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Background: The Nurses' Cancer Pain Management Competency Scale (NCPMCS) is a tool to explore nurses' competencies and subjective experiences in cancer pain management, and to help nurses understand their current shortcomings in cancer pain management. The scale, currently available only in English and translated into Chinese for wider adoption abroad, provides a tool for Chinese nurses to assess their level of cancer pain management. Furthermore, based on the scale's specific score, they can evaluate their lack of understanding about cancer pain management, advance research into this area, and enhance their capacity to control cancer pain while providing patient care., Objective: The purpose of this study was to translate and localize the new scale, and to measure its reliability and validity. The study was also to provide a way to quickly and accurately measure the competency of cancer pain management among nursing staff in China., Methods: The Bristling translation approach was used to translate, translate back, and culturally modify the English version of the cancer pain management competency scale for nurses to create the Chinese version. A convenience sample was used for the study, 220 clinical nurses from three Grade III hospitals in Zhengzhou, Henan Province, China, were chosen by convenience sampling. The Chinese version of the scale was used for this investigation., Results: The Cancer Pain Management Competency Scale for Nurses has 14 items over 4 dimensions in its Chinese form. From the exploratory factor analysis, four common components were recovered; the cumulative variance rate was 81.994%, the scale's Cronbach's α coefficient was 0.902, and the Cronbach's α coefficient for each dimension ranged from 0.800 to 0.938. Retest reliability was 0.915, scale content validity was 0.865, and Spearman-Brown's broken half reliability was 0.808., Conclusion: Nurses' cancer pain management competency in clinics can be assessed using the Chinese version of the Nurses' Cancer Pain Management Competency Scale, which has strong validity and reliability., (Copyright © 2024. Published by Elsevier Inc.)

Background: Pain is a distressing problem which commonly occurs among critically ill patients. Nurses' knowledge of, attitudes, and perceived barriers to pain assessment and management can influence the effectiveness of nursing care., Objective: To explore the current knowledge of, attitudes, and perceived barriers to pain assessment and management among Thai critical care unit nurses., Methods: A cross-sectional survey conducted between November 2022 and January 2023 among 158 Thai nurses working in one of eight adult critical care units in a tertiary hospital, evaluated their knowledge of, attitudes, and perceived barriers to pain assessment and management., Results: Nurses possessed inadequate knowledge and negative attitudes regarding pain assessment and management. The most important barrier to pain assessment and management was "patients are unable to communicate their pain". The results showed a significantly weak positive correlation between nurses' attitudes toward pain assessment and management age (r = 0.26, p = 0.001), year of ICU experience (r = 0.29, p < 0.001), and obtaining a certificate in intensive care nursing (r = 0.37, P < 0.001)., Conclusions: Thai critical care unit nurses possessed inadequate knowledge and negative attitudes. Further training and education regarding pain assessment and management could include case studies or simulation and immersive virtual reality to improve critical care unit nurses' knowledge and attitudes as well as identifying potential barriers to pain assessment and management in the critical care settings., Implications for Clinical Practice: The implications for clinical practice recommend that continued quality assurance procedures should be implemented and maintained to evaluate the effectiveness of current pain assessment practices. Additionally, the perceived barriers to effective pain assessment and management should be considered and managed not only through continued education and training but could include using nursing case review, morbidity and mortality data identifying those patients that experience chronic pain post-ICU discharge., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Ltd.)

