Insights Into Tertiary Care Nurses: Awareness and Practices Regarding Nonpharmacological Pediatric Pain Management in Qatar

BackgroundHealth outcomes are a global priority, and the use of nonpharmacological methods for labor pain relief is recommended to improve these outcomes. However, there is a lack of a review regarding on the utilization of nonpharmacological labor pain management.Objectivesthis study aimed to assess the pooled utilization of nonpharmacological labor pain management and the associated factors among healthcare providers in Ethiopia.MethodsThe Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed for this review. A total of 2837 articles were retrieved from international databases, including Scopus, PubMed, Web of Science, Science Direct, and National Digital Library repositories. The search for articles was conducted from February 1, 2024, to February 30, 2024. To assess the methodological quality Newcastle Ottawa Scale was utilized. Data extraction was performed using Excel, and the analysis was conducted with Stata 11 software.The effect size measurement utilization of nonpharmacological labor pain management was estimated using the Random Effect Mode. The Cochran’s Q test and I2 statistic were used to assess the heterogeneity of studies. The symmetry of the funnel plot and Egger’s test were used to check for publication bias.ResultsFourteen studies met the eligibility criteria with a total sample size of 4,821. The overall pooled utilization of nonpharmacological labor pain management among healthcare provider was 45.48% (95% CI: 35.74–55.22). Healthcare providers aged 20–29 years (AOR: 4.10; 95% CI: 1.79–9.39), those having with knowledge about nonpharmacological pain management (AOR: 3.11; 95% CI: 1.88–5.16), and those who allowed companions to support laboring mothers (AOR: 3.37; 95% CI: 1.56–7.24) were determinants of outcome variables.ConclusionOver half of Ethiopian healthcare providers did not use nonpharmacological pain management during childbirth. Key factors healthcare providers aged 20–29, those with adequate knowledge, and healthcare providers’ ability who allowed companions to enter labor ward to support laboring mothers. Providing updated in-service training programs for older healthcare providers are recommended to utilize nonpharmacological pain management techniques. Policymakers should also create clear understand about obstetric guidelines to promote pain management during childbirth.

Resource-limited countries like Malawi often face shortages of essential medications, often leaving neonates with unmet pain management needs and contributing to poor neonatal outcomes. Involving parents to provide nonpharmacological pain management interventions (NPPMI) would be a safer and cost-effective strategy to promote maternal involvement and improve neonatal outcomes. This study was conducted to explore maternal involvement in nonpharmacological pain management during painful procedures in Chatinkha Neonatal Unit at Queen Elizabeth Central Hospital in Blantyre, Malawi. A descriptive qualitative design was used to collect data from in-depth interviews conducted with 20 parents of neonates who had undergone painful procedures in the neonatal unit. Data were analyzed using thematic analysis. Four themes emerged from the study: (1) parent knowledge on involvement and NPPMI, (2) healthcare worker practices in involving parents in pain management, (3) parent desire for involvement in pain management, and (4) barriers to parent involvement in neonatal pain management. This study showed that maternal involvement in neonatal pain management is poor and the use of NPPMI is substandard in Malawian neonatal units. A contributing factor is lack of parental knowledge, which results from lack of education and support from healthcare providers. To address this, clear protocols to guide maternal involvement in pain management are needed. Future studies should aim at designing and evaluating structured educational programs for both healthcare providers and parents on the use of NPPMI.

Practice of non-pharmacological post-operative pain management and associated factors among nurses working in public referral hospitals of Amhara regional state, Ethiopia, 2019

Beyond the needle: expanding the role of anesthesiologists in the management of chronic non-malignant pain.

Effectiveness of maternal-targeted training on nonpharmacologic pain management on heel stick sampling: A randomized controlled trial

To map the practice of paediatric perioperative pain assessment and management among consultant anaesthetists working in teaching institutions in the two provinces of Pakistan. A cross-sectional survey. Place and Duration of the Study: Department of Anaesthesiology, Teaching institutions of Sindh and Khyber Pakhtunkhwa (KPK), Pakistan, from January to October 2022. A questionnaire was designed to determine the participants' practices about perioperative pain assessment and management. It consisted of 26 questions that included participants' demographic data and questions about their paediatric practice. A total of 152 responses were received (response rate 76%). Most participants (n = 84, 55.3%) had a two-year diploma in anaesthesiology, while 38.2% had a four-year diploma. Additionally, 66.4% worked at public sector hospitals and 28.3% at private hospitals. Only 66% of respondents used paediatric pain scales for pain assessment in the recovery rooms. Most participants, 72.2%, had no Paediatric Pain Management Guidelines available at their institution. Only 5% had access to 5 analgaesic medications, while 32% had access to only 2 medications for intraoperative pain management. The practice of anaesthesiologists in these two provinces of Pakistan is highly varied since there is a lack of national guidelines. Paediatric anaesthesia, Acute pain, Pain management, Pain measurement, Paediatric pain assessment, Anaesthesia and analgaesia, Survey and questionnaires.

