Pain Management Education Research Articles

Teaching pain management to health professional students: A systematic review and meta-analysis.

Satisfactory pain management can have a significant impact on clients' activities of daily living. We questioned what types of pain management education might improve health professional students' knowledge, skills and perceptions? From inception until 30th July 2020, we searched MEDLINE, EBM Reviews, CINAHL Plus, ERIC, EMBASE, Cochrane database and Monash University library. Inclusion criteria were controlled trials of health professional students' pain education compared to alternative education, usual curriculum or no intervention. Studies were limited to English. Data were synthesised using meta-analysis. Fourteen articles were included in this review. For continuous data, meta-analysis demonstrated a clear effect favouring the intervention for knowledge SMD 1.47 [95% CI 1.18, 1.77], skills 0.93 [0.58, 1.28] or perceptions 0.69 [0.31, 1.08]. For dichotomous data, results showed no effect for knowledge 4.21 [0.65, 27.41], skills 2.26 [0.47, 11.01] or perceptions 1.96 [0.66, 5.76]. However, the overall result showed an effect 2.82 [1.20, 6.59] favouring the intervention. In summary, short theoretical interventions are sufficient to change students' knowledge and perceptions. Longer interventions incorporating interactivity improve skills. Further research is required to indicate the best method, outcome measure, length of intervention and follow-up in delivering these pain courses and assessing the cost and long-term retention of information.

Effect of a Multimodal Analgesic Protocol on Short-Term and Long-Term Opioid Use After Orthopaedic Trauma

To determine whether the use of a multimodal analgesic protocol reduced short-term and long-term opioid use in patients hospitalized after orthopaedic trauma. Retrospective pre-post intervention study. Regional, academic, Level 1 trauma center in Central Kentucky. Patients were hospitalized after orthopaedic injury before (n = 393) and after (n = 378) the implementation of a multimodal analgesic protocol. The intervention involved a multimodal analgesic protocol consisting of acetaminophen, ibuprofen/ketorolac, gabapentinoids, skeletal muscle relaxants, and standardized doses of opioids plus standardized pain management education before hospital discharge. End points included discharge opioid prescription, days' supply and daily morphine milligram equivalent (MME), and long-term opioid use after hospitalization. Opioid use in the 90 days before and after hospitalization was assessed using state prescription drug monitoring program data. Discharge opioid prescription rates were similar in the intervention and control cohorts [79.9% vs. 78.4%, odds ratio (OR) 1.30 (0.83-2.03), P = 0.256]. Patients in the intervention cohort received a shorter days' supply [5.7 ± 4.1 days vs. 8.1 ± 6.2 days, rate ratio 0.70 (0.65-0.76), P < 0.001] and lower average daily MME [34.8 ± 24.9 MME vs. 51.5 ± 44.0 MME, rate ratio 0.68 (0.62-0.75), P < 0.001]. The incidence of long-term opioid use was also significantly lower in the intervention cohort [7.7% vs. 12.0%, OR 0.53 (0.28-0.98), P = 0.044]. Implementation of a multimodal analgesic protocol was associated with reductions in both short-term and long-term opioid use, including long-term opioid therapy, after orthopaedic trauma. Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Preoperative Opioid Prescription is a Risk Factor for Extended Opioid Filling After Ankle Arthroscopy

