Professionals Encounter Research Articles

Moral challenges and understanding of clinical ethics in Tanzanian hospitals: Perspectives of healthcare professionals.

Healthcare professionals encounter many moral challenges in their daily clinical practice. However, there have been few studies on the subject matter in Tanzania. This study aims to provide an account of moral challenges faced by healthcare professionals in Tanzanian hospitals, their understanding of clinical ethics, and the ethics education they have received. Many participants reported receiving some kind of ethics training through formal education and on-the-job training. Some participants understood ethics in healthcare settings as adherence to established laws, regulations, guidelines, procedures, norms, and rules essential in clinical practice. Analysis of the data identified four themes of moral challenges. These challenges are related to 1) decision-making and communication in clinical practice, 2) scarcity of medical resources and prioritization in clinical practice, 3) withdrawal of curative treatment, and 4) conflicts between professional judgment, religious convictions and adherence to alternative treatments. Based on the findings, we suggest a context-sensitive form of clinical ethics training to prepare healthcare professionals to recognize and address these moral challenges.

Characteristics of patients with somatoform pain disorder

AbstractBackgroundPatients with somatoform pain experience physical pain that cannot be attributed to any underlying medical or physiological cause, and it is often thought to be related to psychological factors. Health professionals encounter difficulties identifying this specific type of chronic pain, leading to suboptimal treatment strategies. Therefore, we aimed to describe the characteristics of patients with somatoform pain, to support the identification of affected patients.MethodsWe collected and analyzed a cross‐sectional survey data from 200 patients with somatoform pain admitted to one of three psychosomatic centers in Germany between August 2013 and July 2014. The survey contains 10 different categories, all of them referring to pain‐related topics. Within the survey, we analyzed validated as well as non‐validated questionnaires. Here, we present the following five: Personal data, Body: Pain perception, Cognition: Pain processing, Pain behavior, and Physical complaints.ResultsOur results highlight that most patients with somatoform pain experience it in several body parts and as persisting, lasting >12 h/day (50%), and constantly changing (71%). Furthermore, patients indicate feelings of helplessness, by agreeing to the expressions the pain controls me (70%). Finally, we found that pain is predominantly seen as suffering, failing to convey emotional pain, despite cognitively acknowledging the dependency of emotional and physical pain.ConclusionThe study identified specific and distinctive characteristics in the emotional and behavioral responses of patients with somatoform pain, potentially distinguishing them from other patients with chronic pain.

On dementia, duties, and daughters. An ethical analysis of healthcare professionals being confronted with conflicts regarding filial duties in informal dementia care.

Existing literature on moral conflicts that healthcare professionals encounter in dementia care has explored, amongst others, issues related to autonomy, decision-making capacity, privacy, and more. Notably, conflicts related to healthcare professionals who support informal dementia caregiving and who are confronted with family members being overburdened with their care responsibly remains an underexplored topic in the current literature, particularly in the context of Low-and Middle-Income Countries. The present paper introduces such an encounter, presenting an ethical case analysis of a conflict that occurred during a larger research project conducted in North Macedonia. Due to the absence of formal care services that could have relieved an overburdened family caregiver, healthcare professionals felt compelled to reach out to the uninvolved adult daughters, requesting them to participate in their parents' care. Wondering about whether their reaching out to the daughters might count as an attempt of pressure and undue interference, professionals conflicted over the appropriateness of their action. This paper follows up on their concern, ethically assessing the professionals' action. To answer the question on whether the healthcare professionals acted appropriately or not, and to what extent, theories of filial duties are applied, embedding their action in the larger context of dementia care in North Macedonia. It is argued that the lack of formal care services in North Macedonia is of utmost relevance to the conflict. Thus, the conclusion is that the ethical inappropriateness of the case is to be located not so much with the action of the healthcare professionals but with the state because of its failure to provide professional care services that allow healthcare professionals to take ethically sound actions to counteract overarching burdens that family members face when providing informal dementia care.

