Communicating and understanding pain: Limitations of pain scales for patients with sickle cell disorder and other painful conditions

Collins, Peter; Renedo, Alicia; Marston, Cicely

doi:10.1177/1359105320944987

Cited by 10 publications

(9 citation statements)

References 63 publications

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“…Pain scales are broadly recognized as one of the most validated ways to assess pain, yet Collins et al have identified potential limitations, particularly in patients with SCD who experience severe or prolonged pain episodes. 39 Under-addressed issues with pain scale use include individual social motivations for misreporting pain (e.g., shielding family members from the pain they experience, reporting a certain score to receive a specific type or dose of analgesic) and clinical misinterpretation of reported pain characteristics. 39 Nevertheless, pain scores reliably incorporate the patient's evaluation of treatment efficacy into the results, yielding insight into the success of the pain management regimen, and as such, their use would have been a valuable adjunct to this study.…”

Section: Discussionmentioning

confidence: 99%

“…39 Under-addressed issues with pain scale use include individual social motivations for misreporting pain (e.g., shielding family members from the pain they experience, reporting a certain score to receive a specific type or dose of analgesic) and clinical misinterpretation of reported pain characteristics. 39 Nevertheless, pain scores reliably incorporate the patient's evaluation of treatment efficacy into the results, yielding insight into the success of the pain management regimen, and as such, their use would have been a valuable adjunct to this study. Investigations into ketamine's efficacy would be strengthened by multimodal assessments of pain, including metrics beyond pain scores and opioid consumption.…”

Section: Discussionmentioning

confidence: 99%

“…have identified potential limitations, particularly in patients with SCD who experience severe or prolonged pain episodes 39 . Under‐addressed issues with pain scale use include individual social motivations for misreporting pain (e.g., shielding family members from the pain they experience, reporting a certain score to receive a specific type or dose of analgesic) and clinical misinterpretation of reported pain characteristics 39 . Nevertheless, pain scores reliably incorporate the patient's evaluation of treatment efficacy into the results, yielding insight into the success of the pain management regimen, and as such, their use would have been a valuable adjunct to this study.…”

Section: Discussionmentioning

confidence: 99%

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Low‐dose ketamine infusions reduce opioid use in pediatric and young adult oncology patients

Anghelescu

Ryan

et al. 2022

Pediatric Blood & Cancer

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Background: Ketamine is an NMDA-receptor antagonist with analgesic and opioidsparing properties. Although well studied in adults, more robust evidence supporting ketamine's use for pediatric pain management is needed. This retrospective study evaluates ketamine's opioid-sparing effectiveness in pediatric and young adult oncology and hematology patients.Procedure: Continuous ketamine infusions administered for pain management between 2010-2020 were reviewed. Data including demographic characteristics, oncology/hematology and pain diagnoses, concurrent pain medications, and ketamine infusions' dose and duration were collected. Opioid consumption data based on delivery via patient-controlled analgesia were collected 1 day before (D1), all days during (cumulatively named D2), and 1 day after (D3) ketamine infusions and calculated as morphine-equivalent doses (mg/kg/day). Data were reported for the entire study group as well as for distinct oncology and end-of-life categories, and short-term acute pain circumstances which included vaso-occlusive crises in hematology patients. Side effects were reviewed.Results: Significantly lower daily opioid consumption was noted in the oncology group, while decreases were not significant in the end-of-life group and in the overall study population. The acute pain group did not show an opioid reduction associated with the ketamine infusions. A largely tolerable side-effect profile was observed, with no differences among each group's incidence.Conclusions: Ketamine infusions were associated with significantly reduced opioid consumption for oncology patients. The opioid-sparing effects of ketamine may vary according to clinical diagnoses and circumstances of use. Overall, low-dose ketamine infusions present an acceptable safety profile in pediatric and young adult patients; nevertheless, individual risks and benefits should be considered.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Low‐dose ketamine infusions reduce opioid use in pediatric and young adult oncology patients

Anghelescu

Ryan

et al. 2022

Pediatric Blood & Cancer

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“…Pain assessment is a social transaction that involves open communication and a trusting relationship. 25 Through this transaction, nurses may reframe unhealthy behaviors using therapeutic approaches.…”

Section: Construct Of Pain Catastrophizingmentioning

confidence: 99%

Pain catastrophizing

Thompson

Powell-Roach

Taylor

et al. 2022

Nursing

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“…Communication with their HCP has been identified as an essential element of quality care among patients who have SCD [ 17 ]. Collins and colleagues note that using pain scales without a relational context can further exacerbate problems in securing appropriate pain relief for individuals with SCD [ 19 ]. The literature suggests that poor communication between this patient population and HCPs may be due to various factors.…”

Section: Introductionmentioning

confidence: 99%

Individuals with Sickle Cell Disease Using SBAR as a Communication Tool: A Pilot Study

Jean-Baptiste

Wassef

Bolyai

et al. 2022

IJERPH

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Background: Sickle cell disease (SCD) is a hemoglobinopathy that causes debilitating pain. Patients often report dissatisfaction during care seeking for pain or a sickle cell crisis (SCC). The Theory of Self-Care Management for SCD conceptualizes assertive communication as a self-care management resource that improves healthcare outcomes. Objectives: This pilot study aimed to determine whether adults with SCD could learn to use the Situation, Background, Assessment, Recommendation (SBAR) communication method using a web-based trainer, and it aimed to determine their perceptions of the training. Methods: The participants included n = 18 adults with SCD. Inter-rater reliability (IRR) among three reviewers was used to evaluate the participants’ ability to respond as expected to prompts using SBAR communication within the web-based platform. Content analysis was used to describe the participants’ perspectives of the acceptability of using the SBAR patient–HCP communication simulation. Results: The SBAR IRR ranged from 64 to 94%, with 72% to 94% of the responses being evaluated as the using of the SBAR component as expected. The predominant themes identified were (1) Patient–Provider Communication and Interaction; (2) Patients want to be Heard and Believed; (3) Accuracy of the ED Experience and Incorporating the Uniqueness of each Patient; and (4) the Overall Usefulness of the Video Trainer emerging. Conclusions: This pilot study supported the usefulness and acceptability of a web-based intervention in training adults with SCD to use SBAR to enhance patient–HCP communication. Enhancing communication may mitigate the barriers that individuals with SCD encounter during care seeking and improve the outcomes. Additional studies with larger samples need to be conducted.

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Communicating and understanding pain: Limitations of pain scales for patients with sickle cell disorder and other painful conditions

Cited by 10 publications

References 63 publications

Low‐dose ketamine infusions reduce opioid use in pediatric and young adult oncology patients

Low‐dose ketamine infusions reduce opioid use in pediatric and young adult oncology patients

Pain catastrophizing

Individuals with Sickle Cell Disease Using SBAR as a Communication Tool: A Pilot Study

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