Category:Arthroscopy; Ankle; Sports; OtherIntroduction/Purpose:Opioids can be an important tool in the management of postoperative pain, however, increased prescribing of these medications following orthopaedic procedures has significantly contributed to the current opioid crisis. Post- operative opioid utilization and duration varies greatly among surgeons, procedures, and patients. We sought to investigate patterns of opioid prescription following ankle arthroscopy and determine patient factors associated with increased postoperative opioid prescribing.Methods:A national claims-based database was queried for patients undergoing first-time ankle arthroscopy. Only patients with continuous database inclusion for at least one year prior to and one year after index ankle arthroscopy were included. Patients carrying an International Classification of Diseases (ICD)-9 or ICD-10 code(s) for diagnosis of septic ankle joint or a CPT code for total ankle arthroplasty prior to index ankle arthroscopy were excluded from the study. Patients who filled at least 1 opioid prescription between 1 and 4 months prior to surgery were defined as preoperative opioid-use group. Monthly relative risk ratios for filling an opioid prescription were calculated for the first year after surgery. Multiple logistic regression analysis was performed to identify factors associated with opioid prescription refills at 3, 6, 9, and 12 months after ankle arthroscopy. For analysis, P<0.05 was defined as significant.Results:We identified 6,039 patients who underwent primary ankle arthroscopy. The preoperative opioid-use group consisted of 1,514 patients (25.1%), of which 24 (1.6%) filled opioid prescriptions at 6 months postoperatively compared to 39 (0.9%) of opioid-naive patients (relative risk [RR], 1.84 95% confidence interval [CI], 1.11-3.05). Multivariate analysis determined that the preoperative opioid-use group was at increased risk of filling prescriptions at 3 (odds ratio [OR], 2.22; 95% CI 1.42-3.48) and 6 months (OR, 1.74; 95% CI, 1.01-2.95) postoperatively. Patients with Body Mass Index (BMI) > 30 were also at increased risk at 3 months (OR, 1.65; 95% CI, 1.04-2.62) and 6 months (OR, 2.01; 95% CI, 1.17-3.49) postoperatively. Comorbidities such as diabetes, hypertension, fibromyalgia, alcohol, and tobacco abuse were not associated with opioid filling (P>0.05).Conclusion:Preoperative opioid prescription filling and BMI 30 were associated with an increased risk of extended opioid prescription utilization following ankle arthroscopy. Overall, prolonged opioid prescribing was not widespread in either group postoperatively. This may represent the indications and outcomes of ankle arthroscopy. Patients presenting with preoperative opioid-use and increased BMI may benefit from multimodal pain management and additional perioperative education around non- pharmacologic pain-management strategies to decrease risk of prolonged opioid use.

Pengaruh Edukasi Managemen Nyeri Non-Farmakologi Desminore terhadap Pengetahuan Remaja Putri di SMP Nurul Jadid

Menstruation can cause disturbances that can be related to changes in the length of the menstrual cycle, the amount of blood that comes out during menstruation, and other menstrual disorders. The most common disorder is dysmenorrhea. Health education is needed to provide information that can affect the knowledge of young women so that adolescents who experience dysmenorrhea can handle it well. The purpose of this study was to determine the effect of Non-Pharmacological Pain Management Education on Dysmenorrhea on Adolescent Girls' Knowledge at Junior high school Nurul Jadid. This research design uses a Quasy-Experimental approach with a Prettest-Posttest research design with a control group. Data were collected using a questionnaire with a total sample of 30 in the intervention group and 30 in the control group using a total sampling technique. The results of the Wilcoxon analysis of students' knowledge levels showed that there was a significant difference between the prettest and posttest in the intervention group (p= Sig 0.000), the results of the Wilcoxon analysis showed no significant difference in the level of knowledge of students in the control group (p=1,000). The Mann-Whitney analysis showed that there was a significant difference in the posttest student knowledge level between the two groups with a p-value of 0.001 (&lt;0.05). Conclusion: Non-pharmacological pain management education for dysmenorrhea has an effect on increasing knowledge in adolescent girls at Mts Nurul Jadid. The results of the study are expected to provide input in the development of health promotion, especially reproductive health education for female adolescents.

Therapeutic Education and Physiotherapy in Low Back Pain Management

BACKGROUND: Low-back pain (LBP) is one of the most common musculoskeletal problems; it is the leading cause of disability worldwide. Therapeutic patient education is a method that enables health care professionals to pass on their knowledge and experience to patients so that they can participate consciously and actively in their recovery. AIM: The present study aims to examine the effect of therapeutic education (TE) combined with a specific physiotherapy (PT) approach in people with LBP. МАTERIALS AND METHODS: This was an experimental pre- and post-study design. The study involved 25 patients, mean age 43.08 ± 12 years, divided into two groups: experimental group (EG), with TE (n =18) and control group (CG), without TE (n = 7). The PT treatment frequency and duration were consistent between groups. The patients were monitored for one month, and the intervention under supervision – face-to-face and self-monitored home-based PT have been organized. The included outcome measures were Oswestry Disability Index, Tampa Scale for Kinesiophobia, STarT Back Screening Tools, and the movement-induced pain in the lumbar spine. RESULTS: At the end of the study improved pain-free movements in the lumbar region, functionality, reduced catastrophizing was observed in both groups. There is a tendency for better results in the EG compared to the CG in terms of functionality and pain-free movement. The subjective feeling of the catastrophizing was reduced only in the EG below the cut-off score from 45.2 ± 7.7 to 33.2 ± 3.3 points. CONCLUSION: TE in combination with PT interventions improves functional abilities, decreases the pain during movements, and the subjective perception of kinesiophobia. The results suggest TE should be included in a LBP management approach.