Olivia, a 13-year-old neurologically intact patient with cerebral palsy, arrived from a routine abdominal procedure screaming in pain. The medical team was baffled as to why she experienced such agony despite receiving copious doses of morphine. We spoke with her adoptive parents to obtain more history. They revealed long-standing physical and sexual abuse before Olivia’s adoption 6 years ago and noted extreme distress to all medical procedures and prolonged surgical healing time. Although her parents hoped to give her a better life and ensure she received appropriate care for her condition, they felt helpless that Olivia was at risk for retraumatization (reexperiencing posttraumatic symptoms from her original traumas) each time she came to the hospital. The amplification of pain and delayed medical recovery secondary to a history of psychological trauma and adverse childhood experiences (ACEs) is well recognized.1–3 Health care institutions are aware of the need for the integration of trauma-informed care into practice, yet they struggle to find the right approach. Although screening for ACEs has been widely adopted as a trauma-informed practice, there are multiple concerns with ACEs screening, including operating from a deficit- versus strength-based model, risk for traumatization from screening, and limited follow-up resources.4 ACEs scores also do not fully capture trauma and posttraumatic stress symptoms, which may be better predictors of negative outcomes than ACEs alone. Many organizations have now implemented the Substance Abuse and Mental Health Services Administration guidelines of educating clinicians on realizing …

BackgroundPain is an unpleasant sensory and emotional experience associated with or resembling that actual or potential tissue damage. Different study findings show that about 55% to 78.6% of inpatients experience moderate-to-severe pain. Nurses are one of the health professional who may hear of pain suffered by the patients and who can manage patient suffering by themselves. Therefore, their correct skill is very important in non- pharmacology and pharmacology pain management methods.ObjectiveTo assess non-pharmacological pain management practice and barriers among nurses working in Debre Tabor Comprehensive Specialized Hospital, Ethiopia.MethodsData were collected using structured observational check list with interviewer administered questionnaires that measure nurses’ practice on non-pharmacological pain management. Data were entered using Epi Data version 3.1 and analyzed using SPSS (Stastical Package for Social Sciences) version 23. Bivariable and multivariable analysis were conducted to examine the association between independent and outcome variables.ResultsA total of 169 nurses participated in the study, with a response rate of 100%. Among the study participants 94 (55.6%) were females, and the mean age of nurses were 34.9(SD = 5.7) years. Only 44(26%) of nurses had good practice on non- pharmacology pain management methods. About 130(77.55%), 125(74.0%), and 123(72.8%) of nurses reported that inadequate cooperation of physicians, multiple responsibilities of nurses and insufficient number of nurses per patient ratio as barriers for practice of non -pharmacology pain management respectively.ConclusionMajority of nurses didn’t apply non-pharmacological pain management practices for their patients in pain and the overall practice level of nurses was very poor. The major identified obstacle factors for the poor practice of non–pharmacological pain management methods were nurses’ fatigue, inadequate cooperation of physicians, heavy workload, multiple responsibilities of nurses, and insufficient number of nurses per patient ratio and unfavorable attitude of nurse on non-pharmacology pain management. Even if nurses experiences different challenges, they shall use non‐pharmacological pain management methods complementary to pharmacological treatment of pain as they are low cost and safe. And also boosting nurse’s attitude towards the effect of non–pharmacological pain management methods is crucial.