Nurses practicing in critical care units manage all forms of traumatic, acute, and chronic pain. Chronic pain must be managed in critical care scenarios to facilitate patient comfort and eventual recovery and healing. Patients with orthopedic injuries and conditions have distinct care needs that require specialized knowledge on the provider's part. Critical care nurses manage orthopedic traumatic injuries while simultaneously managing underlying acute orthopedic conditions. Pain experiences are individual to the person experiencing pain. The Internet is a rich source for pain-management materials that the critical care nurse should have in their resource repertoire., Competing Interests: Disclosure The author reports no commercial or financial conflicts of interest. There was no funding from any source for this publication., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Nurses have an ethical responsibility to manage pain and the suffering derived from it. Given the complexity of patients in the critical care setting and the high incidence of pain experienced by critically ill patients, critical care nurses may experience moral distress when pain is inadequately managed. To address moral distress associated with pain management, critical care nurses should be provided with education on evidence-based pain management practices and encouraged to evaluate their personal biases and beliefs regarding pain management. Furthermore, organizations should consider the implementation of programs to address moral distress stemming from pain management and other precipitating factors., Competing Interests: Disclosure The author has no disclosures or conflicts of interest to report., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Delving into the complexities of pain management in women with polysubstance use, the focus of this article is on the intersection of chronic pain and mental health. One in 5 adults in the United States experience chronic pain, with women being particularly susceptible. To address these challenges, a careful and patient-centered is crucial. To guide our approach, we utilize the nursing process to address gender-specific factors, which influence substance use disorder, such as trauma, societal stigmas, and pain management. The significance of an interdisciplinary, multimodal approach is essential to achieve effective patient outcomes for women that misuse substances., Competing Interests: Disclosures The authors have nothing to disclose., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Objectives: Provide an overview of how pain impacts mobility in patients with cancer., Methods: A literature search was conducted in PubMed and on Google Scholar using search terms, cancer pain with mobility, acute and chronic pain syndromes, enhanced recovery after surgery, nursing care, and rehabilitation. Peer-reviewed research studies, review articles, and pain guidelines and position papers were reviewed to provide an overview on cancer pain, its impact on mobility, and the nurse's role in managing pain and optimizing mobility and functional outcomes., Results: Firty-two references were included in this overview. This body of literature is replete with studies on the management of pain; however, the tie between pain and mobility has not been well described aside from the breakthrough pain literature. This manuscript weaves these two important concepts together to better inform nurses and other clinicians regarding the importance of managing pain to even begin mobilizing patients, especially following surgery and for other painful conditions., Conclusions: Oncology nurses play an integral role in assessing and managing cancer pain. It is important for nurses to recognize how their pain management interventions lead to improved mobility and functioning in patients with cancer., Implications for Nursing Practice: Nurses comprise the largest workforce around the globe and are well-equipped to assess and manage cancer pain in all cancer care settings. As leaders within the healthcare team, making recommendations to better control pain and communicating with other team members regarding the pain plan is essential in improving mobility in patients with cancer., Competing Interests: Declaration of competing interest The authors declare no potential conflicts of interest., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Objective: The objective of this study is to evaluate the effectiveness of targeted nursing measures in relieving swollen limb pain after extremity fractures. The term "targeted nursing measures" refers to specific nursing interventions and care strategies that are designed to address the issue of swollen limb pain in patients with extremity fractures., Methods: Patients with extremity fractures treated in our hospital between January 2020 and December 2021 were recruited for eligibility assessment, and 100 patients were eventually included and assigned alternately at the time of admission to receive routine care, namely standard nursing interventions commonly provided to individuals with extremity fractures (These interventions included preoperative assessment, vital sign monitoring, postoperative status monitoring, local ice application, elevation of the affected limb, functional exercise, pain relief measures, postoperative nutrition, medication administration, and general health instruction) (routine group) or targeted care, namely care measures tailored to address swollen limb pain. (These targeted care measures included health education regarding the causes of limb fractures, precautions, causes of swollen limb pain after fractures, and treatment methods, decongestion care, ice compresses to promote vasoconstriction and reduce pain and swelling, psychological counseling to relieve negative emotions, and targeted rehabilitation training supervision) (targeted group), with 50 patients in each group. Outcome measures included swelling, pain, emotional state, and nursing satisfaction., Results: Targeted care resulted in better mitigation of swelling versus routine care (P < .05). Patients with targeted care had significantly lower visual analog scale (VAS) scores, self-rating anxiety scale (SAS) scores, and Hamilton depression scale (HAMD) scores, and higher Connor-Davidson resilience scale (CD-RISC) scores versus those with routine care (P < .05). Targeted care was associated with significantly higher nursing satisfaction versus routine care (P < .05)., Conclusion: Targeted care rapidly relieves the degree of swelling and pain of patients with extremity fractures and ameliorates their emotional state, thereby promoting health recovery and effectively improving patient satisfaction.

Fundamental to the quality of life is assisting patients in relieving pain including at the end of life. Compassionate, effective, evidence-based pain care for the dying improves the quality of life for patients and may reduce distress and complicated bereavement in the loved ones witnessing this death. However, efforts designed to mitigate the consequences of the opioid epidemic have seriously compromised pain care at the end of life. This has created an urgent need to focus on the barriers to relief, and solutions necessary to provide safe and effective pain and symptom management in this population. To that end, a committee of experts was convened by the American Society for Pain Management Nursing and the Hospice and Palliative Nursing Association. These experts reviewed the current literature, developed a draft position statement which underwent consecutive revisions. This statement was then endorsed by the respective organizations. Elucidation of barriers to effective pain control in advanced disease allows targeted interventions; including those related to clinical care, education, accessibility, and research. As nurses, we must continuously advocate for humane and dignified care, promoting ethical, effective pain and symptom management at the end of life for all., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Inc.)

Purpose: To explore nurses' experiences of establishing partnerships with parents for pain care of hospitalized children with cognitive impairment (CI) and identify related facilitators and barriers., Design and Methods: In this qualitative, interpretive descriptive study, individual semi-structured interviews were conducted via videoconferencing with pediatric nurses from inpatient wards in a Canadian pediatric quaternary hospital. Verbatim transcripts were analyzed using an inductive, data-driven thematic analysis approach., Results: Eleven nurses were interviewed. The overarching theme was Assessing Pain as an Outsider: "A Complete Guessing Game". Seven major themes were identified.: Relying on Parent Expertise for Pain Assessment, Brainstorming with Parents for Pain Treatment, Supporting Parents as Advocates for Pain Care, Individualizing Pain Care with Parents, Involving the Child in Pain Care: A Spectrum, Barriers to Partnership in Pain Care and Facilitators to Partnership in Pain Care., Conclusions: Nurses described the many ways they involve parents as partners in pain care. However, nurses shared strong feelings of uncertainty associated with pain care in children with CI. Consequently, nurses felt the need to rely on parents for appropriately assessing and treating pain in children with CI. Findings highlighted the practice and education gaps that may contribute to nurses' uncertainty and reliance on parents., Practice Implications: By identifying related practice and education gaps, healthcare organizations can implement strategies to further support nurses in establishing partnerships and potentially optimize pain care practices., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: There is no standardized practice in pediatric pain assessment with burn injuries in the outpatient clinic setting., Objective: This review aims to identify reliable, validated tools to measure pain in the pediatric burn clinic population., Methods: The literature search for this integrative review was conducted using the databases of PubMed, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Cochrane, and Embase from 2011 to 2023. Quality and relevance were appraised using the Johns Hopkins Nursing Evidence-Based Practice Model. Reporting was done according to a Preferred Reporting Items for Systemic Reviews and Meta-Analysis checklist., Results: Fourteen articles and two clinical practice guidelines met inclusion criteria and were included in this review., Conclusion: The Pain Observation Scale for Young Children and the COMFORT Behavior Scale tools have shown good reliability and construct validity and can be safely used to measure background and procedural pain in daily burn practice. Further research on reliable, validated pain assessment techniques in the pediatric burn population is needed., Competing Interests: The listed authors have no conflicts of interest to report., (Copyright © 2024 Society of Trauma Nurses.)

