Medicine and Health Sciences Commons^™

Development Of Clinical Practice Guidelines For Incorporating Paravertebral Blockade For Thoracic Surgery Adult Patients, India Hutchison

Doctor of Nursing Practice Scholarly Projects

Thoracic surgery is considered one of the most painful surgical procedures due to its severity and the duration of the procedure. Pain is detrimental to the patient experience, and poor patient satisfaction results in revenue loss for hospitals. Maintaining adequate pain control after surgery is crucial in preventing pulmonary complications such as atelectasis and respiratory failure that prolong patient recovery. It is the responsibility of the anesthesia provider to ensure adequate pain control throughout the perioperative experience. Although current evidence-based data shows that regional anesthesia provides superior thoracic postoperative pain control, the current practice continues to be the utilization of …

A Multimodal Approach: Implementing Omm For Spinal Surgery Patients' Pain And Anxiety, Summer Barnes

Doctor of Nursing Practice Final Manuscripts

Introduction: The purpose of this evidence-based practice Doctor of Nursing Practice (DNP) project was to encourage thorough assessment of pain and anxiety prior to spinal surgery in order to identify the need for implementation of additional modalities, such as osteopathic interventions for pain and anxiety management. It is pertinent that as holistic providers we address this populations often missed psychological distress and ineffective pharmacological pain regimens to promote better patient outcomes.

Background: Research says there are approximately 1.62 million instrumented spinal procedures performed annually in the United States. Spinal surgery is not uncommon, and neither is the chronic pain and …

Implementing Pain Management Policies And Procedures At A Rural Pain Clinic, Jamie Swearingen

Doctor of Nursing Practice Projects

The United States is facing an uprising in opioid use disorder and a rise in overdoses due to the disorder. Due to the high addiction potential of opioids and the potential for overdose, providers must be cautious and conservative in their opioid prescribing practices. In 2022, the Centers for Disease Control (CDC) updated the Clinical Practice Guidelines for Prescribing Opioids for Pain to help in prevention of developing opioid use disorder and unintentional overdoses. The lack of an opioid use disorder risk screening tool, random urine drug screens, and clear pain management contracts were identified as issues at one rural …

Development Of Evidence-Based Practice Guidelines For Perioperative Multimodal Analgesia During Spine Surgery, Jonathan Wagner

Doctor of Nursing Practice Scholarly Projects

The most common cause of adult disability is chronic back pain. As medication maintenance therapy becomes ineffective, surgical intervention is the last resort for treatment. Patients with chronic pain often rely on pain medication such as opioids for relief. The exposure and dependency of opioids can create unique challenges for anesthesia providers to deliver safe and adequate anesthesia for surgery. Patient’s dependent on chronic opioids develops many adverse effects including sleep disordered breathing, suppression of the immune system, and higher risk of developing cardiovascular events under stress. There is a lack of consistent perioperative guidelines for patients undergoing spinal surgery …

Development And Validation Of The Pain Resilience And Optimism Scale (Pros), Wonjin Seo

Electronic Thesis and Dissertation Repository

Numerous self-report questionnaires have been used in pain research to explore patients' experiences. However, these questionnaires often employ negatively worded items that can potentially worsen patients' distress. In response to the emergence of positive psychology, this thesis aimed to develop a new questionnaire that adopts a positive and strengths-focused approach, incorporating resilience, to replace the negative items found in existing tools such as the Pain Catastrophizing Scale (PCS). First, the effectiveness of the Connor-Davidson Resilience Scale (CD-RISC) in measuring resilience following trauma was assessed through a systematic review using the COnsensus-based Standards for the selection of health status Measurement INstruments …

Psychological Distress, Resilience, And The Impact On Quality Of Life In Breast Cancer Survivors With Taxane-Induced Peripheral Neuropathy, Lauren Schwab

USF Tampa Graduate Theses and Dissertations

The purpose of this dissertation study was to longitudinally examine psychological distress (depressive symptoms and anxiety symptoms), resilience, and the impact on quality of life (QOL) in breast cancer survivors (BCS) with taxane-induced peripheral neuropathy (TIPN). The specific aims were 1) to describe psychological distress (depressive and anxiety symptoms) in BCS with TIPN and the impact on QOL using a scoping review; 2) to determine the relationship between psychological distress, QOL, and resilience in BCS with TIPN over time in a 16-week randomized controlled trial (RCT); and 3) to determine if resilience moderates psychological distress and QOL in BCS with …

