Postoperative pain management is a core indicator of care quality after abdominal surgery and is influenced by both clinical and psychological factors. This study aimed to identify determinants of postoperative pain care quality in patients undergoing abdominal surgery and to examine the effects of preoperative fear of pain and postoperative pain intensity on perceived pain care quality. This single-center descriptive and correlational study included 102 patients undergoing laparoscopic abdominal surgery. A university hospital located in the south of Turkey. Data were collected using a Patient Information Form, the Strategic and Clinical Quality Indicators in Postoperative Pain Management questionnaire, the Fear of Pain Questionnaire-III, and the Visual Analog Scale. Descriptive statistics, correlation analyses, and multiple linear regression were performed with a significance level of 0.05. The mean pain care quality (strategic and clinical quality indicators in postoperative pain management questionnaire) score of the patients was 58.74 ± 8.31. The findings indicated that as preoperative fear of pain and postoperative pain intensity increased, patients' perceived quality of pain care decreased significantly. Examination of the determinants of pain care quality showed that ASA score, postoperative pain intensity, and fear of pain together accounted for approximately 21% of the variance in perceived pain care quality and were identified as significant predictors. In this study, the perceived level of postoperative pain management quality was found to be moderate, and preoperative fear of pain, postoperative pain intensity, and ASA score were identified as significant predictors of perceived pain care quality. Assessing pain-related fear and optimizing postoperative pain control may improve nursing pain management quality.
Pain management in patients in the intensive care units (ICUs) is highly complex. Pain management is a fundamental human right and an ethical duty. This study examined the relationship between ethical sensitivity and pain management self-efficacy among ICU nurses. This is a cross-sectional and correlational study. This study sample consisted of 416 ICU nurses (292 women, 124 men). The "Descriptive Characteristics Form", "Moral Sensitivity Questionnaire (MSQ)" and "Pain Management Self-Efficacy Questionnaire (PMSEQ)" were used to collect the data. There was a weak, statistically significant correlation between MSQ and PMSEQ total scores (r = -0.156, p = .001). In the regression analysis conducted to determine the predictive effects of ethical sensitivity, age, ethics and pain training factors on pain management self-efficacy, the model was found to be statistically significant (F = 73.337, p < .001) and explained 41% of the variance in pain management self-efficacy (Adjusted R² = 0.411). This study emphasizes the importance of developing and maintaining the knowledge and sensitivity of ICU nurses about pain management and ethical approaches and the importance of continuing training on the subject throughout their professional lives. The ethical sensitivity and pain management self-efficacy of nurses working in ICUs were at a moderate level. The pain management self-efficacy was significantly affected by ethical sensitivity, age, and training on ethics and pain. Higher ethical sensitivity is associated with higher levels of pain management self-efficacy. These results reveal that both personal and professional factors play a role in shaping nurses' self-efficacy in pain management.
Nurse leaders at our site identified a gap in evidence-based practice related to dementia-specific pain assessment. The purpose of this quality improvement project was to improve pain detection and management in patients with advanced dementia by implementing the observational Pain Assessment in Advanced Dementia (PAINAD) scale in the clinical electronic medical record. Our project team used a pre- poststudy design to evaluate practice changes in implementing the PAINAD scale. Nurses were notified of the change to documentation through hospital-wide newsletters, daily huddles, and unit managers. Data was retroactively collected through chart review of patients with advanced dementia for the four weeks prior to implementation, and at 4- and 6-weeks after the implementation. Data collected included documentation of an observational pain assessment, treatment (pharmacologic or nonpharmacologic), whether pain was present, use of psychotropic medications, and documented improvement in pain at reassessment. We also surveyed nurses to understand their perceptions of the PAINAD. Improvements were observed in rates of observational pain assessment, analgesic or nonpharmacologic treatment of pain, and avoidance of psychotropic medications at 6-weeks post-implementation. However, no improvement was observed in the proportion of patients with reduced pain at reassessment after treatment. No changes were statistically significant. Overall, nurses were comfortable using the PAINAD and perceived it as useful. Implementing the PAINAD scale appeared to improve observational pain assessments and pain treatment at our facility. Implementation of the PAINAD scale across all clinical care units and expanded staff education are necessary to improve pain outcomes for patients with advanced dementia.
