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Adherence to Swedish guidelines for pain treatment in relation to pediatric tonsil surgery: A survey of the multidisciplinary team.

https://arctichealth.org/en/permalink/ahliterature286661
Source
Int J Pediatr Otorhinolaryngol. 2017 Oct;101:123-131
Publication Type
Article
Date
Oct-2017
Author
F. Alm
M. Jaensson
S. Lundeberg
E. Ericsson
Source
Int J Pediatr Otorhinolaryngol. 2017 Oct;101:123-131
Date
Oct-2017
Language
English
Publication Type
Article
Keywords
Analgesics - therapeutic use
Anesthesia
Child
Child, Preschool
Cross-Sectional Studies
Female
Follow-Up Studies
Guideline Adherence
Humans
Male
Pain Management - methods
Pain, Postoperative - drug therapy
Palatine Tonsil - surgery
Patient care team
Surveys and Questionnaires
Sweden
Tonsillectomy - adverse effects
Abstract
Pain management in children after tonsil surgery is essential, and optimal pain treatment has been discussed for many years. Data from the National Tonsil Register in Sweden (NTRS) and a national mapping have demonstrated the need for national pain treatment guidelines for pediatric tonsil surgery. As a result, Swedish national guidelines, together with updated patient information on the website tonsilloperation.se, were developed and implemented in 2013.
The objective of this study was to evaluate the professionals' opinions of and adherence to pain treatment guidelines for pediatric tonsil surgery patients in a two-year follow-up.
This descriptive cross-sectional study was based on data from an inter-professional questionnaire, which was validated by an expert group using a content validity index (S-CVI 0.93). The questionnaire was sent to all Swedish ear, nose and throat (ENT) departments (n = 49) that the NTRS identified as performing tonsil surgery on children younger than 18 years of age. In each clinic, we asked for responses from staff in each of the following professions: ENT physicians, anesthesia physicians, registered nurse anesthetists, and registered nurses in the ENT departments.
Respondents from 48 ENT departments participated, and 139/163 (85%) completed questionnaires were returned. The guidelines were reported as being clear, ensuring patient safety and providing optimal pharmacological treatment. Treatment was given according to the guidelines: Half of the departments gave pre- or intraoperative treatment with clonidine, betamethasone and high-dose paracetamol (acetaminophen). A multimodal pain approach (paracetamol and COX-inhibitors) after hospital discharge was prescribed by all departments after tonsillectomy and, extensively, after tonsillotomy. One-third of the departments prescribed paracetamol with a higher normal dose for the first three postoperative days. Half of the departments prescribed rescue analgesics, clonidine or opioids after tonsillectomy. None of the departments prescribed codeine or tramadol, drugs that are discouraged in the guidelines. The majority of the departments used the website tonsilloperation.se to provide information to the patients and their caregivers.
The respondents' opinions of and the ENT departments adherence to the Swedish national guidelines were considered to be good. The national implementation process in Sweden has impacted the manner in which ENT departments treat pain after tonsil surgery.
PubMed ID
28964282 View in PubMed
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Adjunct High Frequency Transcutaneous Electric Stimulation (TENS) for Postoperative Pain Management during Weaning from Epidural Analgesia Following Colon Surgery: Results from a Controlled Pilot Study.

https://arctichealth.org/en/permalink/ahliterature278492
Source
Pain Manag Nurs. 2015 Dec;16(6):944-50
Publication Type
Article
Date
Dec-2015
Author
Kristofer Bjerså
Pether Jildenstaal
Jan Jakobsson
Madelene Egardt
Monika Fagevik Olsén
Source
Pain Manag Nurs. 2015 Dec;16(6):944-50
Date
Dec-2015
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Analgesia, Epidural
Colon - surgery
Combined Modality Therapy - methods
Female
Humans
Male
Middle Aged
Pain Management - methods
Pain Measurement
Pain, Postoperative - prevention & control
Pilot Projects
Prone Position
Respiration
Sweden
Transcutaneous Electric Nerve Stimulation - methods
Treatment Outcome
Walking
Abstract
The potential benefit of nonpharmacological adjunctive therapy is not well-studied following major abdominal surgery. The aim of the present study was to investigate transcutaneous electrical nerve stimulation (TENS) as a complementary nonpharmacological analgesia intervention during weaning from epidural analgesia (EDA) after open lower abdominal surgery. Patients were randomized to TENS and sham TENS during weaning from EDA. The effects on pain at rest, following short walk, and after deep breath were assessed by visual analog scale (VAS) grading. Number of patients assessed was lower than calculated because of change in clinical routine. Pain scores overall were low. A trend of lower pain scores was observed in the active TENS group of patients; a statistical significance between the groups was found for the pain lying prone in bed (p 
PubMed ID
26541070 View in PubMed
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Ambulance nurse's experience to relieve pain in patients with addiction problems in Sweden.

