Evaluation of the effectiveness of the web-based chronic pain management training program developed for nursing students: Triple-blind randomized controlled trial.

AIM: The aim of the study was to evaluate the effectiveness of a web-based chronic pain management training program developed for nursing students. BACKGROUND: Web-based training is effective in increasing the knowledge and attitude levels of nursing students. In the literature, data on the effectiveness of web-based education on chronic pain management education of nursing students are limited. DESIGN: This was a triple-blind randomized controlled trial conducted between May and June 2022. METHODS: The study was conducted with 66 fourth-year students enrolled in the Nursing Department of a state university in a province of Türkiye.. The students were divided into two groups: intervention (n=33) and control (n=33). A dedicated website was developed for chronic pain management training, incorporating video modules, end-of-video evaluation questions and data collection tests, all of which were made available on this platform. The personal information form, chronic pain management knowledge test, Healthcare Professionals' Attitudes toward Patients with Chronic Pain and Chronic Pain Management Training Program Evaluation Form were the data collection tools. In the implementation phase of the study, the pre-test was first applied to the control group via the website and the post-test was applied two weeks later. After the intervention group completed the pre-test, the intervention group was given web-based chronic pain management training for two weeks and the post-test was applied at the end of the training and the data collection was completed. RESULTS: After web-based training chronic pain management, the chronic pain management knowledge score of the intervention group was significantly higher than the control group (p<0.05). The intervention group had significantly higher scores in sensitivity and misconception orientation, sub-dimensions of the attitude scale towards patients with chronic pain, compared with the control group (p<0.05). CONCLUSIONS: These results show that the web-based educational intervention positively increased students' knowledge of chronic pain management and attitudes towards patients with chronic pain. It shows that web-based education is effective in chronic pain management education.

Implementing an Evidence-Based Functional Pain Assessment Scale in an Adult Inpatient Unit.

BACKGROUND: The focus on pain assessment using a single, one-dimension pain assessment scale can be problematic. Locally, challenges we faced with this were; a) pain was percieved as not being effectively managed, b) patients with chronic pain were not having their pain adequately controlled, and c) misconceptions and subsequent confusion between health care teams and patients related to what pain intensity scores mean to each individual. AIMS: The purpose of this paper is to describe an evidence-based practice project aiming at improving pain assessment through the implementation of a Functional Pain Scale (FPS) on an adult inpatient cardiothoracic unit. DESIGN: The Iowa Model-Revised and the Implementation Strategies for Evidence- Based Practice Guide served as the framework for this project. SETTING: Over an 18-month period at a academic tertiary medical center in the midwest. PARTICIPANTS/SUBJECTS: Staff and patients on an adult inpatient 48-bed medical and surgical cardiothoracic unit. METHODS: Following a synthesis of the evidence, implementation of the FPS required various strategies, such as, individualized patient and staff education, audit and feedback, a pain policy revision, and creating documentation in the electronic medical record. Evaluation of the FPS consisted of patient and staff surveys pre- and postimplementation to assess knowledge, attitudes, and behaviors. RESULTS: After the pilot period, over 75% of the patients preferred to use the FPS and almost all the patients found the scale easy to use. Nurses reported an increase in perception that pain documentation was complete, that the FPS allowed them to accurately document their patients' pain experience, and that their patients were well informed of their pain management plan. CONCLUSIONS: This project supports successful implementation of the FPS within nursing workflow. The goal of using the FPS is to change pain management discussions from an intensity reduction to meeting goals of care, aligning expectations, and creating common language among patients and providers.

