Cancer Pain
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Cancer pain is highly prevalent, especially in advanced stages of the disease, and often persists even after treatment. It negatively impacts quality of life and functionality. Certain groups like women, minorities, and the elderly are at greater risk of not receiving proper treatment for cancer pain. While analgesic therapy can help, pain is usually not fully eliminated and the relationship between pain management and quality of life is difficult to define.
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Meanings of cancer-related pain
Presented and recorded at the Australian Pain Society Annual Scientific Meeting, April 2021 virtual event
Topical Session
3C: Meanings of Cancer-Related Pain
Tuesday, April 20, 2021
11:15 AM – 12:30 PM
Session Description: Cognitive factors are important determinants of cancer-related pain experience. Simon van Rysewyk describes how cancer-related is particularly sensitive to cognitive factors and describes some common cognitions that people with cancer-related pain have and how they influence patient outcomes. Xiangfeng Xu (Renee) presents on the cultural and social factors that influence cancer pain management of Chinese migrants and what culturally congruent strategies may be implemented to improve their pain outcomes. Melanie Lovell compares levels of suffering in people with cancer-related pain versus non-cancer chronic pain, highlighting differential meanings of existential or spiritual distress and mood dysfunction. Lovell outlines management approaches to cancer pain and suffering that are not responsive to analgesia, such as meaning- or peace-centred therapies.
Session Objectives:
At the end of the session, attendees will know:
– Common meanings of cancer-related pain and what meanings influence specific patient outcomes
– Common meanings of suffering in cancer-related pain and the relationship between these meanings and non-cancer chronic pain experience and mood dysfunction
– Effective approaches to diagnosis and management of cancer-related pain symptoms, including interventions based on meaning
– Impact of culture on Chinese migrants’ perspectives and responses to cancer pain and recommendations for clinical practice
Presenter Duties
Chair: Dr Simon van Rysewyk, University of Tasmania
Organiser/Presenter 1: Dr Simon van Rysewyk, University of Tasmania
Presenter 2: Dr Renee Xu, University of Sydney
Presenter 3: Associate Professor Melanie Lovell, University of Sydney
Cancer Pain
Palliative care aims to relieve suffering and improve quality of life for patients with chronic or terminal illnesses. It provides comprehensive pain and symptom management as well as psychological, emotional, and spiritual support for both patients and their families. Cancer pain is a major problem, with up to 80% of cancer patients experiencing moderate to severe pain at some point. Cancer pain can be somatic, visceral, neuropathic, or breakthrough in nature. A thorough assessment of pain is important for effective management.
Barriers to successful treatment of cancer pain
Objectives:
1. To discuss barriers that prevent effective treatment of cancer pain
2. To propose solutions to promote effective cancer pain management
Pain assessment in cesarean women
This document discusses pain assessment and management after cesarean section. It provides information on common pain scales like numeric, visual analogue, and Wong-Baker FACES scales. It summarizes a study that assessed pain quality using the Pain Quality Assessment Scale in 153 post-cesarean women. Scores showed unpleasant sensation was most common, followed by intensity and tenderness. While pain interfered more with physical health, most women reported feeling healthy overall. Adherence to medication was moderate. The study concluded that age, education, and occupation impacted pain levels with primiparous women experiencing slightly more severe pain.
Dr. David Flamer – Cancer Pain Management: Specialized Care
CCSN held its fifth All-party Cancer Caucus at Queen’s Park in Toronto on December 5, 2019. Once again, we provided MPPs and their staff information on an issue related to rehabilitation for cancer survivors – sporadic and chronic pain.
Alexander Wyatt, CCSN’s Public Policy Coordinator, and Owen Brady, CCSN’s Partnerships and Fundraising Manager, hosted the event. Speakers included Jennifer Jones, PhD, who spoke on cancer survivorship and rehabilitation (https://youtu.be/nwxzBvErBqE); Dr. David Flamer, who provided information on cancer pain management (https://youtu.be/yaYGeOojS2M). These two speakers were followed by Vinesha Ramasamy, a bone cancer survivor, who spoke about her chronic pain journey (above) and John Peachey, a stage 4 lung cancer survivor who was unable to attend, but asked that his experience with pain medications be read (https://youtu.be/2M6gS6OZiHk).