Patient safety initiatives and practices in Nigerian healthcare settings: A comprehensive analysis of current knowledge, challenges, and barriers

The imperative of patient safety in healthcare takes a central stage, more so in the context of Nigeria. This review aims to provide a comprehensive understanding of the patient safety landscape in Nigeria, drawing on 12 empirical studies. This study aims to elucidate the multifarious challenges and barriers health-care professionals encounter in Nigeria concerning patient safety. Concurrently, it delves into the prevailing patient safety culture and the factors shaping it. This study used secondary data to conduct a systematic review of existing literature; 12 studies, spanning from 2015 to 2022, were meticulously examined. These explorations cover a broad spectrum of patient safety aspects in Nigeria, focusing particularly on the insights of nurses and doctors. Through the use of thematic analysis, the studies’ synthesis illuminates a significant gap between the envisioned safety protocols and their on-ground realization. Exacerbating this challenge is the acute lack of resources, which invariably hampers the quality of care. In addition, barriers to effective communication and inadequate reporting mechanisms emerge as significant obstacles. The deficiencies in consistent training and education are also prominent, which stand as potential vulnerabilities in the system. The palpable need for heightened awareness, emphasis on recurrent training initiatives, and strict adherence to established safety guidelines are amplifying these concerns. It was, thus, concluded that the healthcare trajectory in Nigeria, as informed by this review, underscores a pressing need for systemic interventions to elevate patient safety standards. Such a transformative journey demands the concerted efforts of all stakeholders, fostering an environment that prioritizes patient safety and enhances the overall trust in Nigeria’s healthcare system.

Vasoactive Intestinal Peptide-Producing Neuroblastic Tumors: A Rare Cause of Refractory Diarrhea.

Neuroblastic tumors are the most common malignant extracranial solid tumors of childhood. A small subgroup presents chronic incoercible diarrhea due to the tumor's production of vasoactive intestinal peptide (VIP). The hypothesis of an occult tumor is not always considered, which delays and impairs treatment. We aim to identify these patients' characteristics and help alert health professionals to the hypothesis of a neuroblastic tumor in children with chronic diarrhea refractory to the usual approach. We carried out an epidemiological study on all retrievable reports of neuroblastic tumors between 1975 and 2021 described in the Medical Literature Analysis and Retrieval System Online (MEDLINE), Excerpta Medica database (EMBASE), and Latin American & Caribbean Health Sciences Literature (LILACS) databases. Patient information was divided into categories, and we performed a descriptive analysis. We analyzed 96 cases; 83 (86.5%) cases had diarrhea prior to the diagnosis of the neoplasm, 49 (51%) were ganglioneuroblastomas, 69 (71.8%) were abdominal, and 59 of the 60 patients (98%) with reported acid-base disorders had hypokalemia. When serum VIP was reported, the majority of values varied between one and 20 times the upper reference limit. Seventy-two (75%) patients underwent complete tumor resection, and the overall survival rate was 70%. Serum VIP production by neuroblastic tumors is related to cell differentiation and better prognosis. Such children often require intensive hospital support to reverse the malnutrition and acid-base disorders related to this paraneoplastic syndrome. Its early diagnosis and treatment significantly change the prognosis and quality of life. We, therefore, suggest screening for neuroblastic tumors when health professionals encounter unmanageable chronic secretory diarrhea in children with no defined etiology in the usual investigations.

Exploration of Mental Health and Well-Being of Healthcare Professionals During the COVID-19 Pandemic.

In response to curbing the spread of SARS-CoV-2, healthcare professionals (HCPs) encounter a multitude of mental stresses. The primary intent was to explore the mental health and well-being experienced by HCPs in Ekiti State, Nigeria, amid the COVID-19 pandemic. Data were analyzed using inductive qualitative methodology. The study was undertaken among HCPs in two teaching hospitals in Ekiti State during the SARS-CoV-2 outbreak. Convenience sampling techniques were employed to select participants for this study. A comprehensive interview ranging from 30 to 50 minutes per participant was administered to a sample of 14 HCPs (doctors and nurses) representing various departments within the hospital. The interviews were conducted between March 2020 and May 2020. COVID-19 stressful situations, the physiological consequences of stress, personality, disposition, stress management techniques, and coping mechanisms were evaluated. The study outcomes indicate that a significant proportion of HCPs currently face mental well-being. The primary sources of stress identified in this study included heavy workloads and pressure from social media platforms and government agencies. The outbreak crisis significantly influenced on their lives and work, with the fear of catching diseases and their anxiety about spreading infections to their loved ones. HCPs require a secure working environment during the current circumstances, along with an enhanced support system to alleviate stressors. This study contributes to a significant proportion of HCPs currently facing stress.