Intervenções de enfermagem para pessoas com dor crônica em paliação: protocolo de revisão de escopo / Intervenciones de enfermería para personas con dolor paliativo crónico: protocolo de revisión del alcance / Nursing interventions for people with chronic palliation pain: scoping review protocol

Objetivo: mapear intervenções de enfermagem no manuseio da dor crônica em adultos e idosos em cuidados paliativos. Método: trata-se de um protocolo de revisão de escopo, alicerçado nas diretrizes do Joanna Briggs Institute e nas recomendações do Preferred Reporting Items for Systematic Reviews and Meta-analysis Protocols. Serão utilizadas cinco bases de dados: MEDLINE/PubMed, Scopus, Web of Science, CINAHAL e National Grey Literature Collection, utilizando os descritores em saúde, a fim de responder a pergunta de pesquisa: "Quais intervenções de enfermagem são realizáveis no cuidado da dor crônica em indivíduos adultos e idosos em cuidados paliativos no campo da Enfermagem?" O processo de busca, identificação e avaliação será realizado por dois avaliadores independentes. Serão incluídos artigos nos idiomas inglês, português e espanhol, que atendiam ao objetivo. Os dados serão incluídos em uma planilha previamente construída e apresentados em tabelas, figuras e diagramas.

Objetivo: mapear las intervenciones de enfermería en el manejo del dolor crónico en adultos y adultos mayores en cuidados paliativos. Método: se trata de un protocolo de revisión exploratoria, basado en las directrices del Joanna Briggs Institute y las recomendaciones de los Preferred Reporting Items for Systematic Reviews and Meta-analysis Protocols. Se utilizarán cinco bases de datos: MEDLINE/PubMed, Scopus, Web of Science, CINAHL y National Grey Literature Collection, utilizando los descriptores de salud, con el fin de responder a la pregunta de investigación: "¿Qué intervenciones de enfermería son alcanzables en el cuidado del dolor crónico en adultos y ancianos en cuidados paliativos en el campo de la Enfermería?" El proceso de búsqueda, identificación y evaluación estará a cargo de dos evaluadores independientes. Se incluirán artículos en inglés, portugués y español, que cumplieron con el objetivo. Los datos se incluirán en una hoja de cálculo previamente construida y se presentarán en tablas, figuras y diagramas.

Objective: mapping nursing interventions in the management of chronic pain in adults and elderly in palliative care. Method: this is a scope review protocol, based on the guidelines of the Joanna Briggs Institute and the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-analysis Protocols. Five databases will be used: MEDLINE/PubMed, Scopus, Web of Science, CINAHL and National Grey Literature Collection, using the descriptors in health, to answer the research question: "Which nursing interventions are feasible in the care of chronic pain in adults and elderly in palliative care in the field of Nursing?" The search, identification and evaluation process will be performed by two independent evaluators. Articles in English, Portuguese and Spanish will be included, which met the objective. The data will be included in a previously constructed spreadsheet and presented in tables, figures and diagrams.

Efectividad de una intervención multimodal para la mejora de la atención al dolor crónico / Effectiveness of a multimodal intervention for improving chronic pain care

Fundamentos: La prevalencia de dolor crónico en España es del 17% y causa sufrimiento y pérdida significativa de la calidad de vida. Las terapiasno deben enfocarse sólo a la reducción del dolor, sino que es necesario mejorar la función y la calidad de vida. Actualmente, se apuesta por combinarfármacos y otras terapias como la relajación, meditación, terapia cognitivo conductual, ejercicios dirigidos, estilos de vida saludable y técnicas de aumentode la autoestima y motivación para el cambio. Estas terapias pueden ser utilizadas como parte de un abordaje multimodal, formando parte de programaso talleres multicomponente. En este trabajo nos planteamos evaluar la efectividad de un taller desarrollado en el Hospital San Juan de Dios del Aljarafe, queintegraba distintas terapias no farmacológicas en el control del dolor crónico no oncológico y analizar las percepciones de los pacientes sobre las técnicasaplicadas y cómo afectaban al dolor y a sus estilos de vida. Métodos: Se realizó un estudio intragrupo antes-después (inicio-final del taller), comparando dolor, bienestar, consumo de fármacos, calidad de vida yautoestima. Se realizaron encuestas para profundizar en aspectos más cualitativos e identificar mejoras. El taller consistió en una acción psicoeducativa yde entrenamiento para el control mental del dolor y las emociones, fundamentada en la participación activa del paciente en el manejo de su enfermedad,promoviendo su autocuidado y autoestima, y persiguiendo mejorar el bienestar y calidad de vida. Constó de cinco sesiones de tres horas (una por semana);de carácter grupal, interactivo y práctico. El análisis estadístico se realizó con SPSS vs.27.0. Para comparar medidas relacionadas (antes-después) se realizaron las pruebas T de Student para muestras apareadas y test de Wilcoxon, y para comparar grupos independientes se usó la T de Student y U de MannWhitney; para las variables cualitativas se empleó Chi-Cuadrado y test de Fisher...(AU)

