Pain Management Commons^™

Personalized Pain Management Pathway Based On Individual Diagnoses, Tiana Bell Asn, Rn, Diana Desmornes Asn, Rn, Autumn Dwyer Bsn, Rn, Monica Foley Asn, Rn, Marissa Forleo Bsn, Rn, Heather Mcmillan Asn, Rn, Nicole Valenti Bsn, Rn

Posters

The intervention we’re proposing offers a comprehensive, individualized approach to pain management, taking into account diagnosis-specific pain scales, nonpharmacological interventions, and continued pain control post-discharge.

Using Musical Interventions As A Non-Pharmacological Strategy To Improve Chronic Pain Levels And Satisfaction Among Patients With Sickle Cell Disease, Fredeline Metellus

Doctor of Nursing Practice Final Project Abstract

Background

Sickle Cell Disease (SCD) is a chronic, inherited blood disorder characterized by severe pain episodes that are often poorly managed with standard pharmacological treatments. In response to patient dissatisfaction with pain control and the desire for holistic alternatives, this quality improvement project explored music therapy as a non-pharmacological pain management strategy.

Purpose

The primary aim was to reduce chronic pain by at least 20% and improve patient satisfaction with pain management among adults with SCD using a structured musical intervention.

Methodology

This project was implemented at a comprehensive outpatient SCD clinic using the Plan-Do-Study-Act (PDSA) model. Five adult patients …

Psychosocial Outcomes Of Pain And Pain Management In Adults With Osteogenesis Imperfecta: A Qualitative Study, Whitney S Shepherd, Andrew D Wiese, Hannah E Cho, W Conor Rork, M Usman Baig, Kristin M Kostick, Dianne Nguyen, Erin M Carter, Members Of The Bbdc, Chaya N Murali, Marie-Eve Robinson, Sophie C Schneider, Brendan Lee, V Reid Sutton, Eric A Storch

Faculty, Staff and Students Publications

Objectives

Osteogenesis imperfecta (OI) is a genetic disorder characterized by bone fragility and fractures, short stature, dental abnormalities, hearing loss, scoliosis, and chronic pain. Despite a growing literature on the functional outcomes of OI, limited research has explicitly examined the psychosocial outcomes of pain within OI.

Methods

Adults with OI (N=15) were interviewed to understand pain-related experiences through a thematic analysis of semi-structured interview data. Research team members, genetic research experts, and OI clinicians developed an interview guide focused on topics related to pain and mental health challenges. Participants’ transcripts were coded by two independent coders; codes were then merged …

Benefits Of Acceptance And Commitment Therapy (Act) For Chronic Pain, Maria Kleinstaeuber, Ashley Yaugher, Emily Roundy, Michael Levin

All Current Publications

Chronic pain is a common experience for people and can be difficult to manage. However, there are many evidence-based and effective psychological treatments for chronic pain to help people improve their lives. One of these is acceptance and commitment therapy, or ACT. ACT teaches how to accept pain and live a life full of meaning and quality, with pain. It helps individuals increase their quality of life through mindfulness-based methods, experiential processing, and a focus on values, goals, and actions. ACT has been shown to be effective in reducing pain and improving pain management and personal well-being. Consult the resources …

Techniques In Medicine: Ipsilateral Transforaminal Epidural Steroid Injection In Bertolotti’S Syndrome, Peter D Vu, Christopher L Robinson, Omar Viswanath, Ivan Urits, Jamal Hasoon

Faculty, Staff and Student Publications

Bertolotti's syndrome, also known as lumbosacral transitional vertebrae, is a relatively rare spinal condition characterized by an anatomical variation in the lower spine. Conservative approaches such as physical therapy, anti-inflammatory medications and lifestyle modifications may be recommended for mild cases. In more severe cases or when conservative measures fail to provide relief, injections such as may be considered to alleviate pain. This case is unique in that we document a challenging technique of ipsilateral transforaminal epidural steroid injection in a patient with Bertolotti's syndrome.