For the first time and with the permission of the speakers, CCSN was able to video the Caucus. We are pleased to share them with you.
To view the slide go on: http://bit.ly/36T4DmX
Follow CCSN on social media:
Twitter - https://twitter.com/survivornetca
Facebook - https://www.facebook.com/CanadianSurvivorNet
Instagram: https://www.instagram.com/survivornet_ca/
Pinterest - https://www.pinterest.com/survivornetwork
Optimalization of the 3 stepladder who
Optimalization of the 3 stepladder whoDepartment of Anesthesiology, Faculty of Medicine Hasanuddin University
HISTORY OF 3-STEP LADDER WHO
1980 – WHO establishes Cancer Control Programme
Cancer prevention
Early diagnosis with curative treatment
Pain relief and palliative care
1986 – ” Cancer Pain Relief “ published by WHO
Step Ladder WHO
Updated on 1996
Worldwide acceptance protocol
Today, worldwide consensus favouring its used for management of all pain associated with serious illness Managing Chronic Pain -guidance
The pain cycle, the role of strength, physical activity, sleep and nutrition in managing it - CREDITS Versus Arthiritis
Intensity of chronic pain — the wrong metric
The document discusses how pain intensity is an imperfect metric for evaluating chronic pain treatment outcomes. While pain intensity was widely used as the goal of acute and end-of-life pain treatment, it fails as a measure for chronic pain, which has different causes and meanings. For chronic pain patients, factors like suffering, distress, disability, and quality of life may be better indicators of treatment success than pain intensity alone. The document advocates for moving beyond a focus solely on pain intensity and adopting multimodal treatments and a biopsychosocial approach that considers the complex nature of chronic pain.
Recommended
Meanings of cancer-related pain
Presented and recorded at the Australian Pain Society Annual Scientific Meeting, April 2021 virtual event
Topical Session
3C: Meanings of Cancer-Related Pain
Tuesday, April 20, 2021
11:15 AM – 12:30 PM
Session Description: Cognitive factors are important determinants of cancer-related pain experience. Simon van Rysewyk describes how cancer-related is particularly sensitive to cognitive factors and describes some common cognitions that people with cancer-related pain have and how they influence patient outcomes. Xiangfeng Xu (Renee) presents on the cultural and social factors that influence cancer pain management of Chinese migrants and what culturally congruent strategies may be implemented to improve their pain outcomes. Melanie Lovell compares levels of suffering in people with cancer-related pain versus non-cancer chronic pain, highlighting differential meanings of existential or spiritual distress and mood dysfunction. Lovell outlines management approaches to cancer pain and suffering that are not responsive to analgesia, such as meaning- or peace-centred therapies.
Session Objectives:
At the end of the session, attendees will know:
– Common meanings of cancer-related pain and what meanings influence specific patient outcomes
– Common meanings of suffering in cancer-related pain and the relationship between these meanings and non-cancer chronic pain experience and mood dysfunction
– Effective approaches to diagnosis and management of cancer-related pain symptoms, including interventions based on meaning
– Impact of culture on Chinese migrants’ perspectives and responses to cancer pain and recommendations for clinical practice
Presenter Duties
Chair: Dr Simon van Rysewyk, University of Tasmania
Organiser/Presenter 1: Dr Simon van Rysewyk, University of Tasmania
Presenter 2: Dr Renee Xu, University of Sydney
Presenter 3: Associate Professor Melanie Lovell, University of Sydney
Cancer Pain
Palliative care aims to relieve suffering and improve quality of life for patients with chronic or terminal illnesses. It provides comprehensive pain and symptom management as well as psychological, emotional, and spiritual support for both patients and their families. Cancer pain is a major problem, with up to 80% of cancer patients experiencing moderate to severe pain at some point. Cancer pain can be somatic, visceral, neuropathic, or breakthrough in nature. A thorough assessment of pain is important for effective management.