Pain is one of the major stressors in hospitalized patients. Despite increased awareness and advancements in medicine, technology, and knowledge, many patients continue to suffer from unbearable pain, affecting their physical, emotional, and spiritual well-being. Nurses play a crucial role in pain management decisions. Limited knowledge and negative attitudes toward pain management were reported as one of the major obstacles to implementing effective pain management among nurses. To investigate the knowledge and attitudes toward pain management among nurses working in a secondary care hospital in Oman and their association with demographic factors. This descriptive cross-sectional study used the Knowledge and Attitudes Survey Regarding Pain (KASRP). It recruited a random sample of 191 registered nurses from a total eligible population of 375 at Sur Hospital, Oman. A total of 162 valid responses were obtained, yielding an 84.8% response rate. Data were analyzed using IBM SPSS Statistics (version 29.0). Among participants, the median KASRP score was 48.78% (interquartile range: 41.46%-60.98%), well below the 80% competency benchmark, indicating inadequate knowledge and attitudes toward pain management. Based on KASRP score categories for poor (<50%), moderate (50%-80%), and good (>80%) performance, 89.5% of the sample (n = 145) fell into the poor to moderate ranges, while only 10.5% (n = 17) demonstrated good competency. Significantly higher KASRP scores were observed among nurses aged 30-40 years (p = .018) and non-Omani nurses (p = .038). In contrast, no statistically significant associations were observed for sex, level of education, years of experience, area of practice, or prior pain management training (p > .05). The findings revealed significant gaps in knowledge and attitudes toward pain assessment and management among nurses at Sur Hospital. They highlight the need for more effective, structured pain management training programs and for integrating comprehensive pain management content into undergraduate nursing curricula. Future randomized controlled trials are needed to assess the impact of structured pain training on nurses' knowledge and attitudes and to close gaps in nursing competency across healthcare settings.
This study aimed to identify factors influencing poststroke pain and evaluate the stability of self-reported and observational pain scales to support nurses in selecting and using pain assessment tools more accurately. A cross-sectional study. A total of 122 patients with stroke were recruited from a hospital in northern Taiwan. Pain was assessed using the Numeric Rating Scale (NRS), Faces Pain Scale (FPS), and Pain Assessment in Advanced Dementia (PAINAD). Multiple regression analyses were performed to identify demographic and clinical factors associated with pain scores. Item response theory (IRT) was used to evaluate the stability and measurement performance of the three scales across different levels of pain severity. Participants with diabetes or cognitive impairment had significantly higher PAINAD scores, whereas those with a history of stroke had higher NRS scores. Depressive symptoms were associated with higher scores on all three pain scales. The scales demonstrated moderate correlations with one another. IRT analysis showed that the FPS had the highest discrimination across pain levels. In contrast, the PAINAD had the greatest difficulty and may underestimate pain in patients experiencing higher levels of pain. Diabetes, prior stroke, cognitive impairment, and depressive symptoms significantly influenced poststroke pain assessment. All three scales were suitable for assessing pain in patients with stroke. The NRS was most appropriate for mild to moderate pain, the FPS for moderate to severe pain, and the PAINAD for a broad range of pain levels. Nurses should consider patients' clinical characteristics, cognitive function, communication ability, and pain severity when selecting a pain scale. The FPS may be prioritized because of its high discrimination, whereas PAINAD scores should be interpreted cautiously because this scale may underestimate severe pain.