Adherence To Opioid Patient Prescriber Agreements At A Safety Net Hospital, Soraira Pacheco, Linh M T Nguyen, John M Halphen, Nikitha N Samy, Nathaniel R Wilson, Gregory Sattler, Shane E Wing, Christine Feng, Rex A D Paulino, Pulin Shah, Supriyanka Addimulam, Riddhi Patel, Curtis J Wray, Joseph A Arthur, David Hui

Faculty, Staff and Student Publications

Patient prescriber agreements, also known as opioid contracts or opioid treatment agreements, have been recommended as a strategy for mitigating non-medical opioid use (NMOU). The purpose of our study was to characterize the proportion of patients with PPAs, the rate of non-adherence, and clinical predictors for PPA completion and non-adherence. This retrospective study covered consecutive cancer patients seen at a palliative care clinic at a safety net hospital between 1 September 2015 and 31 December 2019. We included patients 18 years or older with cancer diagnoses who received opioids. We collected patient characteristics at consultation and information regarding PPA. The …

A Multicenter Study To Evaluate Pain Characteristics In Osteogenesis Imperfecta, Mercedes Rodriguez Celin, Karen M Kruger, Angela Caudill, Chaya N Murali, Sandesh C S Nagamani, Peter A Smith, Gerald F Harris

Faculty, Staff and Students Publications

The objective was to describe pain characteristics and treatments used in individuals with varying severity of osteogenesis imperfecta (OI) and investigate pain-associated variables. This work was derived from a multicenter, longitudinal, observational, natural history study of OI conducted at 12 clinical sites of the NIH Rare Diseases Clinical Research Network's Brittle Bone Disorders Consortium. Children and adults with a clinical, biochemical, or molecular diagnosis of OI were enrolled in the study. We did a cross-sectional analysis of chronic pain prevalence, characteristics, and treatments used for pain relief and longitudinal analysis to find the predictors of chronic pain. We included 861 …

Altop (Alternatives To Opioids), Fall 2022, Dr. Susan L. Davis, Rn & Richard J. Henley College Of Nursing

News, Magazines and Reports

In this issue:

• New Principal Investigator (PI) ALTOP Grant
• 2021-2022 Graduating Class
• ANEW HRSA 2022-2023 Awardees
• Students Quality Improvement Projects
• April 9th, 2022, Preceptor Workshop Photos
• New Clinical Partner: The Bridgeport Rescue Mission/ Sage Health Care
• Save the Date: Annual DNP Colloquium

Regional Anesthesia For Sickle Cell Disease Vaso-Occlusive Crisis: A Single-Center Case Series, Cecile Karsenty, Venée N Tubman, Chyong-Jy Joyce Liu, Titilope Fasipe, Karla E K Wyatt

Faculty, Staff and Students Publications

Pain management is challenging for patients with sickle cell disease (SCD) who present in vaso-occlusive crisis (VOC). Opioid therapy is highly effective, nevertheless undesirable side effects can hinder their effectiveness. Regional anesthesia with deposition of perineural anesthetic offers nociceptive blockade, local vasodilatation, and reduces the inflammatory response. Among pediatric patients, continuous peripheral nerve block (CPNB) for perioperative adjunctive analgesia is safe. Herein, we describe the trajectory of a cohort of pediatric SCD patients with opioid-refractory upper-extremity VOC following placement of CPNBs for analgesia; highlighting reduced opioid consumption, improved pain scores, and decreased length of hospitalization.

Telehealth Delivery Of Acceptance And Commitment Therapy And Recreational Therapy: Supporting People With Chronic Pain During The Covid-19 Pandemic, Grace L. Roy

Honors Theses and Capstones

Chronic pain is a significant public health problem that requires person-centered and comprehensive care to address the many socioecological factors that contribute to pain. Within the context of the COVID-19 pandemic, telehealth options for chronic pain management can help more people access the care that they need. The purpose of the current pilot study was to investigate the efficacy and feasibility of delivering a 6-week Acceptance and Commitment Therapy (ACT) and recreational therapy intervention via telehealth for a group of seven participants with chronic pain. It was found that TeleACT-RT was associated with positive behavioral outcomes including increased psychological flexibility, …

Mindfulness And Pain Regulation: The Role Of Acceptance And Commitment Therapy For Individuals With Chronic Pain, Ariana C. White

Honors Theses and Capstones

Chronic pain is a significant and widely prevalent health condition which requires comprehensive care to address the many facets contributing to symptomatology. In 2016, 20% of American adults (about 50 million) reported experiencing chronic pain, of which 7.4% indicated that chronic pain frequently limited their life and participation in activities within the past 3 months (CDC, 2018). As a result, many individuals with chronic pain turn to opioid-based medication for pain relief, but long-term use of opioids actually increases pain sensation (Tobin, 2019). Moreover, opioid medication is unable to target underlying mental health components which emerge as part of chronic …