Barriers to successful treatment of cancer pain
Objectives:
1. To discuss barriers that prevent effective treatment of cancer pain
2. To propose solutions to promote effective cancer pain management
Pain assessment in cesarean women
This document discusses pain assessment and management after cesarean section. It provides information on common pain scales like numeric, visual analogue, and Wong-Baker FACES scales. It summarizes a study that assessed pain quality using the Pain Quality Assessment Scale in 153 post-cesarean women. Scores showed unpleasant sensation was most common, followed by intensity and tenderness. While pain interfered more with physical health, most women reported feeling healthy overall. Adherence to medication was moderate. The study concluded that age, education, and occupation impacted pain levels with primiparous women experiencing slightly more severe pain.
Dr. David Flamer – Cancer Pain Management: Specialized Care
CCSN held its fifth All-party Cancer Caucus at Queen’s Park in Toronto on December 5, 2019. Once again, we provided MPPs and their staff information on an issue related to rehabilitation for cancer survivors – sporadic and chronic pain.
Alexander Wyatt, CCSN’s Public Policy Coordinator, and Owen Brady, CCSN’s Partnerships and Fundraising Manager, hosted the event. Speakers included Jennifer Jones, PhD, who spoke on cancer survivorship and rehabilitation (https://youtu.be/nwxzBvErBqE); Dr. David Flamer, who provided information on cancer pain management (https://youtu.be/yaYGeOojS2M). These two speakers were followed by Vinesha Ramasamy, a bone cancer survivor, who spoke about her chronic pain journey (above) and John Peachey, a stage 4 lung cancer survivor who was unable to attend, but asked that his experience with pain medications be read (https://youtu.be/2M6gS6OZiHk).
For the first time and with the permission of the speakers, CCSN was able to video the Caucus. We are pleased to share them with you.
To view the slide go on: http://bit.ly/36T4DmX
Follow CCSN on social media:
Twitter - https://twitter.com/survivornetca
Facebook - https://www.facebook.com/CanadianSurvivorNet
Instagram: https://www.instagram.com/survivornet_ca/
Pinterest - https://www.pinterest.com/survivornetwork
Optimalization of the 3 stepladder who
Optimalization of the 3 stepladder whoDepartment of Anesthesiology, Faculty of Medicine Hasanuddin University
HISTORY OF 3-STEP LADDER WHO
1980 – WHO establishes Cancer Control Programme
Cancer prevention
Early diagnosis with curative treatment
Pain relief and palliative care
1986 – ” Cancer Pain Relief “ published by WHO
Step Ladder WHO
Updated on 1996
Worldwide acceptance protocol
Today, worldwide consensus favouring its used for management of all pain associated with serious illness Managing Chronic Pain -guidance
The pain cycle, the role of strength, physical activity, sleep and nutrition in managing it - CREDITS Versus Arthiritis
Intensity of chronic pain — the wrong metric
The document discusses how pain intensity is an imperfect metric for evaluating chronic pain treatment outcomes. While pain intensity was widely used as the goal of acute and end-of-life pain treatment, it fails as a measure for chronic pain, which has different causes and meanings. For chronic pain patients, factors like suffering, distress, disability, and quality of life may be better indicators of treatment success than pain intensity alone. The document advocates for moving beyond a focus solely on pain intensity and adopting multimodal treatments and a biopsychosocial approach that considers the complex nature of chronic pain.
drmkj
This document discusses pain, its types, effects, assessment, and management. It defines pain and outlines types including acute, chronic, neuropathic, and postoperative pain. It describes physiological and behavioral responses to pain and factors influencing pain. Methods of pain assessment including scales, questionnaires, and initial evaluation are provided. The importance of pain management and various pharmacological and non-pharmacological approaches are summarized.
Psychological Profiling Preop
This study examined preoperative pain and symptom profiles in 70 children undergoing surgery for idiopathic scoliosis. The researchers found that 30% of children had a high preoperative pain and symptom profile characterized by higher levels of depression, fatigue, pain interference, widespread pain, and pain catastrophizing. Children with this high profile, particularly girls and those with long-standing pain, had worse postoperative pain outcomes including higher reported pain, greater opioid use, and ongoing pain issues up to 6 months later. The findings suggest a subset of children are more vulnerable to pain due to central sensitization, and this vulnerability predicts poorer recovery after spine fusion surgery.
