scholarly journals The Postoperative Pain Assessment Skills Pilot Trial

2011 ◽  
Vol 16 (6) ◽  
pp. 433-439 ◽  
Author(s):  
Michael McGillion ◽  
Adam Dubrowski ◽  
Robyn Stremler ◽  
Judy Watt-Watson ◽  
Fiona Campbell ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Pain Assessment ◽  
Health Care Professionals ◽  
Pilot Trial ◽  
Standardized Patients ◽  
Analysis Of Covariance ◽  
Group Differences ◽  
Pain Beliefs ◽  
Assessment Skills ◽  
Deteriorating Patient

BACKGROUND/OBJECTIVES: Pain-related misbeliefs among health care professionals (HCPs) are common and contribute to ineffective postoperative pain assessment. While standardized patients (SPs) have been effectively used to improve HCPs’ assessment skills, not all centres have SP programs. The present equivalence randomized controlled pilot trial examined the efficacy of an alternative simulation method – deteriorating patient-based simulation (DPS) – versus SPs for improving HCPs’ pain knowledge and assessment skills.METHODS: Seventy-two HCPs were randomly assigned to a 3 h SP or DPS simulation intervention. Measures were recorded at baseline, immediate postintervention and two months postintervention. The primary outcome was HCPs’ pain assessment performance as measured by the postoperative Pain Assessment Skills Tool (PAST). Secondary outcomes included HCPs knowledge of pain-related misbeliefs, and perceived satisfaction and quality of the simulation. These outcomes were measured by the Pain Beliefs Scale (PBS), the Satisfaction with Simulated Learning Scale (SSLS) and the Simulation Design Scale (SDS), respectively. Student’sttests were used to test for overall group differences in postintervention PAST, SSLS and SDS scores. One-way analysis of covariance tested for overall group differences in PBS scores.RESULTS: DPS and SP groups did not differ on post-test PAST, SSLS or SDS scores. Knowledge of pain-related misbeliefs was also similar between groups.CONCLUSIONS: These pilot data suggest that DPS is an effective simulation alternative for HCPs’ education on postoperative pain assessment, with improvements in performance and knowledge comparable with SP-based simulation. An equivalence trial to examine the effectiveness of deteriorating patient-based simulation versus standardized patients is warranted.

scholarly journals Individual Differences and Similarities in the Judgement of Facial Pain: A Mixed Method Study

2020 ◽  
Vol 10 (4) ◽  
pp. 1186-1194
Author(s):  
Sheila Glenn ◽  
Helen Poole ◽  
Paula Oulton
Keyword(s):  
Individual Differences ◽  
Undergraduate Students ◽  
Pain Assessment ◽  
Health Care Professionals ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Pain Catastrophizing ◽  
Sensory Sensitivity ◽  
Facial Cues ◽  
Numerical Rating

Accurate assessment of pain by health-care professionals is essential to ensure optimal management of pain. An under-researched area is whether personality characteristics affect perception of pain in others. The aims were (a) to determine whether individual differences are associated with participants’ ability to assess pain, and (b) to determine facial cues used in the assessment of pain. One hundred and twenty-eight undergraduate students participated. They completed questionnaire assessments of empathy, pain catastrophizing, sensory sensitivity and emotional intelligence. They then viewed and rated four adult facial images (no, medium, and high pain—12 images total) using a 0–10 numerical rating scale, and noted the reasons for their ratings. (a) Empathy was the only characteristic associated with accuracy of pain assessment. (b) Descriptions of eyes and mouth, and eyes alone were most commonly associated with assessment accuracy. This was the case despite variations in the expression of pain in the four faces. Future studies could evaluate the effect on accuracy of pain assessment of (a) training empathic skills for pain assessment, and (b) emphasizing attention to the eyes, and eyes and mouth.

scholarly journals ‘Tracking Together’—Simultaneous Use of Human and Dog Activity Trackers: Protocol for a Factorial, Randomized Controlled Pilot Trial

2021 ◽  
Vol 18 (4) ◽  
pp. 1561
Author(s):  
Wasantha Jayawardene ◽  
Lesa Huber ◽  
Jimmy McDonnell ◽  
Laurel Curran ◽  
Sarah Larson ◽  
...  
Keyword(s):  
Physical Activity ◽  
Controlled Trial ◽  
Pilot Trial ◽  
Activity Level ◽  
Analysis Of Covariance ◽  
Moderate Intensity ◽  
Randomized Controlled ◽  
Activity Trackers ◽  
Dog Owners ◽  
Simultaneous Use

