Analysis : Quantitative Meta Analysis

pain is the usual cause for persons to look for treatment. Inadequate pain management can cause delay in healing process. It can also leads to prolonged hospital stay. The acute pain management theory describe how nurse can manage pain with minimal effects from the pharmacological interventions and use of alternative methods of pain management (Good &Moore, 1996) The main factors are in the management of pain are Pharmacological, non-pharmacological, patient participation, education and different interventions. Effective pain management involves the application of non-pharmacological interventions and usage of pain medications. (McEwen & Willis, 2014). The pain management theory deals with management of pain in daily basis. It offers the knowledge about alternate methods in pain

First pain is an everyday experiences that is expressed through the use of language and is then legitimized (Waddie, 1996). If a patient as a history of depression or chronic pain they have pain every day and the concept is used to help explain their pain. As nurse we use the concept of pain to find a base line of the pain and to assess new pain. In surgical patients they may have multiple types of pain from the incision, emotional, and history. The concept educates the nurse of the different form that pain can present itself. Pain can also guide how we treat the patient. Emotional pain would not be treated with the “so know pain pills”, but with talking or listening to patient. Concept of pain also address the different form of patient and how the nurse and patient response to it. If a patient is having somatic pain from an incision the nurse could react by applying heat or ice. Pain is what the patient says it is.

The purpose of a systematic review is to attempt to find, evaluate and synthesize high quality research relevant to the research question. A systematic review uses carefully developed data collection and sampling procedures that are put in place in advance as a protocol. (Polit, 2012). A systematic review must contain the following: a clear inclusion and exclusion criteria, an explicit search strategy, systematic coding and analysis of included studies, and a meta-analysis if possible. (Hemingway & Brereton, 2009). Systematic reviews are conducted by nurse researchers to avoid reaching incorrect or misleading conclusions that

Evidence based practice is the incorporation of individual clinical expertise with best research evidence and patient values and expectations. Health care decision of individual patients should be based on best available research evidence. A health decision made from a sound research evidence has the potential to ensure best practice and reduce variations in health care delivery. In health science, an ever increasing plethora of studies being published and is challenging for clinicians to keep up with the literature. Integrating research into practice is time consuming and need methods for easy access to such evidences for busy clinicians. Indeed, clinical decision should be based on the latest research evidence. Systematic reviews and meta-analyses summarize the research evidence, which is generally the best form of evidence, thereby making the available evidence more accessible to decision makers and are positioned

JCAHO (2011) also stated that patients and their families needed to be educated about pain and how the patients’ pain is going to be managed. Every patient perceives and exhibits pain in a different manner and if nurses do not assess the patient thoroughly they can miss it. For instance, Engebretson et al. (2006) acknowledged that, patients manifest pain in different ways and this resulted in nurses performing an inadequate assessment of their patients’ pain. Also, Engebretson et al. recognized that patients often conceal their pain because they do not want to be viewed by staff as complainers or addicts, and if patients decide to speak up the nurses frequently view their patients’ statements from their own cultural, moral and ethical belief system and not their patients which leaves the patients’ pain untreated.

1. Is the article proposing to answer a specific clinical question or questions? What are the questions?

The study was a systematic review of scientific papers selected by a search of the SciELO, Cochrane, MEDLINE, and LILACS-BIREME databases. Among the 2169 articles found, 12 studies proved relevant to the issue and presented an evidence strength rating of B. No publications rated evidence strength A. Seven of the studies analyzed were prospective cohorts and 5 were cross-sectional studies.

In the last few years, unarmed African American civilians were gunned down by police officials. These encounters left the community feeling vulnerable to police violence and caused them to lose trust in the officers' and the justice system. Nordberg, Crawford, Praetorius, and Hatcher (2016), article entitled "Exploring Minority Youth's Police Encounters: A Qualitative Interpretive Meta-synthesis" performed a qualitative interpretive meta-synthesis to capture the experiences of the minority communities through the voices of the minority youth in describing their encounters with police officials (p. 137). In this study, nine articles were analyzed that revealed five common themes associated with the youth experiences with police officials. Those themes were identified as dangerous, controlling, prejudice, ineffective and dehumanization (Nordberg et al., 2016, p.

