Malignant Wounds
Margaret O’Connor, Sanchia Aranda, Susie Wilkinson in Palliative Care Nursing, 2018
The assessment of malignant wounds should be a holistic process that includes the gathering of information on the person’s psychological and social state, as well as local wound factors. The management of the symptoms of malignant wounds should always be focused on the person’s quality of life, and priorities should therefore be based on problems that are identified by the patient as being the most troublesome, combined with the clinical concerns of health professionals (Grocott 1995b; Jones, Davey & Champion 1998; Pudner 1998; Collier 1997a). In discussions with the person, it is important to discuss the acceptability of various wound-management strategies (Price 1996). This information can best be gained by using patient self-report—for example, assessing pain using a pain scale (visual or descriptive), or asking the patient to rate the severity of wound odour (Collier 1997a).
Craniosacral Therapy for Traumatic Brain Injury Clients with Neurobehavioral Disorders
Gregory J. Murrey in Alternate Therapies in the Treatment of Brain Injury and Neurobehavioral Disorders, 2017
Some specific assessment methods include the following: Watch how patients get on the treatment table and how their bodies position themselves while relaxing.Look for areas where patients are unable to relax and even how they are breathing. Factors such as weakness, tightness, or restriction of motion are noted for later consideration in the treatment plan.Test the dural tube to rule out restrictions in the craniosacral complex that may be causing pain or are transferring tension or pressure from other sources.Observe closely the way patients move, the way they stand, how they function, and where their pain patterns are.Have patients rate their pain using the pain scale of 0 to 10. Break down each complaint area and ask how it feels when it is at its best, how it feels normally, and how much pain they have when it is at its worst.
Ocular history taking and slit-lamp examination
Mary E. Shaw, Agnes Lee in Ophthalmic Nursing, 2018
Ask the patient to open both eyes as this is easier than opening one. Use a slit lamp or a good pen torch. Ensure that the patient’s head is well supported. If the patient is experiencing ocular pain, topical anaesthetic drops may be necessary. However, the patient’s pain must be assessed before administering any topical anaesthetic. The patient’s pain can be assessed using a pain-rating tool such as the verbal pain scale. Care should be taken not to ‘misuse’ the topical anaesthetic in controlling a patient’s corneal pain since this can actually delay corneal epithelial healing. On no account must these drops be given to the patient to take home. If the patient is in a great deal of pain, more effective oral analgesia or a non-steroidal anti-inflammatory such as Voltarol can be prescribed.
The association between pain intensity and disability in patients with failed back surgery syndrome, treated with spinal cord stimulation
Published in Disability and Rehabilitation, 2021
Mats De Jaeger, Lisa Goudman, Sam Eldabe, Robert Van Dongen, Ann De Smedt, Maarten Moens
Pain relief is the most frequently reported outcome variable when documenting pain treatment results in the literature. However, pain (and pain intensity) is a complex and subjective concept, posing several measurement challenges [1]. One commonly used unidimensional tool is the numerical rating scale (NRS), which scores pain intensity on a 11-point scale, ranging from 0 (no pain) to 10 (worst pain imaginable). As an alternative to the NRS, a visual analog scale (VAS) may be used, but the NRS has the advantage of being enquired verbally [1–3]. However, these pain measurements present several methodological issues such as, a single snapshot measurement versus a pain diary, recollection difficulties and the subjective nature of pain measurement. Additionally, these questionnaires are relying on the self-reporting of patients, which make them subjective markers of pain. Despite those difficulties, these and other approaches are often used to collect useful information about pain intensity in clinical practice. The next challenge consists of how these pain intensity scores relate to “pain relief”. As pain relief is frequently used as an interpretation of the quality of a specific pain treatment [4]. Up till now, the different ways of reporting on pain intensity and pain relief resulted in different interpretations of important terms, such as responders, non-responders, and remitters [5,6].
Noninvasive brain stimulation combined with exercise in chronic pain: a systematic review and meta-analysis
Published in Expert Review of Neurotherapeutics, 2020
Alejandra Cardenas-Rojas, Kevin Pacheco-Barrios, Stefano Giannoni-Luza, Oscar Rivera-Torrejon, Felipe Fregni
Despite exercise and NIBS have shown good results in improving pain conditions on their own, the combination of them for chronic pain is not well established yet. We found that NIBS with exercise have a moderate to large effects in chronic pain compare to sham NIBS and exercise, we included conditions as osteoarthritis, low back pain, fibromyalgia, among others. Despite the protocols for the NIBS were more homogeneous, the protocols for the exercise were more heterogeneous and a further description of the intervention is needed including the type of exercise, the duration, the timing (before or after NIBS), the intensity and the addition of any other therapy. Moreover, despite the visual analog scale is the most used pain measurement technique, further information regarding other objective pain measurements are suggested as neurophysiological measurements. Future studies should consider a factorial design with these techniques in order to isolate the efficacy of exercise and NIBS alone and their combination in order to establish their synergistic effect.
Pain experiences of adults with osteogenesis imperfecta: An integrative review
Published in Canadian Journal of Pain, 2018
Tracy Nghiem, Khadidja Chougui, Alisha Michalovic, Chitra Lalloo, Jennifer Stinson, Marie-Elaine Lafrance, Telma Palomo, Noémi Dahan-Oliel, Argerie Tsimicalis
In the seven quantitative studies, pain was measured as a primary (28.6%)22,25 or secondary (71.4%)19–21,23,24 outcome with pain assessments conducted (1) during or after specific events (71.4%), including bisphosphonate treatment,19,20 surgery,24,25 and childbirth,22 or (2) to describe impact of pain on functioning and quality of life (QoL; 28.6%).21,23 The majority of studies did not specify what type of pain was being assessed with the exception of one study that assessed chronic pain.21 All participants self-reported their pain, except in two case studies where an observational pain scale (the Face Scale Score) was used.27,28 In these two case studies, there was no rationale given for evaluating pain through observation rather than self-report. All seven case reports reported that pain was the main reason for consultation; in six of these cases,26–28,30–32 chronic pain was present. Only one case study observed acute pain from a fracture related to an automobile tire change; the patient had no previous history of pain.29
Related Knowledge Centers
- Dolorimeter
- Vital Signs
- Preterm Birth
- Pain
- Flacc Scale
- McGill Pain Questionnaire
- Oswestry Disability Index
- Wong–Baker Faces Pain Rating Scale
- Visual Analogue Scale
- Pain Assessment In Advanced Dementia