Background: Critically ill patients admitted to intensive care units (ICUs) frequently experience pain, but the severity of pain in this group of patients is underestimated by the treatment team due to barriers to verbal communication. The aim of the present study was comparing the severity of pain measured by two scales: behavioral pain scale (BPS) and critical-care pain observation tool (CPOT) in ICU-admitted patients during routine daily procedures. Materials and Methods: Ninety patients were enrolled in the study. The severity of pain was measured during resting, invasive (suctioning) and noninvasive (mouthwash and body position change) procedures, and respiratory physiotherapy with two scales: BPS and CPOT. Wilcoxon and Friedman statistical tests were used to compare the score of pain in different situations, and Spearman correlation coefficient was also used to measure the correlation of pain score measured by two scales. Results: Patients experienced no pain during resting, mild pain during changing position, and respiratory physiotherapy, mild-to-moderate pain during mouthwash and moderate pain during secretion suctioning. Wilcoxon test used for pairwise comparisons between pain score in different situations showed a significant difference in both scales ( p < 0.05). There were positive and strong correlations ( r > 0.80, p < 0.05) between the pain score measured by BPS and CPOT from ICU-admitted patients in all procedures. Conclusions: Critically ill patients in ICU experience a different range of pain in routine daily care. BPS and CPOT scales could be used successfully for monitoring of pain in this group of patients.
Background: Pain is one of the main complaints of many patients in intensive care units. However, most nurses and physicians are unable to properly monitor and relieve pain in these patients. Factors such as patients' inability to describe their pain and insufficient knowledge of nurses and physicians have made pain management difficult. Given that the knowledge and attitude of nurses play an important role in the effective implementation of the pain management process, this study aimed to investigate the effect of comprehensive pain management training program on the awareness and attitude of intensive care unit nurses. Methods: This quasi-experimental single-group study was conducted in two phases (pre and post-intervention) to investigate the awareness and attitude of all nurses employed in the intensive care unit of Tehran Modarres Hospital, based on the determined inclusion and exclusion criteria. In the pre-intervention phase, the awareness and attitudes of the nurses were assessed using a questionnaire. After conducting the pain management training course, an executive program and algorithm were implemented for pain management in ICUs. Then, the nurses' awareness and attitude toward pain management were assessed again. Finally, changes in the scores of the nurses' awareness and attitude were analyzed by SPSS V. 22 software in two phases before and after applying the interventions using the Wilcoxon test. The relationship between some demographic variables and the level of awareness and attitude of nurses was also investigated using the Kruskal-Wallis and Mann-Whitney tests. Results: The results of this study indicated that the mean score of the nurses' awareness was significantly different in pre-and postintervention phases (P < 0.05). Despite an increase in the post-intervention mean score of the nurses' attitude (71.03), no statistically significant change was observed. Additionally, among the demographic variables, there was only a significant relationship between the nurses' job experience in ICUs and their attitudes. Conclusions: Based on the results of this study, teaching and implementing a comprehensive program for pain management can play an effective role in promoting the nurses' awareness. Therefore, it is proposed to use pain management models to improve the nurses' knowledge and attitude toward pain management in ICU patients.
Context: The most common side effect reported by Sickle cell disease patients is unforeseen and chronic pain crisis. A combination of pharmacological and non-drug treatments is suggested for managing pain in patients with SCD. One of the non-drug treatments is massage therapy. This study aimed to evaluate the use and effectiveness of massage in reducing pain in patients with SCD.Evidence Acquisition: This study is a literature review of the period of 1990 to 2016. The search was done in databases and reputable sites including Medline, Cochrane Library, ProQuest, Ovid, Web of Knowledge, SID, Magiran, and Barakat using the keywords including massage therapy, pain, sickle cell, and patient. A total of 14 articles were selected for review.Results: Among 14 articles, five studies experimentally tested the effect of massage on reducing pain in patients with SCD, while the other nine studies only examined the rate of patients using massage and reported the rate of massage in the range between 5% and 79%. The results of the experimental studies indicated the effectiveness of massage therapy in reducing pain in patients with SCD. Conclusions:Massage therapy is one of the most common types of alternative medicine used for patients with SCD. Studies showed that massage therapy could have a role in reducing pain in patients with SCD. However, more extensive studies are needed in this field.
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