Hospitalized patients’ vs. nurses’ assessments of pain intensity and barriers to pain management

Dequeker, Sara; Lancker, Aurélie Van; Hecke, Ann Van

doi:10.1111/jan.13395

Cited by 33 publications

(33 citation statements)

References 43 publications

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“…One of the included studies decided to base the pain score on behaviour and expression of patients unable to self‐rate. Pain rating by proxy is difficult . Other possible scorings systems designed for cognitive impaired patients are PAINAD, which address advanced dementia, and Abbey Score which is used especially in movement‐based assessment …”

Section: Discussionmentioning

confidence: 99%

Pre‐operative femoral nerve block for hip fracture—A systematic review with meta‐analysis

Skjold

Møller

Wildgaard

2019

Acta Anaesthesiol Scand

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Background: Pre-operative pain management of hip fracture patients is complex.Femoral nerve block (FNB) is used for hip fractures to reduce pain and demand for systematic analgesia. The objective of the study was to systematically investigate the efficacy of single-shot FNB for hip fracture patients. Methods:Five databases were searched from inception until 8 May 2019. We included randomized controlled trials (RCT's) assessing pain relief in patients with hip fractures. Intervention was pre-operative FNB compared to any systemic analgesic (eg opioids, non-steroidal anti-inflammatory drugs or paracetamol). Primary outcomes assessed were pre-operative pain and use of rescue analgesics. Secondary outcome was cognitive impairment. We present a bias assessment, a meta-analysis and a grading of certainty of evidence. Results:We included five trials (n = 254), where participants received FNB 30 minutes or more prior to surgery; all were judged as having high risk of bias. All studies found significantly decreased pain scores at least once in the intervention group compared to the control group. Meta-analysis on the primary outcome of pain showed significance. Mean difference was −2.13 point (in cm) (CI:-3.53,-0.72) on visual analogue scale in the intervention group, but is judged low on certainty. Conclusions:The quantity of evidence supporting pre-operative single-shot FNB for hip fractures is very low, and the certainty of evidence supporting pre-operative single-shot FNB for hip fractures is low. No studies using ultrasound guided technique were identified. Data on non-ultrasound guided FNB's suggest a decreased pain score compared to the use of systemic analgesia. S U PP O RTI N G I N FO R M ATI O NAdditional supporting information may be found online in the Supporting Information section.How to cite this article: Skjold C, Møller AM, Wildgaard K.Pre-operative femoral nerve block for hip fracture-A systematic review with meta-analysis.

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Section: Discussionmentioning

confidence: 99%

Pre‐operative femoral nerve block for hip fracture—A systematic review with meta‐analysis

Skjold

Møller

Wildgaard

2019

Acta Anaesthesiol Scand

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“…The results of applying the scale also showed that, of all pain management practices, nurses carry out mostly pharmacological interventions. This finding, which several studies sustain, is mainly because this is an interdisciplinary intervention and that there are difficulties in implementing other pain management measures, such as non--pharmacological interventions and pain assessments (which include initial assessment, planning, education, recording, and reassessment; Becker et al, 2017;Dequeker, Van Lancker, & Van Hecke, 2018;Gan et al, 2018). Pain assessment is recognized in the scientific literature as a challenge, pain education and intervention planning being the most neglected areas in clinical practice (Araujo & Romero, 2015;Medrzycka-Dabrowka, Dąbrowski, Gutysz-Wojnicka, Gawroska-Krzemińska, & Ozga, 2017).…”

Section: Discussionmentioning

confidence: 99%

Psychometric study of the Nursing Care Scale for Pain Management

2019

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Background: Pain is inefficiently managed by nurses in part due to the lack of tools capable of measuring and monitoring such practice. Objective: To assess the psychometric properties of the Nursing Care Scale for Pain Management. Methodology: This descriptive correlational study assessed internal consistency using Cronbach's alpha coefficient and confirmatory factor analysis using the covariance matrix-maximum likelihood algorithm. Results: The study involved 260 nurses with a mean age of 35.42 years, 78.5% of whom were women. After the refinement of the scale, the overall internal consistency was α = 0.95, and the score by factors was: initial assessment α = 0.85; Planning α = 0.76; Implementation of non-pharmacological interventions α = 0.80; Educating the person with pain α = 0.89; Registration α = 0.76; Reassessment α = 0.81, and Implementation of pharmacological interventions α = 0.70. The highest mean values of the overall scores are related to pharmacological interventions (3.13 ± 0.60). Conclusion: The scale is a reliable and valid tool for assessing the pain management practices of Portuguese nurses. Most nurses apply pharmacological interventions to manage the pain endured by patients.

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“…The agreement between the actual pain levels was considered to be moderate, suggesting room for improvement of nurses' pain assessment techniques. This study suggests that assessment techniques can be improved, particularly when caring for the elderly and females (Dequeker et al, 2018).…”

Section: Pain Assessmentmentioning

confidence: 93%

“…In a study completed by Dequeker, Van Lancker, and Van Hecke (2018), pain intensity described by patients was compared with the pain assessment completed by nurses. The validated instrument used by patients in this study included the numeric pain scale ranging from zero to ten.…”

Section: Pain Assessmentmentioning

confidence: 99%

Nurses' Perceptions of the Barriers to Using Nonpharmacological Methods to Relieve Patients' Pain in the Adult Care Setting

Ethier¹

2019

Preprint

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Managing patients’ pain is a challenge that many caregivers face as they balance adequate pain management with minimal drug side effects. Nonpharmacological pain management techniques exist that literature has shown to be effective. Although caregivers may be aware that nonpharmacological pain relief options exist, pharmacological pain management still remains the primary, and often the sole form of pain intervention. The purpose of this project was to identify nurses’ perceptions of barriers to using nonpharmacological methods to manage their patients’ pain in the inpatient hospital setting. A modified survey was created using the Nurses’ Perceived Obstacles to Pain Assessment and Management Practices questionnaire by Coker et al (2010). The modified survey included 19 questions that were relevant to nonpharmacological pain management of an adult patient in the hospital setting. The participants’ years of nursing experience was also collected with this tool. A total of 19 nurses that work in the Intensive Care Unit of Newport Hospital, a 129-bed community hospital in Newport, RI were surveyed. The results of the survey showed that over half of all respondents perceived they had inadequate time to educate their patients on the use of nonpharmacological pain management and that their institution did not have clear policies or guidelines of best practices regarding nonpharmacological pain management. Over 45% of all respondents found a lack of system support and education and patient attitude to be barriers. This project identified that both nurses and patients would benefit from further guidance by the institution with the use of guidelines and policies to enhance their knowledge, confidence, efficiency, and skills to manage their patients’ pain with nonpharmacological options.

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Hospitalized patients’ vs. nurses’ assessments of pain intensity and barriers to pain management

Abstract: Aims: The aim of the study was to identify if nurses and patients equally assessed pain intensity and patient-related barriers to pain management in hospitalized patients.Background: Several studies reported poor to moderate agreement between

Cited by 33 publications

References 43 publications

Pre‐operative femoral nerve block for hip fracture—A systematic review with meta‐analysis

Pre‐operative femoral nerve block for hip fracture—A systematic review with meta‐analysis

Psychometric study of the Nursing Care Scale for Pain Management

Nurses' Perceptions of the Barriers to Using Nonpharmacological Methods to Relieve Patients' Pain in the Adult Care Setting

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