https://arctichealth.org/en/permalink/ahliterature310226
Source
Int Emerg Nurs. 2019 09; 46:100779
Publication Type
Journal Article
Date
09-2019
Author
Katarina Bohm
Roger Lund
Jörgen Nordlander
Veronica Vicente
Author Affiliation
Karolinska Institutet, Department of Clinical Science and Education, Södersjukhuset in Stockholm, Sweden; The Emergency Department, Södersjukhuset in Stockholm, Sweden.
Source
Int Emerg Nurs. 2019 09; 46:100779
Date
09-2019
Language
English
Publication Type
Journal Article
Keywords
Adult
Ambulances
Emergency Medical Services - methods - standards - trends
Female
Humans
Male
Middle Aged
Nurses - psychology - statistics & numerical data
Pain Management - methods - psychology - standards
Qualitative Research
Substance-Related Disorders - drug therapy - psychology
Sweden
Abstract
Pain is a personal and subjective experience. Prehospital emergency nurses (PEN) should work on the basis that all people are equal and entitled to the same care regardless of gender, age, disability or social status. The objective of treatment in health care is that all the pain to be alleviated. People with addiction problems often seek emergency care and pain is a frequent symptom. Research shows that medical staff often under treats pain and treat patients with addiction differently.
To describe PENSs' experiences of relieving pain in patients with addiction problems, otherwise called Substance Abuse Syndrome.
The study is designed with a qualitative approach with semistructured interviews. Eight PENs were interviewed and the material was analyzed according to a manifest content analysis.
The study's main finding is that the PENs wanted to give all patients equal care but often experienced uncertainty in the care of addicts. Many of the perceived emotions created a doubt in what situations would be resolved. Lack of information and knowledge about addiction and their own feelings and values of addicts made it difficult to decide what was right or wrong treatment. The difficulty was further increased when the unclear guidelines and lack of support meant that the treatment still perceived to be different.
Pain management of patients with drug addiction can be characterized as a complex task that requires a high level of skill. PENs often encounter this population in their work. Several factors lead to their experiencing these care situations as difficult to manage. Treatment guidelines are perceived as unclear and giving weak support as to how patients with addiction and pain should be treated. To handle this, PEN sought support in their decision-making from colleagues in ambulance care and the Emergency Department. Their conclusion was that treatment would be different every time, and that patients with addiction and pain were all treated differently. Despite advances in treatment options, patients will continue to be under-treated. Unfortunately, it is not just better knowledge of pain physiology and pharmacology that is the solution. Knowledge about and attitudes to pain and addiction must be corrected before any behaviour can be changed. The results of this study will hopefully make knowledge more nuanced and raise awareness of shortcomings in order to optimize care and treatment in the prehospital environment.
PubMed ID
31345691 View in PubMed
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Ambulance personnel's experience of pain management for patients with a suspected hip fracture: A qualitative study.

https://arctichealth.org/en/permalink/ahliterature278758
Source
Int Emerg Nurs. 2015 Jul;23(3):244-9
Publication Type
Article
Date
Jul-2015
Author
D. Jakopovic
A-C Falk
V. Lindström
Source
Int Emerg Nurs. 2015 Jul;23(3):244-9
Date
Jul-2015
Language
English
Publication Type
Article
Keywords
Aged
Allied Health Personnel
Ambulances
Emergency Medical Services - organization & administration
Female
Hip Fractures
Humans
Interviews as Topic
Male
Pain Management - methods
Qualitative Research
Sweden
Abstract
Pain management is described to be insufficient for patients suffering from a hip fracture, and the management for this vulnerable group of patients may be challenging due to their medical history (multiple comorbidities) and polypharmacy. Previous research has mainly focused on fast tracks aiming to reduce time to surgery. But the research on how pain management is handled for these patients in the prehospital context has been sparse. Therefore, the purpose of this study was to describe the ambulance personnel's experience of managing the pain of patients with a suspected hip fracture. A descriptive and qualitative design with Critical Incident Technique was used for collecting data. Moreover, a qualitative content analysis was used for analysing the collected data. Twenty-two participants communicated their experiences and 51 incidents were analysed. The main finding in the study was that the ambulance personnel, by using their clinical knowledge and by empowering the patients to participate in their own care, managed to individualize the pain relief for patients with a suspected hip fracture through a variety of interventions.
PubMed ID
25676257 View in PubMed
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Assessment of post-operative pain management among acutely and electively admitted patients - a Swedish ward perspective.