Unveiling Pain: Wearables For Objective Pain Measurement, Hanqing Tang

Masters Theses

">">Pain perception is a subjective experience that differs significantly among individuals, often leading to inconsistencies in assessment and management. A critical issue within this context is the gender bias in pain evaluation, which contributes to unequal treatment and perpetuates gender inequality within the healthcare system. This thesis presents an in-depth investigation of the problem and proposes the development of a wearable device for objective pain assessment. Physiological parameters — Electrocardiography (ECG) can be collected from cardiac sound signals auscultated by fabrics via nanometre-scale vibrations. Machine learning methods can accurately classify heart rate and acute pain intensity of participants. …

Connecting Linguistic Expressions And Pain Relief Through Transformer Model Construction And Analysis, Sarah M. Chacko

Computer Science Senior Theses

Chronic pain is a widespread problem that significantly impacts quality of life. Overprescription and abuse of pain medication continues to be a major public health issue and can further burden patients due to a fragmented health care system. Previous research has suggested a possible psychological basis to pain and the potential for safer, non-pharmacological alternatives for pain relief. This project leverages language models to study chronic pain development and relief through psychological treatments, which will be assessed through responses to post-treatment interviews. A transformer-based natural language processing model is employed to identify connections between language expressions and pain on a …

A Comparison Of Erector Spinae Plane Block And Epidural Analgesia For Major Abdominal Surgery, Charles Serrano

Doctor of Nursing Practice Projects

A large tertiary care center in central Illinois saw an increase in erector spinae plane (ESP) block administration for abdominal surgery patients, but many anesthesia providers at the facility were not acquainted with the ESP block. This project aimed to develop a comprehensive educational program concerning the ESP block compared to thoracic epidural analgesia for major abdominal surgery patients and ultimately improve patient care. The program introduced the relevant anatomy, indications, technique, advantages, and disadvantages of ESP block and epidural analgesia. Additionally, the risks, benefits, and costs of both adjunctive therapies were compared. The current literature shows that the thoracic …

Effects Of Cannabichromene On Pain And Neuroinflammation In Hiv-1 Tat Transgenic Mice, Sydney Wheeler

Honors Theses

HIV-1 TransActivator of Transcription (Tat) is a vital regulatory protein involved in HIV replication and implicated in development of HIV-associated pain and neurocognitive deficits. Tat is thought to contribute to these pathologies through proinflammatory pathways. Developing mechanisms to curb Tat-mediated inflammation is a key step in improving the quality of life of those living with HIV. Both recreational and medicinal cannabis use is prevalent among many people living with HIV; given this prevalence and the perceived anti-inflammatory benefits of cannabis use, it is important to investigate how chemical constituents of cannabis may impact HIV. In the present study, the effects …

Pectoralis Nerve Block Compared To Thoracic Paravertebral Nerve Block In The Mastectomy Patient: Evidence-Based Practice Recommendations, Eric Boyer

Doctor of Nursing Practice Scholarly Projects

Patients undergoing a mastectomy are at increased risk of becoming opioid dependent. Most patients undergoing a mastectomy are diagnosed with breast cancer, and the use of opioids is known to aid in cancer metastasizing due to the suppression of the body's natural killer cells. In addition, regional anesthesia, also known as a nerve block, has long provided a reduction in sensation by blocking the nerve pathway, thus numbing the feeling of pain in the operative area. The Pectoralis nerve block (PECS) and the Thoracic Paravertebral block (TPVB) are used in patients undergoing a mastectomy to help reduce the severity of …

Perioperative Pain Control: Evaluating Best Practices In Perioperative Pain Measures, Lisa M. Malakowsky

Doctor of Nursing Practice Projects

Background

Postoperative pain is contributing to the nation's opioid epidemic. Pain is an unpleasant sensation felt by the patient. When it is experienced postoperatively, it is a result of the surgical process. Patients up to 80% worldwide state that their pain is not controlled to their satisfaction. When postoperative pain is not treated adequately, it can contribute to chronic pain.