Biopsychosocial Factors Predicting Pain Among Individuals Experiencing the Novel Coronavirus Disease (COVID-19)

BackgroundPain is one of the most common symptoms of novel coronavirus disease (COVID-19). Being both a physical and a psychological experience, pain is affected by many factors, including biological, psychological, and social rather than a single variable. AimsTo determine the effects of biological, psychological, and social factors on pain level among participants experiencing with the COVID-19. DesignA web-based, retrospective, and descriptive study SettingSocial media sources such as Facebook, WhatsApp, Instagram, and E-mail ParticipantsOne hundred forty-nine participants were included. MethodsData were collected based on the biopsychosocial model. Pain level was evaluated using the visual analog scale (VAS). The data were analyzed using descriptive, correlational statistics, and structural equation modeling. ResultsThe mean age of participants was 32.87 (SD = 11.32) years. The VAS scores were associated with gender (Z = -2.103, p = .035), and chronic disease status (Z = 3.001, p = .003), and the Chalder Fatigue Scale total score (β = 0.718, p < .001) associated with biological factors. The Coronavirus Anxiety Scale scores among psychological factors showed a direct impact on the VAS scores (β = 0.583, p < .001). The Patterns of Activity Measure-Pain total score examined within social factors directly affected the VAS score. The VAS score did not correlate with age, smoking status, hospitalization status, respiratory support, marital status, education level, employment, and income status. ConclusionsThe pain level in COVID-19 participants was determined by biological, psychological, and social factors. Females and participants with chronic illness, anxiety, fatigue, and low physical activity were found to experience high levels of pain. Education and counseling programs for pain management should be comprehensively structured and include anxiety reduction programs, and fatigue management.

Development of a national pain management competency profile to guide entry-level physiotherapy education in Canada

ABSTRACT Background National strategies from North America call for substantive improvements in entry-level pain management education to help reduce the burden of chronic pain. Past work has generated a valuable set of interprofessional pain management competencies to guide the education of future health professionals. However, there has been very limited work that has explored the development of such competencies for individual professions in different regions. Developing profession-specific competencies tailored to the local context is a necessary first step to integrate them within local regulatory systems. Our group is working toward this goal within the context of entry-level physiotherapy (PT) programs across Canada. Aims This study aimed to create a consensus-based competency profile for pain management, specific to the Canadian PT context. Methods A modified Delphi design was used to achieve consensus across Canadian university-based and clinical pain educators. Results Representatives from 14 entry-level PT programs (93% of Canadian programs) and six clinical educators were recruited. After two rounds, a total of 15 competencies reached the predetermined endorsement threshold (75%). Most participants (85%) reported being “very satisfied” with the process. Conclusions This process achieved consensus on a novel pain management competency profile specific to the Canadian PT context. The resulting profile delineates the necessary abilities required by physiotherapists to manage pain upon entry to practice. Participants were very satisfied with the process. This study also contributes to the emerging literature on integrated research in pain management by profiling research methodology that can be used to inform related work in other health professions and regions.

A qualitative understanding of nurses’ challenges with pain management

BackgroundStudies have shown that providers deliver inadequate pain management, which is important since ineffective pain management can lead to patient safety concerns and negative health outcomes. There is a gap in the literature understanding the specific details of nurses’ struggles treating patients who need help with pain management. MethodsThis qualitative descriptive study assessed nurses’ challenges with pain management to provide a comprehensive, low-inference summary of the data. Participants were interviewed about their biggest challenges. FindingsThree main themes emerged from the data: prescribing patterns, education on zero pain, and system problems. Major challenges identified in this study were understanding nurses’ perceptions of pain management care delivery and the need for quality pain management education. DiscussionThe health community needs to raise awareness and provide more comprehensive education regarding the nurse’ role in pain management.