Pain Management And Telemedicine: A Look At The Covid Experience And Beyond, Jamal Hasoon, Ivan Urits, Omar Viswanath, Alan D Kaye

Faculty, Staff and Student Publications

COVID-19 caused a drastic change in clinical medicine around the globe. In the United States, telemedicine was rapidly adopted on a wide scale to minimize direct patient interaction and to reduce the spread of the COVID-19 virus. Telemedicine also went hand in hand with the rapid movement of working remotely. This has provided several challenges to chronic pain management clinics along with other subspecialties. Telemedicine has also opened opportunities for providing valuable care for patients with significant barriers to healthcare professionals. Given the benefits and downfalls of telemedicine, it is ultimately up to the provider who has an established patient-physician …

Anxiety And Mood Disorders Impacting Physician Opioid Prescribing In The Pediatric Hospital Setting, Candice D. Donaldson, Zeev N. Kain, Louis Ehwerhemuepha, Michelle A. Fortier, Michael T. Phan, Daniel M. Tomaszewski, Sun Yang, William Feaster, Brooke N. Jenkins

Psychology Faculty Articles and Research

This research examined whether pediatric inpatients without an anxiety/mood disorder are more likely to receive opioids in response to pain compared to patients diagnosed with a mental health condition. Research questions were tested using cross-sectional inpatient electronic medical record data. Propensity score matching was used to match patients with a disorder with patients without the disorder (anxiety analyses: N = 2892; mood analyses: N = 1042). Although patients with anxiety and mood disorders experienced greater pain, physicians were less likely to order opioids for these patients. Analyses also disclosed an interaction of anxiety with pain—the pain-opioid relation was stronger for …

Shu Altop News Issue #2, Spring, Dr. Susan L. Davis, Rn & Richard J. Henley College Of Nursing

News, Magazines and Reports

Updates from the Davis & Henley College of Nursing Sacred Heart University Alternatives to Opioids for Pain Grant.

Alternatives to Opioids for Pain (ALTOP) is a HRSA funded project to help combat the opioid epidemic in Connecticut.

Nursing Students’ Knowledge And Attitudes About Pain Management And Opioids, Hedieh Hatami Sirjani

Health Services Research Dissertations

Statement of the problem: healthcare professionals’ knowledge of using opioids for pain management safely is critical in preventing opioid abuse and overdose. Undergraduate curricula of health professional schools, including undergraduate nursing programs, need to improve and adopt a comprehensive education regarding this issue.

Method: the first project was a systematic analysis of the literature regarding the educational interventions’ impact on healthcare professional knowledge and practice behavior regarding prescription opioids. The second project was a qualitative study of nursing students to explore their experience, self-efficacy, and knowledge of prescription opioid use for pain management and whether they feel the need for …

Parent Responses To Pediatric Pain: The Differential Effects Of Ethnicity On Opioid Consumption, Candice D. Donaldson, Brooke N. Jenkins, Michelle A. Fortier, Michael T. Phan, Daniel M. Tomaszewski, Sun Yang, Zeev N. Kain

Psychology Faculty Articles and Research

Objective

Within the context of the United States opioid epidemic, some parents often fear the use of opioids to help manage their children's postoperative pain. As a possible consequence, parents often do not dispense optimal analgesic medications to their children after surgery, putting their children at risk of suffering from postsurgical pain. The objective of this research was to assess ethnicity as a predictor of both pain and opioid consumption, and to examine how Hispanic/Latinx and Non-Hispanic White parents alter their child's opioid consumption in response to significant postsurgical pain.