The association between a history of lifetime traumatic events and pain sever...
This study examined the associations between a history of lifetime abuse and affective distress, fibromyalgia symptoms, pain severity, interference, and physical functioning in 3,081 chronic pain patients. The study found that those with a history of abuse had greater depression, anxiety, worse physical functioning, greater pain severity, worse pain interference, higher catastrophizing, and higher scores on the 2011 Fibromyalgia Survey criteria. Mediation models showed that fibromyalgia survey scores and affective distress independently mediated the relationship between abuse history and pain severity and physical functioning. The findings support a biopsychosocial model where affective distress and fibromyalgia symptoms interact to play roles in how abuse relates to increased pain morbidity.
00006250 201409000-00021
Chronic pelvic pain is a complex condition with no single cause. It often involves both physical and psychological factors. The document discusses the evaluation and treatment of chronic pelvic pain. It describes how understanding of the condition has evolved over time to recognize that visible pathology often does not fully explain a patient's pain. A multidisciplinary approach is needed that considers potential contributors beyond just organic findings, such as muscle tension, trauma history, and central sensitization. A thorough history and physical exam aim to identify all potential pain generators that can be addressed through treatment.
Treatment of Catastrophizing
1. Chronic pain treatment often fails for patients who catastrophize, or have an exaggerated negative mental set about pain where they feel helpless, ruminate about pain, and expect the worst.
2. While cognitive-behavioral therapy is effective for many chronic pain patients, its typical components may not adequately address catastrophizing thoughts and behaviors.
3. This paper outlines a targeted cognitive-behavioral group treatment approach to specifically reduce catastrophizing in chronic pain patients by drawing from stress management, cognitive therapy, assertiveness training, and communal coping models.
Gt41 initialmanagementchronicpelvicpain2005
The document provides guidelines for the initial management of chronic pelvic pain. It defines chronic pelvic pain and outlines that the goal is accurate diagnosis and effective management from the first presentation to reduce disruption to a woman's life. The document then reviews possible contributing factors to chronic pelvic pain including physical, psychological, and social influences. It examines evidence related to conditions like endometriosis, adhesions, irritable bowel syndrome, and more that may cause or affect chronic pelvic pain.
Indiana University Health University Hospital Palliative Care Services
Introduction
In the past three years, Indiana University Health (IUH) University Hospital Palliative Care Services has expanded its size and scope. Our mission remains to treat the suffering of patients with chronic, progressive illnesses, their families, and their providers through symptom optimization and the search for meaning. While continuing to work with patients near the end-of-life and transitioning to hospice we have increasingly been involved with complex patients whose deaths are not imminent or even expected.
Our Team
The team has transitioned from a part-time to a full-time physician, a new full-time nurse practitioner, a new position in a nurse clinical coordinator, increased time for out part-time social worker, and continued part-time chaplain.
New Opportunities for Palliative Care
IUH University Hospital sees some of the sickest of the sick including advanced liver failure, advanced pulmonary disease, and transplant patients. Our service has become involved in alleviating suffering in pancreatic, liver, renal, and multivisceral transplant patients. Our expertise in opiates has placed us in a unique position to assist with patients having pain due to opioid-hyperalgesia and narcotic bowel syndrome. In addition we have started seeing more hepatology, oncology, hematology, and pulmonary patients earlier in their disease.
Out-Patient Services
We have expanded our service to now include out-patient, currently by embedding within other clinics at University Hospital including seeing patient in the multidisciplinary oncology clinic, hematology, digestive and liver disease clinic, and surgical out-patient clinic. In the near future we hope to have dedicated clinic space within the geriatrics clinic.
Palliative Care: What every medical student needs to know
Building on the lecture I gave (and uploaded) "Palliative Care: what every primary care doctor should know" I built this talk. It is geared for 1st year medical students who are learning anatomy, physiology, and perhaps some pharmacology and pathophysiology.
In this talk, I do not explicitly address hospice care - as that was provided in an online chapter for students at UMass. I will later upload another slide set on that topic.
I hope you enjoy it.