A descriptive review of the impostor experience to support the health of music therapy students and professionals

The impostor experience (IE) is an inaccurate self-assessment negatively impacting a person’s internal sense of success despite objective evidence to the contrary. IE commonly occurs in a variety of students and professionals and is associated with negative affective states as well as occupational burnout. The purpose of this descriptive review was to survey the existing IE literature and describe, normalize, and mitigate IE specific to music therapy students and professionals. I conducted a descriptive review of the IE literature to determine how IE might manifest itself in music therapy students and professionals as well as potential ways to mitigate IE. IE is highly prevalent and may be especially widespread in students, healthcare professionals, musicians, academics, and people who are from communities who have been marginalized. Music therapy students and professionals may be at heightened risk for IE because they exist at the intersection of a small creative arts profession within various larger healthcare systems. Resultant of the review, I developed a model to name and normalize IE for music therapy students and professionals and provided specific recommendations for mitigating IE to augment the health and wellbeing of music therapy students and professionals. Through exposure to the IE scholarly literature and unpacking unique challenges that music therapy students and professionals encounter, I hope that IE can be named, normalized, and mitigated. Implications for academic and clinical training, limitations of the literature, suggestions for future research, and recommendations for continuing education to prevent and mitigate IE are provided.

Developing an interprofessional decision support tool for diabetic foot ulcers management in primary care within the family medicine group model: a Delphi study in Canada

BackgroundPrimary care professionals encounter difficulties coordinating the continuum of care between primary care providers and second-line specialists and adhere to practice guidelines pertaining to diabetic foot ulcers management. Family medicine groups are providing primary care services aimed to improve access, interdisciplinary care, coordination and quality of health services, and reduce emergency department visits. Most professionals working in family medicine groups are primary care physicians and registered nurses. The aim of this study was to develop and validate an interprofessional decision support tool to guide the management of diabetic foot ulcers for primary care professionals working within the family medicine group model.MethodsA one-page decision tool developed by the research team was validated by an expert panel using a three-round Delphi protocol held between December 2019 and August 2021. The tool includes 43 individual actions and a care pathway from initial presentation to secondary prevention. Data collection was realized with both paper and electronic questionnaires, and answers were compiled in an electronic spreadsheet. Data was analyzed with use of descriptive statistics, and consensus for each item was defined as ≥ 80% agreement.ResultsExperts from 12 pre-identified professions of the diabetic foot ulcer interdisciplinary care team were included, 39 participants out of the 59 invited to first round (66.1%), 34 out of 39 for second (87.2%) and 22 out of 34 for third (64.7%) rounds. All items included in the final version of the decision support tool reached consensus and were deemed clear, relevant and feasible. One or more professionals were identified to be responsible for every action to be taken.ConclusionsThis study provided a comprehensive decision support tool to guide primary care professionals in the management of diabetic foot ulcers. Implementation and evaluation in the clinical setting will need to be undertaken in the future.

Slovene Translation of the Difficulties in Suicidal Behaviors Intervention Questionnaire (DSBQ).

