Pain Management Nursing最新文献

{"title":"Nursing Interventions for Prevention and Management of Acute Post-Thoracotomy Pain: Scoping Review.","authors":"Sevilay Senol Celik, Ruhat Tilki, Aleyna Ozkan","doi":"10.1016/j.pmn.2026.06.015","DOIUrl":"https://doi.org/10.1016/j.pmn.2026.06.015","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to determine the effects of nursing interventions for acute pain after thoracotomy.</p><p><strong>Methods: </strong>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.</p><p><strong>Findings: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148549941","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":"Suzetrigine: A New and Novel Analgesic for Acute Pain.","authors":"Christopher Dextras, Peggy Compton","doi":"10.1016/j.pmn.2026.06.017","DOIUrl":"https://doi.org/10.1016/j.pmn.2026.06.017","url":null,"abstract":"<p><strong>Objectives: </strong>Suzetrigine (Journavx), from a new class of non-opioid analgesics, is the first approved agent indicated for adults with moderate to severe pain in almost 3 decades. Reviewed are the drug's unique pharmacology, history of development, clinical evidence of safety and effectiveness, with an emphasis on implications for nursing practice. Literature describing the basic pharmacology as well as the results from extant clinical trials are integrated in this narrative educational review.</p><p><strong>Findings: </strong>Suzetrigine provides analgesia by blocking a specific sodium channel on peripheral nociceptors, interrupting pain signal transmission before reaching the central nervous system. In the clinical trials underlying Food and Drug Administration approval, 50 mg of suzetrigine (following a 100 mg loading dose) was demonstrated to be as effective as 5/325 mg hydrocodone/acetaminophen in patients undergoing bunionectomy or abdominoplasty and better tolerated. In subsequent open-label studies, 83%-91% of patients with diverse surgical and non-surgical conditions who received suzetrigine for up to 14 days rated analgesia as good to excellent, with few requiring rescue opioids. Currently, suzetrigine is approved only for acute pain, with ongoing trials evaluating its use for chronic pain conditions.</p><p><strong>Nursing practice implications: </strong>Concomitant medications must be carefully assessed as CPY3A inhibitors or inducers can change dosing requirements or even contraindicate use. The medication must be taken orally, with the loading dose on an empty stomach. Analgesia should be assessed within 2 to 4 hours and inadequate relief supplemented with multimodal pharmacotherapy including opioids. Suzetrigine may require prior authorization which should be considered prior to discharge.</p>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148536586","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-Pharmacological Interventions for Postoperative Pain in Breast Cancer Patients: A Network Meta-analysis.","authors":"Yuanyuan Wang, Jiawei Song, Huiling Zhang, Jestoni Maniago, Yingying Li, Zheyuan Xia, Di Zhang, Weijing Sun, Huihui Jiang","doi":"10.1016/j.pmn.2026.06.011","DOIUrl":"https://doi.org/10.1016/j.pmn.2026.06.011","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;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.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;A systematic review and network meta-analysis of randomized controlled trials (RCTs).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;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).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;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).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;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 ","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148471821","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":"Knowledge and Attitudes Toward Pain Management Among Nurses in Oman.","authors":"Khamis Al Saadi, Intisar Al Senaidi, Moza Al Musharafi","doi":"10.1016/j.pmn.2026.06.012","DOIUrl":"https://doi.org/10.1016/j.pmn.2026.06.012","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Purpose: </strong>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.</p><p><strong>Design and methods: </strong>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).</p><p><strong>Results: </strong>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).</p><p><strong>Conclusions and clinical implications: </strong>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.</p>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148437307","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":"Relationship Between Hygiene and Comfort Care and Pain in Patients Admitted to an ICU.","authors":"Ana Catarina Ferreira Marçalo, João Filipe Fernandes Lindo Simões, Neuza Maia","doi":"10.1016/j.pmn.2026.06.010","DOIUrl":"https://doi.org/10.1016/j.pmn.2026.06.010","url":null,"abstract":"<p><strong>Introduction: </strong>Hospitalization in intensive care units is associated with high levels of pain, experienced both at rest and during nursing interventions. Hygiene and comfort care, essential to patient well-being, often require mobilization and manipulation maneuvers that can be nociceptive, intensifying pain and discomfort.</p><p><strong>Objective: </strong>To analyze the relationship between the provision of hygiene and comfort care and the pain experienced by critically ill patients admitted to an intensive care unit, measured before, during, and after these interventions.</p><p><strong>Methods: </strong>A quantitative, prospective, observational study with repeated measures was conducted in the intensive care unit of a Local Health Unit in Portugal. A total of 101 patients were assessed for pain using either the Numerical Rating Scale for perceived pain or the Behavioral Pain Scale for behavioral indicators at three time points: before, during, and after care.