Upper-limb pain is a frequent and disabling sequela following breast cancer treatment, often persisting beyond the acute postoperative period and substantially impairing function, self-management, and quality of life. Telerehabilitation has emerged as a strategy to expand access to physiotherapy-based care; however, its effectiveness for pain management in this population remains unclear. To systematically evaluate the effectiveness of telerehabilitation interventions in reducing upper-limb pain in women after breast cancer treatment. This systematic review was conducted in accordance with the PRISMA 2020 guidelines and prospectively registered in PROSPERO (CRD420261332939). PubMed, CINAHL, Web of Science, and EMBASE were searched through December 2025. Randomized controlled trials evaluating telerehabilitation-based physiotherapy interventions and reporting outcomes related to upper-limb pain were included. The risk of bias was assessed using the Cochrane Risk of Bias 2 tool, and the certainty of evidence was evaluated using the GRADE framework. Six randomized controlled trials involving 517 women were included. Telerehabilitation interventions varied in delivery format (synchronous, asynchronous, app-based, or telephone-based), intensity, and duration. One trial demonstrated a significant reduction in the proportion of women reporting chronic arm pain, and another reported greater improvement in pain interference, but not pain intensity. The remaining studies showed pain outcomes comparable to usual care or no significant benefit. Methodological limitations included heterogeneity in pain assessment tools, limited individualization of interventions, attrition, lack of blinding, and inconsistent reporting of analgesic use. Overall certainty of evidence was rated as low. Telerehabilitation appears feasible and comparable to usual care for upper-limb pain management after breast cancer treatment; however, consistent superiority has not been demonstrated. Evidence of benefit is primarily associated with structured, high-frequency, and multimodal programs. Further well-designed trials with standardized pain-specific outcomes are needed. Management of upper-limb pain after breast cancer treatment through telerehabilitation requires coordinated input from multidisciplinary healthcare teams, including nurses and physical therapists. Telerehabilitation may facilitate remote pain monitoring, patient education, and self-management across survivorship care, provided that interventions are structured, clearly protocolized, and focused on pain-specific outcomes.
To investigate the effects of reflexology on pain and quality of life in patients with diabetes and neuropathic pain. Randomized controlled trials of reflexology on pain and quality of life in patients with diabetes and neuropathic pain were searched comprehensively in PubMed, Embase, Medline, Scopus, ScienceDirect, Web of Science, CINAHL, Cochrane Central Register of Controlled Trials, Google Scholar, DergiPark, and the Turkish Higher Education Center Dissertation databases up to March 10, 2025. The risk of bias was assessed using the revised Cochrane risk-of-bias tool for randomized trials. The effect of the intervention was estimated as the standard mean difference with 95% confidence interval (CI) using random-effects models in Review Manager 5.4, and heterogeneity was assessed using the I2 statistic. Eight experimental trials were included in this meta-analysis, comprising five randomized controlled trials and three quasi-experimental studies. The total sample size of the studies was 590 (experimental group: 296; control group: 294). The findings revealed a statistically significant reduction in total pain levels of 1.64 points (mean difference: -1.64; 95% CI: [-1.81, -1.47]; Z = 18.79; p < .00001). The quality of life scale showed a decrease of 14.31 points, which was statistically significant and favored the experimental group (mean difference: -14.31; 95% CI: [-18.75, -9.87]; Z = 6.32; p < .0001). However, significant heterogeneity and risks of bias were observed across studies (I2 < 40%). Based on the combined results of this study, reflexology was found to reduce pain and improve quality of life in patients with diabetes and neuropathic pain. Therefore, reflexology may be a potentially effective complementary technique for improving neuropathic pain, and healthcare professionals could play an important role in advising patients on how to access qualified reflexology practitioners. Reflexology massage significantly reduces neuropathic pain and improves quality of life in patients with diabetes and neuropathic pain, offering a noninvasive, potentially cost-effective complementary therapy that can enhance multidisciplinary care plans for managing diabetic neuropathy.
