Pain Management Nursing最新文献

{"title":"Spiritual Suffering in Acute Care Pain Management: A Higher Power Session","authors":"Cecile Evans PhD, RN ,&nbsp;Lucinda Larimore EdD-c, MBA, BSN, RN","doi":"10.1016/j.pmn.2025.01.059","DOIUrl":"10.1016/j.pmn.2025.01.059","url":null,"abstract":"<div><h3>Background</h3><div>Most bedside nurses are not aware of the role of hospital chaplains in pain management. This includes the belief that nurses often view chaplains as offering care based on strict religious doctrines. Most nurses view spiritual care to be only associated with emotional well-being. Our recent study described the concept of spiritual suffering and how hospital chaplains provide spiritual interventions. This collaboration may augment pain management in acute care, to improve patient outcomes.</div></div><div><h3>Purpose</h3><div>This power session describes the implications of nursing around spiritual suffering and the collaboration of nurses and chaplains.</div></div><div><h3>Methods</h3><div>A pain and spirituality study involving hospital chaplains revealed clinical applications that will be presented. A detailed summary of the data and concepts discovered in this small qualitative study informs new insight into the individual pain experience.</div></div><div><h3>Conclusions</h3><div>Hospital chaplains’ approach to care is not pastoral or preaching, but as a spiritual counselor and assess spiritual suffering through qualitative assessment. Nurses use well-defined quantitative assessments to describe pain intensity. The collaboration between the two disciplines creates a distinct overlapping of the domains that allows for objectively measured results. These results will be compared to an existential approach to pain assessment. This creates a new theoretical approach to explaining the pain experience.</div></div><div><h3>Implications</h3><div>Clinical practice implications include collaboration between nurses and chaplains to augment pain management and provide comprehensive spiritual care. Research may include a theoretical approach that includes spirituality and existentialism in the interpretation of the pain experience.</div></div>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":"26 2","pages":"Page e227"},"PeriodicalIF":1.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143715554","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 Journey to Initiating Minimal Sedation Across the Children's Institute","authors":"Nicholette Pagan MS, CCLS,&nbsp;Shannon Pignatiello MSN, APRN, CPNP, CPN, CCRN","doi":"10.1016/j.pmn.2025.01.060","DOIUrl":"10.1016/j.pmn.2025.01.060","url":null,"abstract":"<div><div>The pediatric patient population is faced with many anxiety provoking procedures in the medical setting that can have lasting psychological and emotional effects and negatively impact procedural success. A variety of comfort interventions exist for children that can and should be used during procedures to minimize psychological trauma, prevent behaviors that decrease procedural efficacy, improve patient and family experience, and promote the safety of medical staff during procedures. One comfort intervention includes using minimal sedation for select procedures in pediatric inpatient and outpatient settings. At this 400-bed children's hospital within a large, Midwestern, academic health system, a team led by a Pediatric Palliative Care Physician and a Pediatric Clinical Nurse Specialist standardized the use of minimal sedation by utilizing specific medications, doses, and monitoring guidelines.</div><div>Minimal sedation is a drug-induced state that allows patients to respond normally to verbal commands, while airway, spontaneous ventilation, and cardiovascular functions are unaffected. Children who have received minimal sedation require only observation and intermittent assessment of their level of sedation. This intervention is safe and effective when implemented with one drug given at one time via one route in controlled healthcare settings. Using a continuous improvement model, which includes a cycle of planning, doing, checking, and adjusting, the team created a practice guideline, an order set within the electronic medical record, and multidisciplinary education to direct both the provider and nursing staff. The guideline outlines key considerations and suggests standard steps for safe administration of minimal sedation. The order set guides providers in choosing one of three benzodiazepines at a set weight-based dose via an appropriate intranasal, oral, or intravenous route. Minimal sedation education includes group presentations to all of the pediatric specialty provider teams and other relevant councils. A module and self-assessment were developed for the pediatric inpatient and outpatient nurses and child life specialists. Next steps for this initiative include continuous improvement and close monitoring during the initial rollout phases. A research study to explore the efficacy and safety of this guideline is in process.</div></div>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":"26 2","pages":"Pages e227-e228"},"PeriodicalIF":1.