Dog-walkers are more likely to achieve moderate-intensity physical activity. Linking the use of activity trackers with dog-walking may be beneficial both in terms of improving the targeted behavior and increasing the likelihood of sustained use. This manuscript aims to describe the protocol of a pilot study which intends to examine the effects of simultaneous use of activity trackers by humans and their dogs on the physical activity level of humans and dogs. This study uses nonprobability sampling of dog owners of age 25–65 (N = 80) and involves four parallel groups in an observational randomized controlled trial with a 2 × 2 factorial design, based on use of dog or human activity trackers for eight weeks. Each group consists of dog-human duos, in which both, either or none are wearing an activity tracker for eight weeks. At baseline and end, all human subjects wear ActiGraph accelerometers that quantify physical activity for one week. Commercial activity trackers are used for tracking human and dog activity remotely. Additional measures for humans are body composition and self-reported physical activity. Dog owners also report dog’s weight and physical activity using a questionnaire. A factorial analysis of covariance (ANCOVA) is used to compare physical activity across the four groups from baseline to week-10.

scholarly journals Assessment of pain during rest and during activities in the postoperative period of cardiac surgery

2014 ◽  
Vol 22 (1) ◽  
pp. 136-143 ◽  
Author(s):  
Larissa Coelho de Mello ◽  
Silvio Fernando Castro Rosatti ◽  
Priscilla Hortense
Keyword(s):  
Cardiac Surgery ◽  
Postoperative Pain ◽  
Postoperative Complications ◽  
Postoperative Period ◽  
Pain Assessment ◽  
Descriptive Study ◽  
Deep Breathing ◽  
Cohort Design ◽  
Surgical Recovery ◽  
Over Time

OBJECTIVE: to assess the intensity and site of pain after Cardiac Surgery through sternotomy during rest and while performing five activities. METHOD: descriptive study with a prospective cohort design. A total of 48 individuals participated in the study. A Multidimensional Scale for Pain Assessment was used. RESULTS: postoperative pain from cardiac surgery was moderate during rest and decreased over time. Pain was also moderate during activities performed on the 1st and 2nd postoperative days and decreased from the 3rd postoperative day, with the exception of coughing, which diminished only on the 6th postoperative day. Coughing, turning over, deep breathing and rest are presented in decreased order of intensity. The region of the sternum was the most frequently reported site of pain. CONCLUSION: the assessment of pain in the individuals who underwent cardiac surgery during rest and during activities is extremely important to adapt management and avoid postoperative complications and delayed surgical recovery.

scholarly journals Multimodal spatio-temporal deep learning approach for neonatal postoperative pain assessment

2021 ◽  
Vol 129 ◽  
pp. 104150
Author(s):  
Md Sirajus Salekin ◽  
Ghada Zamzmi ◽  
Dmitry Goldgof ◽  
Rangachar Kasturi ◽  
Thao Ho ◽  
...  
Keyword(s):  
Deep Learning ◽  
Postoperative Pain ◽  
Pain Assessment ◽  
Learning Approach ◽  
Spatio Temporal

scholarly journals Knowledge translation and process improvement interventions increased pain assessment documentation in a large quaternary paediatric post-anaesthesia care unit

2018 ◽  
Vol 7 (3) ◽  
pp. e000319 ◽  
Author(s):  
Daniel Stocki ◽  
Conor McDonnell ◽  
Gail Wong ◽  
Gloria Kotzer ◽  
Kelly Shackell ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Knowledge Translation ◽  
Pain Intensity ◽  
Process Improvement ◽  
Nursing Staff ◽  
Pain Assessment ◽  
Pain Intensity Score ◽  
Chart Audit ◽  
Anaesthetic Care ◽  
Pacu Stay