Nurse and Provider Pain Management Education Priorities and Barriers

BackgroundThe purpose of this research was to describe health care nurse and providers’ pain management education priorities and barriers for pediatric cardio-thoracic surgical (CTS) patients and their caregivers. DesignThis was a qualitative-descriptive study design using survey methodology. MethodsA convenience sample of 206 (CTS) health care professionals including 172 nurses, 11 advanced practice providers, and 23 physicians were invited to participate in this study. The survey was distributed through a work e-mail within a 145-bed tertiary pediatric hospital and focused on collaborative pain management educational priorities and barriers. ResultsOf the 206 cardio-thoracic service health care nurses/providers surveyed, 45.6 % (N = 94) responded to the survey. The top pain management education priority for these nurses/providers included immediate postoperative pain management knowledge for the caregiver and pediatric CTS patient. The lowest priority 13.8% (N = 13) included education related to pain management needs after discharge. Of the 94 nurses/providers who responded, 31.9% (n = 30) identified the presence of timing and communication barriers in providing pain management education with caregivers and pediatric CTS patients. AimsThe aim of this research was to describe health care providers pain management education priorities and barriers for cardio-thoracic surgical (CTS) pediatric patients and their caregivers. Setting145-bed tertiary pediatric hospital. Participants/SubjectsNurses, advanced practice providers [APP's], and physicians. ConclusionsNurses and providers prioritize immediate postoperative pain management education; however, there remains a need to focus more on the outcomes of pain management education for caregivers and pediatric CTS patients after discharge.

A Nonrandomized Pretest Posttest Study on the Impact of an Educational Pain Management Program on Nurses’ Knowledge and Attitudes Regarding Pain in a Middle Eastern Country

BackgroundAlthough nurse's knowledge and attitudes regarding pain management has been sufficiently studied worldwide, the impact of an educational intervention program in improving such attitudes and knowledge has not been likewise researched, especially in Middle Eastern countries. AimsTo examine nurses’ knowledge and attitudes regarding pain at a university hospital in Lebanon before and after the introduction of a pain management educational program. And to assess the relationship between the characteristic of nurses and their pain knowledge. MethodsDesign; A nonrandomized pretest posttest study design was used. Setting; A university hospital in Lebanon. Participants; Included 183 nurses using the Nurses' Knowledge and Attitudes Survey Regarding Pain questionnaire. The pain educational intervention was based on the principles of Ajzen's theory of planned behavior. ResultsA significant difference between the pre and post test scores was noted (p = .016). Questions answered correctly by 80% of participants were related to questions about pain, pain assessment and management, and questions related to medications, such as correct dosages and opioid side effects were not answered correctly by the majority of nurses. There were significant associations between test scores and the nurses’ educational level, their age, and their years of experience. Nurses who worked in critical care units, the emergency department and oncology had higher scores than nurses who worked on general units. ConclusionsDespite the intensive pain education provided at our institution, the pain knowledge of nurses remains below that recommended level which indicates a dire need for more intensive and continuous education in order to provide a pain free environment.

The Effect of Standardized Perioperative Patient Education on Opioid Use After Minor Soft Tissue Procedures Distal to the Wrist

Several studies have explored opioid consumption and opioid prescriber education for upper extremity procedures; however, less literature has focused on patient-centered interventions and their impact on opioid consumption after surgery. The purpose of this study was to create a standardized perioperative patient education program regarding postoperative pain management after hand surgery and to determine if it could reduce opioid use after hand surgery. Patients scheduled to undergo elective outpatient hand surgery comprising minor soft tissue procedures at and distal to the wrist were randomized to receive pain management education or standard care. Before the surgery, all patients viewed a webinar with instructions for participation, whereas the education group received an additional 10 minutes of education on postoperative pain management and a pain management reference card for review after the surgery. All patients completed a postoperative daily log documenting the number of opioids consumed, other pain management modalities used, and pain scores. The primary outcome of the number of opioid pills consumed by the patients was compared between the groups. We constructed a linear regression model to determine the risk factors for postoperative opioid use after surgery. One hundred seventy-four patients completed the study (n= 90 education group; n= 84 standard care group). Patients in the education group took significantly fewer opioid pills (median= 0, range 0-13) than those in the standard care group (median= 0.5, range 0-40). A linear regression model showed that average week-1 pain (B= 0.93; 95% confidence interval, 0.56-1.3) and the number of pills prescribed (B= 0.12; 95% confidence interval, 0.017-0.22) were predictive of greater opioid use. Perioperative patient education significantly reduced postoperative opioid use following a minor soft tissue hand surgery, with greater than 70% of the patients taking no opioids. Prognostic II.

