Pain Management Nursing最新文献

{"title":"Breast Pain in Randomized Controlled Trials: Options Beyond the Daily Visual Analog Scale.","authors":"Mithilesh Kumar Sinha, Apurba Barman","doi":"10.1016/j.pmn.2024.12.002","DOIUrl":"https://doi.org/10.1016/j.pmn.2024.12.002","url":null,"abstract":"","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conditioned Pain Modulation (CPM) Paradigms: Reliability and Relationship With Individual Characteristics.","authors":"Antonio Gil-Ugidos, Lara Rubal-Otero, Alberto González-Villar, María Teresa Carrillo-De-la-Peña","doi":"10.1016/j.pmn.2024.12.001","DOIUrl":"https://doi.org/10.1016/j.pmn.2024.12.001","url":null,"abstract":"<p><strong>Purpose: </strong>Conditioned Pain Modulation (CPM) is a useful tool for testing the functionality of endogenous pain modulation. However, inconsistent results have been obtained in clinical populations, possibly due to the wide variety of CPM protocols used and the influence of demographic and psychological characteristics of the individuals assessed.</p><p><strong>Methods: </strong>We tested the sensitivity and reliability of four commonly used CPM paradigms in a sample of 58 healthy participants. We also checked how these measures were related to Temporal Summation of Second Pain (TSSP), sociodemographic (age and sex) and psychological variables (anxiety and stress).</p><p><strong>Results: </strong>CPM results were influenced by the test stimulus used, with tests using pain pressure threshold (PPT) obtaining a greater number of responders (over 65%) and being the most sensitive (higher size effect: Cohen's d > 0.5). However, all measures showed excellent intrasession reliability, with strong agreement between the CPM magnitudes. CPM indices were not correlated with TSSP, age or sex, and the psychological scales did not differentiate CPM responders and non-responders.</p><p><strong>Conclusions: </strong>Although the CPM indices showed good reliability, construction of a large database with standardized values for healthy individuals seems necessary for the use of CPM in clinical settings.</p>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and Risk Factors for Moderate to Severe Pain After Foot and Ankle Surgery: A Retrospective Study.","authors":"Busara Sirivanasandha, Pongpeera Jitsrisakda, Dudsadee Atungkoon, Wiruntri Punchuklang, Arissara Iamaroon","doi":"10.1016/j.pmn.2024.12.004","DOIUrl":"https://doi.org/10.1016/j.pmn.2024.12.004","url":null,"abstract":"<p><strong>Background: </strong>Severe pain after foot/ankle surgeries is often underestimated because these procedures are perceived as less extensive than other orthopedic surgeries. However, surgeries involving the bones and joints in the foot and ankle can result in intense pain.</p><p><strong>Aims: </strong>This study aimed to identify the incidence and risk factors associated with postoperative moderate to severe pain.</p><p><strong>Design: </strong>We reviewed the medical records of 334 patients undergoing foot/ankle surgery under spinal anesthesia. The maximum numeric rating scale (NRS) pain scores were recorded at 12-hour intervals for 48 hours postsurgery, and the incidence of postoperative pain was calculated. Patients were then classified into two groups based on their maximum NRS score from the first postoperative day: those with no or mild pain (NRS score of 0-3) and those with moderate to severe pain (NRS score of 4-10). We collected variables related to the patient, surgery, and anesthesia and used logistic regression analysis to identify the factors associated with moderate to severe pain.</p><p><strong>Results: </strong>Approximately 67% of patients experienced moderate to severe pain on the first day after foot/ankle surgery, with the peak severity occurring during the initial 12 hours. Performing spinal anesthesia alone (adjusted risk ratio [ARR], 1.44; 95% confidence interval [CI], 1.21-1.71; p < .001) and hindfoot/ankle surgery (ARR, 1.22; 95% CI, 1.03-1.44; p = .020) were identified as independent risk factors for moderate to severe pain.</p><p><strong>Conclusions: </strong>Due to the high incidence of severe pain following foot/ankle surgery, patients who had spinal anesthetic alone or underwent hindfoot/ankle surgery are more likely to experience moderate to severe pain. Improved pain management measures are crucial for these patients to achieve better outcomes.