https://arctichealth.org/en/permalink/ahliterature279455
Source
J Eval Clin Pract. 2016 Apr;22(2):283-9
Publication Type
Article
Date
Apr-2016
Author
Mahnaz Magidy
Margareta Warrén-Stomberg
Kristofer Bjerså
Source
J Eval Clin Pract. 2016 Apr;22(2):283-9
Date
Apr-2016
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Elective Surgical Procedures
Female
Hospitals, University - organization & administration
Humans
Male
Middle Aged
Pain Management - methods
Pain Measurement
Pain, Postoperative - therapy
Patient satisfaction
Quality Indicators, Health Care
Quality of Health Care - organization & administration
Sex Factors
Socioeconomic Factors
Sweden
Abstract
Swedish health care is regulated to involve the patient in every intervention process. In the area of post-operative pain, it is therefore important to evaluate patient experience of the quality of pain management. Previous research has focused on mapping this area but not on comparing experiences between acutely and electively admitted patients. Hence, the aim of this study was to investigate the experiences of post-operative pain management quality among acutely and electively admitted patients at a Swedish surgical department performing soft-tissue surgery.
A survey study design was used as a method based on a multidimensional instrument to assess post-operative pain management: Strategic and Clinical Quality Indicators in Postoperative Pain Management (SCQIPP). Consecutive patients at all wards of a university hospital's surgical department were included. Data collection was performed at hospital discharge.
In total, 160 patients participated, of whom 40 patients were acutely admitted. A significant difference between acutely and electively admitted patients was observed in the SCQIPP area of environment, whereas acute patients rated the post-operative pain management quality lower compared with those who were electively admitted.
There may be a need for improvement in the areas of post-operative pain management in Sweden, both specifically and generally. There may also be a difference in the experience of post-operative pain quality between acutely and electively admitted patients in this study, specifically in the area of environment. In addition, low levels of the perceived quality of post-operative pain management among the patients were consistent, but satisfaction with analgesic treatment was rated as good.
PubMed ID
26507572 View in PubMed
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[Background and perspectives of opioid analgesics for the treatment of chronic pain in cancer patients in Russia].

https://arctichealth.org/en/permalink/ahliterature265129
Source
Anesteziol Reanimatol. 2015 Jan-Feb;60(1):19-25
Publication Type
Article
Author
G R Abuzarova
V E Khoronenko
R R Sarmanaeva
Source
Anesteziol Reanimatol. 2015 Jan-Feb;60(1):19-25
Language
Russian
Publication Type
Article
Keywords
Analgesics, Opioid - supply & distribution - therapeutic use
Chronic Pain - drug therapy
Drug and Narcotic Control - legislation & jurisprudence
Government Regulation
Neoplasms - complications
Pain Management - methods - trends
Palliative Care - legislation & jurisprudence - organization & administration - statistics & numerical data
Russia
Abstract
The article deals with an analysis of availability of narcotic analgesics for the patients in the Russian Federation. The analysis was based on datafrom official sources on the scopes of opioids delivery in different regions of the Russian Federation and showed an extremely limited availability of narcotic analgesics for the patients in the Russian Federation. We found that availability of narcotic analgesics in Russia is hundreds times lower than the same indexes in European countries with various level of economic activity and in the USA. The analysis showed ten most progressive Russian regions where the use of opioids in the noninvasive forms has become part of systematic clinical practice according to WHO recommendations as well as 10 ten most backward regions where these drugs are hardly used despite of high figures of case death rates from cancer. We made a list of most needed modern Russian and internationally produced drugs according to international data and personal experience. Drugs from this list can be effectually used for the chronic pain therapy in oncology. The most advanced drugs that are soon will be produced are also named. The article describes high priority measures that have already been done to improve current situation and measures to be executed in the future.
PubMed ID
26027219 View in PubMed
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Barriers to cancer pain management in Danish and Lithuanian patients treated in pain and palliative care units.

