Pain perception can be drastically affected by external factors in the surrounding environment. Previous studies relying on subjective ratings of pain have shown that guided meditations supplemented by virtual reality (VR) can reduce the perception of pain more successfully than the audio alone. The research question for this study was: How does the efficacy of meditation as a means of pain mitigation differ with and without the application of VR? To answer this question, we used fNIRS to visualize changes in the dorsolateral prefrontal cortex (DLPFC), which has been shown to play a role in the larger pain matrix in the brain. To induce discomfort, we used a Cold Pressor Arm Wrap (CPAW), which is a variation of the more common Cold Pressor Task (CPT). This study was a within-subjects design where in each of the three conditions participants experienced CPAW. The three conditions were: (1) control (no VR & no audio), (2) audio (audio only), and (3) VR (audio + VR). We hypothesized that there would be a decrease in cortical activity in the DLPFC during CPAW when supplemented by VR meditation compared to audio-led meditation and no meditation, due to a decrease in perceived pain in the VR condition. Our results showed that VR meditation did significantly reduce perceived pain, according to the subjective pain ratings. Participants rated their discomfort the lowest in the VR condition, slightly higher in the audio condition, and highest for the control condition (in the absence of meditation). However, there were no significant differences in activity in the DLPFC between the conditions. The lack of any significant findings with the fNIRS data could be the result of many issues, including not having a large enough sample, physiological noise, improper localization of the pain ROIs, and not having a strong enough discomfort stimulus. The future directions for this study would seek to remedy these issues in order to obtain more informative fNIRS results. Overall, this study did show that VR meditation does effectively reduce pain perception and is therefore a promising tool for nonpharmacological pain management.

Bakgrund: Smärta är ett subjektivt fenomen som kan definieras som en personlig sensoriskt eller emotionellt obehaglig upplevelse relaterad till faktisk eller potentiell skada, där biologiska, psykologiska och sociala faktorer har betydelse. Långvarig smärta definieras som smärta vilken har pågått eller varit återkommande under mer än tre månader. Smärta kan påverka kroppens system och funktioner, såsom sömn, sinnesstämning och kognitiv funktion. En biopsykosocial förklaringsmodell, vilken tillstår smärtproblematiks flerdimensionalitet, är idag vedertagen för att beskriva, bedöma och behandla smärta. Långvarig smärta är en vanligt förekommande diagnos i både industrialiserade och utvecklingsländer. Behandling vid långvarig smärta innefattar farmakologisk behandling men även icke-farmakologiska alternativ, exempelvis psykoterapeutisk behandling, akupunktur eller fysisk aktivitet. Syfte: Syftet var att belysa patienters erfarenheter av icke-farmakologisk smärtbehandling vid långvarig smärta. Metod: Litteraturstudien var av kvalitativ, induktiv ansats och baserades på tio kvalitativa artiklar. Datan bearbetades genom en kvalitativ innehållsanalys. Resultat: Fyra huvudkategorier framkom av analysen; Fysiska erfarenheter, Inverkan på känsloliv och inre förmågor, Resurser och strategier för smärthantering och Inverkande faktorer på användande och effekt. Vanligt förekommande erfarenheter av icke-farmakologisk smärtbehandling, både vid fysikaliska och psykologiska behandlingsmetoder, innefattade förändrade upplevelser av välmående och livskvalitet, samt ökad kunskap och förståelse. Konklusion: Flertalet icke-farmakologiska smärtbehandlingsmetoder gav smärtlindring. Deltagare lade dock genomgående tyngd vid andra erfarenheter relaterade till exempelvis livskvalitet, avslappning, kunskap kring smärttillstånd, relation till vårdgivare samt tillgång till resurser och strategier för smärthantering. Genom förståelse för patienters erfarenheter, kunskap kring långvarig smärta och behandlingsalternativ samt förmåga till relationsbyggande kan sjuksköterskan skapa en förbättrad personcentrerad omvårdnad och bidra till minskat lidande hos patienter med långvarig smärta. / Background: Pain is a subjective phenomenon which can be defined as a personal sensory or emotional experience associated with actual or potential tissue damage, influenced by biological, psychological and social factors. Chronic pain is defined as pain persisting or recurring for three months or longer. Pain can influence the body’s functions, such as sleep, frame of mind and cognitive function. A biopsychosocial explanatory model, which acknowledges pain’s multidimensionality, is an established way of describing, assessing and treating pain. Chronic pain is common in both developed and developing countries. Treatment includes pharmacological therapy as well as non-pharmacological options, for example psychotherapy, acupuncture or exercise movement techniques. Aim: The aim of the study was to illustrate chronic pain patients’ experiences of non-pharmacological pain management. Method: The literature study was done with a qualitative, inductive approach on the basis of ten qualitative articles. A qualitative content analysis was performed to process the data. Result: Four categories were found through the data analysis; Physical experiences, Impact on emotions and inner capabilities, Resources and strategies for pain management and Factors influencing use and effect. Common experiences of non-pharmacological pain management, both physical and psychological treatments, included changed perceptions of well-being and quality of life, as well as increased knowledge and understanding. Conclusion: Multiple non-pharmacological pain management methods gave pain relief. Participants put an emphasis on other experiences related to for example quality of life, relaxation, knowledge of pain mechanisms, caregiver relationships and access to pain management resources and strategies. Through understanding patients’experiences, having knowledge of chronic pain conditions and treatment options and relationship building skills nurses can provide a more person-centered care and can contribute to decreased suffering in patients with chronic pain.