Gender differences in perceived pain and health-related quality of life in people with chronic non-malignant pain: a cross-sectional study

Background Chronic pain has a disproportionate impact on members of vulnerable population groups, and women are at substantially greater risk than men of suffering multiple chronic pain disorders. Moreover, one of the aspects most affected by the presence of chronic pain is that of health-related quality of life (HRQoL), worsening over time, as the disease persists. Objectives To describe the profile of patients who suffer non-malignant chronic pain, from a gender perspective, and to identify factors related to their HRQoL and mental health. Design A cross-sectional study was carried out in patients with chronic non-cancer pain. Methods Sociodemographic variables, pain intensity at rest and in motion, SF-36 health questionnaire, anxiety, and depression were evaluated. Results The study population consisted of 531 subjects, of whom 64.2% were women. The mean age was 52.9 (SD: 10.4) years. The pain intensity recorded on the visual analogue scale was 6 (SD: 2.7) at rest and 8 (SD: 2) in motion. Physical component score and mental component score of quality of life were worse in women vs men: 33.73 (6.77) vs 32.33 (6.20), for the physical component; 36.89 (12.77) vs 32.91 (11.51), for mental component. Anxiety, depression and pain intensity, showed poorer results in women. Conclusion Gender is a factor that should be considered in assessing and managing chronic pain, due to its influence on the perception of pain, and HRQoL. Impact statement Gender is an important modifier of the perception of pain, and HRQoL. To achieve a patient-centred approach, nurses should incorporate gender as a differential factor to adapt and individualize pain management and patient education.

Effects of self-management education programmes on self-efficacy for osteoarthritis of the knee: a systematic review of randomised controlled trials

BackgroundEnhancing self-efficacy to manage symptoms and functions is an important aspect of self-management for patients with knee osteoarthritis (OA). Many reports have investigated the effects of self-management education programmes for arthritis patients. However, a study that exclusively focuses on patients with OA in the same joints is required to clarify the effects of self-management programmes because individuals with knee OA experience physical and psychological difficulties different from those experienced by individuals with other arthritis diseases. Furthermore, previous studies have reported a wide range of delivery styles of self-management education programmes. This systematic review aimed to evaluate the effects of group-based and face-to-face self-management education programmes conducted by health professionals targeting self-efficacy for knee OA exclusively.MethodsThe MEDLINE, CENTRAL, EMBASE, CINAHL, Web of Science, and PEDro databases were searched to identify quantitative measures used in randomised controlled trials (RCTs) to assess the effects of self-management education programmes targeting self-efficacy in patients with knee OA. We included studies in which medical professional-delivered self-management education programmes were conducted in a group-based and face-to-face manner in community or outpatient settings.ResultsSeven RCTs from five countries were included in this review. Our retrieved studies included various types of self-management education programmes such as cognitive behavioural counselling, pain management education, physical education, weight management education, and arthritis self-efficacy management education, and control arms. They assessed various aspects of self-efficacy, including pain, physical function, arthritis symptoms excluding pain, weight management, mobility, and self-regulation. The total score of the Arthritis Self-Efficacy Scale was also measured. Some studies have reported beneficial effects of group-based and face-to-face self-management education programmes on self-efficacy for management of pain and other symptoms and for self-regulatory, knee OA. However, the results of the included studies were varied and inconsistent.ConclusionsThe current review only included seven studies, and there was a wide range of clinical heterogeneity among these studies. Thus, the effects of group-based and face-to-face self-management education programmes conducted by health professionals on self-efficacy for knee OA exclusively are inconclusive to date. Therefore, high-quality studies are required to provide significant information on clinicians, patients, and healthcare professionals in the future.

Integrative pediatric pain management: Impact & implications of a novel interdisciplinary curriculum

ObjectivesObjectives of this paper are to: 1) Describe a novel interdisciplinary, integrative pain curriculum for pediatric residents. 2) Describe changes in residents’ understanding of pain epidemiology, physiology, and management; application of the biopsychosocial model in pain management; and understanding and application of non-pharmacologic approaches to pain management. Design, settingThis study was done in a pediatric residency program within an urban pediatric teaching hospital. It employed both anonymous, Likert-scale surveys administered via Qualtrics, as well as open-ended, free response questions. InterventionsWe provided a multidisciplinary pain education curriculum to pediatric residents with a focus on pain neuroscience, a history of pain management, the biopsychosocial model of care, and exposure to non-pharmacologic interventions to pain management over six hours of instruction conducted in two blocks of three hours each. Outcome measuresSelf-identified changes via survey measuring resident physician knowledge, comfort, approach, and management of pediatric pain through an interdisciplinary pain curriculum. ResultsPrior to this training, many residents were not confident in their understanding of pain neuroscience, the biopsychosocial model of care, and non-pharmacologic interventions. At completion of training, residents indicated positive changes in knowledge of, and comfort with, all of the domains taught. Ninety percent of residents indicated that the curriculum changed the way they conceptualized, approached, and/or managed pain, and reported thinking more holistically about pain management. Nearly all residents indicated they would like to have more training (98 %, N = 57) in integrative modalities. ConclusionsPediatric resident physicians are receptive to training in an interdisciplinary, integrative, pediatric pain management education intervention, and subsequently show positive changes in knowledge and comfort levels. There is a need and desire for additional pain education in resident training programs.

