Assessment of the Management of Patients with Chronic Pain Referred to a Specialized Pain Unit: A Cross-Sectional Multicenter Study (the DUO Project).
Ontology highlight
ABSTRACT:
SUBMITTER: Mayoral Rojals V
PROVIDER: S-EPMC9267154 | biostudies-literature |
REPOSITORIES: biostudies-literature
Similar Datasets
Project description:Abstract Preterm birth is a risk factor for early experience of pain. Despite advances in neonatal care, evidence‐based knowledge of the importance of adequate pain management and strong international guidelines for assessment and treatment of neonatal pain, only 10% of sick term and preterm infants were assessed for pain and stress on a daily basis. The aim of this quality improvement (QI) project is evaluation of implemented guidelines for pain assessment and management, and increased parental involvement in a Norwegian single‐family room NICU. Method: The different steps of the project entailed translation of the English version of COMFORTneo, development and implementation of guidelines with flowcharts for pain management, and pain assessment certification of the interprofessional staff. Part two of the project is supervision of the interprofessional staff in parental involvement in stress‐ and painful procedures. Our study showed that one year after implementation, 88.8% of the COMFORTneo assessments were performed according to the pain management guidelines. The staff used the flowcharts to assess, treat and reassess pain and stress. There was a high interrater reliability with linearly weighted Cohen's kappa values ranging from 0.81 to 0.95, with a median of 0.90. In addition, our study showed increased parental involvement in procedures, from 50.3% before to 82.3% after the quality improvement project. The success of this quality improvement project is explained by systematic use of flowcharts and implemented guidelines for pain management, interprofessional collaboration, and cultural change agents. Theoretical lectures and practical bedside supervision to interprofessional staff increased parental involvement in stress‐ and painful procedures. The aim of this quality improvement (QI) project is evaluation of implemented guidelines for pain assessment and management and increased parental involvement in a Norwegian single‐family room (SFR) NICU. The main steps were translation and implementation of the COMFORTneo scale and development of flowcharts and pain management guidelines. The study showed high compliance to guidelines, high COMFORTneo assessment inter‐rater reliability, and increased parental involvement in procedures.
| S-EPMC9189914 | biostudies-literature
Project description:Objective:To describe the rate and demographics of pain among Vietnamese people in 48 provinces and describe the impact of pain on individuals, levels of satisfaction with treatment results, and behavior of pain sufferers. Methods:The cross-sectional study was conducted in adults presenting to outpatient clinics throughout 48 provinces in Vietnam and were randomly selected for inclusion in this study. A physician trained to administer a questionnaire in a standardized fashion interviewed each patient and collected data regarding gender, age, career, acute and chronic pain, diagnoses, treatment, and satisfaction with treatment. Results:There were 12,136 respondents (50.65% male and 49.35% female) from 48 of the 63 provinces in Vietnam. About 86.53% of respondents reported experiencing pain that affected their daily lives, with 24.10% complaining of acute pain and 62.43% having chronic pain. About 67.71% reported pain that affected job performance. Headache was the most common complaint in 35.43% of the respondents. Fewer than half (43.35%) of all patients with pain sought help from a doctor; only a quarter (27.50%) sought help within 1 month of experiencing that pain. A majority (61.98%) of patients who did seek help were satisfied with treatment results. The median cost of treatment was between 150 and 250 USD. Conclusion:Pain severe enough to impact patients' daily lives is common in Vietnam. Treatment costs are a significant economic burden and may help explain why only a minority of patients seek treatment. Access to lower cost, effective treatment for pain should be improved.
| S-EPMC6394241 | biostudies-literature
Project description:Background Patient satisfaction with postoperative pain management is a vital tool for measuring the quality of care in health centers, which associated with the care process and care outcome. There is still few evidence on factor for patient satisfaction with postoperative pain management. Objective These study aimed to assess magnitude of Patient satisfaction with post-operative pain management and associated factors among surgical patients at Tikur Anbessa Specialized Hospital, from Feb 1- Apr 30, 2021. Method Institutional based cross-sectional study was conducted among 335 adult patients using a systematic random sampling technique. Data were collected through structured questionnaires based on the modified APS-POQ to obtain responses from the patients. Both bivariable and multivariable logistic regression analysis was done to evaluate the association. P-value less than 0.05 was considered as statistically significant. Result The find of this study revealed that 74.5% of patients were satisfied with overall pain management services. Patients with ASA I (AOR = 2.3; 95%CI: (1.06–5.08), received multimodal analgesics (AOR 4.30; 95% CI: (2.02–9.18), no perceived pain (AOR = 6.7; 95% CI: (1.54–29.7), had pain discussion (AOR = 8.9; 95% CI: (3.67–21.90) and waiting for analgesia service less than 30 min (AOR = 6.3; 95% CI: (1.34–29.58) were more satisfied. Conclusion The study shows that patient satisfaction with postoperative pain management was low in our setup compared to many studies. Thus, there is a need to improve the quality of pain management services in the study area. Highlights • Patient satisfaction with postoperative pain management was suboptimal.• ASA status, pain, analgesic techniques & management were significantly associated.• Patient satisfaction also associated with empathy, patient education, & communication.