Aim: To explore registered nurses' experiences with pain management in patients with opioid use disorder (OUD) in home care., Design: Qualitative explorative-descriptive design., Methods: Data were collected via nine individual semi-structured interviews with registered nurses working in home care meeting patients with OUD. Data were analysed using systematic text condensation., Results: Three categories were identified: Reciprocity in relationships and a professional approach enhance pain management; Discrepancies between guidelines, patient-reported pain and RNs' observations challenge pain management; and Interprofessional collaboration makes or breaks pain management., (© 2024 The Author(s). Nursing Open published by John Wiley & Sons Ltd.)

Aim: To develop a nurse-led model of analgesia to manage post-operative pain in the surgical neonate., Design: A four-round e-Delphi study was conducted from March to December 2022., Methods: An e-Delphi method was used seeking a consensus of 70% or greater. Fifty-one experts were invited to join the panel. Members consisted of multi-disciplinary healthcare professionals who work in areas associated with neonatal care. In round 1, 49 statements relative to neonatal pain assessment and management were distributed to the panel. Panel members were asked to rate their level of agreeance on a Likert scale from 1 to 5 (1 = strongly disagree to 5 = strongly agree). Ratings equal to or greater than 4 represented agreement, 3 indicated uncertainty and 2 or less disagreement with the proposed statement. An opportunity for free-text responses after each statement was provided. This iterative process continued for three rounds. In the fourth and final round, the completed model of neonatal nurse-controlled analgesia was presented along with a further opportunity to provide feedback on the final version., Results: Four rounds of statements and voting were required to reach consensus on a model of neonatal nurse-controlled analgesia. The model consists of criteria for use, over-arching guidelines and three separate pathways based on an individual baby's pain assessment scores, need for pain relieving interventions and time-lapsed post-surgical procedure., Conclusion: A comprehensive model of neonatal nurse-controlled analgesia, applicable to the Australasian context, was developed in collaboration with a group of neonatal experts., Impact: This study provides a multi-modal family-integrated model to manage neonatal post-operative pain. By providing nurses with increased autonomy to assess and manage acute pain, this model has the potential to not only provide a more responsive and individualized approach to alleviate discomfort, but highlights the integral role of parent partnerships in the neonatal intensive care., Reporting Method: This study was reported in line with the Conducting and REporting of DElphi studies (CREDE) guidance on Delphi studies., Patient or Public Contribution: No patient or public contribution was utilized for this study., (© 2023 John Wiley & Sons Ltd.)

This study aims to evaluate the impact of integrating pain nursing with hospice care on the quality of life among patients with advanced lung cancer. This study involving 60 advanced lung cancer patients admitted from January 2022 to January 2023. Participants were randomly assigned to 2 groups: the observation group received a combination of pain nursing and hospice care, while the control group received standard nursing care. The study assessed changes in the numeric rating scale for pain, self-rating anxiety scale (SAS), self-rating depression scale (SDS), cancer fatigue scale (CFS), death attitude, and various quality of life dimensions as measured by the Quality of Life Questionnaire-Core 30. Post-intervention, both groups exhibited reductions in numeric rating scale, SAS, SDS, and CFS scores compared to baseline, with more significant improvements observed in the observation group (P < .05). Additionally, post-intervention scores for death attitude and Quality of Life Questionnaire-Core 30 domains (physical, cognitive, social, role, and emotional functioning, as well as overall health) increased in both groups, with the observation group showing greater improvements than the control group (P < .05). The combination of pain nursing and hospice care significantly reduces pain, anxiety, and depression, decreases cancer-related fatigue, and improves the quality of life and death attitudes in patients with advanced lung cancer, highlighting the benefits of this integrative approach in palliative care settings., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

