Thesis (Ph.D.)--Memorial University of Newfoundland, 2005. / Bibliography: leaves 122-146.

Diss. (sammanfattning) Linköping : Univ., 2003. / Härtill 5 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst., 2004. / Härtill 4 uppsatser.

Thesis (Ph. D.)--University of Washington, 2004. / Vita. Includes bibliographical references (leaves 66-77).

In the United States, 10% to 15% of newborns are admitted to the neonatal intensive care unit (NICU). Painful procedures are unavoidable during NICU care; the neonate experiences approximately 12 painful procedures per day. Inconsistent and/or inappropriate pain management in the NICU remains a problem. The purpose of this study is to identify the prevalent factors that influence the implementation of pain management strategies among nurses who work in a NICU setting in a Central Florida hospital. This study was conducted using a voluntary and anonymous electronic survey. The survey was divided into two sections; the first section designed to describe the sample, and the second section containing a Likert-type scale that assessed the nurses’ general pain knowledge, knowledge of pain assessment, and awareness of accepted pain management strategies. The survey was adapted from previously published research. Results indicate pain was more likely to be addressed when nurses collaborated closely with the attending physician. The majority of nurses were aware of current protocols for pain management on the unit but not all nurses agreed those protocols were adequate. Results also indicated pain assessment education is being provided in the NICU and the nurses feel confident in their skills to assess pain, however, not all nurses agreed that pain is being well managed in their unit. There appears to be a gap between the nurse’s knowledge/skill to assess pain and implementation of strategies to decrease pain. Although it is the nurse’s responsibility to prevent and treat newborn pain in the NICU, not all nurses agreed that newborn pain is well managed in their unit and some believe pain to be an unavoidable experience in the NICU. Nurse-physician collaboration is key to evidence based newborn pain management.

Background: Psychological research has consistently demonstrated the importance of cognitions in the form of thoughts and images on an individual’s wellbeing. Having pain-related verbal cognitions has been shown to lead to poorer outcomes for patients (McCracken & Turk, 2002). Research in other conditions has shown mental images have a more powerful impact on emotion than verbal cognitions (Holmes & Matthews, 2005). To date however, little work has explored the role of mental imagery in adjustment to chronic pain. Methods Fourteen semi-structured interviews were conducted with individuals with chronic pain. Interview transcripts were analysed according to grounded theory methods to construct a substantive theory of the impact spontaneously-invoked images of pain have on functioning. Results Eight participants reported pain-related imagery and three reported mental images associated with related symptoms. In line with previous findings (Gillanders et al., 2012; Gosden, 2008) the frequency and intensity of pain-related images influenced the degree of distress experienced. There was a distinction made between intrusive mental images and visual descriptions or metaphors of pain. The former being conceptualised as a visual cognition and playing a role in the aetiology and maintenance of distress in chronic pain and therefore an adverse impact on functioning. Conclusion Enhancing our understanding of pain related imagery and its impact on functioning could inform the design of interventions in clinical practice. Working systematically with patients’ idiosyncratic pain related images and the beliefs that are associated with them could be a helpful specific target for therapy.

This research project addressed pain at parturition in pigs using three different approaches. Firstly, a survey study explored UK pig farmer and veterinarian attitudes to pain and the use of pain relief in order to understand the commercial context behind decisions relating to pain and its management. Secondly, an observational study was conducted to investigate the use of behaviour to assess pain associated with the process of giving birth (or farrowing) in pigs. A final experimental study was used to investigate the administration of a pain relief drug post-farrowing to improve pig welfare and increase productivity. In a questionnaire to farmers and veterinarians, individuals were asked to identify the anti-inflammatory drugs they used or prescribed and how often for selected conditions in pigs. They were also asked to rate the painfulness of different conditions and indicate their level of agreement with statements about pain and the use of pain relief. Results showed anti-inflammatories were widely used, with high agreement that pigs recovered better when given these drugs. Farmers and vets gave similar scores for painful conditions but females and younger respondents scored higher for specific conditions. The results suggest that potential barriers to the increased use of pain relief include a lack of up to date knowledge and communication between farmers and vets about pain and how best to treat it. A preliminary investigation was conducted to identify novel behavioural measures to assess pain in sows over the periparturient period. A set of spontaneous putative pain behaviours were characterised and quantified, using observations of sows before, during and after farrowing. These potential behavioural pain indicators were rare or absent before farrowing and the highest levels were seen during farrowing. For the post-farrowing observations, levels were highest for the immediate post-farrowing period and remained higher than pre-farrowing values up to 24 hours after the last piglet was born. Positive correlations between behavioural variables measured during and after farrowing indicate the individual consistency in the expression of these behaviours. Putative pain behaviours, along with other measures of welfare and productivity were then used to test the benefits of administering the non-steroidal anti-inflammatory drug ketoprofen, compared with a saline placebo, 1.5 hours post farrowing in primiparous and multiparous sows. No clear treatment differences were observed for the sow welfare measures, including the putative behavioural indicators of pain. For primiparous sows treated with ketoprofen, fewer piglets died, but this could be due to an unexpected treatment difference in piglet birth weight, which is strongly linked with piglet mortality. Further research is needed to validate the spontaneous behaviours used in this study as indicators of pain in periparturient sows.

Diss. (sammanfattning) Stockholm : Karol. inst., 2002. / Härtill 6 uppsatser.

Diss. (sammanfattning) Linköping : Linköpings universitet, 2007. / Härtill 5 uppsatser.

Thesis (DScPT)--University of Alabama at Birmingham, 2007. / Title from first page of PDF file (viewed on June 29, 2009). Includes bibliographical references (p. 28-33).