</p>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of COMT rs4680 Genotype With Chronic Neuropathic Pain Experience in Patients With Sickle Cell Disease.","authors":"Abigail R Islam, Gebre-Egziabher Kiros, Rachael O Ajiboye, Keesha Powell-Roach, Miriam O Ezenwa, R Renee Reams, Robert E Molokie, Zaijie Jim Wang, Yingwei Yao, Diana J Wilkie","doi":"10.1016/j.pmn.2024.11.010","DOIUrl":"https://doi.org/10.1016/j.pmn.2024.11.010","url":null,"abstract":"<p><strong>Purpose: </strong>The pain experience of patients with sickle cell disease (SCD) frequently consists of episodes of acute exacerbation. However, recent studies suggest that many patients who suffer from SCD have symptoms of chronic neuropathic pain. Additional research is needed to determine what role genotype plays in the patient's pain phenotype experience in SCD. The purpose of our project was to determine whether a catechol-O-methyltransferase (COMT) single nucleotide polymorphism (SNP), rs4680, was associated with the experience of chronic neuropathic pain in patients with SCD.</p><p><strong>Design: </strong>Cross sectional study.</p><p><strong>Method: </strong>In our study, 184 patients (98% African American, mean age 36.5 ± 11.6 years, 63% female) completed the Self-Reported Leeds Assessment of Neuropathic Symptoms and Signs (S-LANNS) and the Neuropathic Pain Symptom Inventory (NPSI) and provided blood samples for genotyping of the rs4680 SNP. We conducted a cross-sectional association study using a likelihood ratio test that compared a model with and without genotype as a predictor. We also used linear regression model to determine whether the Met allele was associated with pain in an additive model.</p><p><strong>Result: </strong>50% of the study participants had a Val/Val genotype, 41% had a Val/Met, and 9% had a MET/MET. Between the three rs4680 genotypes, the differences in the mean S-LANNS or NPSI scores were not statistically significant. The Met allele was also not significantly associated with neuropathic pain (S-LANNS p = .23; NPSI p = .73) in an additive SNP model.</p><p><strong>Conclusion: </strong>Further studies with larger samples are needed to determine if the Met/Met genotype predisposes patients with SCD to neuropathic pain and if other polymorphisms in the COMT gene play a role in this process.</p>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effects of Sleep Hygiene Education on Sleep Quality, Pain, and Depression in Individuals With Fibromyalgia.","authors":"Emine Başar Okul, Tülay Kars Fertelli","doi":"10.1016/j.pmn.2024.11.007","DOIUrl":"https://doi.org/10.1016/j.pmn.2024.11.007","url":null,"abstract":"<p><strong>Background: </strong>Sleep problems, pain, and depression are common issues in fibromyalgia. However, studies on sleep hygiene education to address these problems are limited in the literature. Therefore, there is a need to investigate the effects of sleep hygiene education given to individuals with fibromyalgia on their sleep quality, pain, and depression levels.</p><p><strong>Purpose: </strong>This experimental study was conducted to determine the effects of sleep hygiene education on sleep quality, pain, and depression in individuals with fibromyalgia.</p><p><strong>Design: </strong>This study was carried out using an experimental pretest-posttest design with a control group.</p><p><strong>Methods: </strong>Seventy individuals with fibromyalgia (35 experimental, 35 control) were included in the study. Data were collected using the Pittsburgh Sleep Quality Index (PSQI), the Visual Analog Scale (VAS), and the Beck Depression Inventory (BDI). The experimental group received sleep hygiene education, while the control group did not undergo any intervention.</p><p><strong>Results: </strong>The participants in the experimental group had lower PSQI, VAS, and BDI scores after the intervention. In the inter-group comparisons, there were statistically significant differences between sleep quality and pain scores of the groups after the intervention.</p><p><strong>Conclusions: </strong>Sleep hygiene education was found to be effective in improving sleep quality and alleviating pain and depression in individuals with fibromyalgia.