Factors influencing nurses' pain assessment and interventions in children

Research is lacking on factors influencing nurses' decision-making directed at the diagnosis of pain in children and its related interventions This paper reports on two studies, namely a qualitative study and its replication, in which we explored factors influencing nurses' pain assessments and interventions in children Those factors found to influence nurses' decisions were medical diagnosis, child's expressions, age, and parents, and the nurses' knowledge, experience, attitude and workload Some of these factors seem to have more influence than others For example, the presence of a medical diagnosis seems to legitimate being in pain Furthermore, it is suggested that mainly vocal expressions, especially crying, influence nurses' decisions to administer analgesics Finally, nurses' negative views on non-narcotic analgesics were striking In this paper, the results of both studies and their relationship to information reported in the literature are further elaborated and discussed, and hypotheses on strength and direction of influence of factors on pain assessment and intervention are generated     

小儿术后疼痛的护理进展

解除术后疼痛是患儿术后护理工作的重要内容。因此就患儿术后疼痛的评估、疼痛的控制及影响控制的因素、疼痛的护理进行了综述。     

Pediatric pain assessment: trends and research directions

A number of methodologies to assess pain in children are available. These are analyzed from both a clinical and a research standpoint. Research related to factors influencing the response to pain, including age, developmental stage, gender, culture, prior experience, anxiety level, the painful stimulus, and the role of significant others, are reviewed. A range of pain assessment instruments are presented with consideration given to the indications for use, issues of reliability and validity, and practical concerns. The need for further research is defined, particularly in regard to children of ethnically diverse populations.     

Assessment of sickle cell pain in children and young adults using the adolescent pediatric pain tool

The objectives of this study were to describe and compare the characteristics of pain experienced by children and young adults with sickle cell disease (SCD) in inpatient and outpatient settings. The Adolescent Pediatric Pain Tool (APPT), a multidimensional self-report pain assessment, was completed by African American children and young adults (mean age 15.39 +/- 4.32) with SCD during a clinic visit (n = 52), day hospital visit (n = 29), or during the first 24 hours of an inpatient stay (n = 72). Multiple linear regression revealed that pain intensity, number of body areas with pain, and the quality of pain were related to age, sex, and care setting. Pain intensity, location, and quality were of greater magnitude than previous reports of early postoperative pain in children. Examining the specific dimensions of pain intensity, location, and quality and the influencing factors of age, sex, and care setting may lead to more effective treatments for SCD pain.     

恶性肿瘤患儿家庭抗逆力的研究进展

恶性肿瘤不仅给患儿带来生理和心理的痛苦,而且使家庭处于逆境和困难中,家庭需适应恶性肿瘤带来的众多变化。家庭抗逆力是恶性肿瘤患儿家庭成功适应逆境和克服困难的重要因素。本研究旨在分析家庭抗逆力的测量工具、肿瘤患儿家庭抗逆力的现状、影响因素和干预措施,以期为后续相关研究和临床干预方案的制定和实施提供参考。     

Pain assessment and intensity in hospitalized children in Canada

Numerous acute pediatric pain assessment measures exist; however, pain assessment is not consistently performed in hospitalized children. The objective of this study was to determine the nature and frequency of acute pain assessment in Canadian pediatric hospitals and factors influencing it. Pain assessment practices and pain intensity scores documented during a 24-hour period were collected from 3,822 children aged 0 to 18 years hospitalized on 32 inpatient units in 8 Canadian pediatric hospitals. Pain assessment was documented at least once within the 24 hours for 2,615/3,822 (68.4%) children; 1,097 (28.7%) with a pain measure alone, 1,006 (26.3%) using pain narratives alone, and 512 (13.4%) with both a measure and narrative. Twenty-eight percent of assessments were conducted with validated measures. The mean standardized pain intensity score was 2.6/10 (SD 2.8); however, 33% of the children had either moderate (4–6/10) or severe (7–10/10) pain intensity recorded. Children who were older, ventilated, or hospitalized in surgical units were more likely to have a pain assessment score documented. Considerable variability in the nature and frequency of documented pain assessment in Canadian pediatric hospitals was found. These inconsistent practices and significant pain intensity in one-third of children warrant further research and practice change.PerspectiveThis article presents current pediatric pain assessment practices and data on pain intensity in children in Canadian pediatric hospitals. These results highlight the variability in pain assessment practices and the prevalence of significant pain in hospitalized children, highlighting the need to effectively manage pain in this population.     