Breast cancer (BC) is the most prevalent malignancy among women, with surgical resection remaining the cornerstone of treatment. Postoperative pain is a common and significant complication that adversely affects recovery and quality of life. Although pharmacological treatments are widely utilized, their potential adverse effects have led to growing interest in non-pharmacological interventions as complementary approaches. However, there is a lack of comparative evidence regarding the effectiveness of these various non-drug strategies.This study aimed to systematically evaluate and compare the efficacy of different non-pharmacological interventions for managing postoperative pain in patients with BC using a network meta-analysis. A systematic review and network meta-analysis of randomized controlled trials (RCTs). A comprehensive search was conducted across English and Chinese databases, including PubMed, Web of Science, Scopus, MEDLINE, ProQuest, Embase, the Cochrane Library, CNKI, Wanfang, and SinoMed, to identify randomized controlled trials (RCTs) evaluating non-pharmacological interventions for postoperative pain in BC patients. The search included studies published up to December 2024. Primary outcomes included pain scores, anxiety scores, upper limb function, and the effectiveness rate of pain control. Methodological quality was assessed using the Cochrane Risk of Bias tool. A network meta-analysis was conducted using Stata 16.0, and the surface under the cumulative ranking curve (SUCRA) was used to determine the relative effectiveness of interventions. The study was registered in PROSPERO (CRD42024586943). A total of 30 studies involving 2,256 patients and 10 types of non-pharmacological interventions were included. No significant adverse events were reported. Network meta-analysis revealed that Psychological + Exercise therapy was the most effective for pain relief (vs. Conventional therapy: SMD = 3.91, 95% CI [2.21, 5.61]; SUCRA = 96.5), followed by Psychological + Physical therapy (SMD = 3.40, 95% CI [1.13, 5.67]; SUCRA = 92.0). For anxiety reduction, Psychological + Physical therapy demonstrated the greatest benefit (SMD = 3.11, 95% CI [1.29, 4.93]; SUCRA = 99.2). For upper limb function recovery, Exercise + Traditional Chinese Medicine showed significant improvement (SMD = 0.95, 95% CI [0.13, 1.77]; SUCRA = 80.6). Combined non-pharmacological interventions appear to be more effective than single approaches in managing postoperative pain in BC patients. Specifically, Psychological + Exercise therapy and Psychological + Physical therapy yielded the most favorable outcomes. Psychological + Physical therapy also offered substantial benefits for alleviating anxiety, suggesting its broader clinical value. Nevertheless, due to the limited number and quality of included studies, these findings should be interpreted with caution. This study provides evidence-based support for the use of non-pharmacological interventions in the postoperative management of breast cancer and may inform future clinical practice and research.
This study was conducted to examine the validity and reliability of the Turkish version of the Pain-induced Comfort Eating Scale (PICES), which was developed to assess pain-related comfort eating behavior in individuals with chronic pain. This cross-sectional study was conducted between June and October 2025 at an internal medicine outpatient clinic of a university hospital in Elazığ with 161 community-dwelling adults experiencing chronic pain. To ensure a representative sample of stable outpatients, acutely hospitalized inpatients were excluded. Data were collected using a Personal Information Form, PICES, Three-factor Eating Questionnaire, and Brief Pain Inventory. The scale's content and language validity were assessed by expert opinion; its construct validity was examined using Confirmatory Factor Analysis. Reliability analyses included Cronbach's alpha, McDonald's omega, and intraclass correlation coefficient (ICC) for test-retest reliability. The content validity indices were found to be the item-level content validity index = 0.90-1.00 and the scale-level content validity index = 0.94. The Kaiser-Meyer-Olkin value was 0.739, and Bartlett's sphericity test was significant (p < .001). As a result of confirmatory factor analysis, a single-factor structure consisting of three items was confirmed, and factor loadings ranging from 0.850 to 0.970 were determined. The internal consistency of the scale was found to be high (Cronbach's alpha = 0.860; McDonald's omega = 0.902), and the test-retest reliability conducted with 30 participants was determined to be excellent (ICC = 0.924). Positive and significant correlations were found between PICES scores and the pain intensity and pain interference subscales of the Brief Pain Inventory (p < .01). Furthermore, PICES scores showed weak and negative correlations with the cognitive restraint and uncontrolled eating subscales of the TFEQ-18, providing evidence for discriminant validity. The Turkish version of the PICES is a valid and reliable tool for assessing pain-related comfort eating in outpatient clinical settings. Its brevity allows for quick use in research and clinical practice to identify maladaptive eating responses to chronic pain.