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143715555","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":"Factors Associated With Physical Function in Adults With Fibromyalgia","authors":"Heather Lashley RN, BS","doi":"10.1016/j.pmn.2025.01.041","DOIUrl":"10.1016/j.pmn.2025.01.041","url":null,"abstract":"<div><h3>Background</h3><div>Fibromyalgia is a chronic pain condition that impacts 10 million people across the United States. While chronic pain is central in fibromyalgia, individuals with fibromyalgia also experience poor sleep quality, frequent headaches, fatigue, decreased physical function, increased anxiety and depression, and report a higher level of comorbid health conditions compared to individuals with other types of chronic pain.</div></div><div><h3>Purpose/Aim</h3><div>To identify variables that are associated with physical function and furthermore determine if these variables have an impact on physical function.</div></div><div><h3>Methods/Design</h3><div>An observational study was conducted, distributing surveys asking questions about age, race, sex, work status, education level, psychological resilience, comorbidities, pain intensity, depression, and physical function. Bivariate correlations were determined and a linear regression run utilizing SPSS version 29.</div></div><div><h3>Results</h3><div>Age, race, psychological resilience, pain intensity, comorbidities, and employment status all significantly correlate with physical function. The linear regression suggests psychological resilience, comorbidities, and employment status have significant effects on physical function.</div></div><div><h3>Conclusion</h3><div>Age, race, psychological resilience, pain intensity, comorbidities, and employment status all significantly correlate with physical function. The linear regression suggests psychological resilience, comorbidities, and employment status have significant effects on physical function</div></div><div><h3>Implications for Nursing Profession</h3><div>Nurses should pay attention to patient comorbidities, pain intensity, age, and race when determining how best to support the patient with fibromyalgia. Identifying interventions that concentrate on supporting psychological resilience could have a positive impact on overall physical function. Nurses need to see beyond the immediate pain the patient presents with and look at the individual's holistic wellbeing.</div></div><div><h3>Implications for future research</h3><div>More research is needed into variables that impact physical function in individuals with fibromyalgia. Pain intensity, and therefore medication to treat pain intensity, are only one facet of a comprehensive care plan. A better look at sociodemographic factors and at support systems are essential to the care and wellbeing of a patient with fibromyalgia.</div></div>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":"26 2","pages":"Page e223"},"PeriodicalIF":1.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143715097","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":"Case Study: Medication Diversion Through Intravenous Patient Controlled Analgesia (IV PCA) Manipulationion","authors":"Donna Sipos Cox MSN, FNP-C, ONC, PMGT-BC, AP-PMN","doi":"10.1016/j.pmn.2025.01.032","DOIUrl":"10.1016/j.pmn.2025.01.032","url":null,"abstract":"<div><div>The diversion of opioid medications is a concern in the hospital setting. The main focus of diversion in institutions is healthcare providers diverting medications. There are instances in the literature of nurses who have diverted Intravenous Patient Controlled Analgesia medications and reinstated the removed volume with saline infected with bacteria. These cases were investigated because a cluster of patients with bacteremia occurred.</div><div>Patient diversions have been documented as case reports primarily. The manipulations have occurred with opening the lock box with a paper clip or opening if the lock box was loaded incorrectly</div><div>reported diversions occurring from manipulating the programming of the pump or stealing the IVPCA key</div><div>The purpose of this case study was to determine how a patient could divert medication from an IV PCA using the simulation lab arm. The arm is pressurized to simulate blood flow using red colored solution and green food dye colored the IVPCA fluid.</div><div>The second trial provided a mechanism to obtain more medication from the system when the needled syringe was placed proximal to the IVPCA machine. The opioid medication was siphoned after the Patient Controlled Analgesia button was pressed and pulling back of the plunger of the syringe while administering the bolus. The patient was able to divert 2ml (2mg) from the tubing and administer instead of the .2mg with each PCA bolus dose. A small pin hole in the tubing was the only indication medication was removed in a manner other than PCA bolus dose.</div><div>Diversion of medications in the hospital is a concern for patient safety. Patients manipulating programming of pumps or compromising the closed IVPCA system physically needs to be prevented. The hope of this clinical presentation is to provide clinicians with the knowledge of this possible medication diversion method in the hospital setting.</div></div>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":"26 2","pages":"Page e220"},"PeriodicalIF":1.