Bone mineral density and perceived menopausal symptoms: factors influencing low back pain in postmenopausal women

Title.  Bone mineral density and perceived menopausal symptoms: factors influencing low back pain in postmenopausal women.
Aim.  This paper is a report of a study of the relationships between the factors influencing low back pain in postmenopausal women (i.e. menopausal symptoms, bone mineral density, duration of menopause, hormonal therapy, obesity, inactivity during leisure time, parity, osteoarthritis and drinking coffee).
Background.  Previous studies have shown that low back pain in postmenopausal women is associated with bone mineral density, menopausal symptoms and lifestyle factors, yet the factors influencing low back pain are not clear and vary with ethnicity.
Method.  A survey was conducted with postmenopausal women ( n  =   134) in Korea in 2006. Bone mineral density in the lumbar spine, back pain status, menopausal symptoms and health habits were assessed.
Results.  Participants' mean age was 59 years. About 70% experienced back pain on more than 1 day during the week prior to the survey and 35% suffered back pain daily. Women with back pain reported more severe menopausal symptoms than those without back pain. Based on bone mineral density scores, 26·9% of the women were considered to be at risk of osteoporosis. However, there was no association between back pain status and fracture risk status. Based on a multiple logistic regression model, menopausal symptoms, drinking coffee and inactivity during leisure time were statistically significant influencing factors for low back pain in this sample.
Conclusion.  The prevalence of low back pain in postmenopausal women should be recognized in association with menopausal symptoms and health habits. Further research is needed to develop interventions for the management of low back pain in postmenopausal women.     

Risikofaktoren für Rückenschmerzen bei Kindern und Jugendlichen in Industrienationen

Factors that have led to the increasing prevalence of back pain amongst children and adolescents living in industrialized nations are mostly unknown. The following literature review was aimed at determining the risk factors for back pain amongst children and adolescents. We searched both PUBMED and MEDLINE between the years 1985 and 2003 for the keywords "children or adolescents" and "back pain". Only data published in original articles were used. The risk for suffering back pain is influenced by physical, behavioural, emotional and social factors. The effects of physical activity, sitting, muscle status, weight of schoolbags, exercise, television and computer use, as well as age and gender on the development of back pain in children and adolescents were examined. Associations between continuous or recurring back pain and psychosocial factors (lifestyle, emotional factors, social relationships) could be demonstrated. There was no relationship between changes of the spine seen by radiological tests and the development of chronic back pain. Longitudinal epidemiological studies are urgently needed to delineate the risk factors for the development as well as the natural history of chronic back pain in the young.     

孤独症患儿口腔健康状况及影响因素调查

目的 了解孤独症患儿的口腔健康状况及罹患龋齿的影响因素,为孤独症患儿口腔保健提供依据.方法 对126例孤独症患儿进行口腔健康状况检查,并采用全国口腔健康调查问卷对患儿家长进行测评分析.结果 孤独症患儿龋齿患病率为80.9％,患儿家长全国口腔健康调查问卷的口腔保健知识领域得分（62.87±3.90）分,态度领域得分（68.33±3.67）分,行为领域得分（55.10±3.21）分.回归分析显示甜食摄入、饮料摄入、家长是否帮助孩子刷牙、家长是否检查孩子刷牙效果是孤独症患儿罹患龋齿的影响因素.结论 孤独症患儿龋齿患病率较高,其影响因素较多,应对患儿家长进行口腔健康知识教育.     