Background Pain is highly prevalent among individuals with cancer. Consequently, adequate and equitable pain management are hallmarks of quality cancer care. Unfortunately, up to one-third of patients with cancer consider their pain symptoms poorly managed. Objective To characterize clinical and sociodemographic factors associated with opioid, non-opioid, and non-pharmacological pain management among individuals with a history of cancer. Methods We used the 2018 to 2020 full-year consolidated data files of the Medical Expenditure Panel Survey (MEPS), linked to the medical conditions, prescribed medicines, outpatient visits and office-based medical provider visits files. We estimated adjusted relative risk (aRR) of receipt of opioid, non-opioid, and non-pharmacological pain management (acupuncture, chiropractor, and massage/occupational/physical therapy), based on clinical (cancer site, comorbidities, depression status) and sociodemographic (race, sex, age, marital status, education, insurance, income, English speaking ability) factors, accounting for complex survey design in quasi-Poisson regression models. Results The study cohort was composed of 7,035 individuals with cancer, with 19.2% (0.65%; weighted proportions (standard error) receiving opioids, 51.09% (0.9%) receiving non-opioids, and 20.56% (0.75%) receiving non-pharmacological pain management. In our final models, compared to Other cancers, patients with bladder cancer were more likely to receive opioids (aRR 1.52; 95% CI 1.06, 2.17), while those with lung cancer were less likely to receive non-pharmacological pain management (aRR 0.46; 95% CI 0.25, 0.84). Also, depression was associated with increased risk of both opioid (aRR 1.26; 95% CI 1.09, 1.46) and non-opioid (aRR 1.26; 95% CI 1.18, 1.34), but not non-pharmacological pain management. There were no statistically significant differences in risk of opioid prescription between Black vs. White patients with cancer; however, Asian patients were significantly less likely to receive opioids (aRR 0.18; 95% CI 0.05, 0.67) as were patients who did not speak English well (aRR 0.22; 95% CI 0.11, 0.43). Female patients with cancer were significantly more likely to receive non-opioids (aRR 1.21; 95% CI 1.12, 2.31) and non-pharmacological pain management (aRR 1.49; 95% CI 1.27, 1.75) than males. Conclusions There are clinical and sociodemographic factors associated with opioid, non-opioid, and non-pharmacological pain management among individuals with cancer, and those who are depressed are at highest risk for opioid prescription, while those who cannot speak English well are less likely to receive opioids. For equitable pain care in patients with cancer, it is important that barriers associated with pain management are eliminated. Citation Format: Oyomoare L. Osazuwa-Peters, Justin M. Barnes, Eric Adjei Boakye, Trinitia Y. Cannon, Tammara L. Watts, Tomi Akinyemiju, Nosayaba Osazuwa-Peters. Opioid, non-opioid, and non-pharmacological pain management in patients with a history of cancer. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 4360.

Aim of the study: Pain management is a multidisciplinary approach for easing suffering and improving the patients’ quality of life and nurses play a significant role in providing pain assessment and treatment. Non-pharmacological pain management is any intervention intended to improve health or well-being that does not involve the use of any drugs or medicine. This study aimed to assess the nurses’ knowledge and their barriers regard-ing non-pharmacologic pain management. Methods: A descriptive cross-sectional study was carried out at Hawler, Rizgary and Nanakaly teaching hospitals in medical and oncology wards on a non-probability purposive sample of 100 nurses who worked in the above wards. The data was collected from the end of December to the end of February 2020 through self-reports by nurses using a constructive single choice questionnaire. Each correctly answered item was recorded as 1 and the incorrect one as 0. Results: The higher percentages of nurses, including males aged between (30-39) years, institute graduates, and experienced in jobs between (1-10) years. 69% of nurses have a moderate level of non-pharmacologic pain management, and, 47% of nurses have not applied non-pharmacological pain management in hospitals. Only 16% of them applied, and 37% sometimes applied, psychological and physical methods of non-pharmacologic pain management were more applied by 29% and 23% respectively by nurses than other methods. Nurses had many barriers to using non-pharmacological pain management, like nursing workload and lack of protocol for pain management. Conclusion: This study concluded that the majority of nurses have a fair (moderate) level of knowledge about non-pharmacological pain management and applied by only 16 % of nurses. Nurses have many barriers to using non-pharmacological pain management.

Student Nurses' Knowledge, Attitudes, and Self-Efficacy of Children's Pain Management: Evaluation of an Education Program in Taiwan

Despite advances in pain assessment and management, pediatric pain remains undertreated, posing a significant challenge including mortalities. This hinders effective pain management for children, often due to difficulties in pediatric pain assessment by nurses. This study explores pain management practices among pediatric nurses at Korle-Bu Teaching Hospital, Accra. A qualitative descriptive design was used in this study to select 21 practicing nurses using purposive sampling. A semi-structured interview guide was used to collect data via face-face interviews, and data were analysed using inductive content analysis. Four major themes and 8 subthemes emerged from the findings. Pediatric pain assessment was primarily guided by the experience of care providers rather than routine practices, with children themselves serving as the main indicators of pain rather than relying on parents. Despite various barriers, health care providers prioritized pediatric pain management by integrating compassion, flexibility, and cultural sensitivity into their approach. Pediatric nurses were attentive and provided prompt pain relief but faced challenges with pain assessment and medication administration, particularly with suppositories. Implementing standardized protocols for pain management and providing resources to support nurses in overcoming these challenges can improve the quality of care provided to paediatric patients.