The purpose of this research is to examine the effects of organic pain beliefs (OPB) and psychological pain beliefs (PPB) on pain intensity, disability, kinesiophobia, catastrophizing, and pain knowledge in chronic shoulder pain. Cross-sectional observational study. In this cross-sectional study, 109 patients (66 females, 43 males; mean age 49.8 ± 10.4 years) with chronic rotator cuff-related shoulder pain were recruited using a convenience sampling method and completed the Pain Beliefs Questionnaire (PBQ), the Numeric Pain Rating Scale (NPRS), the Shoulder Pain and Disability Index (SPADI), the Tampa Scale for Kinesiophobia (TSK), the Pain Catastrophizing Scale (PCS), and the Revised Pain Neurophysiology Questionnaire (Revised-NPQ). Pearson correlation and multiple linear regression analyses were used to assess the relationships of OPB and PPB with the outcome measures. OPB were significantly positively correlated with activity-related pain (r = 0.30, p = .001), disability (SPADI total; r = 0.21, p = .025), kinesiophobia (TSK; r = 0.42, p < .001), and catastrophizing (PCS; r = 0.40, p < .001), and were negatively correlated with Revised-NPQ (r=-0.34, p = .001). In multiple regression models, OPB significantly predicted greater disability (β=0.25, p = .013), kinesiophobia (β=0.45, p < .001), and catastrophizing (β=0.44, p < .001), explaining 4.8%-17.4% of variance in these outcomes (adjusted R²=0.048-0.174). In chronic shoulder pain, OPB show weak to moderate associations with adverse clinical outcomes and a negative association with pain knowledge, whereas PPB are not significantly related to outcomes. These findings support the potential value of targeting maladaptive beliefs and improving pain knowledge within rehabilitation. Evaluating OPB and PPB in relation to pain-related parameters, kinesiophobia, and catastrophizing may help identify at-risk patients and support individualized rehabilitation and targeted education in chronic shoulder pain.
This study aimed to determine the effects of nursing interventions for acute pain after thoracotomy. In this scoping review study, a total of eight electronic databases, including PubMed, CINAHL, Web of Science, Scopus, Cochrane Library, Ovid MEDLINE(R), TR-Dizin, and Dergi Park, were searched to find relevant studies published between 2003 and January 2024. These databases were searched for the following search terms, including "Nursing Care", "Nurse", "Thoracotomy", "Pain", and "Pain management". This review was conducted in accordance with the PRISMA-ScR guidelines. Nine articles with 521 participants in total are included in this scoping review. Education was the most frequently used intervention for the pain management of thoracotomy patients. Other interventions were cold application, Transcutaneous Electrical Nerve Stimulation (TENS), and chest tube dressing. Cold application and preoperative education decreased the thoracotomy patients' pain significantly. However, TENS caused a significant decrease in one study, and different dressing types did not cause statistically significant differences in pain. This scoping review revealed that education, TENS, and cold application can help decrease thoracotomy pain, whereas the dressing type did not. Also, more nursing interventions about the acute pain management of thoracotomy patients are needed.
Postoperative pain management in children is a critical aspect of pediatric care. This aspect of pediatric care is important because it can lead to psychological stress and distress, impacting both immediate and future emotional well-being in children if not managed well. To explore the experiences of nurses during the management of postoperative pain in the pediatric population at the Tamale Teaching Hospital. A hermeneutic-phenomenological approach was used, with a sample size estimated at three (3) to ten(10) participants. Data collection involved interviews until the four criteria for data saturation (that is, deepness, richness, relevance, and abstractness) were achieved at the seventh interview, conducted over 2 months in a hospital setting. Four themes developed from the data analysis depicting nurses' experiences: physiological, bodily expressions, and pain scale used for pain diagnosis; nonpharmacological and pharmacological methods used for pain management; institutional, personnel, parents', and patients' constraints; and compassion fatigue, physical bodily depletion, and burnout, highlighting the emotional challenges nurses face. Hospitals with a similar context to that of the study site should implement these findings to enhance the improvement and quality of pain management in their pediatric units.
