Biomedical subjects

Roxie L Foster

Publications and source records attributed to Roxie L Foster.

13 recordsLinked to original sources

PubMed2004

The use of "as-needed" range orders for opioid analgesics in the management of acute pain: a consensus statement of the American Society for Pain Management Nursing and the American Pain Society.

The use of "as needed" or "PRN" range orders for opioid analgesics in the management of acute pain is a common clinical practice. This approach provides flexibility in dosing to meet individual patients' unique analgesic requirements. Range orders enable necessary and safe dose adjustments based on an individual's response to treatment. The purpose of this paper is to present the consensus statement of the American Society for Pain Management Nursing and the American Pain Society on the use of "as-needed" range orders for opioid analgesics in the management of acute pain. The implementation of this statement should promote quality pain management through safe medication practices and the appropriate use of range orders for opioid analgesics in acute pain management.

Acute Disease↗

PubMed2003

Physiologic correlates of comfort in healthy children.

Pain assessment is particularly challenging when children are unable or unwilling to provide a self-report. Although clinicians frequently use vital signs as an adjunct to pain assessment, little evidence exists to support this practice. The purpose of this study was to explore the ability of selected physiologic variables (peripheral skin temperature, heart rate, skin conductance activity [SCA], respiratory rate, electromyogram [EMG] of the frontalis and right forearm muscles, and systolic and diastolic blood pressure [BP]) to detect changes in children's autonomic arousal from baseline. A one-group, repeated measures, randomized crossover design guided the study. Chosen from a convenience sample, 100 healthy children (ages 8-17 years) served as their own controls while undergoing two levels of intervention: cold pressor pain and guided imagery. Although most physiologic responses showed changes in the expected direction, EMG, SCA, and heart rate decreased slightly during cold pressor. Few significant intercorrelations were demonstrated among the physiologic variables. SCA, forehead EMG, respiratory rate, systolic and diastolic BP detected significant changes in arousal across measures. Notably, heart rate failed to detect changes for any of the measures. Results emphasize the need for caution in interpreting heart rate as an index of comfort. Further research is needed to examine the effects of clinical pain on physiologic indices and to further examine age and sex influences. To be relevant for assessment of acute established pain, physiologic variables must also be tested for their sensitivity beyond the immediate period of autonomic arousal.

Adolescent↗

PubMed2003

Assessment of the convergent validity of pain intensity in the Pain Sensory Tool.

The purpose of this study was to examine the convergent validity of the Pain Sensory Tool with the Poker Chip Tool. Both tools were used to assess children's pain intensity (ages 5 to 14 years). A total of 104 hospitalized Taiwanese children with acute pain were asked to participate in this study. All children were required to use both the Pain Sensory Tool and the Poker Chip Tool to measure their pain. The results of Pearson correlation revealed a coefficient of.79 to.88. The convergent validity of the Pain Sensory Tool with the Poker Chip Tool was therefore supported. No significant differences in preferences of using the PST and the PCT were found by age group and sex. The findings of this study also demonstrated that the Poker Chip Tool can be used to measure Taiwanese children's pain intensity. In addition, the Pain Sensory Tool and the Poker Chip Tool were reliable instruments to measure pain intensity of Taiwanese children (ranged from 5 to 14 years of age). However, 27 % of five-year-old children failed to understand the instructions of the PST although these children were dropped from the study. This raises concerns about the validity of the PST for five-year-old children. It is not clear whether these five-year-old children were outliers or whether the PST is difficult for younger children. The authors suggested duplicating this study and specifying the five-year-old age group for the validity test.

Acute Disease↗

PubMed2003

A qualitative inquiry of Taiwanese children's pain experiences.

Little information was found in studying Taiwanese children's pain experiences. Because pain is culturally shaped, health care providers should not assume Taiwanese children's pain to be identical to those of children in the US. Thus, a qualitative descriptive study with semi-structured interview of 90 hospitalized Taiwanese children with acute pain was conducted to understand Taiwanese children's pain experiences. Krippendorff's (1980) content analysis was used to guide the data analysis. Seven themes from the interview data were presented, including definition of pain, quality of pain, previous pain experiences, pain expectation, pain acceptance, causes of pain and meaning of pain. Surprisingly, the results of this study revealed few differences in the experiences and meanings of pain. Most results are consistent with the studies done in the US. Differences are minor, including the interpretation of children's crying and how Taiwanese parents talk with their children about pain, and are probably related to the sample sizes and methodology of the studies. Further research is necessary about the influence of culture upon children's pain experiences.

Acute Disease↗

PubMed2002

Measuring the quality of children's postoperative pain management: initial validation of the child/parent Total Quality Pain Management (TQPM) instruments.

Quality improvement measurement instruments for pediatric postoperative pain management are virtually nonexistent. Without standardized instruments to measure pediatric pain management outcomes, practitioners are hampered in their efforts to improve the quality of pain management for children. In this study, instruments for children (8--12 years) and parents were developed and tested to measure the quality of children's postoperative pain management. The child (Child TQPM) and parent (Parent TQPM) Total Quality Pain Management instruments were tested with 50 parent/child dyads across two large treatment centers. The pain rating scale modified for these instruments demonstrated good criterion validity with the well established Varni/Thompson Pediatric Pain Questionnaire Visual Analogue Scale. Parent--child agreement was described for responses across instruments. Construct validity was examined through selected inter-item relationships. Psychometric analyses support the initial measurement properties of the pediatric TQPM instruments.

Adult↗

PubMedDate not supplied

A review of factors predicting children's pain experiences.

Despite decades of research, hospitalized children continue to suffer from unrelieved pain. Failure to apply state-of-the-art knowledge to clinical practice has been termed one of the greatest paradoxes in modern medicine (Kenny, 2001). Clearly, effective pain management requires state-of-the-art knowledge about the pain experience. This article reviews research over the past two decades related to the predictors of age, gender, prior pain experiences, pain expectation, pain acceptance, and pain tolerance. The review underscores implications for clinical practice and indications for future research.

Adolescent↗

PubMedDate not supplied