Background: The prevalence of chronic pain in Spain is 17%, which causes suffering and significant loss of quality of life. Therapies should not focusonly on pain reduction, to improve function and quality of life are necessary. Currently, it is committed to combining drugs and other therapies such asrelaxation, meditation, cognitive behavioral therapy, targeted exercises, healthy lifestyles and techniques to increase self-esteem and motivation for change. These therapies can be used as part of a multimodal approach, forming part of multicomponent programs or workshops. In this paper we proposed toevaluate the effectiveness of a workshop developed from the Hospital San Juan de Dios del Ajarafe, that integrated different non-pharmacological therapiesin the control of chronic non-oncologic pain and to analyze patients’ perceptions of the techniques applied and how they affected pain and lifestyles. Methods: An intragroup before-after study (beginning-end of the workshop) was carried out, comparing pain, well-being, drug use, quality of life, andself-esteem. Surveys were conducted to deepen more qualitative aspects and identify improvements. The workshop consisted of psychoeducational action andtraining for the mental control of pain and emotions, based on the active participation of the patient in the management of his disease, promoting self-care andself-esteem, and aiming to improve well-being and quality of life. It consisted of 5 sessions of 3 hours (1 per week); of a group, interactive and practical nature.Statistical analysis was performed with SPSS vs.27.0. To compare related measures (before-after) we used Student’s T tests for paired samples and Wilcoxon’s testand to compare independent groups, Student’s T and Mann Whitney’s U; for the qualitative variables, we used Chi-Square and Fisher’s test...(AU)

Intervenções de enfermagem à pessoa idosa com dor crónica e família, com procedimentos invasivos, para a promoção do cuidado de si / Nursing interventions for elderly people with chronic pain and their families, with invasive procedures, to promote self-care

A dor crónica é uma doença frequente na pessoa idosa, com impacto reconhecido nas suas atividades de vida diárias, pelas limitações funcionais que interferem com a sua autonomia, independência, e condicionam a sua qualidade de vida. O crescente envelhecimento da população associado à prevalência das doenças crónicas e da multimorbilidade na pessoa idosa, representam um desafio para o tratamento desta patologia. Esta realidade aliada à nossa vivência profissional, foi partilhada pela equipa de saúde, e reforçou a necessidade de desenvolver um plano de intervenção em parceria, para uma prestação de cuidados centrados na pessoa idosa com dor crónica e família, quando submetida a procedimentos invasivos para o controlo da dor, adaptados à sua singularidade. A metodologia assentou na metodologia de projeto, o alicerce teórico de enfermagem foi o Modelo de Parceria de Gomes (2021). Desenvolvemos dois estágios um num Centro Multidisciplinar de Dor e outro numa Unidade de Saúde Familiar, na região de Lisboa e Vale do Tejo. Como ponto de partida do projeto desenvolvemos uma investigação que tomou por objeto de estudo as intervenções de enfermagem à pessoa idosa com dor crónica e família com procedimentos invasivos, sendo objetivos do projeto a identificação dos fatores contribuintes para a melhoria dos cuidados prestados à pessoa idosa com dor crónica e família e, o desenho e implementação de um plano de intervenções desenvolvidas em parceria com a pessoa idosa, família e equipa de enfermagem, com a finalidade de promover a capacitação para o Cuidado -de -Si. A recolha de dados decorreu entre outubro de 2021 e janeiro de 2022. Participaram no estudo pessoas idosas com idade igual ou superior a 65 anos, com dor crónica submetidas a procedimentos invasivos num centro multidisciplinar de dor e os enfermeiros da mesma instituição. Realizou-se um estudo qualitativo, recorrendo ao focus group, com uma amostra intencional de enfermeiros, e à entrevista semiestruturada na abordagem às pessoas idosas submetidas a procedimentos invasivos para o controlo da dor crónica. Dos resultados emergiram um conjunto de pressupostos que definiram o enquadramento para a implementação de um guião orientador para a estruturação dos cuidados à pessoa idosa e família submetidas a procedimentos invasivos para o controlo da dor crónica, com base num modelo de cuidados, respondendo às necessidades da pessoa idosa e família e promovendo a continuidade dos cuidados. O percurso realizado permitiu o desenvolvimento de competências como enfermeira especialista e mestre na área da intervenção à pessoa idosa, e o desenvolvimento de competências da equipa de enfermagem no cuidado à pessoa idosa com dor crónica e família com procedimentos invasivos, para a promoção do Cuidado -de -Si.