FYI- the link to the youtube video: http://www.youtube.com/watch?v=XHtHXGhTIC4
Link to PDF of the slide show: https://files.me.com/s.mak/8fzat6
POSTER FINAL COPY
This study investigated the influence of psychological, behavioral, and social factors on pain experience in 335 patients with chronic orofacial pain. Patients completed questionnaires assessing pain, anxiety, depression, and personal resources. Results showed that patients with inadequate information, poor resources, and poor social environments reported increased pain, anxiety, and depression. Education level also influenced pain experience, with college-educated patients reporting worse outcomes than university-educated patients. The study concluded that psychosocial factors significantly impact chronic orofacial pain experience and should be considered in treatment.
Leading The Way 2009
1) Palliative care aims to improve quality of life for patients facing life-threatening illness through pain relief and prevention of suffering. It addresses physical, psychosocial, and spiritual problems.
2) High-quality palliative care is competent, compassionate, and well-coordinated across different care settings and disease stages. It treats the whole person.
3) Effective pain management for cancer patients requires a holistic, interdisciplinary approach that treats both physical pain and psychosocial suffering using pharmacological and nonpharmacological methods. The goal is to relieve suffering and improve quality of life.
Jens Foell, Asssessing pain
This document discusses various topics related to pain assessment and management, including communication models, pharmacological and non-pharmacological interventions, and specific patient populations. It provides information on pharmacological properties and dosing of medications like duloxetine, venlafaxine, pregabalin, and gabapentin. Non-pharmacological approaches mentioned include self-management education programs and placebo effects. Specific populations discussed are the elderly, where start low and go slow principles apply due to changes in pharmacokinetics.
Pain management for ems providers
1. EMS providers should receive training in pediatric pain assessment and management to improve care of pediatric patients. Protocols should include pediatric-specific pain management measures.
2. Nonpharmacological strategies like involving child life specialists can help reduce pediatric pain and anxiety. Family presence during procedures can also help.
3. Pain assessment for pediatric patients should begin in the prehospital setting and continue through emergency department discharge with instructions for home pain management.
Pain in the elderly. How to better understand and rate it.
It is often difficult to determine the amount of pain an elderly person is experiencing.This is complicated by dementia and verbal impairment. This presentation describes helpful methods to assess pain in the elderly.
P 517
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This study examined the prevalence and characteristics of wound pain in diabetes-related foot ulcers. It found that over 50% of patients reported experiencing wound pain based on formal pain assessment tools, even though some did not report pain to their podiatrist. Pain was described as tender, brief, or intermittent. Both neuropathic and neuroischaemic ulcers had low reported pain intensity and little effect on quality of life. The study concludes wound pain may be underassessed clinically and more research is needed to understand differences in pain between ulcer types.
Pediatric pain assessment
This document provides guidance on assessing pain in pediatric patients from birth through adolescence. It notes that neonates as young as 24 weeks feel pain and their nervous systems may experience greater pain intensity initially. It recommends using age-appropriate pain assessment tools such as the Neonatal Pain Scale for infants, CHEOPS scale for ages 1-7, visual analog scale for ages 2-4, numeric rating scale for ages 7-11, and same methods as adults for adolescents 11+. Non-verbal children can be assessed using the FLACC scale. Hospitals should standardize pain scales for consistency across age groups.
Pain managment
The document discusses pain management standards established by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) in 2001. These standards require facilities to properly assess, treat, and manage patient pain. It also discusses the differences between PRN ("as-needed") medication, where patients receive pain medication as requested, versus around-the-clock (ATC) scheduled dosing. Previous studies have found that ATC dosing results in better pain relief and fewer barriers to patients receiving adequate pain treatment compared to PRN dosing. This quality improvement study similarly found that ATC dosing was associated with lower reported pain levels without increasing adverse events.
Chronic Migraine Severity Scale
The document presents the Chronic Migraine Severity Scale (CMSS), a new scale for measuring the severity and impact of chronic migraine. The CMSS ranges from 0-100 points, with higher scores indicating greater severity: 0-25 is mild, 26-50 is moderate, 51-75 is severe, and 76-100 is very severe. It measures four impact categories: headache frequency, productivity loss, analgesic use, and comorbidities like anxiety, mood, sleep quality and bodily pain. The CMSS is intended to be a useful clinical and research tool for evaluating chronic migraine severity and determining appropriate treatment strategies.