Smärta är en vanlig orsak att söka akutsjukvård, ambulanssjuksköterskan möter en stor variation av patienter i varierande miljöer och ska lindra lidande för patienter. Det saknas kunskap om hur ambulanssjuksköterskor upplever användning av farmakologisk smärtlindring. Syftet var att beskriva ambulanspersonalens erfarenheter av användning av farmakologisk smärtlindring. Metoden som valdes var en litteraturöversikt med systematisk sökning. Sex kategorier identifierades: Patientens fysiska behov, Livsstil och medicinsk historik, Uttryck och uppfattning, Oro för biverkan, Bristande utbildning skapar osäkerhet samt Tidigare erfarenheter. Konklusionen var att det är många faktorer som tas i beaktande vid smärtlindring prehospitalt, allt ifrån patientens livsbetingelser, kulturella preferenser och sjukdomshistorik till hur situationen ser ut på platsen och hur långt det är till sjukhuset. Det är en komplex uppgift att lösa på ett adekvat sätt, det behövs utbildning och erfarenhet för att lösa den uppgiften på ett personcentrerat och tillfredställande sätt. / Pain is a common cause for patients to seek emergency medical assistance, the specialized ambulance nurse meet a variety of patients in all kind of environment and is supposed to ease the suffering of the patients. There is a lack of knowledge of the experience of how specialized nurses experience the use of pharmacological pain management. The aim for this study was to describe the ambulance personnel’s experience of using pharmacological pain management. The opted method was a literature review with systematic search. Six categories were identified: Attention to the patients´ physical needs, Lifestyle and medical history, Expression and perception, Fear of adverse effects, Lack of training results in uncertainty, and Previous experiences. There are a lot of parameters to take into consideration when administrating pain medication prehospital, anything from the patient’s life conditions, cultural preferences and medical history to the status on site and how far away the hospital is located. It is a complex assignment to solve and to solve it in a satisfactory and patient centred manner, additional training and experience is required.

Lower educational attainment has been linked to worse chronic pain outcomes, but the reasons for this relationship are unclear. This study analyzed the relationship between level of education and pain outcomes in patients with musculoskeletal pain, and potential psychosocial mechanisms to explain this relationship. We hypothesized that patients with lower educational attainment would report greater pain intensity and interference, and that pain catastrophizing, anxiety, and depression would mediate the relationship between educational attainment and pain. A total of 843 participants (63% female, 78% White, Mage=55.13), diagnosed with a musculoskeletal pain condition [knee osteoarthritis (29%), back pain (57%), and fibromyalgia (14%)], completed questionnaires including demographics, Brief Pain Inventory (BPI), Pain Catastrophizing Scale (PCS), and Hospital Anxiety and Depression Scales (HADS). Pearson correlations and bootstrapped mediation analyses were conducted to examine the relationships among education, psychosocial, and pain variables. Education was inversely correlated with pain intensity and interference, pain catastrophizing, anxiety, and depression (p < .05). Pain catastrophizing significantly mediated the relationship between education and pain intensity (95%CI [-.05, -.01]), and catastrophizing and depression mediated the effects of education on pain interference (95% CI [-.08, -.01]; 95%CI [-.06, -.01]). Anxiety did not mediate either relationship. These findings indicate that greater pain catastrophizing, and in part depression, partly drive the relationship between lower educational attainment and worse pain outcomes. This work importantly aims to reduce pain disparities and provides direction for psychosocial treatment, suggesting that pain catastrophizing may be a particularly critical target in patients with lower education level. / 2026-02-23T00:00:00Z