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143715400","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":"Non-Opioid Postoperative Analgesic Options for Pediatric Patients Using Regional Anesthesia","authors":"Alexa Ganter MS, APRN, CPNP-PC,&nbsp;Haley Mash DNP, APRN, CPNP-AC, SANE-P,&nbsp;Sharon Wrona DNP, PMGT-BC, CPNP-PC, PMHS, AP-PMN, FAAN","doi":"10.1016/j.pmn.2025.01.064","DOIUrl":"10.1016/j.pmn.2025.01.064","url":null,"abstract":"<div><div>We know that exposure to unnecessary opioids can increase risk for changes in the brain and nervous system in children. There is evidence for use of a variety of regional anesthesia options for treating post-operative pain that can be utilized in lieu of or in addition to opioid analgesics in the pediatric population. Acute Pain Teams should utilize various types of pain management options for post-operative patients including multimodal analgesia such as epidural analgesia, peripheral nerve catheters (PNCs), nerve blocks, paravertebral catheters, and wound catheters. These options often lead to reduced use or no use of opioids, which is a great added benefit.</div><div>At our institution, anesthesiologists evaluate patients pre-operatively to determine eligibility for regional anesthesia. Eligible patients receive induction of regional anesthesia in the OR and are managed by Pain Team while inpatient. Contraindications include low platelet count, abnormal coagulation studies, compartment syndrome, spinal abnormalities, anticoagulation therapy, and weight under 2 kilograms.</div><div>Epidurals are placed by anesthesia and typically stay in for 3-5 days. Caudal epidurals are utilized for NICU patients, often following major abdominal surgeries. They can assist in limiting post-operative mechanical ventilation and continuous opioid infusions. PNCs are frequently used for patients undergoing orthopedic surgeries. They are inserted by anesthesia in the OR and typically removed post-op day five. Patients with PNCs may be discharged home with catheters in place. This helps decrease hospital length of stay and manage pain while at home. Nerve blocks are also performed by anesthesia. They typically provide pain control for 12-24 hours after surgery with various block options in both upper and lower extremities. Wound catheters are inserted in the OR by the surgeon and infuse local anesthetic near the surgical incisions, assisting with surgical incision associated pain. These are a great option for patients ineligible for epidural catheters or for laparoscopic procedures that are converted to open. Our Pain Team manages the medication infusing while it is in place.</div><div>Nurses play a vital role in caring for surgical patients and need to understand regional pain management options, recognize side effects, and monitor for adverse outcomes. It's important for Pain Teams to work closely with other surgical specialties to ensure best outcomes and utilize regional analgesia when appropriate.</div></div>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":"26 2","pages":"Page e229"},"PeriodicalIF":1.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143715492","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":"Multi-Method Pain Management Education for Nurses","authors":"Renata Barbosa Dos Santos MSN, RN, ACNP-BC,&nbsp;Stacey Claus MSN, RN, GCNS-BC, CNRN","doi":"10.1016/j.pmn.2025.01.025","DOIUrl":"10.1016/j.pmn.2025.01.025","url":null,"abstract":"<div><div>Lack of pain management education in nursing schools and absence of a formal pain management education for nurses at this organization, prompted the development of a pain mentor program. The pain mentor program for bedside clinical nurses, initially started in 2018, includes a full day interactive education using didactic, simulation based, and hands-on methods.</div><div>Simulation has been shown to be an effective teaching method to improve self-confidence and clinical performance in addition to enhancing critical thinking. Repeated simulation can aid in decreasing state of anxiety, thus reducing medical error tendency levels. Another benefit of using simulation on nursing education is the incentive to develop a caring behavior towards patients.</div><div>During didactic and standardized patient simulations, learners discuss pain management practices within a safe simulation-based environment, evaluate effective communication techniques, create opportunities for patient participation in the pain management plan of care, and understand how to perform a thorough pain management assessment.</div><div>During the hands-on session learners apply gained knowledge to the variety of available pain management pumps, evaluate pump programming scenarios for accuracy or necessary reprogramming, and analyze the overall documented pain management plan of care in the medical record.</div><div>To evaluate the effectiveness of the educational program in 2022, attendees were provided with a survey. One hundred percent of nurses responded that the education would help improve patient care because they were better prepared to discuss pain management principles for acute, chronic, and acute on chronic pain and through better understanding of pain management principles learned through simulation. When asked how the education would change practice greater than 50 percent responded that they would be able to work more effectively, better interact with patients and improve quality.</div><div>Feedback on the education program was overwhelmingly positive. Measuring the impact of pain management education on patient care would require research and further investigation.