Purpose

Perioperative pain assessment and treatment policy at a rural critical access hospital and compare it to evidence-based guidelines for best practice. The project assessed the patient's pain treatment effectiveness compared to the pain management policy by using the CDC …

Mesenchymal Stem Cell Use In The Treatment Of Osteoarthritis: A Literature Review, Samantha Arrizon, Nolan Barnes, Teresa Del Toro, Lei Wena Herme, Vanessa Mendoza, Thi Tran, Reeta Zamro

Physician Assistant Studies | Literature Reviews

Mesenchymal stem cell (MSC) therapies have been growing in popularity in research due to their anti-inflammatory, immunomodulatory, and regenerative properties. Many ongoing clinical trials are investigating the safety and efficacy of MSC therapies to treat osteoarthritis, also known as “wear and tear” arthritis. As the average life expectancy increases, with age people are more prone to developing this disease, therefore, increasing its prevalence. This condition is progressive and will lead to functional decline, decreased quality of life, and increased medical costs. Our focus is to discuss the efficacy of mesenchymal stem cell injections in alleviating pain, improving functionality, and slowing …

Virtual Reality Pain Intervention For Pediatric Burn Patients, Tanya Ann Hinrichs

Theses and Graduate Projects

Burns can be devasting trauma in the pediatric population, leading to lifelong physical and psychological pain and anxiety. Burn pain management is complicated and undertreated traditionally. The purpose of this scholarly project is to examine the use of virtual reality (VR) for distraction in pediatric patients who have experienced a burn to determine if VR improves pain management during painful procedures. A literature review revealed a gap in pain management in pediatric burn survivors with just traditional pharmacologic analgesia during painful procedures. Leininger’s Culture Care Theory provides a theoretical framework for this project’s purpose to determine if implementing a virtual …

Benefits Of Medical Thc For Neurological Disorders In The U.S., Andrew Lester, Alexandria Gartin

Theses, Dissertations and Capstones

Introduction: The introduction of THC into the medical field has allowed medical professionals to offer a new treatment option to aid in their patients treatment plan by decreasing their symptoms of side effects of other medications used for their conditions.

Methodology: This study utilized a literature review. Five databases were used to collect 116 total sources. These sources were reviewed and reduced to 33 sources that were used in the written research. Of these, 16 sources were used in the results section.

Purpose of the Study: The purpose of this research was to analyze the prescription use of …

Registered Nurses’ Perceptions Regarding Postoperative Pain Management And Opioids For Adolescents, Susan Miller

Walden Dissertations and Doctoral Studies

More than 2.4 million children undergo surgery annually in the United States and many experience postoperative pain. Poor pain management causes negative outcomes to both the individual and society. Increased rates of prescription drug misuse and rising death rates for adolescents from drug overdoses underscore the need for improvements in pain management. However, there is a lack of research, limited guidelines, and significant provider variability in managing adolescents’ acute postoperative pain. The purpose of this qualitative study was to explore the topic of acute postoperative pain management for adolescents through the lens of registered nurses (RNs). Nurses play an essential …

Registered Nurses’ Perceptions Regarding Postoperative Pain Management And Opioids For Adolescents, Susan Miller

Walden Dissertations and Doctoral Studies

More than 2.4 million children undergo surgery annually in the United States and many experience postoperative pain. Poor pain management causes negative outcomes to both the individual and society. Increased rates of prescription drug misuse and rising death rates for adolescents from drug overdoses underscore the need for improvements in pain management. However, there is a lack of research, limited guidelines, and significant provider variability in managing adolescents’ acute postoperative pain. The purpose of this qualitative study was to explore the topic of acute postoperative pain management for adolescents through the lens of registered nurses (RNs). Nurses play an essential …

Knowledge & Attitudes Towards Pediatric Pain With Needle-Based Procedures In The Emergency Department Setting, Charlstyn Paige Brown

DNP Projects

PURPOSE: By the time a child enters kindergarten, they may have faced as many as thirty-three vaccine-related injections. Throughout these experiences, parents and patients associated pain and fear regarding the administration of multiple vaccines concurrently to a child has played a role in vaccine hesitancy and refusal. Parents and patients experience associated fear and pain regarding the administration of multiple concurrent scheduled vaccines, thus leading to vaccination hesitancy and refusal. In addition to scheduled immunizations, there is also the possibility of unexpected needle-based procedures taking place when emergencies arise. The purpose of the study is to explore the current …

A Six-Month Comparison Of Orthodontic Pain Associated With Fixed Edgewise Appliances And Clear Aligners, Victor Chan

Theses and Dissertations

Title: A Six-Month Comparison of Orthodontic Pain Associated with Clear Aligners and Fixed Edgewise Appliances

Objective: To document and compare pain perception, intensity, and analgesic use over a sixmonth period between patients treated with fixed appliances (FA) and clear aligners (CA).

