Background: Unmitigated immunization pain in infants has the potential to impact long-term health outcomes. Teaching parents in the prenatal period may increase utilization of pain management (PM) strategies in clinical practice. Objective: To assess the efficaciousness of teaching parents in the prenatal environment and its impact on the number of analgesic PM strategies utilized during the 2-month immunization appointment. Methods: This partially blinded cluster randomized controlled trial enrolled mothers from prenatal classes at Mount Sinai Hospital. Classes were randomized to receive a presentation on either immunization PM or general immunization information. Results: One hundred and ninety-seven mothers from 28 classes participated in this study. There was a statistically significant increase (p<0.01) in the use of one or more analgesic interventions in the group that received a presentation on immunization PM compared to those who received general immunization information. Conclusions: Prenatal classes are a suitable environment to educate parents about immunization PM.

Background: Unmitigated immunization pain in infants has the potential to impact long-term health outcomes. Teaching parents in the prenatal period may increase utilization of pain management (PM) strategies in clinical practice. Objective: To assess the efficaciousness of teaching parents in the prenatal environment and its impact on the number of analgesic PM strategies utilized during the 2-month immunization appointment. Methods: This partially blinded cluster randomized controlled trial enrolled mothers from prenatal classes at Mount Sinai Hospital. Classes were randomized to receive a presentation on either immunization PM or general immunization information. Results: One hundred and ninety-seven mothers from 28 classes participated in this study. There was a statistically significant increase (p<0.01) in the use of one or more analgesic interventions in the group that received a presentation on immunization PM compared to those who received general immunization information. Conclusions: Prenatal classes are a suitable environment to educate parents about immunization PM.

Background: Chronic pain is a frequent and undertreated ailment within the long-term care community (Herman et al, 2009). The likelihood of experiencing pain increases with age and failure to treat this condition may expose individuals to prolonged and unnecessary suffering (Ramage-Morin, 2008). Furthermore, undertreated pain can lead to a life of inactivity and a failure to carry out normal social and vocational roles which in term may result in higher rates of depression, anxiety and sleep disorders (Clark, 2000). The present study aimed to explore staff perceptions on current pain management within long-term care including insights to future needs in optimizing pain management. This work will contribute to the overall awareness surrounding possible reasons that current pain management within long-term care is viewed as suboptimal (Herman et al, 2009). Methods: A qualitative, post-positivist grounded theory study was carried out in order to investigate staff-perceived strengths, weaknesses and barriers surrounding the topic of pain-management within the long-term care setting. Semi-structured interviews with 17 long-term care staff members from a variety of vocations were conducted with a focus on identifying and clarifying properties surrounding the notion that pain management is currently suboptimal. A focus group session was implemented as a method to further develop the emerging grounded theory. Results: Nine themes surrounding pain management within the long-term care setting were identified in the present study. These themes gave rise to the core concept of creating an environment supportive of optimal pain management. The nine themes were integrated into the theory of optimization of pain management within long-term care through thematic interpretation. The focus group session further developed and confirmed themes identified throughout the one-on-one interviews as well as expanded the discussed theory. Discussion: The developed theory of optimization of pain management within the long-term care setting provides a comprehensive overview of the current barriers facing adequate pain management as well as outlines future suggestions for improvement of managing pain within the long-term care setting.

Cancer pain is a serious problem that requires specialised nursing knowledge to manage. This ethnography study explored the experiences and practices of cancer pain management among nurses at the Cancer Hospital, Sri Lanka. Data were collected at the Cancer Hospital in Sri Lanka during October 2007 to January 2008. Data consisted of participant observation of nursing practice in a cancer ward, semistructured interviews with 10 participants and researcher diary. Analysis of data was undertaken with Richard’s (2005) method of handling qualitative data and consisted of coding data initially and an integrative process to develop categories. Findings identified Sri Lankan nurses have minimum cancer pain management practice because of a lack of resources, large number of patients to care for, shortage of nurses and unbearable workload in this hospital setting. Additionally the nurses are powerless as they have no autonomy in practice as well as no prospects of career promotion. They are stuck in a task oriented system that rarely acknowledges cancer patients’ pain management needs. It is anticipated that this study may lead to improve nursing pain management for cancer patients as well as curriculum change in nursing courses in Sri Lanka. Nursing curriculum change is required to include cancer pain management education as well as care of acute and palliative cancer patients. Additionally, the Ministry of Health in Sri Lanka needs to acknowledge the importance of palliative care service as well as pain management service and a recommendation is made to implement policies at the Cancer Hospital addressing these areas.

Thesis (M.S. or Ph. D.)--University of Florida, 2004. / Typescript. Vita. Includes bibliographical references (leaves 30-32).

Pain is an integral part of the life experience. Furthermore, the factors that influence the experience of pain are dynamic. Of the various influencing factors, ethnicity has a growing literature that is revealing how an individual’s subjectivity that stems from ancestral and geographic origins is affecting this process of pain perception. The actual perception of pain has been shown to be quite different among different ethnicities. Ethnically motivated dispositions, in terms of coping, has also led to more questions on how effectively patients can be treated for pain when medicine often attempts to mandate objectivity. Moreover, the interaction and feedback that patients and providers give to each other is a powerful indicator of how pain is experienced and how successful the outcomes of treatment will be.

Class of 2011 Abstract / OBJECTIVES: The purpose of this study was to survey prescribers who manage patients with chronic pain to evaluate how pharmacy services are perceived to affect patients’ quality of life. METHODS: Surveys were sent to prescribers who manage patients with chronic pain. Prescribers rated pharmacy services on a scale of 0 – 5 (0 being not important at all, and 5 being extremely important) to the quality of life of patients with chronic pain. RESULTS: Surveys were completed by 23 subjects. Prescribers ranked pharmacy services as follows: the pharmacy fills opioid prescriptions for all pain conditions (mean = 4.2; SD = 1.0), the patient is able to obtain the entire quantity of pain medication (mean = 4.1; SD = 1.5), the pharmacy treats the patient as dependent on, not addicted to opioids (mean = 3.9; SD = 1.6), the pharmacy collaborates with the prescriber to manage opiate therapy (mean = 3.9; SD = 1.5), the pharmacy stocks new and recently approved pain medications (mean = 3.8; SD = 1.1), the pharmacy provides the patient with information on adverse effects of pain medications (mean = 3.8; SD = 1.5), the pharmacy is able to use manufacturer co-pay cards to minimize out-of-pocket costs (mean = 3.5; SD = 1.7), the patient can have prescriptions delivered to their home (mean = 2.1; SD = 1.8) and the patient can obtain a prescription without having to wait a specified time period determined by their pharmacy (mean = 1.8; SD = 1.5). CONCLUSION: Prescribers in this study felt that certain pharmacy services are very important in the treatment of patients with chronic pain. Pharmacies may improve patients’ quality of life in the management of their chronic pain by providing these services.

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During a healthcare visit, children report fear of injections. Virtual Reality (VR) has been identified as a possible tool that can help decrease pain associated with receiving injections. The purpose of this study was to examine the effects of VR on decreasing pain children experience when receiving an injection. Children, 4 to 12 years old, were randomly assigned to either a VR group or a control group. In the intervention group, children engaged in VR before and during their injection as a tool for distraction.The control group received standard care. Pain was assessed through self-report, parent observations, and researcher observations. Children who experienced VR distraction displayed significantly less pain, as observed by both parents and an observer. VR appears to be an effective tool to help minimize pain in pediatric patients experiencing an injection. Therefore, pediatricians should consider providing VR as a distraction during injections.