BackgroundDue to inadequate pain assessment documentation in our paediatric post-anaesthetic care unit (PACU), we were unable to monitor pain intensity, and target factors contributing to moderate and severe postoperative pain in children. The purpose of this study was to improve pain assessment documentation in PACU through a process improvement intervention and knowledge translation (KT) strategy. The study was set in a PACU within a large university affiliated paediatric hospital. Participants included PACU and Acute Pain Service nursing staff, administrative staff and anaesthesiologists.MethodsThe Plan–Do–Study-Act method of quality improvement was used. Benchmark data were obtained by chart review of 99 patient medical records prior to interventions. Data included pain assessment documentation (pain intensity score, use of validated pain intensity measure) during PACU stay. Repeat chart audit took place at 4, 5 and 6 months after the intervention.InterventionKey informant interviews were conducted to identify barriers to pain assessment documentation. A process improvement was implemented whereby the PACU flowsheets were modified to facilitate pain assessment documentation. KT strategy was implemented to increase awareness of pain assessment documentation and to provide the knowledge, skill and judgement to support this practice. The KT strategy was directed at PACU nursing staff and comprised education outreach (educational meetings for PACU nurses, discussions at daily huddles), reminders (screensavers, bedside posters, email reminders) and feedback of audit results.ResultsThe proportion of charts that included at least one documented pain assessment was 69%. After intervention, pain assessment documentation increased to >90% at 4 and 5 months, respectively, and to 100% after 6 months.ConclusionAfter implementing process improvement and KT interventions, pain assessment documentation improved. Additional work is needed in several key areas, specifically monitoring moderate to severe pain, in order to target factors contributing to significant postoperative pain in children.

scholarly journals Impact of Mindfulness Training on Spanish Police Officers’ Mental and Emotional Health: a Non-Randomized Pilot Study

Mindfulness ◽  
2022 ◽  
Author(s):  
Jaime Navarrete ◽  
Miguel Ángel García-Salvador ◽  
Ausiàs Cebolla ◽  
Rosa Baños
Keyword(s):  
Police Officers ◽  
Repeated Measures ◽  
Emotional Health ◽  
Analysis Of Covariance ◽  
Controlled Study ◽  
Group Differences ◽  
Control Group ◽  
Depression Symptoms ◽  
Control Group Design ◽  
Paired Samples

Abstract Objectives The purpose of this exploratory non-randomized controlled study was to determine the acceptance and effectiveness of an 8-week mindfulness-based intervention (MBI) co-designed by a police officer. Methods A pretest-posttest control group design was followed. Participants (MBI group = 20; control group = 18) answered baseline and post-training self-reported measures. In addition, the weekly emotional state of the MBI group was collected. Paired-samples t-test and analysis of covariance were performed for pre-post within-group and between-group differences, respectively, as well as linear mixed effects analysis of repeated measures for week-by-week data. Results High acceptance and attendance rates, as well as significant pre-post within-group differences in the MBI group in mindfulness (η2 = 0.43), self-compassion (η2 = 0.43), depression (η2 = 0.54), anxiety (η2 = 0.46), stress (η2 = 0.51), difficulties in emotion regulation, sleep quality (η2 = 0.57), and burnout (η2 = 0.31–0.47), were identified. Moreover, police officers who underwent the MBI experienced a week by week decrease of anger, disgust, anxiety, sadness, and desire. Finally, after adjusting for pre-test scores, significant between-group differences were found in the way of attending to internal and external experiences (observing mindfulness facet; ηp2 = 0.21), depression symptoms (ηp2 = 0.23), general distress (ηp2 = 0.24), and the degree of physical and psychological exhaustion (personal burnout; ηp2 = 0.20). Conclusions The preliminary effectiveness of this MBI on psychopathology and quality of life outcomes in Spanish police officers was discussed. Previous evidence regarding the promising use of MBIs in this population was supported.

scholarly journals Improving the Quality of Care for Acute Pain Management in Recovery Room at the Georgetown Public Hospital Corporation

2019 ◽  
pp. 13-14
Author(s):  
Dorette Husbands-Anderson ◽  
Jennifer Szerb ◽  
Alexandra Harvey
Keyword(s):  
Pain Management ◽  
Pain Assessment ◽  
Health Care Professionals ◽  
Assessment Tool ◽  
Standards Of Care ◽  
Average Dose ◽  
Management Intervention ◽  
Pain Medications ◽  
Post Operative Pain ◽  
Pain Intervention