Myogenic temporomandibular disorder frequently co-occurs with fibromyalgia and is associated with pain, disability, and maladaptive pain cognitions. This study evaluated the short- and long-term effects of an online Pain Neuroscience Education-informed self-management program in individuals with fibromyalgia and myogenic temporomandibular disorder. Prospective single-arm clinical study. Adults with fibromyalgia and myogenic temporomandibular disorder participated in a therapist-led online group self-management program consisting of three sessions integrating Pain Neuroscience Education, temporomandibular exercises, self-care strategies, and mindfulness. Assessments were conducted at baseline, post-treatment (4 weeks), and 12-month follow-up. Pain intensity at rest and during maximum mouth opening were predefined as primary outcomes. Secondary outcomes included pain-related cognitions, pain neurophysiology knowledge, psychological symptoms, central sensitization, jaw function, oral health-related quality of life, and oral habits. Changes over time were analysed using repeated-measures analysis of variance. A total of 107 participants were enrolled. Significant and sustained reductions were observed in temporomandibular pain during maximum mouth opening, whereas pain at rest did not change significantly. Significant, large, and sustained improvements were found in kinesiophobia, pain catastrophizing, and pain neurophysiology knowledge. Moderate short-term reductions were observed in anxiety, depression, and insomnia, but these were not maintained at 12 months. No significant changes were found in central sensitization, jaw functional limitation, oral health-related quality of life, or oral habits. A brief online Pain Neuroscience Education-informed self-management program was associated with durable improvements in movement-evoked temporomandibular pain and pain-related cognitions in individuals with fibromyalgia and myogenic temporomandibular disorder. A brief online self-management program incorporating Pain Neuroscience Education appears feasible for this population and may contribute to improvements in movement-evoked pain and pain-related cognitions. Controlled studies are needed to determine its clinical effectiveness.
To assess the knowledge, attitudes, and practices (KAP) of Chinese nurses regarding perioperative pain management and to identify influencing factors. A cross-sectional study. This study was conducted among nurses from a tertiary hospital in Wuhan, Hubei Province, China in December 2022 using a pretested KAP questionnaire. We used descriptive statistics, the Mann-Whitney U test, the Kruskal-Wallis test, and multiple linear regression. Among 1,082 participants, knowledge gaps were evident in the use of patient-controlled analgesia (PCA), pain assessment during functional activity, and nonpharmacological interventions. Acceptance of PCA for postoperative pain was low. Clinically, nonpharmacological interventions and pain assessment during rest and activity were underutilized. Multiple linear regression showed that knowledge predictors included working department (β = -0.898, p = .002), professional title (β = 1.732, p = .001), and frequency of participation in pain-related training (β = 3.512, p < .001). The attitude predictors included administrative position (β = 1.984, p = .021) and training participation frequency (β = 1.020, p = .001). Practice predictors included working department (β = -1.765, p = .001), professional title (β = 2.587, p = .004), and training participation frequency (β = 4.294, p < .001). Nurses exhibit positive attitudes toward perioperative pain management; however, notable deficiencies in both knowledge and clinical practices are observed. To address these gaps, hospitals should implement structured, evidence-based training programs of at least two sessions annually, along with department-specific programs.
Pain management in hospitalized acute and chronic pain patients should include multimodal analgesic and non-pharmacological interventions. However, empirical data on real-world pain management practices comparing acute and chronic pain patients remains limited. To describe and compare interventions used for hospitalized patients with acute versus chronic pain. In a cross-sectional analysis of Austrian Nursing Quality Measurement 2.0 data from three annual assessments (2021-2023), patients with current pain (n = 2,118) were categorized as acute (n = 1,163) or chronic (n = 955). Trained nurse pairs documented demographics, medical diagnoses, care dependency, and pain interventions received at the time of assessment. Descriptive statistics and bivariate testing were performed. Compared with acute pain patients, those with chronic pain were older (73 vs. 66 years, p < 0.001), more care dependent (p < 0.05), and more likely to have cardiovascular disease (46% vs. 33%, p < 0.001). Pharmacological treatments predominated in both groups, with higher use in acute pain (990%) than chronic pain (86%, p < 0.001). Acute pain care more often included NSAIDs, whereas chronic pain patients received more opioids. Physiotherapy was used similarly in both groups (≈40%). Other non-pharmacological modalities were infrequently applied, typically in < 10% of patients. This descriptive study documents current pain management practices in Austrian hospitals, revealing predominant reliance on medications, with limited integration of non-pharmacological options in both acute and chronic populations. Future research should incorporate pain outcomes, treatment effectiveness measures, longitudinal follow-up, and systematic examination of institutional and patient-level barriers to comprehensive multimodal pain management. Our results provide a baseline for quality improvement initiatives.