</div></div>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":"26 2","pages":"Pages e217-e218"},"PeriodicalIF":1.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143715496","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":"Meeting at the Crossroads of Pain and Psychiatry","authors":"Maureen Cooney DNP, RN, FNP-BC, PMHNP, PMGT-BC, AP-PMN","doi":"10.1016/j.pmn.2025.01.048","DOIUrl":"10.1016/j.pmn.2025.01.048","url":null,"abstract":"<div><h3>Purpose</h3><div>To increase pain management nurses' awareness of co-morbid mental health conditions often experienced by patients with pain, and the treatment of these co-occuring conditions.</div></div><div><h3>Summary</h3><div>There exists a bidirectional link between pain and mood disorders and other mental health conditions. Pain and psychiatric conditions often share risk factors and underlying pathophysiology. The biopsychosocial theory of pain supports the understanding of the co-occurrence of these conditions. Pharmacological and non-pharmacological approaches to pain and mental conditions often overlap. Pain management nurses would benefit from a greater understanding of the use and benefits of common mental health interventions in the treatment of pain.</div></div><div><h3>Method of Evaluation</h3><div>Participation in discussion of patient cases with Q&amp;A.</div></div><div><h3>Relevance to Pain Management</h3><div>Given the frequency of co-occurring disorders, this presentations is highly relevant to appropriate treatment of pain.</div></div><div><h3>Future Implications for Nursing Profession</h3><div>Nurses with knowledge of the impact of pain and co-morbid psychiatric conditions are better prepared to advocate for patients, refer patients for comprehensive treatment strategies, and support research designed to address these co-morbid conditions.</div></div>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":"26 2","pages":"Pages e223-e224"},"PeriodicalIF":1.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143715099","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":"Pharmacogenetic Associations with Hospitalization Frequency in Black Adolescents & Young Adults with Sickle Cell Disease","authors":"Ashley Song BS ,&nbsp;Nathan Lamb PharmD, BCPPS ,&nbsp;Renee Manworren PhD, APRN, PMGT-BC, AP-PMN, PCNS-BC, FAAN","doi":"10.1016/j.pmn.2025.01.020","DOIUrl":"10.1016/j.pmn.2025.01.020","url":null,"abstract":"<div><div>Acute pain of abrupt onset and severe intensity is the hallmark of Sickle Cell Disease (SCD). Approximately 100,000 Black Americans have SCD; but a small subset has a disproportionate number of hospitalizations for acute vaso-occlusive crisis (VOC) pain. Their increased hospitalization frequency is associated with high opioid analgesic use, and higher risk of early death. The burden of SCD-related pain worsens, and chronic pain develops as adolescents age to become adults. We hypothesize that Black Adolescents &amp; Young Adults (AYAs) with SCD who require frequent hospitalizations for acute VOC pain have a greater prevalence of significant pharmacogenetic pain variants (genotypes) that influence pain severity and opioid analgesic effects (phenotype).</div><div>The purpose of this study is to determine if there are significant pharmacogenetic associations with hospitalization frequency in a cohort of 45 Black AYAs with SCD.</div><div>In this prospective exploratory study, a commercial pharmacogenomics panel was used to determine prevalence of 8 highly polymorphic genes that may influence analgesic effects. Here we report the association of the number of hospitalizations 12 months prior to study enrollment and pharmacogenetic results from 45 Black AYAs with SCD. These are initial results from a larger study of pain variants (genetics of pain susceptibility, pain sensitivity &amp; pharmacogenetics) from Black AYAs with SCD.</div><div>Results: CYP2B6, CYP2C8, CYP2C9, CYP2C19, CYP2D6, COMT, OPRM1, and SLC64A genotypes were obtained from 45 Black AYAs with SCD, (Mean &amp; Median age = 15 years, Range 10-23) who had 0 to 21 (Mean 2, SD 4, Median 1) hospitalizations for VOC in the 12 months prior to obtaining genotypes. There was no correlation between age and number of hospitalizations. Frequent hospitalizations (&gt;3 in past year) was also not associated with genotypes. Prevalence of CYP2B6, CYP2C19, CYP2D6, COMT, OPRM1, and SLC64A was not significantly different than reference population, but significantly more patients were CYP2C9 intermediate metabolizers (p&lt;.001). Clinical implications will be presented of how pharmacogenetic testing for might improve clinical care for individual patients will be presented.</div><div>Implications for future research: Larger sample size and exploratory analysis of pain susceptibility &amp; sensitivity genotype and gene expression are needed to advance precision pain management in this vulnerable population.</div></div>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":"26 2","pages":"Pages e215-e216"},"PeriodicalIF":1.