Background: Mental health professionals encounter numerous difficulties when working with suicidal clients. To understand these difficulties in clinical practice better, a valid instrument measuring them is needed. Aims: This study aimed to translate the Difficulties in Suicidal Behaviors Intervention Questionnaire (DSBQ) to Slovene, validate it, and explore Slovenian professionals' experiences with it. Method: The participants were 106 professionals (19 men, 87 women), aged 26-66 years. Apart from the DSBQ, scales on attitudes toward suicide prevention and coping strategies in difficult clinical situations were used. The data were collected between October 2017 and January 2019. Results: Although slightly diverging from the originally reported component structure, the Slovene translation of the DSBQ measures difficulties in working with suicidal clients with acceptable/good reliability and sensitivity, and adequate construct validity. Slovenian professionals most commonly experience difficulties related to working with children, followed by technical, system and setting, and other types of difficulties. Limitations: The sample of participants was relatively heterogeneous. Conclusion: Further studies of the DSBQ structure and validity, as well as difficulties, especially those related to working with children/adolescents and facing the theme of death, are warranted. Considering the difficulties most frequently reported in this investigation, more efforts are also needed in Slovenia to address technical and logistic aspects.

The Relationship Between Work Family Conflict and Performance of Female in The Workplace

The objective of this study is to investigate the correlation between work-family conflict and the performance of female workers. This work employs a quantitative-correlational research methodology. This study distributed a Likert scale questionnaire through the Google Form platform as the data collection method. A correlation coefficient of 0.736 from the Rank Spearman association hypothesis test shows that there is a strong positive relationship between the work-family conflict variable and the performance of female workers. Moreover, the p-value is below 0.05 (particularly 0.037), suggesting a statistically significant association between Variable X (work-family conflict) and Variable Y (performance conflict among female workers). The motivation behind this research stems from the findings of researchers at PT. X, which indicate that married female professionals encounter challenges in balancing their household and public responsibilities.

So chef, does a PhD matter? A Malaysian perspective(s) on Bucher and Lee

This paper offers a critical reflection on the challenges culinary professionals encounter when venturing into academia. We directly respond to Bucher and Lee's (2023) article, "Dear chef, do you really want a PhD?". Bucher and Lee aptly illuminated the intricacies, challenges, hurdles, and barriers that chefs face when pursuing a doctoral education in the hospitality academy. We add to Bucher and Lee's work, providing not only a more nuanced perspective, but also a counternarrative from two different voices acknowledging; (i) the voluntary pursuit of a PhD driven by personal choice and, (ii) the compelled pursuit imposed by organisational pressures. This reflective analysis aims to deepen the understanding of the multifaceted dynamics involved in the intersection of culinary expertise and academic pursuits.

Studying daily fluctuations of emotional effort among nurses of intensive care units: the establishment of latent profiles and its relationship with daily secondary traumatic stress and vitality.

Nursing professionals working in Intensive Care Units (ICU) face significant challenges that can result in secondary traumatic stress (STS). These challenges stem from witnessing patients' suffering and managing difficult tasks (i.e. communication with patients' relatives). Furthermore, these professionals encounter emotional demands, such as emotional effort, which is the dissonance between the emotion felt and the emotion that should be expressed to meet work expectations. Consequently, we aimed to investigate whether different profiles exist concerning nurses' levels of emotional effort over a five-day period and whether these profiles are related to daily STS and vitality. The sample comprised 44 nursing professionals from ICUs in Spanish hospitals. They were assessed daily, using a package of questionnaires twice per day for five working days: a) immediately after their shift and b) at a later time after working. The findings revealed three distinct profiles based on emotional effort levels: high (Profile 1), moderate (Profile 2), and low (Profile 3). These profiles were found to be negative predictors for both daily shattered assumptions and symptomatology. This study underscores the importance of assessing daily emotional demands in an ICU setting. Such assessments are crucial for establishing preventive measures to help nursing professionals manage lower-level emotional demands.