To investigate the effects of refined nursing strategies on postoperative quality of life, pain level, psychological condition, and other rehabilitation training of patients with cervical spondylosis. This study is a retrospective study, and 500 patients with cervical spondylosis admitted to our hospital from April 2022 to June 2023 were selected as the study objects. They were divided into a control group (250 cases) and an experimental group (250 cases) according to whether they received personalized intensive care. The control group received standard nursing care, while the experimental group was given personalized, high-quality nursing care. The refined nursing strategy comprises individualized rehabilitation training plans, psychological support, nutritional counseling, and pain management. Indicators such as pain level, cervical spine function, quality of life, complication statistics, and nursing satisfaction were employed to evaluate the clinical efficacy of 2 nursing methods. In the pain assessment, patients in the experimental and control groups had pain scores of (1.98 ± 0.84) and (5.78 ± 0.63), respectively, after the nursing intervention. The reduction in pain for patients in the experimental group was highly significant (P < .05) compared to pre-nursing care. Six months after the commencement of healthcare, the cervical spine function scores of the experimental and control groups were (93.36 ± 4.74) and (82.68 ± 5.42), respectively. Moreover, the cervical spine function recovery of the experimental group was deemed significant. The experimental group exhibited a lower probability of complications compared to the control group. Additionally, the quality of life was significantly higher in the experimental group than in the control group (P < .05). Improvement time and healing time were significantly shorter in the patients of the experimental group in comparison to the control group. In terms of nursing satisfaction, the experimental group had a significantly higher satisfaction rate of 87.57% than the control group (P < .05). The refined nursing strategy significantly improved the speed and quality of patients' functional recovery. Additionally, the implementation of personalized and comprehensive nursing techniques during postoperative treatment for cervical spondylosis resulted in a significant improvement in patient's quality of life and satisfaction with the treatment process., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

Objective: To understand nursing team perceptions about the barriers in pain management in the care of hospitalized children., Method: Descriptive-exploratory study, with a qualitative approach, conducted with eight nurses and seven nursing technicians. Data were collected at the Universidade de São Paulo University Hospital, between June and September 2022, through individual interviews, analyzed from the perspective of thematic content analysis and in the light of Symbolic Interactionism., Results: The following categories emerged: 1) Knowledge translation: is pain management actuallyperformed? and 2) Reflecting changes: how to achieve the potential of pain management? Professionals have theoretical knowledge about pain management, however, they listed numerous barriers at each stage, mainly related to institutional routine, and, when reflecting on this context, they indicated the need for an institutional protocol., Final Considerations: Barriers stand out from theoretical knowledge and make pain management for hospitalized children disregarded. Knowing this context is relevant forimplementing change strategies.

Background. Postoperative pain is a common problem among intensive care patients. Pain management includes pain assessment and documentation, patient care, and pharmacological treatment. Materials and methods. The study used a prospective, cross-sectional design. Nineteen intensive care nurses and 72 intensive care patients after cardiac surgery with sternotomy approach were studied. Toronto Pain Management Inventory was used to assess nurses and the 2010 Revised American Pain Society Patient Outcome Questionnaire was used to assess the patients. A research protocol was used to document pharmacological treatment data and Visual Analog Scale (VAS) pain measurements. The pharmacological therapy data was available for 72 patients, but patient satisfaction measurements were acquired from 52 patients. Results. Postoperative pain for intensive care patients after cardiac surgery is mostly mild (68.66%). Pain intensity had a tendency to decrease over time, from a mean VAS score of 4.66 two hours after extubation to a mean VAS score of 3.12 twelve hours after extubation. Mostly opioids (100%) and nonsteroidal anti‑inflammatory drugs (NSAIDs, 77.8%) were used for pharmacological treatment, and treatment was adjusted according to pain levels and patient needs. Patient satisfaction regarding pain management in the first 24 hours after surgery was high (94.2%), even though the nurses’ pain knowledge was average (X = 60.6 ± 7.3%). Conclusions. An individualized pain management plan requires pain documentation and ensures high patient satisfaction. Pain levels after cardiac surgery with sternotomy approach are mostly mild and patient satisfaction is high.

The American Association of Nurse Anesthesiology Practice Committee and subject matter experts recently evaluated newly published cannabis guidelines titled "ASRA Pain Medicine Consensus Guidelines on the Management of the Perioperative Patient on Cannabis and Cannabinoids." A summative review of the evidence-based guidelines provides essential recommendations, which are directly applicable to certified registered nurse anesthetist clinical practice., Competing Interests: Name: Daniel King, DNP, CRNA, CPPS Contribution: This author made significant contributions to the conception, synthesis, writing, and final editing and approval of the manuscript to justify inclusion as an author. Disclosures: None. Name: Ewa Greenier, MPH, MBA, CAE Contribution: This author made significant contributions to the conception, synthesis, writing, and final editing and approval of the manuscript to justify inclusion as an author. Disclosures: None. Name: Maya Caballero, MPH Contribution: This author made significant contributions to the conception, synthesis, writing, and final editing and approval of the manuscript to justify inclusion as an author. Disclosures: None. Name: Brett Morgan, DNP, CRNA, FAAN Contribution: This author made significant contributions to the conception, synthesis, writing, and final editing and approval of the manuscript to justify inclusion as an author. Disclosures: None., (Copyright © by the American Association of Nurse Anesthetists.)