https://arctichealth.org/en/permalink/ahliterature258956
Source
Pain Manag Nurs. 2014 Mar;15(1):51-8
Publication Type
Article
Date
Mar-2014
Author
Ramune Jacobsen
Jurgita Samsanaviciene
Zita Liubarskiene
Per Sjøgren
Claus Møldrup
Lona Christrup
Arunas Sciupokas
Ole Bo Hansen
Source
Pain Manag Nurs. 2014 Mar;15(1):51-8
Date
Mar-2014
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Analgesics, Opioid - administration & dosage - adverse effects
Anxiety - psychology
Chronic Pain - etiology - psychology - therapy
Denmark
Depression - psychology
Female
Humans
Lithuania
Male
Medication Adherence - psychology
Middle Aged
Multivesicular Bodies
Neoplasms - complications - psychology
Pain Clinics
Pain Management - methods
Pain Measurement
Palliative Care - methods
Abstract
The prevalence of cancer-related pain is high despite available guidelines for the effective assessment and management of that pain. Barriers to the use of opioid analgesics partially cause undertreatment of cancer pain. The aim of this study was to compare pain management outcomes and patient-related barriers to cancer pain management in patient samples from Denmark and Lithuania. Thirty-three Danish and 30 Lithuanian patients responded to, respectively, Danish and Lithuanian versions of the Brief Pain Inventory pain scale, the Barriers Questionnaire II, the Hospital Anxiety and Depression Scale, the Specific Questionnaire On Pain Communication, and the Medication Adherence Report Scale. Emotional distress and patient attitudes toward opioid analgesics in cancer patient samples from both countries explained pain management outcomes in the multivariate regression models. Pain relief and pain medication adherence were better in Denmark, and the country of origin significantly explained the difference in the regression models for these outcomes. In conclusion, interventions in emotional distress and patient attitudes toward opioid analgesics may result in better pain management outcomes generally, whereas poor adherence to pain medication and poor pain relief appear to be more country-specific problems.
PubMed ID
24602424 View in PubMed
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A behavioral medicine intervention for older women living alone with chronic pain - a feasibility study.

https://arctichealth.org/en/permalink/ahliterature262697
Source
Clin Interv Aging. 2014;9:1383-97
Publication Type
Article
Date
2014
Author
Sara Cederbom
Elisabeth Rydwik
Anne Söderlund
Eva Denison
Kerstin Frändin
Petra von Heideken Wågert
Source
Clin Interv Aging. 2014;9:1383-97
Date
2014
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Aged, 80 and over
Behavior Therapy
Chronic Pain - psychology - rehabilitation
Disability Evaluation
Feasibility Studies
Female
Geriatric Assessment
Humans
Intervention Studies
Morale
Pain Management - methods
Pain Measurement
Patient compliance
Physical Fitness
Physical Therapy Modalities
Self Efficacy
Sweden
Treatment Outcome
Abstract
To be an older woman, live alone, have chronic pain, and be dependent on support are all factors that may have an impact on daily life. One way to promote ability in everyday activities in people with pain-related conditions is to use individualized, integrated behavioral medicine in physical therapy interventions. How this kind of intervention works for older women living alone at home, with chronic pain, and dependent on formal care to manage their everyday lives has not been studied. The aim was to explore the feasibility of a study and to evaluate an individually tailored integrated behavioral medicine in physical therapy intervention for the target group of women.
The study was a 12-week randomized trial with two-group design. Primary effect outcomes were pain-related disability and morale. Secondary effect outcomes focused on pain-related beliefs, self-efficacy for exercise, concerns of falling, physical activity, and physical performance.
In total, 23 women agreed to participate in the study and 16 women completed the intervention. The results showed that the behavioral medicine in physical therapy intervention was feasible. No effects were seen on the primary effect outcomes. The experimental intervention seemed to improve the level of physical activity and self-efficacy for exercise. Some of the participants in both groups perceived that they could manage their everyday life in a better way after participation in the study.
Results from this study are encouraging, but the study procedure and interventions have to be refined and tested in a larger feasibility study to be able to evaluate the effects of these kinds of interventions on pain-related disability, pain-related beliefs, self-efficacy in everyday activities, and morale in the target group. Further research is also needed to refine and evaluate effects from individualized reminder routines, support to collect self-report data, safety procedures for balance training, and training of personnel to enhance self-efficacy.
Notes
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PubMed ID
25170262 View in PubMed
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Benefits of using the Brief Pain Inventory in patients with cancer pain: an intervention study conducted in Swedish hospitals.

