研究生英文文献汇报.ppt

Postgraduatestudent:*Tutor：*,ProfessorofNursing,1.McDonald,D.D.,etal.,Acloserlook:Alternativepainmanagementpracticesbyheartfailurepatientswithchronicpain.HeartLung,2015.,Acloserlook:Alternativepainmanagementpracticesbyheartfailurepatientswithchronicpain,Literaturesource,Contents,06,Background,Methods,05,01,Objective,Results,04,Discussion,Conclusions,02,03,Background,Atotalof76%ofpeoplewithchronicheartfailure(HF)reportchronicnon-cardiacpain,morethantwicetheprevalenceofthegeneralUnitedStatesadultpopulationestimateof30.7%.Non-cardiacpainreportedbypeoplewithHFrangesinintensity,andpaininterferencewithactivityfrommildtosevere,withsevereratingsreportedby38.9%.,Background,NegativeconsequencesofchronicpainforpeoplelivingwithHF,Reducethequalityoflife,Increaseburden,Increaseddepression,Decreasedphysicalactivity,Background,Littleisknownaboutalternativepainself-treatmentsusedbyHFpatientswithchronicpain.Assessmentofchronicpainandpainself-managementstrategiesandtheincorporationintocareofsafeandfeasibleself-managementstrategiesmightassistpatientstoreducepainduringand/oraftertheirhospitalstays.,Objective,Todescribealternativenon-pharmaceuticalnon-nutraceuticalpainself-managementstrategiesusedbypeoplewithHFinordertoreducechronicnon-cardiacpain.WhataresomecommonstrategiesusedbyHFpatientswithchronicpain?,Methods,1.DesignAcross-sectionaldescriptivedesign2.SampleandsettingN=25,conveniencesampleDatacollection:February2013toOctober2013InclusioncriteriaExclusioncriteria3.InstrumentsBriefPainInventoryShortForm(BPI-SF)4.Procedure,InclusioncriteriaAdultswithHFandchronicpainabletoreadandunderstandEnglishorSpanish,painofatleastthreemonthsdurationcurrentlyusingatleastonealternativenon-nutraceuticalself-managementpainstrategy.ExclusioncriteriaHistoryofdementiaorothercognitiveimpairment,TheBPI-SFwasusedtomeasurepatientself-administeredpaintreatments,painintensityandpaininterferencewithfunction.CronbachsalphaTheoverallBPI-SF(=0.770.85)TheBPIpainintensity(=0.82)Paininterferencewithactivity(=0.87),1.Alternativetreatmentsincludedwalking,stretching,useofheatandcold.2.Fivepatients(20%)usedevidence-basedpaintreatmentsfortheirchronicpainconditions.3.Patientsreportedmoderatepainintensityandpaininterferencewithactivity.,Results,Fiveofthe11men(45.5%)usedevidencebasedpaintreatmentsspecifictoalloftheirpainsyndrome(s),whichincludedbackand/orosteoarthritispain.,Discussion,1.Fewparticipantsusedevidence-basedalternativetreatmentsfortheirchronicpainconditions.2.Paininterferencewithenjoymentoflifeandsleeparethemainproblematicpaininterferencefactors.3.PainreductionislikelytoreduceoverallsymptomburdenforpeoplewithHFandmightalsoreduceco-morbidsymptoms.,Painreduction,Reduceoverallsymptomburden,Reduceco-morbidsymptoms,Discussion,4.IncreaseduseofevidencebasedalternativepaintreatmentsmightreduceuseofNSAIDsbypeoplewithHF.5.Althoughmalegenderwassignificantlyassociatedwithuseofevidence-basedalternativetreatmentsforalloftheirchronicpainsyndromes,approximatelyhalfofbothmenandwomenmissedtheopportunitytouseanevidence-basedpaintreatmentforoneormoreoftheirpainconditions.,ReduceuseofNSAIDs,Reduceadversecardiovasculareventsandhospitalizations,Increaseduseofevidencebasedalternativepaintreatments,Conclusions,1.PatientshospitalizedforHFwithchronicpainusesomealternativepaintreatments,butfewofthemuseavailableevidence-basedalternativepaintreatments.2.ScreeningforchronicpainandreferraltoIntegrativeMedicineand/orPalliativecareforapainmanagementconsultmightreducetheaddedburdenofpaininpeoplewithHF.,Limitations,1.Thesmallsamplesizeandsinglehospitalsite.2.Additionalvariablesrelatedtopain,suchasstressandanxiety,werenotmeasuredandmightincreasepain.3.Thenumberofpatientsscreenedforeligibilityandapproachedforconsent,thepercentageofHFpatientswhouseevidence-basedchronicpaintreatmentswerenotdocumented.,Reflections,1.WeshouldscreenforHFpatientswithchronicpainandreferthemforasafeandevidence-basedaltern