Abstract: This article discusses nonpharmacologic pain management interventions for alternative or concomitant use with nonopioid medications. Potential barriers as well as facilitators to integrating nonpharmacologic interventions are discussed as they relate to nursing practice., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Acute pain is a common presenting complaint in the emergency department (ED) and is most often treated with opioid or nonopioid analgesia. However, studies have shown that receiving analgesia alone does not always influence patient satisfaction with pain management in the ED. Pain anxiety and catastrophizing have been shown to affect pain intensity and patients' response to analgesia. The objective of this study was to determine whether a brief therapeutic conversation would improve patient satisfaction with pain management compared with standard care for adult patients presenting to the ED with moderate to severe acute pain. Adult (18 years or older) patients presenting to the ED with moderate to severe acute pain were randomized to either the standard care group or the intervention group. Patients in the intervention group participated in a brief therapeutic conversation with an ED nurse to discuss their perceived cause of pain, level of anxiety, and expectations of their pain management. Prior to discharge, all patients were asked to complete a self-reported, 9-item questionnaire to assess their level of satisfaction with their overall ED experience. A total of 166 patients (83 in each group) were enrolled. Patient satisfaction with ED pain management and the proportion of patients who received analgesia in the ED were similar in both the control (n = 57; 68.7%) and intervention (n = 58; 69.9%) groups (Δ 1.2%; 95% CI [12.6, 15]). Qualitative findings demonstrate that patients place high importance on acknowledgment from ED staff and worry about the unknown cause of pain. This study suggests that patient satisfaction with pain management in the ED is multifactorial and complex. Further research should investigate additional methods of integrating nurse-led interventions into the care of patients in acute pain., Competing Interests: Disclosure: The authors report no conflicts of interest., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Pain is an unpleasant sensory and emotional experience associated with or resembling that actual or potential tissue damage. Different study findings show that about 55% to 78.6% of inpatients experience moderate-to-severe pain. Nurses are one of the health professional who may hear of pain suffered by the patients and who can manage patient suffering by themselves. Therefore, their correct skill is very important in non- pharmacology and pharmacology pain management methods., Objective: To assess non-pharmacological pain management practice and barriers among nurses working in Debre Tabor Comprehensive Specialized Hospital, Ethiopia., Methods: Data were collected using structured observational check list with interviewer administered questionnaires that measure nurses' practice on non-pharmacological pain management. Data were entered using Epi Data version 3.1 and analyzed using SPSS (Stastical Package for Social Sciences) version 23. Bivariable and multivariable analysis were conducted to examine the association between independent and outcome variables., Results: A total of 169 nurses participated in the study, with a response rate of 100%. Among the study participants 94 (55.6%) were females, and the mean age of nurses were 34.9(SD = 5.7) years. Only 44(26%) of nurses had good practice on non- pharmacology pain management methods. About 130(77.55%), 125(74.0%), and 123(72.8%) of nurses reported that inadequate cooperation of physicians, multiple responsibilities of nurses and insufficient number of nurses per patient ratio as barriers for practice of non -pharmacology pain management respectively., Conclusion: Majority of nurses didn't apply non-pharmacological pain management practices for their patients in pain and the overall practice level of nurses was very poor. The major identified obstacle factors for the poor practice of non-pharmacological pain management methods were nurses' fatigue, inadequate cooperation of physicians, heavy workload, multiple responsibilities of nurses, and insufficient number of nurses per patient ratio and unfavorable attitude of nurse on non-pharmacology pain management. Even if nurses experiences different challenges, they shall use non-pharmacological pain management methods complementary to pharmacological treatment of pain as they are low cost and safe. And also boosting nurse's attitude towards the effect of non-pharmacological pain management methods is crucial., Competing Interests: The authors have declared that no competing interests exist.

Purpose: To examine the effect of an educational intervention intended to improve medical nurses' adherence to breakthrough cancer pain (BTCP) assessment practices and their level of knowledge, attitudes and perceived assessment practices regarding BTCP management., Methods: Nurses working in a regional hospital were recruited to this quasi-experimental study. The intervention group received a 3-h educational workshop and one session of individual clinical instruction, whilst the control group did not receive any intervention. Chart audits were performed to examine adherence to BTCP assessment practices as the primary outcome. A self-developed questionnaire was used to measure nurses' knowledge, attitudes and perceived assessment practices regarding BTCP management as the secondary outcomes. The chi-square or Fisher's exact test was used to compare the rate of adherence to BTCP assessment practices between groups. A generalised estimating equation was used to compare changes in knowledge, attitudes, and perceived assessment practices between groups over time., Results: One hundred and five nurses completed the study. The chart audits revealed a significantly higher rate of adherence to BTCP assessment practices in the intervention group after the intervention (p < .05). The intervention group exhibited significant positive changes in scores for knowledge (β = 25.49, p < .001), attitude (β = 0.98 to 2.81, p < .01), and their perceived assessment practices (β = 1.33 to 3.14, p < .002) when compared with the control group., Conclusions: This theory-driven educational intervention significantly improved the medical nurses' adherence to BTCP assessment practices and their level of knowledge attitudes and perceived assessment practices regarding BTCP management., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Questions from patients about pain conditions and analgesic pharmacotherapy and responses from authors are presented to help educate patients and make them more effective self-advocates. Nurses play a critical role in the care of people living with pain throughout the life span-from birth to death. They provide important services that strongly influence the quality and effectiveness of a pain care plan. The role of the professional nurse and his/her responsibilities in pain and palliative care are discussed throughout these questions and answers. [ABSTRACT FROM AUTHOR]