Evaluation of a multimodal analgesic regimen on outcomes following laparoscopic living donor nephrectomy.

Postoperative pain is a significant source of morbidity in patients undergoing living donor nephrectomy (LDN) and a deterrent for candidates. We implemented a standardized multimodal analgesic regimen, which consists of pharmacist-led pre-procedure pain management education, a combination transversus abdominis plane and rectus sheath block performed by the regional anesthesia team, scheduled acetaminophen and gabapentin, and as-needed opioids. This single-center retrospective study evaluated outcomes between patients undergoing LDN who received a multimodal analgesic regimen and a historical cohort. The multimodal cohort had a significantly shorter length of stay (LOS) (days, mean±SD: 1.8±0.7 vs. 2.6±0.8; p<.001) and a greater proportion who were discharged on postoperative day (POD) 1 (38.6% vs. 1.5%; p<.001). The total morphine milligram equivalents (MME) that patients received during hospitalization were significantly less in the multimodal cohort on POD 0-2. The outpatient MME prescribed through POD 60 was also significantly less in the multimodal cohort (median [IQR]; 180 [150-188] vs. 225 [150-300]; p<.001). The mean patient-reported pain score (PRPS) was significantly lower in the multimodal cohort on POD 0-2. The maximum PRPS was significantly lower on POD 0 (mean±SD: 7±2 vs. 8±1, respectively; p=.02). This study suggests that our multimodal regimen significantly reduces LOS, PRPS, and opioid requirements and has the potential to improve the donation experience.

Facilitation of nursing students' competency acquisition for paediatric pain management in low- and middle-income countries: a scoping review

Objective: To elucidate evidence regarding nurse educators' and preceptors' capacity to facilitate students' learning about paediatric pain management (PPM) in low- and middle-income countries(LMICs).Methods: The five-stage framework by Arksey and O'Malley guided this review. Studies published in English between January 2010 and April 2020 were searched using EBSCO Host/ ScienceDirect, CINAHL, MEDLINE, PUBMED and Scopus. Of 300 papers identified through the search strategy 27 primary research articles were retained: quantitative (n=18), qualitative (n=8) and mixed-methods (n=1).Results: Knowledge deficiency and inappropriate attitudes toward PPM, lack of autonomy in decisionmaking, scarcity of resources and cultural misconception regarding pain in children were hindering the effective PPM in LMICs. Strategies including nursing curricula review, continuous in-service training, access to resources and the leadership support are required to optimise effective PPM and improve students' facilitation for learning about PPM.Conclusion: Further research is required as a body of evidence to support the development of a framework for capacity enhancement of nurse educators and nurse preceptors who facilitate nursing students acquiring competency for PPM in LMICs.&#x0D; Keywords: Pain management education, Children, Scoping review, Low- and middle- income countries

Prevalence and Impact of Dysmenorrhea Among University Students in Ireland.

ObjectivePrimary dysmenorrhea (PD), or painful menstruation, is a common gynecological condition that can cause intense pain and functional disability in women of reproductive age. As a nonmalignant condition, PD is relatively understudied and poorly managed. The purpose of this study was to estimate the prevalence and impact of PD among third-level students in Ireland.DesignA cross-sectional observational design was used.MethodsStudents (n = 892; age range = 18–45 years) completed an online survey on menstrual pain characteristics, pain management strategies, pain interference, and pain catastrophizing.ResultsThe prevalence of PD was 91.5% (95% confidence interval = 89.67–93.33). Nonpharmacological management strategies were most popular (95.1%); of these, heat application (79%), rest (60.4%), hot shower/bath (40.9%), and exercise (25.7%) were most common. Perceived effectiveness of these methods varied between participants. Analgesic use was also common (79.5%); of these, paracetamol was most used (60.5%) despite limited perceived effectiveness. Pain catastrophizing was a significant predictor of variance in both pain intensity and pain interference scores such that those with higher pain catastrophizing scores reported more intense pain and greater interference with daily activities and academic demands.ConclusionsThis article presents the first investigation into PD among third-level students in Ireland. Poorly managed menstrual pain may impact functional ability across several domains. Future research should focus on improving menstrual pain management education and support and promoting menstrual health literacy for women affected by PD.