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401 vehu pccpain_burgo_hunt-8.5
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drmkj
This document discusses pain, its types, effects, assessment, and management. It defines pain and outlines types including acute, chronic, neuropathic, and postoperative pain. It describes physiological and behavioral responses to pain and factors influencing pain. Methods of pain assessment including scales, questionnaires, and initial evaluation are provided. The importance of pain management and various pharmacological and non-pharmacological approaches are summarized.
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This study examined preoperative pain and symptom profiles in 70 children undergoing surgery for idiopathic scoliosis. The researchers found that 30% of children had a high preoperative pain and symptom profile characterized by higher levels of depression, fatigue, pain interference, widespread pain, and pain catastrophizing. Children with this high profile, particularly girls and those with long-standing pain, had worse postoperative pain outcomes including higher reported pain, greater opioid use, and ongoing pain issues up to 6 months later. The findings suggest a subset of children are more vulnerable to pain due to central sensitization, and this vulnerability predicts poorer recovery after spine fusion surgery.
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Treatment of Catastrophizing
1. Chronic pain treatment often fails for patients who catastrophize, or have an exaggerated negative mental set about pain where they feel helpless, ruminate about pain, and expect the worst.
2. While cognitive-behavioral therapy is effective for many chronic pain patients, its typical components may not adequately address catastrophizing thoughts and behaviors.
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Indiana University Health University Hospital Palliative Care Services
Introduction
In the past three years, Indiana University Health (IUH) University Hospital Palliative Care Services has expanded its size and scope. Our mission remains to treat the suffering of patients with chronic, progressive illnesses, their families, and their providers through symptom optimization and the search for meaning. While continuing to work with patients near the end-of-life and transitioning to hospice we have increasingly been involved with complex patients whose deaths are not imminent or even expected.
Our Team
The team has transitioned from a part-time to a full-time physician, a new full-time nurse practitioner, a new position in a nurse clinical coordinator, increased time for out part-time social worker, and continued part-time chaplain.
New Opportunities for Palliative Care
IUH University Hospital sees some of the sickest of the sick including advanced liver failure, advanced pulmonary disease, and transplant patients. Our service has become involved in alleviating suffering in pancreatic, liver, renal, and multivisceral transplant patients. Our expertise in opiates has placed us in a unique position to assist with patients having pain due to opioid-hyperalgesia and narcotic bowel syndrome. In addition we have started seeing more hepatology, oncology, hematology, and pulmonary patients earlier in their disease.
Out-Patient Services
We have expanded our service to now include out-patient, currently by embedding within other clinics at University Hospital including seeing patient in the multidisciplinary oncology clinic, hematology, digestive and liver disease clinic, and surgical out-patient clinic. In the near future we hope to have dedicated clinic space within the geriatrics clinic.
Palliative Care: What every medical student needs to know
Building on the lecture I gave (and uploaded) "Palliative Care: what every primary care doctor should know" I built this talk. It is geared for 1st year medical students who are learning anatomy, physiology, and perhaps some pharmacology and pathophysiology.
In this talk, I do not explicitly address hospice care - as that was provided in an online chapter for students at UMass. I will later upload another slide set on that topic.
I hope you enjoy it.
FYI- the link to the youtube video: http://www.youtube.com/watch?v=XHtHXGhTIC4
Link to PDF of the slide show: https://files.me.com/s.mak/8fzat6
POSTER FINAL COPY
This study investigated the influence of psychological, behavioral, and social factors on pain experience in 335 patients with chronic orofacial pain. Patients completed questionnaires assessing pain, anxiety, depression, and personal resources. Results showed that patients with inadequate information, poor resources, and poor social environments reported increased pain, anxiety, and depression. Education level also influenced pain experience, with college-educated patients reporting worse outcomes than university-educated patients. The study concluded that psychosocial factors significantly impact chronic orofacial pain experience and should be considered in treatment.
