TY - JOUR
T1 - Assessing and managing pain in AIDS care
T2 - The patient perspective
AU - Holzerner, William L.
N1 - Funding Information: Acknowledgements. This work has been supported by NIH NR02215 and a pilot grant from the AIDS Clinical Research Center, University of California, San Francisco.
PY - 1998
Y1 - 1998
N2 - Although the prevalence and complexity of pain management in HIV/AIDS has been described in the literature, little is known about the management of pain from the patient perspective. This study used a set of standardized instruments, a medication chart audit, and a semistructured interview to elicit patients'selfreports of pain and patients' perceptions of nursing and self-care pain management strategies and examined potential physiological and psychosocial correlates of pain. The sample of 249 AIDS patients from three types of care settings (hospital, home care, skilled nursing facility) reported a modest overall current pain intensity (M = .14, range = 0-1). They reported experiencing pain in all body parts as measured by a body outline and characterized their pain with an average of 8.96 words from a list of 67 words. A lower pain rating was correlated with higher ratings on quality of life and perceived psychological support. An audit of the medication record revealed that the study sample received the following medications: narcotic analgesics (49%), nonnarcotic analgesics (47%), andantidepressants (22%). In a semistructured interview, medications were rated as effective by 80% of patients experiencing pain who stated that their health care providers included pain medications as part of the patient's pain management plan. Patients reported few nonpharmacologic self-care or health care provider interventions to manage their pain, and the effectiveness ratings of the interventions demonstrated wide variability. The study findings suggest that because pain was related to quality of life ratings and the pain management strategies reported by patients were not completely effective, further work is needed to examine pain management strategies that incorporate both pharmacologie and nonpharma-cologic interventions with particular attention to selfcare interventions. In addition, the data suggest that nursing assessments should include questions aimed at eliciting potentially harmful (e.g., street drugs, selfprescribed medications) strategies that patients may be using to manage their pain.
AB - Although the prevalence and complexity of pain management in HIV/AIDS has been described in the literature, little is known about the management of pain from the patient perspective. This study used a set of standardized instruments, a medication chart audit, and a semistructured interview to elicit patients'selfreports of pain and patients' perceptions of nursing and self-care pain management strategies and examined potential physiological and psychosocial correlates of pain. The sample of 249 AIDS patients from three types of care settings (hospital, home care, skilled nursing facility) reported a modest overall current pain intensity (M = .14, range = 0-1). They reported experiencing pain in all body parts as measured by a body outline and characterized their pain with an average of 8.96 words from a list of 67 words. A lower pain rating was correlated with higher ratings on quality of life and perceived psychological support. An audit of the medication record revealed that the study sample received the following medications: narcotic analgesics (49%), nonnarcotic analgesics (47%), andantidepressants (22%). In a semistructured interview, medications were rated as effective by 80% of patients experiencing pain who stated that their health care providers included pain medications as part of the patient's pain management plan. Patients reported few nonpharmacologic self-care or health care provider interventions to manage their pain, and the effectiveness ratings of the interventions demonstrated wide variability. The study findings suggest that because pain was related to quality of life ratings and the pain management strategies reported by patients were not completely effective, further work is needed to examine pain management strategies that incorporate both pharmacologie and nonpharma-cologic interventions with particular attention to selfcare interventions. In addition, the data suggest that nursing assessments should include questions aimed at eliciting potentially harmful (e.g., street drugs, selfprescribed medications) strategies that patients may be using to manage their pain.
KW - HIV/AIDS
KW - Nursing care
KW - Pain
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U2 - https://doi.org/10.1016/s1055-3290(98)80073-3
DO - https://doi.org/10.1016/s1055-3290(98)80073-3
M3 - Article
C2 - 9436165
VL - 9
SP - 22
EP - 30
JO - Journal of the Association of Nurses in AIDS Care
JF - Journal of the Association of Nurses in AIDS Care
SN - 1055-3290
IS - 1
ER -