Methods: A prospective, parallel, two-arm, multi-center, longitudinal cohort study was conducted with 87 adults treated with CA (n=59) or FA (n=28). Subjects were selected according to inclusion and exclusion criteria. A seven-item, digital survey was sent at three timepoints (preappointment, 2-days post-appointment, and 7-days post-appointment) at each adjustment over a six-month period. The variables measured included pain experience, pain …

Cultural Perspectives In Pain And Palliative Care, Loan Lagué

Master's Projects

Culturally and linguistically diverse (CALD) patients are constantly challenged by the different levels on which lack of cultural competency or bias occurs in healthcare. This literature review focuses on the healthcare providers’ experiences when providing pain and palliative care to CALD populations and explores the challenges that may result in health inequalities. A review of current literature was conducted using PubMed, CINHAL, Sage Journals, Ovid, and Science Direct electronic databases. Sixteen published articles between 2015-2023 were reviewed. Findings from this review identified factors that induce poor quality palliative, pain, and end-of-life (EOL) care among culturally diverse groups. Improving quality of …

The Effectiveness Of Laser Acupuncture In Pain Management: A Systematic Review, June Park

Theses and Graduate Projects

Background: Pain is a common symptom across many medical conditions that patients experience. Pain management is complex and may need a combination of several management techniques. Laser acupuncture(LA) has been previously used as an adjunct to conventional pain treatments.

Objective: This systematic review aims to evaluate the effectiveness of laser acupuncture in various fields of medical situations such as chronic pain, low back pain, osteoarthritis, osteoporosis, postoperative pain and dental procedures.

Methods: A computer based literature search of databases through GoogleScholar and PubMed was used to identify randomized controlled trials(RCTs) published after 2018 that studied the effect of LA in …

The Lived Experiences Of Pain And Fatigue In Persons Living With Neurological Conditions: A Phenomenological Study, Lauren L. Kane

Electronic Thesis and Dissertation Repository

Purpose: The aim of the study was to understand the experiences and impact of pain and fatigue and to further explore the relationship between participants' descriptions of their lived experiences with these phenomena within and across multiple sclerosis, Parkinson's disease, and cerebral palsy. Methods: Semi-structured interviews were used to interview nine participants about their experiences of living with pain and fatigue in their respective conditions. A new phenomenological approach was adopted, and data was analyzed inductively using interpretive phenomenological analysis. Results: Three final themes including a lack of understanding, negative perceptions of pain and fatigue, and coping strategies used to …

Remifentanil Patient Controlled Analgesia Use In Laboring Women: A Feasibility And Acceptability Study, Joshua Carr

Dissertations

Background/Purpose: Interest in remifentanil patient controlled analgesia (RPCA) as a treatment for labor pain has increased due to its unique pharmacodynamics and effectiveness on pain control among parturients. Despite its promise, RPCA remains infrequently used in the US. The purpose of this study was to 1) examine the implementation and acceptability of a new RPCA protocol in the labor and delivery ward of a mid-sized hospital, and 2) identify the attitudes and beliefs of healthcare workers in a real-world clinical setting.

Theoretical/Conceptual Framework: The holistic nature of Comfort Theory can account for the proposed mechanisms contributing to the …

An Interpretative Phenomenological Analysis Of The Lived Experience Of Parental Caregivers For Children With Severe Epidermolysis Bullosa, Michael J. Valentine

Theses and Dissertations

Providing care to child with a chronic, rare diseases has been identified as a major life stressor with a myriad of negative physical and mental health consequences. These stresses have previously been found to create burden that may impair caregiving efforts and increase the risk of mortality for both the caregiver and affected child. Many rare diseases affect children. It is not known how caregiver burden and the source of stress varies by disease. Qualitative methods have been used to understand caregiver experience with the rare disease, epidermolysis bullosa (EB), but no such studies have occurred in the United States. …

