’s work status, general health and participation level will be collected. The qualitative results of each phase will be analysed following the Consolidated Framework for Implementation Research (CFIR) and will be used to refine NPRL in daily practise.Ethics and disseminationInformed consent will be obtained from all participants. The results of this feasibility study will form the basis for refinement of NPRL and planning of a large-scale process and effect evaluation of the Quadruple Aim outcomes. Dissemination will include publications and presentations at national and international conferences. Ethical approval for this study was granted by the Medical Ethics Committee Z, the Netherlands, METC 17 N-133.

Pain management in new amputees: a nursing perspective

Phantom limb pain (PLP) is a widespread and challenging neuropathic pain problem, occurring after both surgical and traumatic amputation of a limb. It may occur immediately after surgery or some months later, however, most cases it presents within the first 7 postoperative days. Patients report a range of pain characteristics in the absent limb, including burning, cramping, tingling and electric shock sensation. The incidence of PLP has been reported to be between 50% and 85% following amputation. Its management is notoriously difficult, with no clear consensus on optimal treatment. It is often resistant to classic balanced analgesia and typical neuropathic pain medications. Taking into account these issues, the authors aimed to improve the management of patients undergoing amputation at their institution, by ensuring accurate and holistic assessment, the selection of suitable interventions through critical analysis and synthesis of available evidence, and the appropriate evaluation and adaptation of treatment plans, to ensure patients achieved their individualised goals.

ASUHAN KEPERAWATAN KANKER NASOFARING DENGAN FOKUS STUDI PENATALAKSANAAN NYERI DI RSUD TIDAR KOTA MAGELANG

Cancer / nasopharyngeal carcinoma (NPC) is a malignant cancer in the head and neck. This cancer is located in the nasopharynx, behind the nose. NPC including five large malignant tumors. Ebstein Barr is one of the triggers of this carcinoma. Most NPC patients come to the clinic for treatment at an advanced stage. The purpose of writing is to discuss and examine the application of nursing care with a focus on pain studies on clients with nasopharyngeal cancer. The method used by the writer is descriptive by managing one client who has nasopharyngeal cancer. The results of the study were obtained as long as 2x24 hours of nursing care was provided, the pain problem was resolved in accordance with the established criteria with the results of the implementation carried out in accordance with the client's developmental response. During the evaluation of nursing care that has been given for 2 consecutive days there is a nursing problem that pain can be resolved. Keywords: Nasopharyngeal Cancer, Pain, Nursing Care

Nonsteroidal anti-inflammatory drugs for management of pelvic pain in women

Pelvic pain is one of the common causes for visiting a doctor, which can be the main symptom of gynecological diseases and an independent pathological condition. Acute pelvic pain is most often caused by an infection that affects the organs of a woman’s reproductive system. Non-infectious causes of pain are also associated with inflammation, and estrogens support pain and inflammation in women, which increases the risk of chronic pelvic pain (CPP). The urgency of the pelvic pain problem is considered not only in connection with an adequate diagnosis of its causes, but also from the perspective of managing the pain symptoms themselves. The anaesthesia strategy significantly improves the quality of life and prevents the development of chronic inflammatory diseases and CPP syndrome. Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used in pain therapy, and their effect consists in reducing the synthesis of prostaglandins and is pathogenetically substantiated both in the complex treatment of acute pelvic infections and in the treatment of idiopathic menstrual pain. The article presents clinical observations of the use of NSAIDs with the specified purpose.