Chronic pain is a frequent disease in the elderly, with a recognized impact on their daily activities, due to the functional limitations that interfere with their autonomy, independence, and condition their quality of life. The increasing aging of the population associated with the prevalence of chronic diseases and multimorbidity in the elderly represent a challenge for the treatment of this pathology. This reality, combined with our professional experience, was shared by the health team, and reinforced the need to develop an intervention plan in partnership, for the provision of care centered on the elderly with chronic pain and family, when subjected to invasive procedures for the pain control, adapted to your uniqueness. The methodology was based on the project methodology, the theoretical foundation of nursing was the Partnership Model by Gomes (2021). We developed two internships, one in a Multidisciplinary Pain Center and the other in a Family Health Unit, in the Lisbon and Tagus Valley region. As a starting point for the project, we developed an investigation that studied nursing interventions for elderly people with chronic pain and families with invasive procedures. chronic pain and family, and the design and implementation of an intervention plan developed in partnership with the elderly person, family and nursing team, with the aim of promoting training for self-care. Data collection took place between October 2021 and January 2022. Elderly people aged 65 years and over, with chronic pain undergoing invasive procedures in a multidisciplinary pain center and nurses from the same institution participated in the study. A qualitative study was carried out, using a focus group, with an intentional sample of nurses, and a semi-structured interview in approaching elderly people undergoing invasive procedures to control chronic pain. From the results, a set of assumptions emerged that defined the framework for the implementation of a guideline for the structuring of care for the elderly and family submitted to invasive procedures for the control of chronic pain, based on a care model, responding to the needs of the elderly person and family and promoting continuity of care. The route taken allowed the development of skills as a specialist nurse and master in the area of intervention for the elderly, and the development of skills of the nursing team in the care of elderly people with chronic pain and families with invasive procedures, for the promotion of Care - of -Si.

Evaluation of the Arabic version of the Chronic Pain Grade scale: Psychometric properties.

To increase our understanding of chronic pain in clinical and research contexts, an assessment of its dimensions using reliable and valid self-reported pain measures is imperative. However, well-validated Arabic chronic pain assessment scales are lacking. The Chronic Pain Grade (CPG) scale has been used worldwide, yet an Arabic version of the CPG scale has not yet been validated. Thus, we conducted this study to demonstrate the psychometric properties, including reliability, convergent validity, and construct validity of the Arabic CPG scale. A cross-sectional study was conducted in two hospitals in Saudi Arabia. Data were collected from a convenience sample of 233 chronic pain patients. The confirmatory factor analysis showed an excellent fit with the factor structure of the CPG scale and, thus, supported construct validity. The two identified subscales were pain intensity and pain disability. Convergent validity was supported by having significant correlations between the short-form McGill Pain Questionnaire and CPG subscales. Internal consistency reliability was demonstrated, as Cronbach's α was 0.916 for pain intensity and 0.815 for pain disability. This study provides evidence that the Arabic CPG scale is a reliable and valid measure of chronic pain dimensions, including pain intensity, and pain-related disability. This Arabic version of the CPG scale has the potential to expand research and clinical assessment in the Arab world. Future studies are required for further validation.