</p><p><strong>Results: </strong>Pain intensity significantly increased during hygiene and comfort care. NRS scores rose from 0.56 ± 1.27 at baseline to 1.35 ± 2.17 during care and decreased to 0.35 ± 0.81 after 30 minutes, remaining slightly above baseline (p < .001). BPS scores increased from 3.28 ± 0.70 to 4.10 ± 1.18 and returned to 3.41 ± 0.63 post-procedure (p < .001). Systolic and diastolic blood pressure also increased significantly during care (p < .001), reflecting nociceptive responses.</p><p><strong>Conclusions: </strong>Hygiene and comfort care in intensive care unit settings significantly increase pain in critically ill patients. Pain assessment and management should be prioritized even during routine nursing interventions, reinforcing the importance of nursing practices that are sensitive to the comfort and well-being of these patients. Findings highlight the need for anticipatory analgesia and systematic pain assessment during routine hygiene care in Intensive Care Units nursing practice. Integrating these practices may enhance patient comfort and improve pain management in Intensive Care Units.</p>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148437367","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":"Implementing Resilience Engineering for Safety Management in Patient-Controlled Analgesia.","authors":"Yi-Lin Li, Yung-Ching Liu","doi":"10.1016/j.pmn.2026.06.009","DOIUrl":"https://doi.org/10.1016/j.pmn.2026.06.009","url":null,"abstract":"<p><strong>Purpose: </strong>To apply the functional resonance analysis method (FRAM) and resilience engineering (RE) to identify sources of functional variability and systemic risk in the administration process of patient-controlled analgesia (PCA).</p><p><strong>Design: </strong>A qualitative case study conducted in a regional branch of a university-affiliated medical center in Taiwan.</p><p><strong>Methods: </strong>Three focus group interviews were conducted with eight anesthesia nurse specialists (ANSs) who had more than four years of experience in PCA care. Functional mapping using the FRAM identified five main functional groups and 19 associated tasks. Functional variability and task coupling were analyzed based on participant narratives.</p><p><strong>Results: </strong>Performance variability was observed across all stages of the PCA administration process. Critical risks emerged from tightly coupled steps, particularly under conditions of high workload, shift handovers, and limited staffing. Functional resonance led to delays, configuration errors, and increased reliance on informal coping strategies. Recommended interventions included improved monitoring, early warning mechanisms, structured near-miss learning, and targeted training.</p><p><strong>Conclusions: </strong>The FRAM effectively captured real-world variability in PCA workflows and revealed latent risks not evident in formal protocols. RE provided a framework for developing adaptive strategies to improve safety.</p><p><strong>Clinical implications: </strong>Integrating the FRAM into routine practice may enhance medication safety by making variability visible and supporting system-level redesign. Targeted staff training and workflow reorganization may reduce task interruptions and improve PCA delivery in high-demand environments.</p>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148423155","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":"Effect of Pain, Pain-Related Beliefs, and Fear-Avoidance Beliefs on Functional Disability and Fear of Falling in Patients With Degenerative Spinal Diseases: A Path Analysis Study.","authors":"Gulsah Kose, Sevim Saltay, Asena Sayacı, Gulcan Kozluk, Beste Daltaban, Guven Gursoy","doi":"10.1016/j.pmn.2026.06.002","DOIUrl":"https://doi.org/10.1016/j.pmn.2026.06.002","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to determine the effects of pain, pain-related beliefs, and fear-avoidance beliefs on functional disability and the fear of falling in patients with degenerative spinal diseases.</p><p><strong>Design: </strong>This cross-sectional correlational study was conducted between December 1, 2024, and March 1, 2025, at the Neurosurgery Clinics of two hospitals.</p><p><strong>Methods: </strong>The study sample comprised 102 patients who were diagnosed with degenerative spinal diseases, and who voluntarily consented to participate. Data were collected using the Patient Information Form, the Pain Beliefs Questionnaire (PBQ), the Falls Efficacy Scale-International (FES-I), the Oswestry Disability Index (ODI), the Fear-Avoidance Beliefs Questionnaire (FABQ), and the Visual Analog Scale (VAS). Path analysis was performed to determine the relationships among the variables.</p><p><strong>Results: </strong>Significant positive correlations were observed among the PBQ, FES-I, ODI, FABQ, and VAS scores. Path analysis further revealed that FABQpa (β = 0.20) and PBQ-OB (β = 0.34) exerted direct positive effects on FES-I scores. In addition, both the VAS (β = 0.45) and FES-I scores (β = 0.47) exerted significant direct effects on ODI scores. The FES-I score was identified as a mediator of the relationships among FABQpa, PBQ-OB, and ODI.</p><p><strong>Conclusion: </strong>This study demonstrated that fear-avoidance and pain-related beliefs play critical roles in improving functional ability in patients with degenerative spinal diseases, even in the absence of the fear of falling.</p><p><strong>Clinical implications: </strong>To reduce the fear of falling and improve functional outcomes, interventions should incorporate strategies targeting both pain-related and fear-avoidance beliefs.</p>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148423166","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":"Psychological Inflexibility in Pain Scale: Turkish Adaptation, Validity, and Reliability Study.","authors":"Furkan Bahadır Alptekin, Tuba Tanyel Saraçoğlu, Burak Erken, Afra Selma Taygar, Huseyin Şehit Burhan, Hasan Mervan Aytac","doi":"10.1016/j.pmn.2026.05.027","DOIUrl":"https://doi.org/10.1016/j.pmn.2026.05.027","url":null,"abstract":"<p><strong>Purpose: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusions: </strong>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.