Pain Management Education Initiative: Creating S.T.A.R.S. (Specialized Treatment Approach Requires a Skill-set)

Effective pain management is a key component of patient care on a surgical unit. It was identified that there was an opportunity to improve nurse adherence and compliance with clinical practice guidelines and best practice in pain management. A pain education program was created by a pain certified nurse and nurse educator. Outcomes showed a positive trend in nurse confidence, knowledge, documentation compliance, and nurse-driven non-pharmacological interventions; pain HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) scores improved. The EBP (evidence-based practice) process was implemented to identify best pain management practices for clinical nurses. Problem identification, literature search, critical appraisal and synthesis of relevant sources were completed. A gap analysis was conducted using an online survey to assess nurses' knowledge and confidence with pain management assessments, opioid administration, and non-pharmacological interventions. Based on learning needs identified, an educational program was designed and implemented. Post implementation, audits were completed monthly to trace nurses' knowledge, confidence, documentation, and use of non-pharmacological interventions, and HCAHPS scores. Post implementation improvement consecutively for three months showed the nurse-driven non-pharmacological interventions (9% to 55%), pain assessments (33% to 52%), and use of pain management in nursing care plans (45% to 52%). HCAHPS scores (“staff discussion regarding pain”) improved from 70.5 to 72.1%, 95 to 96 percentiles. Enhanced nurses' pain management education showed marked improvement in pain management strategies and patient outcomes. This EBP initiative opened the door for a future role of a Pain Management Nurse Scholar facility wide resource to maintain outcomes and relevant ongoing education initiatives in pain management.

C4. Filling the Gap in Pain Management Education for Palliative Patients and Caregivers

C4. Filling the Gap in Pain Management Education for Palliative Patients and Caregivers

Burn patients’ pain experiences and perceptions

IntroductionBurns are painful injuries associated with a long recovery. Patients may not be receiving sufficient pain management education to optimize their experience and recovery after burn injury. Therefore, we aimed to obtain patients’ perspectives about the effectiveness of current burn pain education to inform future efforts. MethodsWe used a mixed-methods research design that included both inpatients and outpatients cared for at a single, American Burn Association-verified burn center. Participants were at least 14 years of age with an acute burn who received a minimum of two wound interventions. The interview was designed by clinician stakeholders using a modified Delphi technique and focused on patient respondent's pain experience, understanding and desire to gain knowledge concerning burn pain and its management. Descriptive quantitative analysis was performed on categorical data. Recorded interview segments were transcribed for content analysis. ResultsTwenty-one adult burn patients were interviewed. Participants reported experiencing variable levels of pain and pain management effectiveness. Inpatients reported more severe pain than outpatients. Only 11% of inpatients reported having received enough pain information, compared to 50% of outpatients. Content analysis yielded 3 themes: patient’s pain experience, range of expectations, and clinical information/services desired. Mental and physical effects were key factors in respondents' pain experiences, with many participants reporting mental anguish in addition to pain. Of participants who had pain expectations, most were matched by their experience (56%), although many individuals (44%) described higher pain levels than they anticipated. Positive experiences with the burn care team primarily revolved around receiving pain education from a provider, whereas negative experiences focused on wound care events. Participants desired more information on sleep and pain medications, alternative treatments, weaning and addiction risk, realistic expectations of recovery timelines, and available mental health services. Written (pamphlet) education ranked as the most desirable delivery method, followed by in-person and video education. ConclusionsBurn patients reported variable pain experiences and a strong desire to receive additional pain education. This project informs key strategies to educate burn patients on pain: leverage the high-level of interest in pain to foster education, describe pharmacologic and alternative therapies, offer weaning plans and explanation of addiction risks. Applicability to practiceBurn patients’ perspectives help inform strategies and content creation for pain-related education materials that burn centers can provide to improve patients’ experiences. External FundingProject was supported in part by the NIH grant for Insight Student Research Program at the Harborview Injury Prevention and Research Center (R25 HD094336).