Purpose/aims: The aim of this study was to describe how persons given a diagnosis of a brain tumor who have had a craniotomy describe the quality of their pain after surgery., Design: A qualitative descriptive design was used., Methods: Qualitative descriptive methods as described by Sandelowski guided this study. Semistructured interviews were conducted with patients hospitalized on a neurological step-down unit in an urban teaching hospital in the Midwestern United States. Interviews focused on the quality of participants' pain after surgery. Narratives were analyzed using standard content analysis., Results: Twenty-seven participants were interviewed. Most were White and female. Most underwent a craniotomy using an anterior approach with sedation. Participants described the quality of their pain with 6 different types of descriptors: pain as pressure, pain as tender or sore, pain as stabbing, pain as throbbing, pain as jarring, and pain as itching., Conclusions: Participants' descriptions of their pain quality after surgery provide a different understanding than do numerical pain ratings. Clinicians should use questions to explore patients' individual pain experiences, seeking to understand the quality of patients' pain and their perceptions., Competing Interests: The authors report no conflicts of interest., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Abstract: Local or regional anesthetics are becoming more common pain management options for patients, especially considering concerns regarding opioid use disorders. Though mostly safe, these interventions may carry serious risks such as local anesthetic systemic toxicity (LAST). This article discusses LAST and the importance of recognizing its signs and symptoms., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Ambulatory surgery presents unique challenges regarding adequate pain management and education. Studies have documented issues with transfer of information and patient comfort. Our objective was to explore perioperative nurses' perspectives of current practices and challenges with pain management and education., Materials and Methods: We used a qualitative descriptive design and conducted four focus group interviews, with 24 total participants from two perioperative areas of an academic medical center, using a standardized script. Using qualitative analysis software, two investigators reviewed the data and coded major themes and subthemes. The consolidated criteria for reporting qualitative studies guidelines were followed for reporting the data., Results: We identified four major themes impacting current perioperative pain management and education practices: communication among the perioperative care team, sources of nurses' frustrations in the perioperative setting, patient expectations for pain, and nurse-driven pain management and education. Nurses highlighted their work became easier with adequate information transfer and trust from physicians. Frustrations stemmed from surgeon, system, and patient factors. Nurses often use their clinical experience and judgment in managing patients throughout the perioperative period. Furthermore, nurses felt patients have limited pain education and stressed education throughout the surgical care pathway could improve overall care., Conclusions: Perioperative pain management, assessment, and education practices are inconsistent, incomplete, and sources of frustrations according to participants. Participant experiences highlight the need for improved and standardized models. Patient pain education should use a multidisciplinary approach, beginning at the point of surgery scheduling and continuing through postoperative follow-up., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Management of traumatic extremity injuries in the emergency department is typically time consuming, often requiring multiple resources including pain control and procedural sedation. A hematoma block is a safe and effective alternative treatment of pain and may eliminate the need for procedural sedation. The hematoma block requires fewer emergency department resources and may decrease time and costs that are associated with procedural sedation and analgesia. This technique is easily performed by the emergency nurse practitioner, and complications are rare. This article presents the appropriate technique required to perform a hematoma block for pain control and fracture reduction in patients with closed traumatic injuries., Competing Interests: Disclosure: The author reports no conflicts of interest., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Competing Interests: The authors have no conflicts of interests to disclose.

Abstract: Managing pain can be challenging, especially in patients with serious illnesses and a history of substance use disorders. This article discusses the challenges of addressing pain in these patients and offers perspectives regarding their clinical management., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Objective: This study was conducted to investigate the effects of cognitive behavioral techniques using virtual reality on birth pain., Desing: This study was planned as a double blind randomized controlled experimental study., Setting and Participants: It was conducted with 273 pregnant women who were randomized between July 2016 and June 2019 at maternity hospital located in eastern Anatolia, Turkey., Methods: The study included 5 groups. (A: videos of newborn photographs with classical music, B: the video of the newborn photograph album, C: an introductory film of Turkey, D: only classical music, E: routine hospital care). The data were collected by using the "Personal Information Form", "Visual Analogue Scale", "Verbal Rating Scale" and "Virtual Reality"., Findings: Groups show homogeneity in terms of demographic and obstetric variables. It was found that mean Visual Analogue Scale posttest mean score of the group A was 4.98 ± 1.69; group B 4.96 ± 1.72; group C 5.96 ± 2.05; group D 5.60 ± 1.63 and group E 6.38 ± 1.86. Mean Verbal Rating Scale posttest score was found that group A was 2.64 ± 0.73, group B 2.70 ± 0.87, group C 3.18 ± 1.14, group D was 2.80 ± 0.86 and group E was 3.96 ± 1.01. It was obtained that the groups' mean Visual Analogue Scale and Verbal Rating Scale posttest mean scores was statistically significant (p<0.05)., Conclusion: In this study, all cognitive techniques applied with virtual reality reduced labor pain during the active phase of labor. Especially the video of newborn photographs with classical music and newborn photograph album have been found more effective than other interventions evaluated in reducing labor pain., Implications for Practice: Midwives can use these techniques to reduce birth pain., Competing Interests: Conflict of interest No conflict of interest has been declared by the authors, (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Abstract: The analgesic properties of opioids make them valuable pharmacologic options for patients with severe post-op pain, but healthcare providers must be cautious due to opioid-related adverse reactions. This article reviews select nonopioid adjuvant and adjunctive medications, as well as select nonpharmacologic therapies, as part of a multimodal approach to postoperative analgesia. The role of nurses in assessing, monitoring, and educating patients is also explored., (Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Pain is an important symptom in wound management, and the choice of treatment directly affects the patient's quality of life. Pain assessment (PA) is essential for quality wound care and, in Italy, mandatory by law., Objective: To administer a dedicated learning survey to obtain a better sense of current PA practices, ensure more training, improve procedures, and reduce malpractice., Methods: A 16-month learning survey of nurses based on a validated questionnaire developed for this project., Results: The survey sample comprised 512 questionnaires. Of respondents, 78% were female, 56.1% were older than 40 years, 94% were RNs, and 6% were wound care specialist nurses. Participants performed a range of dressing changes per week (1-5, 46.3%; 6-20, 34.4%; >21, 19.3%). Although 93% of respondents considered PA important, only 26% recognized it as a vital parameter, and barely one-quarter (25.4%) were aware of current legislation mandating PA. The majority (95.3%) believed that PA is not consistent with pain perceived by the patient. Further, 87.3% stated that they did not have adequate knowledge to conduct a PA, 91.4% did not consider themselves up-to-date on PA, and 81% did not document PA results. However, specific wound care training leads to significantly better PA (P < .001): 71.9% of wound care specialist nurses recognized pain as a vital parameter, and 59.4% were aware of current legislation regarding PA; further, 81.3% consistently evaluated pain, 59.4% documented PA results, and 50% communicated the outcome to the physician in charge., Conclusions: The results illustrate the lack of sensitivity, training, and education that Italian RNs have regarding PA in wound care.