白血病患儿父母健康促进生活方式调查及影响因素分析

目的探讨白血病患儿父母健康促进生活方式水平及其主要影响因素,为提升白血病患儿父母健康促进生活方式提供参考依据。方法采取便利抽样方法,选取2019年9月—2020年7月于河南3家医院就诊的375名白血病患儿父母作为研究对象,采用一般资料调查表、健康促进生活方式量表-Ⅱ对其进行调查,采用单因素和多重线性回归分析白血病患儿父母健康促进生活方式水平的影响因素。本研究共发放375份,收回有效问卷366份,问卷有效回收率为97.6%。结果366名白血病患儿父母的健康促进生活方式得分为(113.06±28.91)分。多重线性回归分析结果显示,患儿对康复的期望、家庭月收入以及与患儿关系是白血病患儿父母健康促进生活方式的主要影响因素(P<0.05)。结论白血病患儿父母的健康促进生活方式水平处于中等水平,患儿对康复的期望、家庭月收入以及与患儿关系是影响白血病患儿父母健康促进生活方式的主要因素,医护人员应根据健康促进生活方式的影响因素制订针对性的干预措施,以改善白血病患儿父母的健康促进生活方式水平。     

儿童艾滋病患者服药依从性影响因素及护理干预研究进展

通过对儿童艾滋病患者服药依从性影响因素及护理干预方面的国内外文献进行回顾分析,指出目前儿童艾滋病患者服药依从性的影响因素包括监护人及家庭、患儿、药物治疗、社会等因素。护理干预可以此为切入点,具体可行的干预方法包括健康教育、咨询与支持以及针对不同年龄段患儿的护理干预等。     

癌性疼痛患者应用吗啡的影响因素及分析

目的 探讨癌性疼痛患者使用吗啡的影响因素,为临床护士实施护理措施提供帮助.方法 2010年4月1日-2010年10月31日对收住上海中医药大学附属普陀医院肿瘤科未服用吗啡的癌性疼痛患者87例进行调查,内容包括一般情况和影响吗啡应用的因素.结果 影响吗啡应用的主要因素:63.2%患者担心吗啡成瘾性;60.9%患者担心吗啡耐药性、剂量会增加;57.4%患者担心吗啡的不良反应难以忍受;44.8%患者认为疼痛一定会有,无法治疗,只能忍受;34.5%患者认为病情还未发展到需服用吗啡的程度;28.7%患者担心过早使用吗啡,今后疼痛加重则无法控制疼痛;21.8%患者担心吗啡价格昂贵、负担不起等.结论 根据影响患者吗啡应用的主要因素,制订适合患者需求的健康教育,提高癌性疼痛患者正确应用吗啡的认知状态,有助于癌症患者正确使用吗啡,减少不良反应的发生,提高癌症患者的生活质量.     

220名癌症患儿父母养育内疚感现状及影响因素分析

目的 调查癌症患儿父母养育内疚感现状,并分析其影响因素。方法 采用便利抽样法,于2021年11月—2022年4月选取山东省某三级甲等医院儿童肿瘤科的220名癌症患儿父母作为研究对象。采用一般资料调查表、养育内疚感量表、心理适应量表、压力知觉量表和领悟社会支持量表对其进行调查。采用多重线性回归分析癌症患儿父母养育内疚感的影响因素。结果 本组癌症患儿父母养育内疚感总分为（51.37±9.17）分,多重线性回归分析结果显示,子女数量、孕期健康状况、心理适应、压力知觉进入回归方程（P<0.01）,共解释癌症患儿父母养育内疚感总变异的47.9%。结论 本组癌症患儿父母养育内疚感处于中等偏上水平,子女数量、孕期健康状况、心理适应、压力知觉是养育内疚感的主要影响因素,医护人员可通过加强心理疏导、压力应对等措施,减轻癌症患儿父母的养育内疚感水平。     