Leading The Way 2009
1) Palliative care aims to improve quality of life for patients facing life-threatening illness through pain relief and prevention of suffering. It addresses physical, psychosocial, and spiritual problems.
2) High-quality palliative care is competent, compassionate, and well-coordinated across different care settings and disease stages. It treats the whole person.
3) Effective pain management for cancer patients requires a holistic, interdisciplinary approach that treats both physical pain and psychosocial suffering using pharmacological and nonpharmacological methods. The goal is to relieve suffering and improve quality of life.
Jens Foell, Asssessing pain
This document discusses various topics related to pain assessment and management, including communication models, pharmacological and non-pharmacological interventions, and specific patient populations. It provides information on pharmacological properties and dosing of medications like duloxetine, venlafaxine, pregabalin, and gabapentin. Non-pharmacological approaches mentioned include self-management education programs and placebo effects. Specific populations discussed are the elderly, where start low and go slow principles apply due to changes in pharmacokinetics.
Pain management for ems providers
1. EMS providers should receive training in pediatric pain assessment and management to improve care of pediatric patients. Protocols should include pediatric-specific pain management measures.
2. Nonpharmacological strategies like involving child life specialists can help reduce pediatric pain and anxiety. Family presence during procedures can also help.
3. Pain assessment for pediatric patients should begin in the prehospital setting and continue through emergency department discharge with instructions for home pain management.
Pain in the elderly. How to better understand and rate it.
It is often difficult to determine the amount of pain an elderly person is experiencing.This is complicated by dementia and verbal impairment. This presentation describes helpful methods to assess pain in the elderly.
P 517
This study examined predictors of pain experienced during oocyte retrieval among 837 women undergoing IVF or ICSI treatment. The mean reported pain level was 1.95 on a 7-point scale. High pain (5-6) was reported by 7% of women. Negative gynecological experiences and hormonal side effects predicted high pain before retrieval, while anxiety, low perceived control, and longer procedure duration predicted high pain after retrieval according to multiple logistic regression. The findings suggest psychological factors like anxiety and perceived control influence pain levels during oocyte retrieval and should be considered in pain management.
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Pediatric pain assessment
This document provides guidance on assessing pain in pediatric patients from birth through adolescence. It notes that neonates as young as 24 weeks feel pain and their nervous systems may experience greater pain intensity initially. It recommends using age-appropriate pain assessment tools such as the Neonatal Pain Scale for infants, CHEOPS scale for ages 1-7, visual analog scale for ages 2-4, numeric rating scale for ages 7-11, and same methods as adults for adolescents 11+. Non-verbal children can be assessed using the FLACC scale. Hospitals should standardize pain scales for consistency across age groups.
Pain managment
The document discusses pain management standards established by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) in 2001. These standards require facilities to properly assess, treat, and manage patient pain. It also discusses the differences between PRN ("as-needed") medication, where patients receive pain medication as requested, versus around-the-clock (ATC) scheduled dosing. Previous studies have found that ATC dosing results in better pain relief and fewer barriers to patients receiving adequate pain treatment compared to PRN dosing. This quality improvement study similarly found that ATC dosing was associated with lower reported pain levels without increasing adverse events.
Chronic Migraine Severity Scale
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Preventing pain from becoming chronic short1
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401 vehu pccpain_burgo_hunt-8.5
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About AOMA: The Academy of Oriental Medicine at Austin offers a masters-level graduate program in acupuncture and Oriental medicine, preparing its students for careers as skilled, professional practitioners. AOMA is known for its internationally recognized faculty, award-winning student clinical internship program, and herbal medicine program. Since its founding in 1993, AOMA has grown rapidly in size and reputation, drawing students from around the nation and faculty from around the world. AOMA also conducts more than 20,000 patient visits annually in its student and professional clinics. AOMA collaborates with Western healthcare institutions including the Seton Family of Hospitals, and gives back to the community through partnerships with nonprofit organizations and by providing free and reduced price treatments to people who cannot afford them. The Academy of Oriental Medicine at Austin is located at 2700 West Anderson Lane. AOMA also serves patients and retail customers at its south Austin location, 4701 West Gate Blvd. For more information see www.aoma.edu or call 512-492-303434.
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