</p><p><strong>Clinical implications: </strong>Sleep hygiene education, which has been neglected in improving sleep quality and pain in the care of fibromyalgia, should be used in clinical settings.</p>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142896414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pain Experiences and Coping Methods of Living Liver Donors Experiencing Chronic Pain After Surgery: Qualitative Study.","authors":"Runida Doğan, Hatice Oltuluoğlu, Emine Bayrakçi","doi":"10.1016/j.pmn.2024.11.002","DOIUrl":"https://doi.org/10.1016/j.pmn.2024.11.002","url":null,"abstract":"<p><strong>Background: </strong>Living liver donors are known to experience many physical symptoms such as pain in the postoperative period.</p><p><strong>Aim: </strong>This qualitative study was conducted to examine pain experiences and coping methods of living liver donors experiencing postoperative chronic pain.</p><p><strong>Methods: </strong>The study sample consisted of 16 living liver donors. Data were collected using a personal information form and a semi-structured questionnaire. Quantitative data were analyzed as number, mean, standard deviation, and percentage. Qualitative data were analyzed within the framework of thematic and content analysis methods.</p><p><strong>Results: </strong>The mean postoperative chronic pain rate of living liver donors was 4.5. Eight of these people reported experiencing sudden, pinprick-like pain after liver transplantation. Living liver donors stated that the greatest factor that increased their pain was exertion/spontaneous movement. Half of them stated that the pain they experienced after transplantation had no impact on their daily life activities. Most of the living liver donors stated that the pain they experienced had no impact on their social lives; however, it caused sadness and psychological deterioration. The most preferred method to cope with pain was the use of medication.</p><p><strong>Conclusions: </strong>Living liver donors experienced moderate postoperative chronic pain, and a significant proportion of them reported psychological symptoms related to the pain they experienced. A multidisciplinary pain team can help with pain management by providing training conducted in transplant centers.</p>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transcutaneous Auricular Vagus Nerve Stimulation for Managing Pain: A Scoping Review.","authors":"Jie Chen, Huan Kuang, Aokun Chen, Jennifer Dungan, Lakeshia Cousin, Xiaomei Cong, Param Patel, Angela Starkweather","doi":"10.1016/j.pmn.2024.11.006","DOIUrl":"https://doi.org/10.1016/j.pmn.2024.11.006","url":null,"abstract":"<p><strong>Objectives: </strong>To examine the pain conditions that have been studied using transcutaneous auricular vagus nerve stimulation (taVNS), the various methods and dosage configurations used, as well as identify current gaps in the literature.</p><p><strong>Design: </strong>Scoping review with the literature search and reporting guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement-extension for scoping reviews.</p><p><strong>Review methods: </strong>A systematic search was conducted across four databases-Pubmed/Medline (n = 24), PsycInfo (n = 218), CINAHL (n = 114), and Scopus (n = 52)-comprising a total of 408 publications from peer-reviewed journals. The MeSH terms used for the search were: \"transcutaneous nerve stimulation AND vagus nerve stimulation\" along with \"transcutaneous vagus nerve stimulation OR taVNS AND pain\" with filters placed for clinical trials published between 2014 to March 2024.</p><p><strong>Results: </strong>A total of 26 publications met eligibility for inclusion in this scoping review. The most common types of pain that have been used to evaluate the efficacy of taVNS include episodic migraine without aura, rheumatoid arthritis, fibromyalgia, irritable bowel syndrome, and chronic low back pain. The device type and settings, dosage, and placement of electrodes varied across studies. Identified research gaps include the need to determine optimal dosage for the pain condition under study, inclusion of measures to evaluate intervention fidelity, long-term outcomes and symptoms that co-occur with pain, and subanalyses to examine outcomes among various sociodemographic variables.