呼吸道合胞病毒肺炎患儿发生反复喘息的影响因素

目的 探讨呼吸道合胞病毒肺炎患儿发生反复喘息的影响因素。方法 回顾性分析,将2018年5月-2020年6月我院收治的45例发生反复喘息的呼吸道合胞病毒肺炎患儿临床资料纳入喘息组,将同期我院收治的45例未发生反复喘息的呼吸道合胞病毒肺炎患儿临床资料纳入无喘息组。比较两组基线资料,分析可能导致呼吸道合胞病毒肺炎患儿发生反复喘息的影响因素。结果 喘息组患儿年龄＜3岁、有过敏史、家庭饲养宠物、被动吸烟占比高于无喘息组,差异有统计学意义(P＜0.05);经Logistic回归分析结果显示,年龄＜3岁、有过敏史、家庭饲养宠物、被动吸烟均为呼吸道合胞病毒肺炎患儿发生反复喘息的影响因素(OR＞1,P＜0.05)。结论 年龄＜3岁、有过敏史、家庭饲养宠物、被动吸烟均为呼吸道合胞病毒肺炎患儿发生反复喘息的影响因素。     

Unresolved pain in children: a relational ethics perspective

It is considered the right of children to have their pain managed effectively. Yet, despite extensive research findings, policy guidelines and practice standard recommendations for the optimal management of paediatric pain, clinical practices remain inadequate. Empirical evidence definitively shows that unrelieved pain in children has only harmful consequences, with no benefits. Contributing factors identified in this undermanaged pain include the significant role of nurses. Nursing attitudes and beliefs about children's pain experiences, the relationships nurses share with children who are suffering, and knowledge deficits in pain management practices are all shown to impact unresolved pain in children. In this article, a relational ethics perspective is used to explore the need for nurses to engage in authentic relationships with children who are experiencing pain, and to use evidence-based practices to manage that pain in order for this indefensible suffering of children to end.     

322例脑瘫患儿行为问题调查及影响因素

目的 明确脑瘫患儿行为问题状况及影响因素.方法 对322例患儿采用儿童行为评定量表及自拟基本情况调查表进行测评.结果 患儿行为问题总检出率为59.32％,显著高于全国常模(P＜0.01);不同年龄段、不同性别患儿单项行为因子检出率从高到低前3位排列均以内向性行为问题为主;患儿行为问题主要影响因素包括:家庭经济状况、父母情绪反应、住院时间长短、教养方式、患儿年龄及参与社会活动情况.结论 脑瘫患儿行为问题突出,护理人员应引起高度重视,采取针对性心理护理措施,促进患儿身心健康发展.     

儿童青少年防晒影响因素的系统评价

目的分析儿童青少年防晒影响因素的研究现状,并系统评价儿童青少年防晒的影响因素。方法计算机检索h e Cochrane Library、Pub Med、Web of Knowledge、Ovid、EBSCO、EMbase、CBM、CNKI、VIP和Wan Fang Data数据库,纳入关于儿童防晒相关因素的横断面研究,检索时限均为从建库至2012年12月。采用美国卫生保健质量和研究机构（AHQR）推荐的横断面研究评价标准评价纳入的研究,并采用定性分析的方法系统归纳纳入研究的信息和结果。结果共纳入10个研究。结果显示：性别、年龄、皮肤颜色、眼睛颜色、大众媒体信息、学校健康教育等是防晒保护行为的影响因素。其中研究性别、年级、皮肤光型、眼睛颜色等防晒影响因素的研究较多。结论当前儿童青少年防晒影响因素的研究较多,不同地区的研究分析影响因素也各不相同。     

癌症病人癌因性疲乏影响因素的研究进展

综述国内外癌症病人癌因性疲乏影响因素的研究现状,病人性别、肿瘤位置、治疗方式、疼痛、睡眠、情绪、社会支持等因素已被证实会对癌因性疲乏产生不同程度的影响,血液学中血清细胞因子以及血红蛋白浓度会对癌因性疲乏产生影响,但目前尚无明确的病理生理学机制,且众多因素互相影响,还需进一步的探讨。