No abstract available.
Pain Management

No abstract available.
Pain Management

Background: In Vietnam, head nursing staffs are not yet managers and controlling health care of patients. Management ability of them is limited, professional knowledge and nursing management skills of them are not improved. Objective: Evaluation of the real situation of head nursing staffs\u2019 ability and training requirements and propose solutions to improve their nursing management ability.\r\n', u'Subject and methods: A cross-sectional descriptive study with interview questionnaire was conducted on 99 head nursing staffs, working at medical institutions in Vinh city, Nghe An province from June to December 2007.\r\n', u'Results: 76.8% did not have proper management qualifications; 62.6% did not know any foreign languages; 54.5% had no knowledge on informatics; all their skills on nursing management were at medium level (less than 64.6%); the ability in collecting, analysis and processing information was limited (63.6%). Therefore, most of them had the need to improve their professional level and skills of nursing management. Conclusion: The continuous training plan for head nursing staffs includes professional knowledge and management skills are required. It is important that, criterions for appointing head nursing staffs should have built, in condition requiring the appointee to have a nursing management qualification.\r\n', u'
nursing management

No abstract available.
Airway Management

Patient’s belief towards pain management may affect pain management outcomes and quality of life. The main aim of the present study was to determine the impact of a pre-operative pain education package towards pain belief among patients undergoing orthopaedic surgery in a tertiary hospital. A one-group pre-test post-test design study was conducted on orthopaedic surgery patients. Thirty respondents were recruited and pre-operative pain education was administered individually before surgery. Pre-operative and post-operative pain belief, management scores and side effects were measured using the Barrier Questionnaire (BQ-13). The results reported significant differences between pre-test scores (Mean = 41.87, Standard Deviation = 11.467) and post-test scores (Mean=34.80, Standard Deviation=13.026) of pain belief (t = 2.84, p = 0.004). There were also significant differences between pre-test scores (Mean = 37.10, Standard Deviation = 10.610) and post-test scores (Mean=30.80, Standard Deviation = 11.424) of pain management (t = 3.856, p = 0.0005). Respondent’s gender (t = -2.403, p = 0.023) and ethnicity (F = 5.038, p=0.014) reported significant differences with p value < 0.05, respectively. However, there were no significant differences between educational level, ethnicity, prior surgical history with pain belief (p> 0.05). There was positive impact of the pain education package towards pain belief and painmanagement among respondents who underwent orthopaedics surgery in a tertiary hospital. Reinforcement of pain educational program is pivotal in order to achieve optimal post-operative pain management.
Pain management

Pain is an unpleasant sensation that can cause physical and psychological problems for the patient. Despite the pharmacological intervention for reducing pain, it remains as an issue after surgery. Music therapy as non-pharmacological intervention can effect post-operative pain and patients’ requirement of analgesics. The purpose of this study was to determine effect of music therapy on pain after elective total knee replacement (TKR) surgery. This study compared analgesics consumption by patients post-operatively for five days. A Quasi-experimental design with convenience sample of patient with a mean of 64.35 (49-76) who underwent TKR in UKM Medical Centre from May to December 2012 was used. Forty patients were randomly assigned in one of the two groups using a sealed-envelope technique. The experimental group listened to music for five days post-operatively and were on analgesics and control group were treated with pharmacological intervention only. Pain was measured by McGill Pain Questionnaire-Short Form (MPQ-SF) for patient on bed rest on day one, day three and day five post-operatively. Statistical (Mann- Whitney) findings between groups showed the experimental group significantly had less pain on day one and day five rather than the control group at 0.05 level using Pain Rating Intensity (PRI), Visual Analogue Scale (VAS) and Present Pain Intensity (PPI). Statistical (Friedman) tests within group showed that the patient had significantly decreased pain over time at level 0.05 using PRI, VAS and PPI. Statistical (Mann- Whitney) tests revealed that there was no significant difference when using analgesics between the two groups in five days post-operatively at milligram but comparing median showed experimental group used less analgesic than control group. Music therapy is simple, available, save and cheap effective intervention for pain management post-operatively. Pain management is one of the key roles of nursing and nurses can use music therapy as a simple intervention to reduce pain.
Pain Management

There is a growing awareness and acceptance of the benefits for cancer pain patients derived from psychiatric contributions to pain control. Unfortunately, cancer patients with pain are more vulnerable to psychiatric complications of cancer such as depression, anxiety and delirium. Knowledge of the indications and usefulness of the psychotropic drugs in the cancer pain population will be the most rewarding, particularly because these drugs are useful not only in the treatment of psychiatric complications of cancer, but also as adjuvant analgesic agents in the management of cancer pain.
PAIN MANAGEMENT