Chronic Pain Management during the Covid-19 Pandemic: A Scoping Review.

BACKGROUND: The COVID-19 pandemic has led caregivers to modify patient healthcare, with a high impact on patients with chronic pain. AIMS: To map recommendations for the management of chronic pain patients during the COVID-19 pandemic and propose a workflow for the management of these patients. DESIGN: This was a scoping review. METHODS: The databases searched were PubMed, Embase, CINAHL, Scopus, Cochrane Library, and LILACS. The studies were examined by two independent reviewers. The disagreements between reviewers were resolved through discussion or with a third reviewer. RESULTS: We presented the results in the form of a table, a workflow, and a narrative summary. The search resulted in 13 studies selected for full reading, including one consensus, five guidance documents, two expert panels, one joint statement, two educational flyers, and two free comments. We considered new technologies, including telemedicine. Each pain service needs to establish a screening model, classifying patients according to corresponding severity. Particular attention should be given to patients who use opioids and are at risk of misusing them. Nonpharmacological approaches and pain education should be maintained, considering the use of telehealth. CONCLUSIONS: Recommendations for the management of chronic pain during COVID-19 include adjustments to the patient care model. The workflow proposes the use of telemedicine, screening for painful intensity, and the use of color-signaled intervention packages according to severity (green, yellow, and red).

Vivir con dolor crónico desde la experiencia de adultos mayores con enfermedades crónico degenerativas / Living with cronic pain from the experience of older adults with chronic degenerative diseases

INTRODUCCIÓN: Ser adulto mayor conlleva a cambios físicos, psicológicos y sociales que se ven aún más afectados por comorbilidades como las enfermedades crónicas y el dolor. El propósito es interpretar las experiencias de vivir con dolor de los adultos mayores con enfermedades crónico-degenerativas. METODOLOGÍA: Diseño cualitativo de tipo fenomenológico, recolectado mediante un muestreo intencional a través de una entrevista semi estructurada, en la cual se seleccionó a la población adulta mayor con una patología crónico-degenerativa que haya experimentado dolor crónico; se analizaron los datos con el proceso cognitivo de Janice Morse, hasta llegar a la saturación de la información. Participaron 8 personas entre los 66 y 72 años, habiendo siete mujeres y un hombre. RESULTADOS: Se encontraron cuatro categorías: 1. El desgaste de vivir con dolor; 2. Cotidianidad del vivir con dolor; 3. Alternativas para aliviar el dolor, y 4. Afectación en el entorno social. CONCLUSIÓN: Ser adulto mayor trae muchos cambios en todas las esferas de la vida, sin embargo, el padecer una enfermedad crónica acelera toda esta transición, viéndose afectados la salud mental, físico y social, adaptando esta situación a su cotidianidad, buscando a su vez medios alternos que mitiguen o disminuya el dolor.

INTRODUCTION: Being an older adult leads to physical, psychological, and social changes that are further affected by comorbidities such as chronic diseases and pain. The purpose is to interpret the experiences of living in pain of older adults with chronic-degenerative diseases. METHOD: Qualitative phenomenological research, recollected by an intentional sampling through a semi-structured interview in which was selected the adult population with a chronic-degenerative pathology that have experienced an state of chronic pain. The data was analyzed with the cognitive process of Janice Morse and reached to a saturation of 8 participants. There were 8 participants between the ages of 66 and 72, with seven women and one man. RESULTS: Four categories were found: 1. Wearing of living with pain; 2. Daily Living with Pain; 3. Alternatives for Pain Relief, and 4. Social Affectation. CONCLUSION: Being an older adult brings many changes in all spheres of life, however, suffering from a chronic disease accelerates this whole transition, being affected mental, physical and social health, adapting this situation to its daily life, seeking in turn alternate means to mitigate or decrease pain.