Nursing assessment is a substantial way of gathering physiological, psychological, spiritual, and emotional condition of the patient. It creates a whole picture of an individual and assist the health care providers to formulate a diagnosis. Assessing the comfort of the patient is equally important as taking the blood pressure or temperature. Pain is the fifth (5th) vital sign that is subjective in nature when performing an assessment of a patient. Various studies were conducted in finding the most appropriate evidence-based nursing practice in assessing and managing the pain of a cognitively impaired patient, whether it is acute or chronic or the underlying cause is cancer or post-operative incision. As emphasized by Song, Eaton, Gordon, Hoyle, and Doorenbos (2015), it is vital to ensure that “pain management is based on the best evidence” (p. 456). Perhaps knowing the causes of inability to assess and manage the pain in a cognitively impaired patient would give a clearer understanding of the practice.

As a student, it is important to build a foundation in implementing these guidelines, so that when they graduate, they can provide competent patient care. Nursing students perform pain assessments regularly while in clinical, so it is important to be familiar with the tools that the North Bay Regional Health Centre uses, so that when reporting findings it is with tools that the hospital approves of. It is also important to know a variety of tools and when it is appropriate to use each one. Performing comprehensive pain assessments and being aware of how the interprofessional team and/or patient has decided to manage potential pain can help form a basis for reference for future nurse. In future practice it is important to respect a patients wants in regards to pain management and to be able to implement both pharmacological and non-pharmacological pain management interventions.

For the literature review an electronic search was undertaken of articles published in English using the Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed and Cochrane databases from 2009 to 2013 were searched for medical subject heading terms, both individual terms and combination of the following

Pain is a complex and multidimensional phenomenon that is subjective and unique to each individual. Pain is difficult to describe and often hard to measure; however, most healthcare professionals agree that pain is whatever the patient describes it to be. Pain is one of the most frequently used nursing diagnosis and is the most common problem for which patients in the clinical setting seek help (Cheng, Foster, & Huang, 2003). Unrelieved pain can have a profound impact on the lives of both the patient and his or her family members. The subjective nature of pain makes pain difficult to assess; therefore, many patients do not receive adequate relief. The Joint Commission on Accreditation of Healthcare Organizations

The concept of managing acute pain is extremely significant to nursing as pain is one of the most common problems for which patients seek out health care resources. Pain is a complex and abstract concept that encompasses sensory, emotional, psychological, social, and spiritual perceptions of pain that may occur in combination with physical pain. Pain is difficult to describe and often hard to measure; although, most healthcare providers agree that pain is subjective and is to be measured qualitatively and quantitatively as the patient perceives its intensity. Pain can affect the quality of life of the individual by impacting them physically, emotionally, and

Cullen and Gendreau compare and contrast the many studies on this subject, the meta-analyses conclusions, their strengths, weaknesses, inconsistencies, and the trends that follow the studies

The most common reason that people seek medical care is pain, and pain is the leading cause of disability (Peterson & Bredow, 2013, p. 51; National Institute of Health, 2010). Pain is such an important topic in healthcare that the United States congress “identified 2000 to 2010 as the Decade of Pain Control and Research” (Brunner L. S., et al., 2010, p. 231). Unfortunatelly, patients are reporting a small increase in satisfaction with the pain management while in the hospital (Bernhofer, 2011). Pain assessment and treatment can be complex since nurses do not have a tool to quantify it. Pain is considered the fifth vital sign, however, we do not have numbers to guide our interventions. Pain is a subjective expirience that cannot be shared easily. Since nurses spend more time with patients in pain than any other healthcare provider, nurses must have a clear understanding of the concept of pain (Brunner, et al., 2010). Concept analysis’ main objective is to clarify ideas, to enhance critical thinking, and to promote communication (Rodgers & Knafl, 2000). This paper will examine the concept of pain using Wilson’s Steps of Concept Analysis (Rodgers & Knafl, 2000).