</p><p><strong>Conclusions: </strong>There is increasing evidence supporting the potential of taVNS in pain management. Further research is necessary to comprehensively evaluate its efficacy, underlying mechanisms, and to optimize its clinical application.</p><p><strong>Nursing practice implications: </strong>The findings indicate a growing body of evidence for effective use of taVNS for pain management, along with reducing co-occurring symptoms, such as depression. Nurses should be knowledgeable about this treatment option and collaborate with other healthcare professionals to develop best practices for the use of this technology in practice.</p>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Topical Capsaicin 8% on Pain in Chemotherapy-induced Peripheral Neuropathy.","authors":"F G A M van Haren, M A H Steegers, P H J M Cornelissen, K C P Vissers, S A S van den Heuvel","doi":"10.1016/j.pmn.2024.10.021","DOIUrl":"https://doi.org/10.1016/j.pmn.2024.10.021","url":null,"abstract":"<p><strong>Background: </strong>Chemotherapy-induced peripheral neuropathy (CIPN) can cause chemotherapy dose reductions and impact patients' quality of life. Few proven treatments exist, with generally modest analgesic effects and possible side effects. Small studies show the beneficial effects of topical capsaicin 8% on pain.</p><p><strong>Aim: </strong>To investigate capsaicin's effects on pain, neurotoxicity, and mood in patients with CIPN.</p><p><strong>Design: </strong>Prospective data collection in patients treated with capsaicin 8% for painful CIPN.</p><p><strong>Methods: </strong>In 17 patients, data was collected before (t0) and directly (t1), 2 weeks (t2), and 8 weeks (t3) after capsaicin 8% treatment. Differences between t0-t2 and t0-3 were assessed for pain (Numeric Rating Scale [NRS]; acceptability), neurotoxicity symptoms (20-item questionnaire [CIPN20]; mechanical detection [MDT] and pain [MPT] thresholds), and mood (Hospital Anxiety and Depression Score [HADS]).</p><p><strong>Results: </strong>For 9 patients (53%), pain became \"acceptable\" at t2 and t3, with a significant reduction (pain intensity difference [PID]_t0-2: -1.72, PID_t0-3: -2.47, both p < .001), whereas average NRS did not change significantly for patients scoring \"unacceptable.\" HADS anxiety scores remained unchanged, whereas depression scores decreased from baseline (t_0-2: -1.47, p = .014; t_0-3: -1.36, p = .021). CIPN20 decreased from baseline (t_0-2: -1.87, p = .004; t_0-3: -3.32 p = .002). MPT was significantly lower post-treatment and MDT did not change.</p><p><strong>Conclusions: </strong>Capsaicin 8% can have a beneficial analgesic effect in patients with CIPN-related pain but with a marked \"on-off\" effect. Mood changes were marginal. Quantitative sensory testing findings do not support earlier findings on nerve degeneration after capsaicin treatment, although the study size was small for definitive conclusions.</p>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peripheral Percutaneous Electrical Nerve Stimulation for Neuropathies: A Systematic Review and Meta-analysis.","authors":"Sara Mogedano-Cruz, María López-Pérez, Diego Gijón-Lago, Carlos Romero-Morales, José Luis Alonso-Pérez, Jorge Hugo Villafañe, Sergio L Jiménez Saiz, María Dolores Sosa-Reina","doi":"10.1016/j.pmn.2024.11.005","DOIUrl":"https://doi.org/10.1016/j.pmn.2024.11.005","url":null,"abstract":"<p><strong>Objective: </strong>The main objective of this review is to demonstrate the use of Peripheral Percutaneous Electrical Nerve Stimulation (PENS), together with its most up-to-date protocols, for the treatment of neuropathies.</p><p><strong>Design: </strong>We conducted a systematic search for randomised clinical trials evaluating the effectiveness of PENS on pain intensity, sleep quality, oral analgesic intake and depression in patients with neuropathic pain.</p><p><strong>Data sources: </strong>The search was performed in Pubmed, PEDro and Cochrane databases.</p><p><strong>Analysis methods: </strong>The meta-analysis was conducted using RevMan 5.4 software. The mean difference was applied for variables with the same measurement scale, while the standardized mean difference was used for different scales. The inverse variance method was employed for statistical analysis, with heterogeneity assessed using the I² and Cochrane Q statistics.