</p><p><strong>Clinical implications: </strong>© 20XX by the American Society for Pain Management Nursing.</p>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148412641","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 Network Meta-Analysis About Effectiveness of Mind-Body Therapies in Pediatric Palliative Care.","authors":"Aline Maria de Oliveira Rocha, Cláudio Arnaldo Len, Flávia Heloisa Santos, João Roberto Bissoto, Simone Brasil de Oliveira Iglesias","doi":"10.1016/j.pmn.2026.06.005","DOIUrl":"https://doi.org/10.1016/j.pmn.2026.06.005","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate and compare the effectiveness of mind-body therapies for managing symptoms and improving quality of life in children receiving palliative care using a network meta-analysis (NMA).</p><p><strong>Design: </strong>A systematic review and network meta-analysis (PRISMA-NMA guidelines) registered with PROSPERO (CRD42020198399).</p><p><strong>Review/analysis methods: </strong>Comprehensive searches were conducted across seven databases and trial registries up to June 2024. Eligible studies involved randomized and nonrandomized trials with children (0-18 years) with life-limiting conditions receiving mind-body therapies. Primary outcomes were symptom control (pain, anxiety, emotional distress) and quality of life indicators. A frequentist NMA was performed using the netmeta package in R. Transitivity was assessed by comparing clinical and methodological characteristics across studies.</p><p><strong>Results: </strong>Forty-three studies (31 randomized trials), primarily in pediatric oncology, were included. Statistical heterogeneity was high (I² > 90%). Most network meta-analysis comparisons were inconclusive due to wide confidence intervals. For pain reduction, indirect hypnosis (SMD -0.91, [95% CI -1.78 to -0.03]) showed point estimates favoring the intervention, but confidence intervals were wide. Notably, most evidence for pain derived from procedural pain studies in pediatric oncology; these findings should not be generalized to chronic disease-related pain or nononcologic palliative populations without caution. For anxiety reduction, indirect hypnosis showed a statistically significant benefit (SMD -2.40, [95% CI -4.73 to -0.06]), while direct hypnosis suggested a potential but imprecise benefit. Comparisons for other therapies (music therapy, mindfulness, aromatherapy) were largely inconclusive, with most confidence intervals crossing the null. P-score rankings suggested a hierarchy based on imprecise point estimates; hypnosis-based interventions had the highest probability of being the best therapy. However, these rankings should be interpreted as hypothesis-generating only.</p><p><strong>Conclusions: </strong>This first NMA in pediatric palliative care suggests that hypnosis-based interventions may be promising for symptom management, but the evidence is limited by high heterogeneity, imprecision and a predominance of procedural pain studies in oncology. These findings generate hypotheses for future research and highlight an urgent need for more rigorous, head-to-head comparative trials to establish a robust evidence base for integrative care in this vulnerable population.</p>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148405334","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":"Understanding Postoperative Persistent Opioid Use: A Qualitative Meta-Synthesis.","authors":"Göknur Parlak, Seçil Taylan, Fatma Eti Aslan","doi":"10.1016/j.pmn.2026.06.003","DOIUrl":"https://doi.org/10.1016/j.pmn.2026.06.003","url":null,"abstract":"<p><strong>Objectives: </strong>Worldwide, the clinical condition referred to as \"new persistent opioid use\" describes prolonged opioid use in the postoperative period. Long-term postoperative opioid use is associated with an increased risk of complications, opioid use disorder, overdose, and death. This study focuses on the subjective experiences of patients using opioids after surgery. The aim was to generate a nuanced understanding of the reasons for the continuation of postoperative opioid use and to elucidate how these experiences shape patients' perceptions, decision-making processes, and coping mechanisms.</p><p><strong>Design: </strong>This study is a thematic meta-synthesis of qualitative research.</p><p><strong>Data sources: </strong>The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines were followed, and the study was registered in PROSPERO (International Prospective Register of Systematic Reviews; CRD4202661291520). The literature search was conducted on January 25, 2026. To identify relevant literature, MEDLINE, Web of Science (WOS), PubMed, EBSCO, Cochrane, Scopus, and Google Scholar were systematically searched, and studies meeting the inclusion criteria were selected.</p><p><strong>Review/analysis methods: </strong>Study data were analyzed in accordance with Thomas and Harden's three-stage thematic synthesis approach.</p><p><strong>Results: </strong>This meta-synthesis was conducted by analyzing eight qualitative studies carried out in four different countries, encompassing findings from a total of 310 patients who met the inclusion criteria. As a result of the analysis, four main themes and 12 subthemes were identified regarding surgical patients' experiences with pain and opioid use.</p><p><strong>Conclusion: </strong>The synthesis of the studies included in this research reveals patients' experiences with postoperative pain and opioid use. It demonstrates that pain relief is not the sole reason for postoperative opioid use; opioids are also used to maintain functionality and to facilitate a return to daily life. Our findings highlight the need for patient-centered approaches, as well as education and guidance, when planning interventions aimed at preventing persistent opioid use.</p>","PeriodicalId":19959,"journal":{"name":"Pain Management Nursing","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148397289","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}