Objectives: To observe the method of pain assessment and pain management intervention performed by nurses in the PACU. Methods and Design: A QI prospective observational study was conducted to observe nurse’s pain assessment and management of thirty (30) patients from the time of PACU admission to discharge. The sample size was determined using the sealed envelope power calculator. Data Collection Included: patients demographics, the method and frequency of pain assessments as well as modalities of the pain intervention and the type and average dose of pain medications administered by PACU nurses. Data analysis was done using Microsoft excel. Results: No validated pain assessment tool was used in the PACU.  The majority of patients 67%, n=20) had no pain assessments or pain interventions. When performed, the frequency of pain assessments recorded were low, 70% of patients had 1-2 assessments. The principal pain management intervention was pharmacological with the use of opioids, accounting for 96%. Conclusion: Post-operative pain management in the PACU at GPHC does not meet accepted standards of care. More frequent nursing pain assessment using a validated pain assessment tool is required. Monotherapy with the opioid was the main pain intervention for pain management. Recommendations: Effective pain management begins with the appropriate pain assessment; therefore pain management education programs for health care professionals are essential. Also, the implementation of a standardized pain assessment tool, a standardized post anesthetic order sheet with a multimodal approach to pain management and restructuring the post-anesthetic record to allow for documentation of pain assessment will greatly improve pain management in the PACU.

Parents’, Health Care Professionals’, and Scientists’ Experiences of a Precision Medicine Pilot Trial for Patients With High-Risk Childhood Cancer: A Qualitative Study

2019 ◽  
pp. 1-11 ◽  
Author(s):  
Janine Vetsch ◽  
Claire E. Wakefield ◽  
Emily Duve ◽  
Brittany C. McGill ◽  
Meera Warby ◽  
...  
Keyword(s):  
Health Care ◽  
High Risk ◽  
Childhood Cancer ◽  
Precision Medicine ◽  
Health Care Professionals ◽  
New Technologies ◽  
Pilot Trial ◽  
Treatment Recommendations ◽  
Laboratory Research ◽  
Drug Access

PURPOSE Children with high-risk cancers have low survival rates because current treatment options are limited. Precision medicine trials are designed to offer patients individualized treatment recommendations, potentially improving their clinical outcomes. However, parents’ understanding is often limited, and expectations of benefit to their own child can be high. Health care professionals (HCPs) are often not familiar with precision medicine and might find managing families’ expectations challenging. Scientists find themselves working with high expectations among different stakeholders to rapidly translate their identification of actionable targets in real time. Therefore, we wanted to gain an in-depth understanding of the experiences of all stakeholders involved in a new precision medicine pilot trial called TARGET, including parents, their child’s HCPs, and the scientists who conducted the laboratory research and generated the data used to make treatment recommendations. METHODS We conducted semistructured interviews with all participants and analyzed the interviews thematically. RESULTS We interviewed 15 parents (9 mothers; 66.7% bereaved), 17 HCPs, and 16 scientists. We identified the following themes in parents’ interviews: minimal understanding and need for more information, hope as a driver of participation, challenges around biopsies, timing, and drug access, and few regrets. HCP and scientist interviews revealed themes such as embracing new technologies and collaborations and challenges managing families’ expectations, timing of testing and test results, and drug access. CONCLUSION Educating families, HCPs, and scientists to better understand the benefits and limitations of precision medicine trials may improve the transparency of the translation of discovery genomics to novel therapies, increase satisfaction with the child’s care, and ameliorate the additional long-term psychosocial burden for families already affected by high-risk childhood cancer.

scholarly journals Cortical thickness in obsessive–compulsive disorder: Multisite mega-analysis of 780 brain scans from six centres

2017 ◽  
Vol 210 (1) ◽  
pp. 67-74 ◽  
Author(s):  
Jean-Paul Fouche ◽  
Stefan du Plessis ◽  
Coenie Hattingh ◽  
Annerine Roos ◽  
Christine Lochner ◽  
...  
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Cortical Thickness ◽  
Group Analysis ◽  
Analysis Of Covariance ◽  
Group Differences ◽  
Grey Matter Volume ◽  
Obsessive Compulsive ◽  
Brain Scans ◽  
Compulsive Disorder