Human resources challenges in global health organizations: Managing a diverse and dispersed workforce

In the dynamic landscape of global health organizations, Human Resources (HR) faces unique challenges in managing a diverse and dispersed workforce. This review explores the multifaceted issues that HR professionals encounter while navigating the intricacies of global health settings. One of the foremost challenges is the diversity inherent in the workforce of global health organizations. These entities often bring together professionals from diverse cultural, educational, and professional backgrounds, creating a melting pot of perspectives and approaches. HR must devise strategies to foster inclusivity, address cultural differences, and promote effective communication to harness the collective strength of this diverse talent pool. Furthermore, the dispersed nature of global health organizations presents a logistical challenge for HR management. With teams spread across different geographic locations, time zones, and cultural contexts, coordinating and integrating human resources practices becomes inherently complex. Virtual collaboration tools and innovative communication strategies become imperative to bridge the geographical gaps and create a cohesive organizational culture. Managing talent retention and development in such a context becomes crucial. HR professionals need to design policies and programs that cater to the professional growth and well-being of employees regardless of their physical location. This involves implementing virtual training programs, mentorship initiatives, and performance evaluation systems that transcend geographical boundaries. Moreover, compliance with local and international labor laws adds another layer of complexity to HR management in global health organizations. Navigating the legal landscape and ensuring adherence to diverse regulatory frameworks require a nuanced approach and continuous monitoring. Human Resources faces a myriad of challenges in global health organizations, from fostering diversity and inclusion to navigating the complexities of a dispersed workforce. Successfully addressing these challenges demands a strategic and adaptive HR approach, leveraging technology, cultural sensitivity, and innovative practices to create a unified and thriving global health workforce.

Health professionals’ experience and perceived obstacles with managing patients’ medication information in Norway: cross-sectional survey

BackgroundAccess to correct and up to date medication information is crucial for effective patient treatment. However, persistent discrepancies exist. This study examines the experiences and challenges health professionals encounter while utilizing current digital solutions in the Norwegian healthcare system to manage patients' medication information.MethodsA cross-sectional descriptive analysis using quantitative survey data was conducted to investigate how health professionals managed patients’ medication information. Content analysis was used to analyze free-text responses concerning challenges they encountered when transferring medication information and to identify factors deemed necessary for implementing the Shared Medication List in Norway.ResultsA total of 262 doctors and 244 nurses responded to the survey. A higher percentage of doctors (72.2%) expressed concerns regarding obtaining accurate and updated medication lists than nurses (42.9%), particularly for patients with polypharmacy (35.3%) or transitioning between primary and specialist care services (27.6%). The patient's verbal information was the main source for hospital doctors (17%) to obtain an overview of the patient’s medication usage, while general practitioners (19%) and nurses (working in both primary and specialist care services, 28% and 27% respectively) predominantly relied on electronic prescriptions. Doctors, in particular general practitioners, reported carrying excessive responsibilities in coordinating with other health actors (84.8%) and managing patients' medication information. The vast majority of both doctors (84.4%) and nurses (82.0%) were in favor of a Shared Medication List. However, about a third of doctors (36.3%) and nurses (29.8%) expressed the need for a more balanced responsibility in updating and managing patients' medication information, while ensuring compatibility with existing digital systems.ConclusionsFragmented resources for medication information and unclear responsibilities were prevalent concerns among both professional groups. Doctors voiced more concern than nurses about the accuracy of patients’ medication list. While both groups are positive about a shared medication list, successful implementation requires proactive training initiatives and clearer role clarification.

Reconciling Work-Life Balance: An In-depth Exploration of Generation X’s Career Experiences

This research delves into the intricate dynamics of work-life balance among Generation X professionals in the context of the 21st century, aiming to understand their challenges within a rapidly evolving technological and workplace landscape. Previous research has demonstrated that Generation X workers are exceptionally adaptable in managing the changing technological world and workplace relations. Work-life balance has been highlighted as an important component impacting job satisfaction and general well-being. It delves deeper into these features by investigating how Generation X professionals deal with these problems and identifying specific ways to inform both professionals and companies to improve the understanding of the complex interplay between technology, workplace dynamics, and work-life balance for Generation X professionals in today’s professional world. Employing an Interpretative Phenomenological Analysis (IPA) methodology, the study emphasizes the importance of adaptability, flexible work methodologies, and work-life balance prioritization. With five participants aged 41 to 56 representing various professional fields, the findings indicate that Generation X professionals adeptly navigate contemporary challenges, focusing on adaptability, client-centric approaches, engagement in leisure activities, and effective work-life balance management. These strategies are closely linked to their job satisfaction and overall well-being. In essence, this research sheds light on the multifaceted relationship between work-life balance and the challenges Generation X professionals encounter in the 21st century, providing insights into their coping mechanisms and underscoring the pivotal role of work-life balance in shaping their experiences and overall professional satisfaction.

