Knowledge and attitudes of Registered Nurses toward pain /

This research provided relevant data to support pain research literature that finds nurses do not have the knowledge base that they require to sufficiently provide effective pain management. The data demonstrated that nurses have mixed attitudes toward pain. These two findings have been observed in the literature for more than 20 years, but were important results for the hospitals and the nurses involved in the study. The purposes of this study were to identify the level of knowledge and attitudes in a sample of nurses fi-om the surgical and medical units in three hospitals, and determine whether a difference between these two groups existed. The institutional resources to support pain relief practices provided by each hospital were also documented. Data were collected using a convenience sample from the medical and surgical units of three hospitals. Ofthe 1 13 nurses who volunteered to participate, 78 worked in surgical units and 35 worked in medical units. Demographic data were collected about the participants. The established instruments used to obtain data about knowledge and attitude included: (a) Nurses Knowledge of Pain Issues Survey, (b)Attitude to Pain Control Scale, and (c) Andrew and Robert Vignette. Data collected were quantitative along with two open-ended questions for a rich, qualitative section. Inadequate knowledge and outdated attitudes were very evident in the responses. Data from the open-ended questions described how nurses assessed pain and the most conmion problems caring for patients in pain. Nursing practice implications for these hospitals involve initiating a process to develop an educational pain program for nurses throughout the hospital. Utilizing findings from other studies, the program should have an interdisciplinary approach to the planning, implementation, evaluation, and ongoing support. This study supports the belief that inadequate pain management has been attributed to many factors, most importantly to a lack of knowledge. Pain is a costly, unnecessary complication for the patient as well as the hospital. It follows then, that it is in the best interest of all involved to implement an educational pain program in order to influence practice.

The effects of simple procedural, cognitive procedural and declarative learning on sleep /

Sleep spindles have been found to increase following an intense period of learning on a combination of motor tasks. It is not clear whether these changes are task specific, or a result of learning in general. The current study investigated changes in sleep spindles and spectral power following learning on cognitive procedural (C-PM), simple procedural (S-PM) or declarative (DM) learning tasks. It was hypothesized that S-PM learning would result in increases in Sigma power during Non-REM sleep, whereas C-PM and DM learning would not affect Sigma power. It was also hypothesized that DM learning would increase Theta power during REM sleep, whereas S-PM and C-PM learning would not affect Theta power. Thirty-six participants spent three consecutive nights in the sleep laboratory. Baseline polysomnographic recordings were collected on night 2. Participants were randomly assigned to one of four conditions: C-PM, S-PM, DM or control (C). Memory task training occurred on night 3 followed by polysomnographic recording. Re-testing on respective memory tasks occurred one-week following training. EEG was sampled at 256Hz from 16 sites during sleep. Artifact-free EEG from each sleep stage was submitted to power spectral analysis. The C-PM group made significantly fewer errors, the DM group recalled more, and the S-PM improved on performance from test to re-test. There was a significant night by group interaction for the duration of Stage 2 sleep. Independent t-tests revealed that the S-PM group had significantly more Stage 2 sleep on the test night than the C group. The C-PM and the DM group did not differ from controls in the duration of Stage 2 sleep on test night. There was no significant change in the duration of slow wave sleep (SWS) or REM sleep. Sleep spindle density (spindles/minute) increased significantly from baseline to test night following S-PM learning, but not for C-PM, DM or C groups. This is the first study to have shown that the same pattern of results was found for spindles in SWS. Low Sigma power (12-14Hz) increased significantly during SWS following S-PM learning but not for C-PM, DM or C groups. This effect was maximal at Cz, and the largest increase in Sigma power was at Oz. It was also found that Theta power increased significantly during REM sleep following DM learning, but not for S-PM, C-PM or C groups. This effect was maximal at Cz and the largest change in Theta power was observed at Cz. These findings are consistent with the previous research that simple procedural learning is consolidated during Stage 2 sleep, and provide additional data to suggest that sleep spindles across all non-REM stages and not just Stage 2 sleep may be a mechanism for brain plasticity. This study also provides the first evidence to suggest that Theta activity during REM sleep is involved in memory consolidation.

A phenomenological approach to understanding the psychological response to chronic low back pain

Chronic low back pain (CLBP) is a complex health problem of psychological manifestations not fully understood. Using interpretive phenomenological analysis, 11 semi-structured interviews were conducted to help understand the meaning of the lived experience of CLBP; focusing on the psychological response to pain and the role of depression, catastrophizing, fear-avoidance behavior, anxiety and somatization. Participants characterized CLBP as persistent tolerable low back pain (TLBP) interrupted by periods of intolerable low back pain (ILBP). ILBP contributed to recurring bouts of helplessness, depression, frustration with the medical system and increased fear based on the perceived consequences of anticipated recurrences, all of which were mediated by the uncertainty of such pain. During times of TLBP all participants pursued a permanent pain consciousness as they felt susceptible to experience a recurrence. As CLBP progressed, participants felt they were living with a weakness, became isolated from those without CLBP and integrated pain into their self-concept.

The effect of synchronized group activities on pain threshold as a predictor of cooperation

Recent research suggests that participating in vigorous synchronized physical activity may result in elevated levels of endorphins, which may in turn affect social bonding (Cohen et. al., 2009). The present research aimed to examine whether or not the change in pain tolerance would be able to predict participants’ willingness to cooperate after statistically controlling for the groups’ condition. Participants were asked to run on a treadmill for 30 minutes under one of two conditions (control vs. synchronized). Prior to and after the run participants underwent a pain tolerance test. Once completed, a second activity was introduced to the participants; a cooperative game. A public goods game was used to measure an individual’s willingness to cooperate. The results showed the synchronized condition was able to predict that participants cooperated more during the public goods game (p = .009), however the change in pain threshold was unable to significantly predict cooperation (p = .32).