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1、Postgraduate student:* Tutor：*, Professor of Nursing,1.McDonald, D.D., et al., A closer look: Alternative pain management practices by heart failure patients with chronic pain. Heart Lung, 2015.,A closer look: Alternative pain management practices by heart failure patients with chronic pain,Literatu
2、re source,Contents,06,Background,Methods,05,01,Objective,Results,04,Discussion,Conclusions,02,03,Background,A total of 76% of people with chronic heart failure (HF) report chronic non-cardiac pain, more than twice the prevalence of the general United States adult population estimate of 30.7%.Non-car
3、diac pain reported by people with HF ranges in intensity, and pain interference with activity from mild to severe, with severe ratings reported by 38.9%.,Background,Negative consequences of chronic pain for people living with HF,Reduce the quality of life,Increase burden,Increased depression,Decreas
4、ed physical activity,Background,Little is known about alternative pain self-treatments used by HF patients with chronic pain. Assessment of chronic pain and pain self-management strategies and the incorporation into care of safe and feasible self-management strategies might assist patients to reduce
5、 pain during and/or after their hospital stays.,Objective,To describe alternative non-pharmaceutical non-nutraceutical pain self-management strategies used by people with HF in order to reduce chronic non-cardiac pain.What are some common strategies used by HF patients with chronic pain?,Methods,1.
6、Design A cross-sectional descriptive design 2. Sample and setting N=25,convenience sample Data collection: February 2013 to October 2013 Inclusion criteria Exclusion criteria 3. Instruments Brief Pain Inventory Short Form (BPI-SF)4. Procedure,Inclusion criteria Adults with HF and chronic pain able t
7、o read and understand English or Spanish, pain of at least three months duration currently using at least one alternative non-nutraceutical self-management pain strategy.Exclusion criteria History of dementia or other cognitive impairment,The BPI-SF was used to measure patient self-administered pain
8、 treatments, pain intensity and pain interference with function. Cronbachs alpha The overall BPI-SF (=0.77 0.85) The BPI pain intensity (=0.82) Pain interference with activity (=0.87),1. Alternative treatments included walking, stretching, use of heat and cold. 2. Five patients(20%) used evidence-ba
9、sed pain treatments for their chronic pain conditions.3. Patients reported moderate pain intensity and pain interference with activity.,Results,Five of the 11 men (45.5%) used evidence based pain treatments specific to all of their pain syndrome(s), which included back and/or osteoarthritis pain.,Di
10、scussion,1. Few participants used evidence-based alternative treatments for their chronic pain conditions.2. Pain interference with enjoyment of life and sleep are the main problematic pain interference factors.3. Pain reduction is likely to reduce overall symptom burden for people with HF and might
11、 also reduce co-morbid symptoms.,Pain reduction,Reduce overall symptom burden,Reduce co-morbid symptoms,Discussion,4. Increased use of evidence based alternative pain treatments might reduce use of NSAIDs by people with HF. 5. Although male gender was significantly associated with use of evidence-ba
12、sed alternative treatments for all of their chronic pain syndromes, approximately half of both men and women missed the opportunity to use an evidence-based pain treatment for one or more of their pain conditions.,Reduce use of NSAIDs,Reduce adverse cardiovascular events and hospitalizations,Increas
13、ed use of evidence based alternative pain treatments,Conclusions,1. Patients hospitalized for HF with chronic pain use some alternative pain treatments, but few of them use available evidence-based alternative pain treatments. 2. Screening for chronic pain and referral to Integrative Medicine and/or
14、 Palliative care for a pain management consult might reduce the added burden of pain in people with HF.,Limitations,1. The small sample size and single hospital site.2. Additional variables related to pain, such as stress and anxiety, were not measured and might increase pain.3. The number of patien
15、ts screened for eligibility and approached for consent, the percentage of HF patients who use evidence-based chronic pain treatments were not documented.,Reflections,1. We should screen for HF patients with chronic pain and refer them for a safe and evidence-based alternative treatments consult with integrative medicine and/or palliative care. 2. Preparations for this report will help me to read English literature more smoothly in the future study.,Thank you and welcome your criticisms and corrections!,