Chronic non-cancer pain management by nurses in specialist pain clinics.

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.

Tell me your dreams and goals: Structuring communication exchanges to improve patient-centered care with chronic pain patients.

BACKGROUND: Communicating pain is a difficult endeavor due to the lack of observable pathology, the immeasurable nature of pain, and the presence of comorbid symptoms. While research has shown the value of cure-centered and care-centered communication, it is unclear how chronic pain patients would like to structure pain communication with their providers so that it produces pain disclosure and emotional support. Aim This study examines communication preferences of chronic pain patients including types of questions asked and information received to allow a holistic portrayal of the experience of living with chronic pain. DESIGN: The research used a quantitative survey that was disseminated via online chronic pain devoted support groups. PARTICIPANTS: 192 respondents took the survey, with women respondents outnumbering men at a 4:1 ratio. Respondents came from 38 states and represented eight countries. RESULTS: For providers to better understand patients' chronic pain, results indicate they would like providers to inquire about how pain impacts their daily activities, relationships, work responsibilities, and goals and dreams using open-ended questions. These low-stake questions can facilitate emotional disclosure, increase feelings of support, and allow for co-morbid linkages. CONCLUSION: These inquiries prioritize patients' own subjective knowledge, can deepen the communication exchange between provider and patient, and facilitate pain disclosure. The findings help to deliver patient-centered care, promote rapport, and foster trust between providers and their patients.

Nurses' experiences of providing nonpharmacological pain management in palliative care: A qualitative study.

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.

Exploring unmet healthcare needs, healthcare access, and the use of practitioner based complementary and alternative medicine in adults with chronic pain.

Background: Chronic pain is a complex condition frequently encountered in nursing practice, resulting in negative multidimensional effects on the individual and healthcare system. Increasingly, people with chronic pain are turning to Complementary and Alternative Medicine (CAM) to manage their pain. Objectives: To explore the relationship between healthcare access, unmet healthcare needs, and practitioner-based Complementary and Alternative Medicine use in adults with chronic pain. Design: A secondary analysis of 1688 individuals ≥18 years old self-reporting chronic pain from Cycle 9 of the Canadian National Population Health Survey. Methods: Multivariate logistic regression and descriptive statistics. Results: When controlling for demographics and health status indicators, the presence of unmet healthcare needs was found to predict CAM use (p < 0.001; OR 2.02; CI [1.45, 2.81]), along with sex, education, income, employment, and restriction of activities. Conclusion: People may be using CAM due to shortcomings of the conventional healthcare system, with implications for policymakers and healthcare professions to develop more integrative strategies to improve chronic pain management. Impact statement: Having unmet healthcare needs is associated with two-fold increased odds of using Complementary and Alternative Medicine in Canadian adults with chronic pain.

Psychometric Evaluation of the Nursing Outcome "Pain: Adverse Psychological Response" in Patients With Chronic Pain.

PURPOSE: To culturally adapt into Spanish and validate the outcome "Pain: Adverse psychological response" (code 1306) in patients with chronic pain. METHODS: A three-stage study was conducted: (a) translation and cultural adaptation, (b) content validation, and (c) clinical validation. FINDINGS: The Spanish version of the outcome "Pain: Adverse psychological response" has high content validity ( 0.91). Fourteen indicators were organized into two factors. This version offers good reliability in both inter-observer agreement (kappa = 0.72) and internal consistency (alpha = 0.89). CONCLUSIONS: The Spanish adaptation of "Pain: Adverse psychological response" is a reliable and valid instrument for the measurement of emotional aspects of chronic pain. IMPLICATIONS FOR NURSING PRACTICE: The Spanish adaptation of this outcome offers nurses a set of structured indicators to measure the adverse emotional impact of chronic pain.

A review of interventions to reduce pain in chronic wounds.