| S-EPMC9289483 | biostudies-literature
Project description:BACKGROUND:To evaluate the performance of a novel triage system for Transient Ischemic Attack (TIA) units built upon an existent clinical prediction rule (CPR) to reduce time to unit arrival, relative to the time of symptom onset, for true TIA and minor stroke patients. Differentiating between true and false TIA/minor stroke cases (mimics) is necessary for effective triage as medical intervention for true TIA/minor stroke is time-sensitive and TIA unit spots are a finite resource. METHODS:Prospective cohort study design utilizing patient referral data and TIA unit arrival times from a regional fast-track TIA unit on Vancouver Island, Canada, accepting referrals from emergency departments (ED) and general practice (GP). Historical referral cohort (N?=?2942) from May 2013-Oct 2014 was triaged using the ABCD2 score; prospective referral cohort (N?=?2929) from Nov 2014-Apr 2016 was triaged using the novel system. A retrospective survival curve analysis, censored at 28 days to unit arrival, was used to compare days to unit arrival from event date between cohort patients matched by low (0-3), moderate (4-5) and high (6-7) ABCD2 scores. RESULTS:Survival curve analysis indicated that using the novel triage system, prospectively referred TIA/minor stroke patients with low and moderate ABCD2 scores arrived at the unit 2 and 1 day earlier than matched historical patients, respectively. CONCLUSIONS:The novel triage process is associated with a reduction in time to unit arrival from symptom onset for referred true TIA/minor stroke patients with low and moderate ABCD2 scores.
| S-EPMC6389093 | biostudies-literature
Project description:This study has aimed to investigate the impact of sustainable project management on sustainable project planning and success in manufacturing firms. Data was collected from project management professionals in a manufacturing firm in Malaysia. A total of 231 responses were analyzed using the partial least square (PLS) method. The findings revealed that sustainable project management has a significant impact on sustainable project success and sustainable project planning. Sustainable project planning is positively correlated with sustainable project success. The results also indicated that sustainable project planning mediates the effect of sustainable project management on sustainable project success. The findings have significant insight into the body of knowledge of the project life cycle and indicated that sustainable project planning is a crucial tool attributed to project management towards the project success of the manufacturing firm. The results can be used as a guideline for organizations, providing direction in project management to achieve sustainable development for business.
| S-EPMC8612515 | biostudies-literature
Project description:AimsPain is underestimated and insufficiently treated in Emergency Departments (ED). The primary objective of this multicenter, prospective, observational, and interventional study is to analyze the clinical impact of a simulation-based training for Emergency Nurses on pain assessment and management. Secondary objectives are to measure instructed staff's satisfaction with the simulation training and to evaluate the progress of participants as well as studying the clinical impact of this course: level of correlation between accuracy of analgesia and level of pain, assessment of patient and caregiver satisfaction.Designthis study will be undertaken in EDs at two university hospitals (Paris, France: Bichat and Beaujon) with randomly selected experimental and control groups.MethodsDuring the first phase, inventories in the EDs of current professional practice will be realized. Then, the control group will have theoretical classes and the experimental group will have both the theoretical class and simulation courses for all the nurses (with simulated patients in trauma pain scenarios). Post course assessment will be established of triage nurses' and other nurses' practice changes concerning trauma pain management in EDs. Moreover, this study will include an assessment of the impact on patient and caregiver satisfaction. All patients over 18 years old who are admitted to the ED for a non-vital trauma are included. Exclusion criteria are patients who are admitted by an EMS ambulance.Clinical implicationthis study seeks to demonstrate that the implementation of a theoretical course combined with a simulation session will improve pain management in EDs by Emergency Nurses.