To compare the efficacy of mirror intervention and music intervention in managing arteriovenous fistula cannulation pain in patients undergoing hemodialysis. A prospective, single-center, three-arm, parallel-group, randomized controlled trial according to CONSORT guidelines. The present study was conducted in a specialized hemodialysis unit between 01 and 06 December 2025. The participants were randomly assigned to either the mirror intervention group (n = 25), the music intervention group (n = 25), or the control group (n = 25). Over the course of one week, participants underwent three cannulation sessions: one baseline session and two intervention sessions. During the intervention sessions, prior to cannulation, the mirror group was instructed to observe the reflection of their non-access arm for a period of 10 minutes, while the music group listened to analgesic instrumental music for a duration of 10 minutes. The control group received standard care. The intensity of pain was measured immediately after each cannulation using a 100 mm Visual Analog Scale. The study was registered with ClinicalTrials.gov (NCT07320859). The mean age of participants was 56.97 ± 15.22 years. Baseline pain scores and demographic characteristics were comparable between groups. The mirror intervention group demonstrated statistically significant lower VAS pain scores at both the first (T1) and second (T2) post-intervention assessments compared to both the music intervention and control groups (p < .001 for both). When controlling for baseline scores, the effect size of mirror intervention was large (η² = 0.554 for T1; η² = 0.509 for T2). No significant difference in pain scores was found between the music intervention and control groups (p > .05). Mirror intervention is significantly more effective than both music intervention and standard care in reducing arteriyovenöz fistül cannulation pain in hemodialysis patients. As a nurse-administered, cost-effective, safe, and evidence-based intervention, mirror intervention should be considered for integration into routine nursing care protocols. The present study provides a protocol for nurses to manage arteriovenous fistula cannulation pain that is both ready-to-use and evidence-based. The integration of mirror intervention into routine care provides nurses with a safe, non-pharmacological skill that directly enhances their role in ensuring patient comfort during the procedure. For patients, the benefits of this approach include a reduction in perceived pain and anxiety related to needle procedures. Furthermore, it has the potential to enhance overall treatment satisfaction and compliance by making hemodialysis sessions less uncomfortable.
To evaluate the measurement performance and clinical feasibility of the Emoji‑FPS for acute procedural pain assessment in children aged 3-5 years, compared with the Wong-Baker FACES Pain Rating Scale (WBFPS). This was an observational study. A total of 192 children aged 3-5 years self-reported acute procedural pain using both the Emoji‑FPS and the WBFPS within 5 minutes of routine clinical procedures. Agreement between the two scales and responsiveness of Emoji-FPS were analyzed, and receiver operating characteristic analysis was used to establish pain severity cutoffs. Clinical feasibility based on observed child performance and scale preference were assessed. The Emoji‑FPS showed strong agreement with the WBFPS. Clinical feasibility improved with age, with 57.69% of 3-year-old children, 75.95% of 4-year-old children, and 89.66% of 5-year-old children reporting that the scale was easy to use. Overall, 67.19% of children preferred the Emoji‑FPS. The Emoji-FPS was able to effectively distinguish between mild, moderate, and severe pain in children aged 3-5 years who were able to understand the scale and complete the rating in acute procedural pain settings, and accurately reflected changes in pain before and after procedure. The Emoji Faces Pain Scale may support procedural pain assessment in preschool-aged children and should be interpreted alongside clinical judgment.
To examine the relationship between nursing students' beliefs about pain and their attitudes toward pain assessment, addressing the limited evidence on this topic in the context of clinical education. A cross-sectional design was employed. The sample consisted of 329 volunteer nursing students. Data were collected using the Descriptive Characteristics Form, the Pain Beliefs Questionnaire (PBQ), and the Nursing Students' Attitudes Scale Toward Pain Assessment (NSASPA). The mean score of students' attitudes toward pain assessment was 56.65 (SD = 11.81). Mean scores for organic (PBQ-O) and psychological (PBQ-P) pain beliefs were 3.40 (SD = 0.66) and 2.51 (SD = 0.83), respectively. Organic pain beliefs showed a weak positive correlation with attitudes toward pain assessment (r = .220, p < .001), while psychological pain beliefs showed a weak negative correlation (r = ‒.215, p < .001). Multiple regression analysis indicated that both organic (β = .34, p < .001) and psychological (β = .33, p < .001) pain beliefs significantly predicted students' attitudes toward pain assessment. The findings indicate that nursing students' pain beliefs serve as significant independent predictors of their attitudes toward pain assessment, with organic beliefs positively and psychological beliefs negatively influencing these attitudes CLINICAL IMPLICATIONS: Comprehensive pain management training will improve patient care by enhancing clinical pain assessment databases.