Ethical Sensitivity Of Padis Care Among Critical Care Nurses: A Mixed Methods Study, Denise Waterfield

Theses & Dissertations

Critically ill patients often experience distressful and impactful symptoms and conditions that include pain, agitation/sedation, delirium, immobility, and sleep disruption (PADIS). The presence of PADIS can affect recovery and long-term patient outcomes. An integral part of critical care nursing is PADIS prevention, assessment, and management. To better understand the complexities of PADIS care, two reviews of the literature were completed. The first is an integrative review of the use of PADIS assessment tools by critical care nurses. The second is a qualitative systematic review of the literature on the integration of care ethics and nursing workload. Ethical sensitivity of everyday …

Vasovagal Syncope During Venipuncture:Alleviating Symptoms Through Leg Muscle Tension And Moving Toes Sequentially, Velina Andrewski

Doctor of Nursing Practice Projects

Venipuncture is a common medical procedure and is considered safe and routine. However, intermittent cases occur where patients develop symptoms of lightheadedness, nausea, weakness, and occasionally a full syncopal episode due to needle phobia, blood phobia, and pain associated with venipuncture. Vasovagal Reactions (VVR) or Vasovagal Syncope (VVS) during a venipuncture procedure can be distressing for the patient, the clinician, and disruptive to clinic routines. This paper examines whether techniques such as simple leg tensing and wiggling of toes can reduce or abort VVR/VVS completely as the patient undergoes venipuncture. Clinicians were instructed in techniques to use if the patient …

Efficacy Of Δ-9-Tetrahydrocannabinol For Hiv-Related Neuropathic Pain, Kaia Horne

Honors Theses

Despite the availability and success of antiretroviral therapeutics, ~30% of patients living with HIV experience neuropathic pain that is often intractable. The mechanisms are not known, but there is evidence to support a role for the HIV virotoxins, Tat and/or gp120, which can damage or degenerate neurons and peripheral nerves. One mechanism by which Tat and gp120 promote nerve damage involves the stimulation of proinflammatory cytokine production from immune cells which can damage or kill bystander cells. Notably, compounds found in Cannabis exert anti-inflammatory effects and many studies report HIV patients to consume more marijuana than seronegative individuals. When people …

Pain Is Personal: Understanding Pain Relativity And The Importance Of The Biopsychosocial Model, Riley Kathleen Magoon '22

Honor Scholar Theses

Pain is undoubtedly a universal concept; however, the way in which one experiences pain is vastly different depending on the individual. These variations are due to pain reflecting one’s identity which encompasses expansive factors including age, sex, ethnicity, coping mechanisms, and past experiences. Because pain is multidimensional, healthcare providers need to integrate a method that treat patients comprehensively. The biopsychosocial approach prioritizes extensive assessment and treatment as well as consistent communication between patient and provider. For healthcare to implement more effective and empathetic care, the biopsychosocial model needs to be integrated in more fields of medicine. This implementation begins with …

Ameliorative Effects Of Minor Cannabinoids Over Hiv-1 Tat-Mediated Visceral Pain, Charlie Worth

Honors Theses

As the total number of people living with HIV continues to rise across the world, an effective HIV treatment is still sought after. While modern-day advanced therapies exist for mitigating much of the negative effects of HIV, the virus remains evasive and problematic in the central nervous system. Thus, even with treatment, many people living with HIV continue to suffer from a plethora of symptoms. However, a large proportion of HIV-positive patients claim to feel a reduction in those persevering symptoms after cannabis usage. This anecdotal evidence has sparked interest in the efficacy of cannabis constituents for HIV therapy. This …

Music As A Treatment For Perceived Postoperative Pain In Adults: A Critically Appraised Topic, Savannah G. Mcdaniel

Honors College Theses

Clinical Question: In postoperative patients, how does listening to music affect perceived pain levels? Clinical Bottom Line: There is consistent evidence to suggest music decreases perceived pain in postoperative patients undergoing nasal septal surgery, open heart surgery, total knee replacement surgery, and general orthopedic surgeries requiring hospitalization. Athletic trainers can confidently implement music during patients’ post-operative care sessions to help reduce pain.