Finnish Palliative Care Nurses' and Physicians' Perceptions of Spirituality and Spiritual Care Related to Their Attitudes toward End-of-Life Care.

Spiritual care constitutes an indispensable aspect of palliative care (PC). Health care professionals encounter challenges when addressing spiritual care at the end of life. Developing appropriate attitudes toward end-of-life care can facilitate the acquisition of competencies needed for effective delivery of spiritual care. To explore the perceptions of spiritual care and attitudes toward end-of-life care among PC professionals. The Finnish version of the "Spirituality and Spiritual Care Rating Scale" (SSCRS-FIN) and a newly developed "Attitudes toward End-of-Life Issues" (AEOLI) questionnaire were validated and utilized. Both questionnaires were distributed to PC professionals involved in PC through an online survey. Exploratory and confirmatory factor analyses were conducted. The newly derived factors were subsequently examined for their associations with age, gender, profession, affiliation with a religious community, personal interpretation of spirituality, and years of professional experience. A total of 204 participants took part in the study (163 nurses, 19 nursing students, and 22 physicians). Exploratory factor analysis demonstrated satisfactory internal consistency, as indicated by Cronbach's alpha coefficients, for the five factors of SSCRS-FIN: "Spirituality" (0.733), "Existential" (0.614), "Spiritual Needs" (0.599), "Passive Spiritual Care" (0.750), and "Active Spiritual Care" (0.665); and for the seven factors of AEOLI: "Anxiety" (0.823), "Discussion" (0.924), "End-of-Life" (0.573), "Education" (0.692), "Medically Induced Death" (0.859), "Suffering" (0.671), and "Knowledge" (0.444). Confirmatory factor analysis demonstrated satisfactory fit values for both questionnaires. Significant positive correlations were observed between end-of-life care and the factors "Existential," "Spiritual Needs," and spiritual care factors, whereas an inverse correlation was found among "Anxiety," "Medically Induced Death," and all factors of SSCRS-FIN. Valid and reliable questionnaires for assessing spiritual care (SSCRS-FIN) and attitudes toward end-of-life care (AEOLI) were developed. Attitudes toward end-of-life care were positively correlated with perceptions of spiritual care.

Evaluation of oral health services and challenges faced by oral health practitioners working in Nyarugenge, Rwanda.

Oral healthcare professionals encounter considerable challenges while providing services to curb the oral disease burden. The aim of this study was to explore the challenges faced by oral health practitioners providing oral health services in Nyarugenge, Rwanda and to appraise the availability and adequacy of oral hygiene equipment, instruments, and materials. This was a cross-sectional concurrent mixed methods study. The quantitative and qualitative parts were independent during data collection and analyses and merged during the interpretation phase. All seven public health facilities and 14 dental professionals working in Nyarugenge were included in the study. Data were collected using an audit checklist and an in-depth interview guide. Descriptive statistics were used to analyze the quantitative data. The interviews were analyzed using thematic content analysis. Most of the dental health professionals were dental therapists (n = 11), women (n = 9), aged 31-40 years (n = 7), and with 11-20 years' experience as oral health practitioners (n = 6). There were five health centers and two hospitals that were audited for equipment, instruments, and materials. The audit of the facilities revealed that most facilities have dental equipment and instruments, but none have adequate preventive dental instruments and materials. Four broad themes emerged from the interviews with the oral health practitioners, namely human resources, supply chain management, patients' oral health awareness and service rendering, and strategic management and administration. The most significant challenges oral health practitioners faced included high dental practitioner/patient ratios, lack of adequate and appropriate equipment and materials, patients' lack of oral health awareness, and a lack of administrative support. Well-established community preventive interventions, such as a mobile oral health App, could reduce the patient/provider ratio by increasing population awareness of oral health and encouraging healthy behaviours. The management of the health facilities should address the human resource challenges and equipment supply chain issues.