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143715200","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":"A Comparison of the CDC Clinical Practice Guidelines on the Use of Opioids for Pain: Clinical Implications","authors":"Rowe Brookfield PharmD, CPE","doi":"10.1016/j.pmn.2025.01.084","DOIUrl":"10.1016/j.pmn.2025.01.084","url":null,"abstract":"<div><div>The rate of opioid prescriptions dispensed in the US from 2006 to 2012 increased annually by 1.9%, to an all-time high of 81.3 opioid prescriptions per 100 persons. Prescriber and societal awareness of an opioid epidemic as seen by a rise in opioid use disorder, overdoses and deaths, healthcare providers decreased writing for opioids by 5.2% annually from 2012-2016. By 2020, the rate of prescribing continued to fall to the lowest rate in 15 years, 43.3 opioid prescriptions per 100 persons were filled.</div><div>In response to concerns about over prescribing, the CDC endeavored to provide guidance and published CDC Guidelines for Prescribing Opioids for Chronic Pain – United States, 2016. While the effort was well intended there were unintended consequences that negatively impacted patients living with pain such as: an erroneous extension to patient populations not covered in the guideline i.e. (cancer and palliative care patients); rapid opioid tapers; rigid application of opioid dosage thresholds; misapplication of guidance to medications for opioid use disorder; duration limits imposed by insurers and pharmacies; and patient dismissal and abandonment.</div><div>These issues and the desire to include patients in shared decision making resulted in new guidance being updated in 2022. The CDC Clinical Practice Guidelines for Prescribing Opioids for Pain – United States, 2022 was released to remediate the adverse effects and include newer research since the earlier 2016 recommendations were made.</div><div>A side-by-side comparison of the new recommendations to the old recommendations will allow the nursing audience to know about key differences in each of the 12 domains, the clinical considerations as well as the rationale for the guidance. By better understanding what the government is saying good looks like for opioid prescribing, nurses can help educate patients in their pain care, and improve discussions with pharmacists and insurers, and better communicate with other healthcare providers on the team. The nurse is often the patient educator and advocate; by being informed on the guidelines they can contribute to safer prescribing and improved outcomes.</div></div>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":"26 2","pages":"Page e236"},"PeriodicalIF":1.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143715305","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 Impact of Depression, Social Support, and Sleep Quality on Opioid Misuse in Ambulatory Cancer Patients","authors":"Jonathan Zhu R.N., B.S.N.","doi":"10.1016/j.pmn.2025.01.031","DOIUrl":"10.1016/j.pmn.2025.01.031","url":null,"abstract":"<div><div>Problem: Prescription opioid analgesics are a cornerstone of cancer-related-pain management. However, recent legislative efforts aimed at reducing opioid prescribing have largely ignored the unique needs of this population. Pervasive fears of opioid misuse have created significant barriers to accessing essential pain relief. In order to safely prescribe and administer opioids in these populations, it is crucial to study predictors of opioid misuse and the development of OUD.</div><div>Purpose: This study aims to explore predictors of opioid misuse and the development of OUD in cancer patients to facilitate safe prescription of opioids.</div><div>Methods: This study concerns the analysis of preliminary data from an ongoing parent study (1R01NR017853) looking at longitudinal outcomes of opioid therapy in patients with cancer and how patterns of opioid use over time relate to patient-reported outcomes and healthcare utilization. Adult patients with cancer receiving outpatient oncology care were recruited from three different sites affiliated with the University of Pennsylvania Health System. A multivariable logistic regression model was used to analyze the extent to which different factors predict opioid misuse risk</div><div>Results: Having moderate depression (OR = 2.39, p = 0.03), moderately severe depression (OR = 12.49, p &lt; 0.001), and severe depression (OR = 18.48, p &lt; 0.001) were all correlated with higher odds of potential current opioid misuse compared to none-minimal levels of depression. Participants with low social support had higher odds of potential current misuse compared to participants with high social support (OR = 2.00, p = 0.011), and poorer sleep quality (OR = 1.11, p = 0.011) was also associated with higher odds of potential current misuse.</div><div>Implications: Depression, social support, and sleep quality are correlated with opioid misuse risk in cancer patients. To mitigate the risk of opioid misuse in cancer patients, nurses should assess patients’ mental health, social support, and sleep quality prior to starting opioid analgesics. Patients who exhibit signs of depression or inadequate social support or sleep should be provided with interdisciplinary support services along with their opioid therapy.</div><div>Future directions: Future research should explore the feasibility and efficacy of interdisciplinary care involving social support, mental health interventions, and sleep facilitation for cancer patients experiencing chronic pain.</div></div>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":"26 2","pages":"Pages e219-e220"},"PeriodicalIF":1.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143715381","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}