The purpose of this integrative literature review was to understand the effects of medical cannabis for chronic pain management in adults. Anecdotal reports suggest the use of medical marijuana as a pain management therapy could be an alternative to opioids and other medications which have long term consequences. Potential uses span the health care continuum, from prescribed outpatient symptom management, to acute care, extended care, home care, and hospice treatment settings. The methodology included a review and synthesis of relevant research articles from 2012 to 2018, written in the English language. The findings suggest medical cannabis has the potential of effectively managing chronic pain in older adults. Adverse effects, if present, are mild and resolve without intervention. Lower doses of medical cannabis were reported to be more effective in treating chronic pain compared to higher doses. Inconsistencies in the efficacy of THC were noted compared to CBD for managing neuropathic pain. Implication for nursing practice, policy, education, and recommendation for future research were discussed along with study limitations.

No description available.

This randomized controlled trial examined the effects of Music Therapy (MT), Music Medicine (MM), or Attention Control (AC) on physiological and psychological parameters of stress for adult and older adult patients receiving care in the Intensive Care Unit of a community general hospital. Previous studies have indicated effectiveness of music therapy or music medicine for these medical patients, but few data are available for music therapy interventions. This study was an attempt to add to available information about the effects of music therapy compared to the effects of music medicine or attention control for this patient population. Participants (twenty-eight adults, ranging in age from 37-83 years; not mechanically ventilated at the time of session) were randomly assigned to music therapy, music medicine or the attention control group. Repeated measures of heart rate, blood pressure, respiratory rate, oxygen saturation, and anxiety and pain levels were collected before the session, immediately after the session and at 60 minutes post-session. Anxiety was measured using the Faces Anxiety Scale, and pain was self-reported via a Visual Analog Scale. Post-session length of stay was collected from the participants' medical records. Overall, there were no significant interactions among study groups and outcome measures. There was a statistically significant difference between length of stay for music therapy participants and attention control. Over time from pre-session to post-session, statistically significant decreases in anxiety scores were measured for both music medicine and music therapy groups. Pain scores decreased for both music medicine and music therapy groups, however not significantly. Some medically beneficial effects of music therapy or music medicine were evident in the data. / Music Therapy

The proliferation of social media and other online forums has allowed female patients to share their experiences in the healthcare system. Female patients and women’s health advocates can more easily speak out about instances of gender bias in medicine, which impact women’s access to equitable healthcare and positive healthcare experiences. Although there are some medical studies addressing gender disparities in various aspects of medicine, the impacts of gender bias on healthcare remain understudied and poorly understood. Patient narratives therefore provide an essential insight into the state of gender bias in medicine today. This paper aims to explore these narratives for common themes, to determine whether the current medical literature supports the presence of gender-based disparities, and to highlight the biological, psychological, and sociocultural factors impacting any disparities. Patient narratives frequently cite frustrations with diagnostic errors or delays and inadequate pain management, and the medical literature generally supports women’s accounts of gender disparities in these areas. Several studies of diagnostic disparities show that women more frequently experience delays in diagnosis, missed diagnoses, and incorrect psychiatric diagnoses. Multiple pain management studies have found that women face longer delays in care, lower rates of analgesic administration (particularly opiates), and fewer referrals for nonpharmacologic management strategies. Explanations for these disparities are likely multifactorial, and include provider ignorance of female-specific presentations and diseases, prevalence of understudied diseases in women, misattribution of symptoms to psychogenic causes, communication differences, normalization of female pain, and misconceptions about pain tolerance. / Urban Bioethics