The purpose of this study was to develop expert-based guidelines for a medical student curriculum on chronic pain evaluation and management in older adults. A modified Delphi approach was used to survey an interdisciplinary panel (N = 12) with expertise in pain assessment, pharmacological and nonpharmacological pain management, and medical student education. A list of core knowledge/attitudes/skills (KAS) competency items was developed based upon a comprehensive literature review and clinical experience. The expert panel was then asked to consider the degree to which each item should be included in a pain education curriculum, using a 5-point Likert scale (1 = strongly disagree and 5 = strongly agree with inclusion of item). Items with a mean>4.0 (agree) and a standard deviation (SD) <1 were retained, while others were discarded. Retained items were refined, and new items were added based upon panel suggestions. The new KAS list was again scored by the expert panel, and items with a mean <4.0 and SD <1 were discarded. The original KAS list contained eight pain assessment knowledge, seven pain management knowledge, 12 pain attitudes, and 14 skills/abilities items. The final list, presented in this paper, consisted of 11 pain assessment knowledge, seven pain management knowledge, 12 pain attitudes, and 12 skills/abilities items. We have developed curriculum content guidelines for educating medical students about the evaluation and management of chronic pain in older adults. Once curricula are developed, their efficacy, in particular their influence on patient outcomes, must be evaluated.

Normal post partum is post partum discomfort due to uterine involution. Uterine involution in patients can cause pain in the uterus called afterpains. Discomfort caused by uterine involution requires various treatments to minimize the pain felt by the mother so that the mother's comfort can return. This can be overcome with non-pharmacological pain management strategies through innovative near infrared phototherapy or near infrared photobiomodulation (PBM NIR). The aim of this research is to analyze the results of implementing pain management with non-pharmacological PBM NIR therapy in normal post-partum mothers with post-partum discomfort nursing problems. Case study that focuses on the implementation of non-pharmacological nursing pain management techniques with PBM NIR therapy. The case study subjects were 3 normal post-partum maternal patients with the same problem, namely post-partum discomfort in the obstetrics room at the Muhammadiyah Hospital in Palembang. The results of the study showed that the implementation of non-pharmacological pain management techniques with PBM NIR therapy had an effective effect on dealing with post-partum discomfort with complaints of decreased discomfort, decreased moaning, and strong uterine contractions. Implementation of pain management can improve the comfort status of normal postpartum mothers. This study makes an important contribution to understanding of the role of nonpharmacological techniques in postpartum pain management, as well as highlighting the importance of implementing innovative therapies for labor, as well as highlighting the importance of implementing innovative therapies to improve the quality of care in postpartum mothers.

Pediatric chronic pain has extensive and frequently sustained detrimental effects on the health, development and quality of life of young people, with an attendant adverse impact on all those invested in their well-being. It has long been appreciated that the optimal management of pediatric chronic pain addresses its equally important biological, psychological, and social components. Nevertheless, despite significant advances in its management, pediatric chronic pain remains underdiagnosed, undertreated, and misunderstood. This discrepancy is largely due to the complexity and diversity of pediatric chronic pain and resulting clinical disconnect between its biomedical and psychosocial elements. This discussion will first present two theoretical models whose tenets and constructs form the basis and justification for a biopsychosocial approach to the management of pediatric chronic pain. The utility and perhaps the necessity of incorporating pediatric health-related quality as a multidimensional clinical measure will in turn be examined. Published biopsychosocial data on the types of pediatric patients who are typically referred to a pediatric pain medicine clinic will then be reviewed. Qualitative survey data on the pediatric chronic pain experience and its attendant personal narrative will also be reviewed in further support of its biopsychosocial nature. Finally, against the backdrop of the overall goal of multidisciplinary pediatric pain management, a brief synopsis of currently available evidence-based best practices, including biomedical and psychosocial modalities, will be provided. Potential areas for future research will lastly be highlighted.