</p><p><strong>Results: </strong>Four articles that met the search requirements were included. After qualitative and quantitative synthesis, the results obtained were an improvement in pain intensity (-3.57 [-4.01, -3.13]; p < .05) and sleep quality (2.48 [1.96, 3.00]; p < .05) and a reduction in medication intake (-2.37 [-4.26, -0.47]; p < .05) and depressive behaviours (-1.10 [-1.55, -0.66]; p < .05). The overall methodological quality was rated as moderate and the risk of bias as unclear.</p><p><strong>Conclusions: </strong>The scientific evidence found is still limited for the use of PENS in neuropathies. However, this study suggests an encouraging future for the use of this therapy as a treatment tool in physiotherapy.</p><p><strong>Nursing practice implications: </strong>PENS requires nurse education on electrode/needle placement and patient instruction, with documentation of key parameters. This review emphasizes the need for further research to establish standardized protocols and optimal application parameters for different neuropathic pain conditions.</p>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers to Pediatric Postoperative Pain Management-Interprofessional Focus Group Interviews.","authors":"Peter Forde Hougaard, Anja Hetland Smeland","doi":"10.1016/j.pmn.2024.11.001","DOIUrl":"https://doi.org/10.1016/j.pmn.2024.11.001","url":null,"abstract":"<p><strong>Background: </strong>Historically, postoperative pain management of children in hospitals has been inadequate, despite advancements in pain physiology and management. Postoperative pain correlates with increased complications, psychological harm, and parental stress, leading to inefficiencies in resource utilization and prolonged hospital stays. Effective pain management relies on organizational, collaborative, and individual efforts, with interprofessional communication and cooperation being crucial.</p><p><strong>Aim: </strong>This study aims to explore healthcare professionals' experiences with barriers to effective pediatric postoperative pain management through interprofessional focus group interviews, aiming to address gaps in understanding and improve care.</p><p><strong>Methods: </strong>Data collection was performed using focus group interviews with twelve healthcare professionals from four surgical wards. Interviews were audio-recorded and transcribed verbatim. Transcriptions were coded and analyzed using reflexive thematic analysis by two researchers independently.</p><p><strong>Results: </strong>Our study aligns with prior research on barriers, revealing issues such as lack of competence among physicians and nurses, limited availability of skilled personnel, heavy workloads, and absence of standardized protocols. These barriers largely reflect resource limitations and resonate with existing literature. Additionally, our findings highlight differences in perceptions between nurses and physicians regarding opioid use and standardized pain assessment tools, underscoring potential barriers to optimal pediatric postoperative pain management.</p><p><strong>Conclusions: </strong>Our study underscores the importance of adhering to standardized, evidence-based pain management protocols, revealing a link to inadequate leadership at the hospital and department levels. Noncompliance may stem from professional inexperience and lack of trust between healthcare professionals, necessitating interprofessional dialogues facilitated by leaders to foster a culture of evidence-based pediatric care.</p><p><strong>Clinical implications: </strong>Establishing best practices and ensuring adherence is a leadership responsibility. Furthermore, a lack of adherence to established routines of pain management might be a consequence of professional inexperience and lack of competence, as well as a symptom of lack of trust between professions and professionals. It is important that leaders of both nurses and physicians facilitate arenas for discussing these topics. A culture of evidence-based PPPM needs to be interprofessional and inclusive of different perspectives and facilitate open discussions.</p>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}