Reduction of chronic wound pain has the potential to improve patients' quality of life, expedite the healing process and, ultimately, relieve pressure on community services. Despite this, education on pain assessment in the management of chronic wounds is lacking. This literature review seeks to provide evidence-based recommendations to reduce chronic wound pain and inform the practice of community nurses. The results of a thematic analysis indicate that a honey dressing or native collagen matrix dressing and conditioning exercises for the lower leg can reduce pain, and nitroglycerin ointment is especially effective. The review also highlights the need for an individualised approach to the assessment and treatment of pain in patients with chronic wounds.

Managing Pain During an Opioid Epidemic.

Resources for nurses, patients, and the public.

Psychometric Evaluation of the Nursing Outcome Knowledge: Pain Management in People with Chronic Pain.

Pain has a major impact on health and quality of life. Since the level of knowledge of painful conditions can influence how these are addressed and managed, assessing this knowledge in patients becomes crucial. As a result, it is necessary to have culturally adapted and validated instruments that specifically measure patients' knowledge of chronic pain management. The objective of this study was to carry out the Spanish cultural adaptation and the validation of the outcome Knowledge: PainManagement of the Nursing Outcomes Classification (NOC) in patients with chronic pain, defined as extent of understanding conveyed about causes, symptoms, and treatment of pain. A three-stage study was designed: 1) translation and cultural adaptation through an expert panel, 2) content validation, 3) clinical validation. This study provides nurses with a Spanish version of this scale adapted to their context, as well as a set of structured indicators to measure patients' knowledge about chronic pain. The results indicated that the culturally adapted Spanish version of the outcome Knowledge: PainManagement had a high level of content validity (CVI = 0.92), with 27 indicators being distributed between two factors. This version has been shown to be reliable in terms of inter-observer agreement (κ = 0.79) and internal consistency (α = 0.95). In conclusion, Knowledge: PainManagement has been shown to be reliable and valid to measure knowledge of chronic pain.

The Perceived Value of Certification in Nonsurgical Pain Management.

Chronic pain is a growing epidemic in America. Challenges in patients' access to care, and in reimbursement to Certified Registered Nurse Anesthetists (CRNAs) who provide pain services, have resulted in a voluntary subspecialty certification in nonsurgical pain management (NSPM) for CRNAs. An evaluation was conducted of perceptions of CRNAs toward the value of certification in NSPM. An invitation to complete the Perceived Value of Certification Tool (PVCT) was sent to 474 CRNAs who identified the subspecialty practice of NSPM upon application for recertification to the NBCRNA. Data were collected on 18 factors related to the perceived value of certification in the NSPM subspecialty. Exploratory factor analysis using principal components analysis with varimax rotation was conducted to assess the latent structure of the PVCT and to identify potential constructs of CRNAs' perceptions. Reliability was assessed using Cronbach α coefficients. Of 64 CRNAs who provided data, a 3-factor solution emerged that explained 72.25% of the overall variance: personal satisfaction, professional recognition, and competence, each with excellent to good reliability (F1: α = 0.95, F2: α = 0.94, F3: α = 0.88). Identification of the 3 constructs in this study will assist with future efforts of examination validation for the subspecialty of NSPM certification for CRNAs.

Opioid Use in Long-Term Care: Guidelines and Policy Recommendations.

Older adults living in long-term care (LTC) settings experience a higher incidence of chronic pain than those living in the community and are prescribed opioids at approximately twice the rate. Opioids are effective in managing pain in LTC residents, who are often not candidates for nonopioid pharmacological or nonpharmacological therapies. The recent Centers for Disease Control and Prevention guideline for opioid stewardship recommends conservative opioid prescribing and discourages long-term opioid use for chronic pain management, raising concern that pain may not be adequately treated for LTC residents. The Society for Post-Acute and Long-Term Care Medicine recently published a policy statement that addresses responsible opioid stewardship in LTC. The current article describes clinical guidelines and standards that can guide LTC nurses in assessing, treating, and monitoring opioid use so that residents have diminished pain without significant adverse events. [Journal of Gerontological Nursing, 45(9), 5-10.].