Knowledge management is an important method for the organization to manage information and knowledge systematically and make knowledge innovate continuously. Knowledge management includes the stages of knowledge acquisition, sharing and use, and finally achieves the goal of taking knowledge as the production factor and improving work efficiency in an organization. The core work of technical evaluation of medical devices is typical knowledge work, and the knowledge management system is of great significance to the review agency in improving work efficiency, promoting talent training, improving management level and service quality. This study briefly introduces the framework of the knowledge management system of medical device technical evaluation in the Center for Certification and Evaluation, SHFDA, and provides reference for relevant organizations to carry out knowledge management of medical device technical evaluation.
Knowledge Management

Background: Diabetes self-management is a fundamental aspect of diabetes care and has a significant impact on diabetes- related mortality and morbidity. Assessment of self-care management is thus essential for clinicians and educators seeking better outcomes. However, there are no Filipino-validated tools to objectively measure this. Methodology: A cross-sectional analytic study was done among adult Type 2 diabetic mellitus (T2DM) patients at the Ilocos Training and Regional Medical Center (ITRMC) Department of Internal Medicine outpatient clinic and three private diabetes clinics to determine the reliability and validity of the Filipino-translated Diabetes Self-Management Questionnaire (DSMQ) and its association with glycemic control as measured using glycosylated hemoglobin (HbA1c) values and categorized into good (< 7%), moderate (7-8.9%) and poor (> 9%) control. The English version of the DSMQ was translated to Filipino using forward-backward translation. The pre-tested Filipino translated questionnaire was then distributed to the participants and the responses were analyzed using Cronbach’s alpha, Pearson’s coefficient, and one–way analyses of variance. Results: There were a total of 78 respondents. The test-retest reliability showed a statistically significant correlation (p < 0.05). All the items showed a high difficulty index. Known group validity was computed based on categorized HbA1c values. DSMQ sum scores and subscales showed no significant differences among the three categories of glycemic control. Conclusion The Filipino-translated DSMQ is a reliable tool for measuring the self-care of Filipinos with type 2 diabetes mellitus. Future research using it with a larger sample size and analysis for other factors affecting diabetes control may be better able to demonstrate its association with glycemic control.
self-management

BACKGROUND: Postoperative Pain control in Open Nephrectomy is one of the leading concerns of patients who underwent the procedure. Many efforts were made to determine the most efficient concoction for pain control, and studies have shown that opioids were the most efficient in reducing pain; however, it was observed that these opioids would produce side effects which hinders the goals of Enhanced Recovery after Surgery (ERAS). Lidocaine Intravenous infusion on the other hand, has been introduced as an adjunct as an opioid sparing alternative. It has been reported that it is effective in managing pain in different types of surgeries with promising results. OBJECTIVE: To determine the effectiveness of perioperative intravenous lidocaine infusion as an adjunct in postoperative analgesia in patients undergoing open nephrectomy. METHODOLOGY: This is a randomized, double-blind, placebo-controlled study among patients admitted at The Institution, who underwent Elective open nephrectomy. Randomization into two treatment groups was done via draw lots. Both groups received treatment 30mins prior to cutting time wherein induction of anesthesia using Midazolam 1 mg IV, Fentanyl 50mcg/dose IV, Propofol 1 % 1 mg/kg IV, with sevoflurane were used and adjusted accordingly. Rocuronium 0.6mg/kg IV was used as muscle relaxant. During induction, Group A received Lidocaine 2% (200mg) diluted to D5W in a 50ml syringe and infused intravenously via Target controlled infusion (TCI) with a maintenance rate of 40mcg/kg/min infusion intra-operatively at the start of cutting time. On the other hand, Group B will receive PNSS in a 50ml syringe. Postoperative outcome measured for this study includes numeric pain scores at 1, 2, 1 2, and 24 hours post operatively, number of morphine rescue doses and presence of adverse drug reactions. RESULTS Patients who received lidocaine had significantly lower mean pain scores across all time periods (7.6±1.2 at 1 hr, 3.4±1.3 at 2 hrs, 2.5±0.8 at 12 hrs, and 1.5±2.0 at 24 hrs) compared to those who received placebo (5.4± 1.6 at 1 hr, 5.4± 1.6 at 2 hrs, 4.9±1.1 at 12 hrs, and 3.5±1.5 at 24 hrs) (pvalue= 0.0021 ). The mean pain scores of both groups significantly decreased starting from 1 hour to 24 hours after surgery (p-value=0.0000). Patients who received lidocaine had significantly lower mean number of rescue morphine (1 .9±2.1) compared to those who received placebo (5.6±2. 9) (p-value=0.0001 ). No patients had significant adverse reactions from the lidocaine group, while 6 patients (33.3%) had nausea from the placebo group (p-value=0.019). Conclusion: Peri-operative intravenous Lidocaine Infusion (IVLI) is effective in reducing postoperative pain during the first, second, twelfth and twenty-fourth hours after nephrectomy. Also, the administration of perioperative IVLI significantly lowered the number of needed rescue morphine.
Pain Management