WORKPLACE BASED CHALLENGES FOR POSTGRADUATE TRAINEE DOCTORS WORKING IN A PUBLIC SECTOR HOSPITAL

Background: Workplace-based challenges are experiences that are seen as inappropriate by the person experiencing or observing the challenge. These challenges may arise every day in different situations or may be a one off incident that is disturbing and affects one’s productivity. The study aims to identify and analyse the major hurdles that healthcare professionals encounter in their daily practice. Methods: A qualitative approach was employed to collect data from a diverse group of doctors at a public sector hospital in Sialkot. Semi-structured interviews were conducted in groups from different departments of the hospital in 2023. The consenting participants were interviewed regarding the challenges they face day to day working in government setup. Themes were extracted and data was tabulated to draw results. Results: We interviewed 21 consenting doctors from different departments mainly, Medicine, Surgery, Paediatrics and Gynaecology and identified six main themes which were high workload, security threats, financial Issues, resource constraints, time constraints, and inadequate work-life and personal-life balance. Amongst the 21 doctors, (47.62%) were females and (52.38%) were males. the challenges of high workload was stated by all (100%) of the participants, followed by security threats (91.5%), resource constraints (85.7%), financial issues (76.1%), time constraints (71%) and work and personal life imbalance (71.4%). Conclusion: Doctors reported significant levels of work-related stress, poor work-life balance, inadequate work capacity, and about one-third of them burned out, a sign of unfavourable working conditions. Pak J Physiol 2023;19(4):15–8

Pain Scales: What Are They and What Do They Mean.

It is essential to have validated and reliable pain measurement tools that cover a wide range of areas and are tailored to individual patients to ensure effective pain management. The main objective of this review is to provide comprehensive information on commonly used pain scales and questionnaires, including their usefulness, intended purpose, applicability to different patient populations, and associated advantages and disadvantages. Acute pain questionnaires typically focus on measuring the severity of pain and the extent of relief achieved through interventions. Chronic pain questionnaires evaluate additional aspects such as pain-related functional limitations, psychological distress, and psychological well-being. The selection of an appropriate pain scale depends on the specific assessment objectives. Additionally, each pain scale has its strengths and limitations. Understanding the differences among these pain scales is essential for selecting the most appropriate tool tailored to individual patient needs in different settings. Medical professionals encounter challenges in accurately assessing pain. Physicians must be familiar with the different pain scales and their applicability to specific patient population.

Enhanced Recovery After Surgery: Exploring the Advances and Strategies.

Enhanced recovery after surgery (ERAS) has emerged as a paradigm-shifting approach in perioperative care, aimed at optimizing patient outcomes, accelerating recovery, and minimizing hospital stays. This review delves into the latest advances and strategies within the field of ERAS, encompassing a comprehensive examination of preoperative, intraoperative, and postoperative interventions. By analyzing an array of clinical studies, meta-analyses, and implementation experiences, this review highlights the multifaceted elements contributing to the success of ERAS programs. Key components such as preoperative patient education, minimally invasive surgical techniques, tailored anesthesia protocols, judicious fluid management, optimized pain control, early ambulation, and structured nutritional support are thoroughly explored. Furthermore, the review delves into the intricacies of ERAS implementation across diverse surgical specialties, emphasizing the significance of multidisciplinary collaboration, protocol customization, and sustained quality improvement initiatives. The analysis not only showcases the tangible benefits of ERAS, including reduced complication rates, shortened hospital stays, and enhanced patient satisfaction, but also underscores the challenges and barriers that medical professionals encounter during program adoption. By synthesizing the current state of ERAS research and practice, this review provides clinicians, administrators, and researchers with valuable insights into the evolving landscape of perioperative care, fostering a deeper understanding of ERAS as a holistic approach that transcends traditional surgical pathways.