The findings of the present study can help nurses identify barriers and implement strategies to promote EBP as part of CQI.

The paradox of patients who are in pain, yet satisfied with their pain management, has been previously reported. To probe this paradox, we used cross-sectional data collected in the primary care setting on cancer patients' patterns of pain and pain treatment, beliefs and expectations about pain and pain relief, willingness to report pain and take pain medication, care from the provider, and satisfaction with their pain management (n = 316). Descriptive findings were similar to other studies: more than 75% of patients were satisfied or very satisfied with their overall pain management, despite almost half of all patients reporting recent moderate to severe pain. Univariate and bivariate analyses were consistent with the hypothesis that patients may expect and are therefore satisfied with the "peak and trough" pattern of pain severity that occurs with "as-needed" administration of analgesics. However, multivariate analyses failed to directly support this hypothesis. Instead, regression analyses identified factors related to characteristics of patients' pain experiences, patients' beliefs about pain and its inevitability, the frequency that patients reported their pain, and aspects of the patient--provider relationship. Predictors of patients' satisfaction with how their primary care doctor managed their pain included: whether or not the patient was told that treating pain was an important goal, whether or not the patient reported sustained long-term pain relief, and the degree to which the patient was willing to take opioids if prescribed by the doctor or nurse (adjusted R(2) = 0.22). Qualitative data collected from patients who were in severe pain during the past three days but satisfied with their pain management (n = 88) further suggest the importance of the patient--provider relationship in shaping patient expectations. Based on these findings, we recommend that future research on outcomes in pain management place greater emphasis on the potential impact of the patient-provider relationship.

The purpose of this study was to evaluate the effect of Reiki as an alternative and complementary approach to treating community-dwelling older adults who experience pain, depression, and/or anxiety. Participants (N = 20) were randomly assigned to either an experimental or wait list control group. The pre- and posttest measures included the Hamilton Anxiety Scale, Geriatric Depression Scale-Short Form, Faces Pain Scale, and heart rate and blood pressure. The research design included an experimental component to examine changes in these measures and a descriptive component (semi-structured interview) to elicit information about the experience of having Reiki treatments. Significant differences were observed between the experimental and treatment groups on measures of pain, depression, and anxiety; no changes in heart rate and blood pressure were noted. Content analysis of treatment notes and interviews revealed five broad categories of responses: Relaxation; Improved Physical Symptoms, Mood, and Well-Being; Curiosity and a Desire to Learn More; Enhanced Self-Care; and Sensory and Cognitive Responses to Reiki.

Nursing interventions should examine the impact of evaluating patients' beliefs in conjunction with pain assessment on pain-related behaviors and pain relief, as well as the ability of patient educational efforts to strengthen accurate beliefs and enable patients to assert themselves when interacting with less knowledgeable providers.

No abstract

No abstract

No abstract

No abstract