Bakgrund: Som grundutbildad sjuksköterska kan du möta barn inom olika verksamheter utanför den typiska barnsjukvården. Venpunktion är en smärtsam procedur och ett vanligt förekommande moment i sjukvården. Smärtan kan lindras och förebyggas med farmakologiska och icke-farmakologiska metoder, exempelvis aktiva och passiva distraktionsmetoder. Syfte: Syftet med studien var att kartlägga effekten av olika distraktionsmetoder för att minska smärta hos barn (6-12 år) vid venpunktion. Metod: En kvantitativ litteraturstudie med sammanställning av 11 interventionsstudier identifierade i PubMed och Cinahl. Resultat: Nio studier visade på statistiskt signifikant smärtlindrande effekt för åtta av elva distraktionsmetoder. Tre av sex studier som undersökte dess effekt på ångest visade på statistiskt signifikant effekt. Två studier presenterade i respektive studie en distraktionsmetod med bättre effekt, en av dessa presenterade att aktiv distraktion gav bättre effekt än passiv distraktion. Konklusion: Distraktionsmetoder kan antas ha både smärtlindrande och ångestdämpande effekt vid venpunktion på barn 6-12 år. Distraktionsmetoder bör vara aktuella att integrera i rutinen för venpunktion på barn inom svensk sjukvård. Det finns dock behov av vidare forskning inom området för att stärka dess evidens. Aspekter som distraktion som tillägg till topikal anestesi, effekt på ångest samt distraktion anpassat till barnets behov och förmågor bör studeras ytterligare. / Background: A registered nurse can meet children in different healthcare departments besides the pediatric department. Phlebotomy is a common painful procedure in healthcare. This pain can be relieved and prevented with pharmacological and non-pharmacological methods, for example, active and passive distraction methods. Aim: The study aimed to collect an overview of the effects of different distraction methods to reduce pain during phlebotomy in children 6-12 years. Methods: A quantitative literature study identified and compared 11 intervention studies collected from PubMed and Cinahl. Results: Nine studies presented a statistically significant pain-relieving effect for eight of the total eleven distraction methods. Three out of six studies presented a statistically significant effect on anxiety. Two studies each presented one distraction method with better effect, one of these presented active distraction to be better than passive. Conclusion: Distraction methods present pain-relieving and anxiety-reducing effects during phlebotomy in children 6-12 years and could therefore be appropriate to integrate into the Swedish phlebotomy routine for children. There is further need for research in the field to strengthen its evidence. Aspects such as distraction in addition to topical anesthesia, the effect on anxiety and distraction based on the child's needs and abilities need further research.

Bakgrund Att arbeta barncentrerat och behandla smärta hos barn inom hälso- och sjukvården är ett komplext arbete. Barn och vuxna har olika fysiologiska och psykologiska behov vilket ställer krav på sjuksköterskans kompetens och kunskap om barn. Syfte Syftet med denna litteraturöversikt var att sammanställa forskningsresultat för att belysa sjuksköterskors upplevelser av att vårda barn med smärta inom slutenvården. Metod Litteraturöversikten genomfördes som en strukturerad litteraturöversikt med inslag av den metodologi som används vid systematiska översikter. Arbetet skrevs som en integrativ översikt där resultatet syntetiserades till en ny helhet. I artikelsökningarna användes databaserna CINAHL och PubMed. Artiklarna var publicerades 2013-2023 och analyserades enligt Fribergs fyrstegsmodell. Resultat Resultatet sammanställdes i två huvudkategorier; faktorer och resurser samt behov av pediatrisk kompetens med fyra underkategorier; tidsbrist, stödfunktioner, teoretiska kunskaper samt erfarenhet som visar på de faktorer som påverkar sjuksköterskornas upplevelser av att vårda barn med smärta. Slutsats Sjuksköterskornas möjlighet att utföra en god och effektiv smärtvård försvårades av faktorer som tidsbrist, personalresurser, brist på fungerande riktlinjer och otillräcklig utbildning inom pediatrisk vård. Välfungerande riktlinjer och utbildning inom pediatrisk vård förbättrade förutsättningarna att kunna utföra en god smärtvård. Sjuksköterskorna ansåg även att familjerna var en viktig resurs, genom att involvera familjen som expert på sitt barn hade sjuksköterskorna goda förutsättningar att göra en individuell bedömning och ge en god smärtvård. / Background To work child-centered and treat pain in children within healthcare is a complex task. Children and adults have different physiological and psychological needs, which demands competence and knowledge about children from the nurse. Aim The aim of this literature review is to compile research literature to highlight nurses' experiences of caring for children with pain in inpatient care. Method The literature review was conducted as a structured literature review in corporating the methodology used in systematic reviews. The work was written as an integrative review where the results were synthesized into a new whole. In the article searches, the databases CINAHL and PubMed were used. The articles were published between 2013 and 2023 and were analyzed according to Friberg's four-step model. Results The results were compiled into two main categories; factors and resources and the need for pediatric expertise, with four subcategories; time constraints, support functions, theoretical knowledge, and experience, indicating the factors influencing nurses' experiences of caring for children with pain. Conclusions Nurses' ability to provide good and effective pain management was hindered by factors such as time constraints, staffing resources, lack of functional guidelines, and inadequate education in pediatric care. Well-functioning guidelines and education in pediatric care improved the conditions for providing good pain management. Nurses also considered families to be an important resource; by involving the family as experts on their child, nurses had good conditions for making individual assessments and providing good pain management.