| S-EPMC6370573 | biostudies-literature
Project description:CONTEXT:Acute postoperative pain remains inadequately assessed and managed. A valid instrument that assesses acute pain in sedated postanesthesia care unit (PACU) patients is needed. OBJECTIVES:Two behavioral pain assessment instruments, the NonVerbal Pain Scale Revised (NVPS-R) and Critical-care Pain Observation Tool (CPOT), were used to determine whether these instruments adequately assess acute pain in the PACU. METHODS:A crossover study design was used. The study was conducted in the Medical Services Administration at the Puerto Rico Medical Center. Upon PACU arrival, patient sedation levels were evaluated using the Richmond Agitation Sedation Scale. Acute pain was assessed using the CPOT (scored, 0 to 8) and the NVPS-R (scored, 0 to 10) at timepoints 0, 15, 30, 45, 60, 90, and 120 minutes. Descriptive statistics and mixed model regression analysis were used to compare pain score assessment between instruments. RESULTS:Clinically significant increases in vital signs and respiratory indicators using the NVPS-R were not seen in patients with significant pain at time 0, 15, and 120 minutes. The CPOT vocalization indicator was more frequent in patients with significant pain. CONCLUSIONS:Findings suggest that NVPS-R and CPOT can assess acute pain in sedated PACU patients. In patients with significant pain, the CPOT vocalization indicator was more consistent than physiological and respiratory indicators in detecting acute pain. Thus, our data do not support the exclusive use of vital sign indicators to assess acute pain, suggesting the superiority of the CPOT for the assessment of acute pain in sedated PACU patients.
| S-EPMC6033670 | biostudies-literature
Project description: Not available
| S-EPMC9373598 | biostudies-literature
Project description:Background and objectivesPain management is a necessary component of palliative care as most patients suffer from pain during the final phase of life. Due to the complex causation of pain in the last phase of life, it is important to utilize methods other than pharmacotherapeutic options in order to achieve adequate pain control. As little is known about treatment of pain in German hospices, a nationwide survey was conducted.Materials and methodsAll German hospices (259) were contacted by post in June 2020 and asked to participate in an anonymous cross-sectional survey.ResultsA total of 148 (57%) German hospices took part in the survey. A broad variety of medication is used in the hospice setting. Metamizole is the most commonly used non-opiod analgesic , hydromorphone the most commonly used opioid, and pregabalin is the most commonly prescribed co-analgesic drug. The pain medication is usually prescribed as an oral slow-release substance. Standardized treatment schemes are rare among the responding hospices. Most of the respondents also use complementary treatment options, such as aroma (oil) therapy or music therapy, in the treatment of pain. Palliative sedation is used by nearly all responding hospices if all other treatment options fail.ConclusionThis survey provides an overview of the treatment options for pain management in German hospices. A broad variety of pain medication is used. Compared to international literature, it is debatable whether such a large variety of different types of pain medication is necessary, or whether a reduction in the type of medication available and the use of standardized treatment schemes could benefit everyone involved.
| S-EPMC10763107 | biostudies-literature
Project description:Alarms in the critical areas are an important component of most of the machines as they alert nurses on the change in the patients' condition. Most patients in the critical care units cannot speak for themselves hence cannot pinpoint when their condition changes. It is therefore important to assess the nurses' interventions when managing clinical alarms. The purpose of this study was to assess interventions employed by nurses in the management of clinical alarms in the care of patients in the Critical Care Unit (CCU), Kenyatta National Hospital (KNH).A descriptive cross sectional study was carried out in the month of June 2014 where 87 nurses were recruited as study respondents. KNH/ University of Nairobi (UoN) Ethics and Research committee approved the research. A structured self administered questionnaire was used to collect data. The questionnaire contained some questions in a Likert scale in relation to the actions the nurses would take in the management of clinical alarms and some on whether policies on alarm management existed in the hospital, if they filled alarm checklists and how often and the types of alarms they would respond to first.The respondents' responses were scored and from the results it was clear that there were some gaps in the management of clinical alarms. Majority of the nurses reported that they respond to alarms of all durations and do not fill alarm checklists as neither alarm checklists nor protocols are provided. From the findings there was a statistically significant association (p = 0.06) between age and whether the respondents assessed the cause of the alarm beep.Respondents in this study respond to alarms of all durations in contrast to other studies where the findings indicate that nurses respond to alarms for different reasons, not just that the alarm sounds. Majority of the respondents scored averagely on the questions on whether they carry out most of the interventions or actions. This is inline with previous studies which have shown that healthcare personnel respond to alarms depending on the patient's physiological status.Nurses in the unit carry out the standard nursing interventions on clinical alarms and, respond to alarms of all durations and do not fill alarm checklists. Alarm protocols should therefore be developed in the hospital, the nurses should be trained on management of clinical alarms and more nurses employed.
| S-EPMC5526251 | biostudies-other