Chronic pain is a major contributor to disability. Research has highlighted psychological inflexibility as a significant factor linked to chronic pain. The Psychological Inflexibility in Pain Scale (PIPS) is a useful tool created to assess this construct in individuals suffering from chronic pain. This study aimed to evaluate the psychometric properties and factor structure of the Turkish version of the PIPS in a population experiencing chronic pain. The sample comprised 278 participants with chronic pain. Participants completed several measures, including the sociodemographic information form, the PIPS, the Acceptance and Action Questionnaire II, the Cognitive Fusion Questionnaire, the Pain Catastrophizing Scale, and the Hospital Anxiety and Depression Scale. Exploratory factor analyses compared 16-item and 12-item versions using two- and three-factor solutions. The 12-item two-factor model was the best option (root-mean-square error of approximation = .084, Tucker-Lewis Index = .928), matching the original avoidance and cognitive fusion subscales. Following exploratory factor, confirmatory factor, and reliability analyses, item 8 was removed owing to consistently poor psychometric performance, resulting in a final 11-item two-factor structure. Internal consistency of the 11-item two-factor structure was good for the total scale (α = .883) and both subscales (avoidance α = .875, fusion α = .702). Test-retest reliability over 2 weeks was strong for the total scale and the avoidance subscale (r = .904 and .907, respectively) but lower for the cognitive fusion subscale (r = .678). Confirmatory factor analysis confirmed the two-factor structure after minor adjustments, with acceptable fit indices (χ2/df = 2.52, Comparative Fit Index = .967, root-mean-square error of approximation = 0.0740). Criterion validity showed significant positive correlations between the avoidance subscale and experiential avoidance (r = .535) and the cognitive fusion subscale and cognitive fusion (r = .385) as well as significant links with depression, anxiety, and pain catastrophizing (r = .291, .361, and .645, respectively). The PIPS is a valid and reliable scale for assessing the psychological inflexibility model in the context of chronic pain in the Turkish-speaking population. Reevaluating this scale in specific groups and analyzing samples based on factors such as pain intensity and duration will enhance the literature on this topic. © 20XX by the American Society for Pain Management Nursing.
Pain remains a major challenge for advanced-stage patients with cancer despite management advances. The transition to outpatient care complicates self-management. Research on multicomponent mHealth-supported interventions for cancer pain self-management in China is limited. This study aims to evaluate a nurse-led multicomponent self-management intervention (MSMI) based on the Information-Motivation-Behavioral Skills model-a framework positing that health behavior change requires information, motivation, and behavioral skills-for reducing pain intensity and improving self-efficacy, quality of life (QoL), pain-related knowledge, and medication adherence in cancer pain patients. A prospective, single-blinded, parallel-group randomized controlled trial was carried out. The trial was carried out at an oncology center in southern mainland China. 88 adults with cancer-related pain were recruited and randomly allocated to the MSMI or control group. The MSMI was given to the intervention group, and usual care was given to the control group. The primary outcome was pain intensity; secondary outcomes were self-efficacy, QoL, pain-related knowledge, and medication adherence. Measures were assessed at baseline, immediately postintervention, and 4 weeks postintervention. Compared with the control group, the intervention (MSMI) showed significantly greater reductions in pain intensity at T2, significantly greater improvements in self-efficacy at T1 and T2, and significantly greater improvements in pain-related knowledge at T2. No significant between-group differences were found for QoL or medication adherence. The nurse-led, digitally enhanced, Information-Motivation-Behavioral Skills-based MSMI effectively improves pain intensity, self-efficacy, and pain-related knowledge for Chinese patients with cancer and moderate-to-severe pain. Implementing proactive nurse-led MSMI significantly enhances self-efficacy, pain knowledge, and pain reduction. It supports high treatment continuity through structured hospital-to-home transitions. Integration into standard care is recommended for managing cancer pain in outpatient settings.