Background: Chronic non-cancer pain (CNCP) is one of the major causes of disability globally, and patients who suffer from it are a complex population, which makes it difficult to provide effective care. Specialist pain clinics and nursing professionals in them are the main care providers, but there is little research conducted in this field., Aim: To explore the attitudes and knowledge of nurses working in specialist pain clinics regarding care of CNCP patients., Methods: Qualitative phenomenological approach. Sixteen semi-structured interviews were conducted in 2017 with nurses who worked in specialist pain clinics in six hospitals in southern Spain., Results: Data analysis led to the formation of two categories, 'being trained and improving knowledge in CNCP' and 'the challenge of caring for patients with CNCP', and five subcategories., Conclusion: The need for care in CNCP is not covered by nurses in all the areas it requires. Lack of time, staffing issues, and specific training in this area makes it difficult to provide care. However, some areas for improvement are proposed, such as psychological interventions, group workshops, continuous training, and multidisciplinary teams.

Background: Pain management is a very important aspect of nursing care among postoperative patients. Deficit in the knowledge and bad attitude towards pain management among nurses remain a problem in Ghana. In order to manage pain better in the surgical wards, nurses should be well equipped with knowledge of pain assessment and management., Purpose: The purpose of the study was to determine nurse's knowledge and attitude towards pain management among postoperative patients in surgical units in Ghana. Methodology . This study used the quantitative study approach with a descriptive cross-sectional study design. A sample of 211 nurses was recruited using the convenience sampling method. Data were collected using a questionnaire regarding postoperative pain management. Descriptive statistics, Pearson's correlation coefficient, and the chi-squared test were used to analyze the data using SPSS version 16.0., Results: The mean age of the nurses was 29.77, with the youngest nurse being 23 years and oldest being 39 years. Majority (72.5%) of nurses had moderate knowledge, and 89.6% of the nurses had negative attitude towards pain management. There was no significant relationship between nurse's knowledge and years of experience as a nurse (r = -0.03, p =0.64), as well as no significant relationship between knowledge and number of years working in the surgical ward (r = 0.06, p =0.36). Also, there was no significant relationship between nurses' knowledge and nurses' attitude (r = 0.06, p =0.36). Conclusion and recommendation . The level of knowledge and attitude towards postoperative management were generally inadequate among nurses. Therefore, there is the need to implement in-service training on pain management for nurses working in the surgical units frequently., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2020 Shamsu-Deen Mahama Adams et al.)

Aim: The aim of this study was to examine the knowledge, perceptions and factors influencing pain assessment and management practices among Australian emergency nurses., Background: Pain is the most commonly reported symptom in patients presenting to the emergency department, with over half rating their pain as moderate-to-severe. Patients unable to communicate, such as critically ill intubated patients, are at greater risk of inadequate pain management., Design: This cross-sectional exploratory study used survey methodology to explore knowledge, perceptions and factors influencing pain management practices among Australian emergency nurses., Methods: Australian emergency nurses were invited to complete an online survey comprising 91 items. The response rate was 450 of 1,488 (30.2%). STROBE guidelines were used in reporting this study., Results: Variations in level of acute pain management knowledge, especially in older, cognitively impaired or mechanically ventilated patients were identified. Poor interprofessional communication, workload and staffing negatively impacted on nurses' intention to administer analgesia. For intubated patients, validated observation pain assessment instruments were rarely used, although respondents recognised the importance of pain management in critically ill patients., Conclusions: Emergency nurses recognise the importance of pain relief. The ability to nurse-initiate analgesia, education and training in pain management education is variable. Little education is provided on assessing and managing acute pain in elderly, cognitively impaired or mechanically ventilated patients. Use of validated pain assessment instruments to assess pain in critically ill patients is poor., Relevance to Clinical Practice: While pain management is the responsibility of all healthcare professionals, in the emergency department, it is a core role of emergency nursing. This study highlights the variation in ability to nurse-initiate analgesia, level of acute pain knowledge, education and training, and use of validated pain assessment instruments to guide pain management in critically ill intubated patients., (© 2020 John Wiley & Sons Ltd.)