https://arctichealth.org/en/permalink/ahliterature307772
Source
Support Care Cancer. 2020 Aug; 28(8):3721-3729
Publication Type
Journal Article
Date
Aug-2020
Author
Viveka Andersson
Stefan Bergman
Ingela Henoch
Hanna Simonsson
Karin Ahlberg
Author Affiliation
The Sahlgrenska Academy, Institute of Health and Care Sciences, University of Gothenburg, Box 457, SE-405 30, Gothenburg, Sweden. viveka.andersson@regionhalland.se.
Source
Support Care Cancer. 2020 Aug; 28(8):3721-3729
Date
Aug-2020
Language
English
Publication Type
Journal Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Cancer Pain - drug therapy
Female
Humans
Male
Middle Aged
Neoplasms - complications - drug therapy
Pain Management - methods
Pain Measurement
Sweden
Young Adult
Abstract
The prevalence of cancer pain is too high. There is a need for improvement of pain management in cancer care. The aim of this study was to explore whether the use of the multidimensional pain assessment questionnaire Brief Pain Inventory (BPI) could improve pain relief in hospitalized patients with cancer.
A controlled intervention study was performed at two hospitals in western Sweden, 264 patients were included, 132 formed a control group and 132 an intervention group. All participants completed the BPI and the Edmonton Symptom Assessment Scale (ESAS) at baseline. Only the researcher had access to questionnaires from the control group. The completed forms from the intervention group were presented to the patients' care team. A follow-up took place after 2-5 days when patients in both groups rated the scales a second time.
In the intervention group, significant differences in all measured items of the BPI were found at follow-up compared with baseline. Symptoms rated with the ESAS also decreased significantly, except shortness of breath. At follow-up, a significant increase in regular use of paracetamol, anti-neuropathic pain drugs and opioids was found, as well as elevated doses of fixed-schedule opioids. In the control group, differences between baseline and follow-up were significant regarding average pain and worst pain over the past 24 h.
Presenting the patient-reported BPI to the care team helped them to focus on patients' pain, identify pain mechanisms and adjust analgesics accordingly. A possible explanation for the results is changes in the medication prescribed.
PubMed ID
31823057 View in PubMed
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A Canadian online survey of oncology nurses' perspectives on the management of breakthrough pain in cancer (BTPc).

https://arctichealth.org/en/permalink/ahliterature114455
Source
Can Oncol Nurs J. 2013;23(1):28-43
Publication Type
Article
Date
2013
Author
Margaret I Fitch
Alison McAndrew
Stephanie Burlein-Hall
Author Affiliation
Odette Cancer Centre T2-234, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, Ontario M4N 3M5.
Source
Can Oncol Nurs J. 2013;23(1):28-43
Date
2013
Language
English
French
Publication Type
Article
Keywords
Adult
Aged
Canada
Data Collection
Female
Humans
Male
Medical Oncology - manpower
Middle Aged
Nurses - psychology
Pain Management - methods
Young Adult
Abstract
This paper explores Canadian oncology nurses' perception of management of breakthrough pain in cancer (BTPc). An online questionnaire was distributed to 668 oncology nurses across Canada, and 201 participated. More nurses reported that patients used hydromorphone (99.5%), morphine (97.0%), codeine (88.1%), or oxycodone (88.1%) for BTPc, than fentanyl preparations (64.7%). Problems with opioid administration reported by nurses included failure to work quickly enough (35.7%), difficulty swallowing (16.6%), need for caregiver assistance (13.2%), mouth sores (12.6%) and dry mouth (11.5%). Although most nurses discussed BTPc management with their patients, the vast majority (72.2%) were not very satisfied with current treatment modalities. Effective dialogue with patients and access to educational resources/tools may help optimize therapy and enhance concordance with BTPc medications.
PubMed ID
23617217 View in PubMed
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82 records – page 1 of 9.