BackgroundThere is accumulating evidence for the role of fronto-striatal and associated circuits in obsessive–compulsive disorder (OCD) but limited and conflicting data on alterations in cortical thickness.AimsTo investigate alterations in cortical thickness and subcortical volume in OCD.MethodIn total, 412 patients with OCD and 368 healthy adults underwent magnetic resonance imaging scans. Between-group analysis of covariance of cortical thickness and subcortical volumes was performed and regression analyses undertaken.ResultsSignificantly decreased cortical thickness was found in the OCD group compared with controls in the superior and inferior frontal, precentral, posterior cingulate, middle temporal, inferior parietal and precuneus gyri. There was also a group x age interaction in the parietal cortex, with increased thinning with age in the OCD group relative to controls.ConclusionsOur findings are partially consistent with earlier work, suggesting that group differences in grey matter volume and cortical thickness could relate to the same underlying pathology of OCD. They partially support a frontostriatal model of OCD, but also suggest that limbic, temporal and parietal regions play a role in the pathophysiology of the disorder. The group x age interaction effects may be the result of altered neuroplasticity.

The revised FLACC score: Reliability and validation for pain assessment in children with cerebral palsy

2015 ◽  
Vol 9 (1) ◽  
pp. 57-61 ◽  
Author(s):  
Line Kjeldgaard Pedersen ◽  
Ole Rahbek ◽  
Lone Nikolajsen ◽  
Bjarne Møller-Madsen
Keyword(s):  
Cerebral Palsy ◽  
Pain Management ◽  
Postoperative Pain ◽  
Pain Score ◽  
Pain Assessment ◽  
Reliability And Validity ◽  
Measurement Properties ◽  
Cosmin Checklist ◽  
Children With Cerebral Palsy

AbstractBackground and aimsPain in children with cerebral palsy (CP) is difficult to assess and is therefore not sufficiently recognized and treated. Children with severe cognitive impairments have an increased risk of neglected postoperative, procedural and chronic pain resulting in decreased quality of life. The r-FLACC (revised Face, Legs, Activity, Cry and Consol ability) pain score is an internationally acclaimed tool for assessing pain in children with CP because of its ease to use and its use of core pain behaviours. In addition the r-FLACC pain score may be superior to other pain assessment tools since it includes an open- ended descriptor for incorporation of individual pain behaviours. The COSMIN group has set up three quality domains, which describe the quality of Health-Related Patient-Reported Outcomes (HR-PROs). These are reliability (internal consistency, reliability and measurement error), validity (content validity, construct validity and criterion validity) and responsiveness. The r-FLACC score has only been assessed for reliability and validity in the original English version by the developers of the score. The aim of this study is to assess reliability and validity of the r-FLACC pain score for use in Danish children with CP.MethodsTwenty-seven children aged 3–15 years old with CP were included after orthopaedic surgery. Two methods for assessment of postoperative pain were used. Pain intensity was assessed by r-FLACC, with a 2 min standardized video recording of the child, and the Observational Visual Analogue Score (VAS-OBS) assessed by the parents. The COSMIN checklist was used as a guideline in the reliability and validity testing of the r-FLACC score.ResultsReliability was supported by three measurement properties. Internal consistency was excellent with a Cronbachs alpha of 0.9023 and 0.9758 (two raters). A factor analysis of the subgroups in the r-FLACC score showed unidimensionality. A test-retest showed excellent intra-rater reliability with an intraclass correlation (ICC) of 0.97530. Inter-rater reliability was acceptable with an ICC of 0.74576. Validity was supported by three measurement properties. Content validity was tested by the originators of the r-FLACC. Construct validity was supported by a significant increase in r-FLACC scores following surgery (n = 17; difference 2.23; p = 0.0397). Criterion validity was acceptable with Pearson’s correlation coefficients of 0.76 and 0.59 when comparing r-FLACC scores and VAS-OBS scores.Conclusions and implicationsThis study benefits from a systematical approach to the validation and reliability parameters by using the COSMIN checklist as a guideline. It is evident that the r-FLACC pain score maintains its psychometric properties after translation. In conclusion, the r-FLACC pain score is valid and reliable in assessing postoperative pain in children with CP not able to self-report pain. With the r-FLACC pain score clinicians have a valid tool for assessing postoperative pain, hence increasing the quality of pain management in children with CP. In addition the validated r-FLACC score has the potential for use in interventional research regarding pain management in this vulnerable group of patients. Future perspectives include validation of the r-FLACC score for procedural and chronic everyday pain and implementation into daily practice.

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