Background: The quality of pain management in hospitalized older adult patients with dementia is a crucial issue in healthcare. The knowledge and beliefs of nurses are known to predict their pain management intentions toward this particularly vulnerable patient population., Purpose: This study was designed to evaluate the reliability and validity of the Chinese version of the Knowledge and Beliefs About Pain in Elderly Patients With Dementia (KBPED-C) questionnaire using a sample of hospital nurses., Methods: A cross-sectional study was conducted. The 17-item KBPED-C was distributed between September 2013 and August 2014 to 350 nurses working at a hospital in northern Taiwan. Consistency assessment was conducted using Cronbach's alpha, and construct validity was examined using principal component analysis. Three hundred five nurses (19 men and 286 women) were enrolled using convenience sampling., Results: The mean age of the participants was 30.8 ± 5.8 years. The Cronbach's alpha for internal consistency was .86. The item-total correlation was acceptable. The observed content validity was strong, with a content validity index of .86. Construct validity testing revealed a four-factor structure that accounted for 55.2% of the total variance. The four factors of the KBPED-C questionnaire were "general beliefs about pain and aging," "pain management in the workplace," "knowledge about pain management in older adult patients with dementia," and "beliefs about pain in older people.", Conclusions/implications for Practice: This preliminary validation study showed the high acceptability, reliability, and validity of the KBPED-C for hospital nurses. Future studies may use this questionnaire to explore the beliefs and knowledge of nurses regarding pain in older adult patients with dementia.

Total joint replacement (TJR) is one of the most commonly performed and painful surgeries in the United States. Over the past few decades, regulatory changes increased the use of oral narcotics as a first-line treatment of this population. In the current opioid crisis, new pain management techniques and therapies have emerged. Research of current therapies, their effectiveness, and emerging best practices are discussed. Clear, thoughtful, and thorough education is an essential next step for closing the gap of the pain experience. Specifically, education of the frontline nurses, patients, and their caregivers on pain reduction techniques is essential., Competing Interests: Disclosure The authors have nothing to disclose., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Pain perception and preferences for pain management are unique to each woman in labor. This article provides an overview of the physiology of labor pain, discusses available nonpharmacologic and pharmacologic approaches to managing pain during active labor, and discusses potential benefits and risks for each option.

Aim and Objectives: To explore the experiences and views of nurses who provide nonpharmacological therapies for chronic pain management in palliative care., Background: Nursing expertise in palliative care is essential in providing pain relief to patients with chronic diseases. Examinations of the use of nonpharmacological therapies for chronic pain management in palliative care have revealed what nonpharmacological therapies have been used, but there is insufficient knowledge regarding nurses' attitudes, views and experiences regarding pain therapies in this context., Design: A qualitative descriptive design was chosen., Methods: Data were collected through individual interviews in a purposive sample with 15 nurses to ensure maximum variation. The data were analysed using qualitative content analysis. This study aligns with the consolidated criteria for reporting qualitative research (COREQ) checklist., Results: The analysis yielded four categories, as follows: "building and sustaining favourable therapeutic relationships" involved the creation of trust and a solid relationship; in "recognising the diversity of patients' needs," person-centred care is expressed as being vital for individualised nonpharmacological pain management; "incorporating significant others" describes how nurses can help to ease the patient's pain by identifying positive encounters with family members or friends; and in "recognising the existence of barriers," nurses highlight vulnerable groups such as children, for whom nurses require special education to enable optimal nonpharmacological pain management., Conclusion: The unique knowledge that nurses gain about the patient through the nurse-patient relationship is central and crucial for successful nonpharmacological pain management., Relevance to Clinical Practice: This study emphasises the need for nurses to get to know their patient and to be open and sensitive to patients' descriptions of their unique life situations, as this provides the necessary knowledge for optimal care and pain management. Nurses should be encouraged and given the opportunity to attend specialised training in palliative care and pain management., (© 2020 The Authors. Journal of Clinical Nursing published by John Wiley & Sons Ltd.)

Pain management in nursing care in outpatient older adults in need of care Abstract. Background: International data report a prevalence rate for chronic pain of up to 50 % in community dwelling older adults (> 65 years). A national study reported a prevalence rate of 68,5 % among outpatient adults (≥ 18 years). Nursing care has an important meaning in pain management. However, previous research on the quality of pain management in nursing care is insufficient. Aim: The aim of this study is to evaluate the appropriateness of pain management in nursing care in our target group. Method: The cross-sectional study is based on data from ACHE . The study comprises 219 patients. Information on subjective pain experience and pain management were obtained by face-to-face interviews and nursing documentation. Results: Our findings indicate considerable deficits in terms of pain management in nursing care. Results show a lack of systematic pain assessment as well as missing documentation of therapeutic aims and pain management in nursing care. Conclusions: The identified deficits might be the result of current framework conditions that separate nursing pain treatment in Volume V and Volume XI of the German Social Security Code services. Appropriateness in pain management in nursing care can only be ensured if framework conditions are optimized.