Methods

Participants were 254 children undergoing outpatient tonsillectomy and/or adenoidectomy …

Pediatric Postoperative Pain Medication: Child Sex And Ethnicity Interact To Predict Parent Medication Attitudes, Vivian Luong, Harshitha V. Venkatesh, Michelle Fortier, Zeev N. Kain, Brooke N. Jenkins

Student Scholar Symposium Abstracts and Posters

Over 85% of children experience significant pain after surgery. Despite this presence of pain, research suggests that a quarter of these children receive very little or even no pain medication at home. Such poor pain management in children can have harmful long-term consequences, both physically and psychologically. Previous research indicates that the amount of pain medication administered to children in the home may be significantly impacted by beliefs and attitudes parents have regarding analgesics. Given this, the purpose of the present study is to identify which demographic factors are associated with certain parent analgesic attitudes or misconceptions among pediatric patients …

Shu Altop News, Vol. 1, Dr. Susan L. Davis, Rn & Richard J. Henley College Of Nursing, Susan M. Denisco, Kerry A. Milner

News, Magazines and Reports

Updates from the Davis & Henley College of Nursing Sacred Heart University Alternatives to Opioids for Pain Grant.

Alternatives to Opioids for Pain (ALTOP) is a HRSA funded project to help combat the opioid epidemic in Connecticut. Through the creation and support of academic clinical practice partnerships at two federally qualified health centers, family nurse practitioner students are gaining clinical training and experience in the appropriate use of opioids and alternative pain modalities, in primary care settings. This project directly benefits the medically underserved areas in Bridgeport.

Pediatric Postoperative Pain Medication: Demographic Predictors And Parent Medication Attitudes, Vivian Luong

Student Scholar Symposium Abstracts and Posters

Over 85% of children experience significant pain after surgery. Despite this presence of pain, research suggests that a quarter of these children receive very little pain medication at home. Such poor pain management in children can have harmful long-term consequences. Previous research indicates that the amount of pain medication administered to children in the home may be significantly impacted by the attitudes parents have regarding analgesics. Given this, the purpose of the present study is to identify how demographic factors such as child sex and ethnicity predict certain parent analgesic attitudes and, in turn, the amount of pain medication their …

Impact Of Serratus Plane Block On Pain Scores And Incentive Spirometry Volumes After Chest Trauma, Nadia Hernandez, Johanna De Haan, Dallis Clendeninn, David E Meyer, Semhar Ghebremichael, Carlos Artime, George Williams, Holger Eltzschig, Sudipta Sen

Faculty, Staff and Student Publications

Background: Adequate pain control is difficult to achieve in patients with multiple rib fractures (MRF). Serratus plane block (SPB) is a novel technique for alleviating rib fracture pain. Several published case reports support this hypothesis.

Purpose: The purpose of this study was to evaluate the use of SPB in MRF at our level 1 trauma center.

Methods: Our hospital’s Regional Anesthesia Registry was queried for all trauma patients with MRF who underwent SPB between August 2014 and January 2018. Data were compared in each patient as a matched pair for the time periods before and after undergoing SPB. Thirty-four patients …

A Comparison Of Combined Versus Individual Cognitive Coping Strategies For Managing Pain, Grant Pointon

Senior Honors Projects, 2010-2019

Several cognitive coping strategies for reducing pain sensation have been identified, but their effects have traditionally only been examined in isolation. The current investigation instead compared the effectiveness of traditional cognitive coping strategies based upon imagery and pain acknowledgement/attention against an “integrated” strategy (that required both strategies to be used in combination) within a cold pressor test (CPT). Participants (N = 24, M_age= 19.46, SD = 1.47) underwent a baseline condition followed by counterbalanced strategy trials: imagery, attention, & integrated condition. Tolerance times, pain ratings, and perceived control ratings were recorded. The imagery condition had lower pain …

Perspectives On Pediatric Pain, Donald E. Greydanus, Dilip R. Patel, Colleen Dodich, Hatim A. Omar, Joav Merrick

Pediatrics Faculty Publications

No abstract provided.

How Patients' Self-Disclosure About Sickle Cell Pain Episodes To Significant Others Relates To Living With Sickle Cell Disease, Valerian J. Derlega, Louis H. Janda, Jeannie Miranda, Ian A. Chen, B. Mitchell Goodman Iii, Wally Smith

Psychology Faculty Publications

Objectives: This cross-sectional study examines to whom and how fully sickle cell disease (SCD) patients talk to others about sickle cell pain, how helpful it is to talk with others about these pain episodes, and the association between talking to others about sickle cell pain episodes and patients' psychological adjustment and coping strategies in managing the disease.

Methods: A convenience sample of 73 African American patients with SCD (30 men and 43 women), were recruited from two SCD clinics at the time of routine medical visits. Most participants had been diagnosed with hemoglobin SS, and they reported an average number …