Produkt

KlappentextMaster paediatric pain management with precision
This practical guide equips nurses and healthcare professionals with evidence-based skills to effectively manage children's pain. Explore assessment techniques, pain relief strategies, and best practices for both hospital and community settings, with a focus on core knowledge, advanced insights, clinical scenarios, and practical tips.
The fully updated third edition includes an expanded procedural sedation section, enhanced coverage of capnography for respiratory monitoring, a new quality improvement sciences section, and additional online MCQs and self-assessment material.
Written by experienced authors, with contributions from global experts, Managing Pain in Children and Young People covers: Why pain prevention and treatment are crucial
Pain's biopsychosocial nature and pharmacology of analgesic drugs
Acute nociceptive, neuropathic, and visceral pain management
Chronic headaches, post-surgical pain, neonatal pain, and procedural pain
Paediatric palliative care and pain management in low-income countries
Drug-free pain relief methods and ethical considerations

With a multidisciplinary focus, this essential resource is tailored for healthcare practitioners working with children and young people; including doctors, nurses, psychologists, and physiotherapists. This essential resource empowers you to provide the best possible care for young patients, helping them find comfort and relief in their journey towards healing.

Details

Weitere ISBN/GTIN9781119645672

ProduktartE-Book

EinbandartE-Book

FormatEPUB

Format HinweisKopierschutz: DRM, Lesegeräte: PC/MAC/eReader/Tablet

Verlag

Wiley-Blackwell

Erscheinungsjahr2024

Erscheinungsdatum01.07.2024

Seiten352 Seiten

SpracheEnglisch

Dateigrösse2725

Artikel-Nr.14335233

Rubriken

Genre9201

Inhalt/Kritik

Leseprobe

1
Introduction

Alison Twycross

Honorary Associate Professor, School of Nursing and Midwifery, University of Birmingham, UK; Editor-in-Chief, Evidence-Based Nursing

Welcome to the third edition of Managing Pain in Children and Young People: A Clinical Guide. In this edition we have done things a little differently. Our aim remains to pull together current evidence for managing pain in children and young people (CYP) in an easily accessible format. However, we wanted the book to be seen as relevant to students and to members of interdisciplinary teams involved in managing children´s pain around the globe. To reflect this broader focus, the editorial line-up now includes a medic (physician), a psychologist and two nurses. We have also extended the range of contributors, again drawing on international expertise across the multidisciplinary team. A new chapter has been added to ensure the book is applicable to those working in low- to middle-income countries (Chapter 15).

The first few chapters set the scene for effective multimodal pain management by focusing on the following:
Why managing pain in children and young people is important.
The anatomy and physiology of pain.
Pain as a biopsychosocial phenomenon.
Pharmacology of analgesic drugs.
Pain assessment.

Given the new International Classification of Diseases (ICD)-11 definition of chronic pain, we have decided to include three shorter chapters in this edition rather than one longer one. These chapters focus on the prevention and treatment of chronic postsurgical pain, musculoskeletal pain, and headaches.

Other chapters pull together the current evidence for the prevention and treatment of nociceptive pain, neuropathic and visceral pain, procedural pain, neonatal pain, and paediatric palliative care.

Despite the extensive research that has been carried out over the past 25 years, CYP still do not receive evidence-based pain care. To address this issue, the final chapter covers how to effectively move forward with knowledge dissemination and implementation.
Multimodal Pain Management

Pain is a biopsychosocial phenomenon (see Chapter 4) and often has a spiritual element (Friedrichsdorf and Goubert 2020). Given this, the prevention and treatment of pain requires a multimodal approach (Figure 1.1). To make this explicit, one of the changes we have made to this edition is to integrate the evidence for physical and psychological pain-relieving interventions into the chapters focusing on the prevention and treatment of pain. A brief description of physical and psychological pain-relieving interventions is provided in Tables 1.1 and 1.2. Physical and psychological strategies used with neonates are outlined in Chapter 13.

Figure 1.1 Components of effective multimodal pain management.
World Health Organization Pain Ladder

An integral part of multimodal pain management is the use of analgesic drugs to prevent and treat pain. The World Health Organization (WHO) (2020) has devised a two-step pain ladder to help guide decision-making in this context (Figure 1.2). The 2020 WHO ladder takes into account the fact that codeine is no longer recommended for use in CYP (Box 1.1).

Table 1.1 Physical pain-relieving interventions.
Active physical interventions Activity pacing and energy conservation Pacing involves reaching a balanced pattern of varied activity that is achievable on good and bad days without causing crashes´ or increases in symptoms
The Royal College of Occupational Therapy provides useful advice about how to pace: https://www.rcot.co.uk/conserving-energy
Energy conservation is identified as a strategy for chronic pain management in the Canadian Pediatric Pain Management Standards (HSO 2023)
Physiotherapy and daily exercise Identified as a key strategy for chronic pain management by the Scottish Government (2018) and in the Canadian Pediatric Pain Management Standards (HSO 2023)
Seen as a key component of managing chronic pain in CYP (Caes et al. 2018; Harrison et al. 2019)
Involves individualised exercise programmes aimed at increasing muscle strength and flexibility
Likely to be more effective when combined with psychological therapies, e.g. cognitive behavioural therapy, and goal setting (Caes et al. 2018)
Relaxation Identified as a strategy for acute and chronic pain management in the Canadian Pediatric Pain Management Standards (HSO 2023)
The Scottish Government (2018) suggests relaxation is a low-risk intervention that should be considered in the management of chronic pain in CYP
Yoga Some evidence to support its use in chronic pain management (Harrison et al. 2019)
Passive physical interventions Acupuncture Identified as a strategy for acute pain management in the Canadian Pediatric Pain Management Standards (HSO 2023)
The Scottish Government (2018) recommends the use of acupuncture for CYP with back pain or headache
Ice and heat Thermal applications identified as a strategy for chronic pain management in the Canadian Pediatric Pain Management Standards (HSO 2023)
Massage Identified as a strategy for chronic pain management in the Canadian Pediatric Pain Management Standards (HSO 2023)
Transcutaneous electrical nerve stimulation (TENS) Identified as a strategy for acute pain management in the Canadian Pediatric Pain Management Standards (HSO 2023)
The Scottish Government (2018) suggests that TENS is a low-risk intervention that should be considered in the management of chronic pain in CYP
Sensory and brain-based strategies Graded motor imagery and mirror therapy The process of thinking and moving without actually moving
Has been shown to be particularly effective when moving the injured body part is too painful (Ramsey et al. 2017)
Tactile stimulation or desensitisation Desensitisation techniques help to restore normal sensitivity and include varied exercises to increase tolerance to the feel of different tactile and thermal sensations on the affected body part (Ayling Campos et al. 2011)
The start of desensitisation can be difficult, as CYP experience increased discomfort during the application of sensory techniques (Ayling Campos et al. 2011)
No evidence to support its use in practice

Table 1.2 Psychological pain-relieving strategies.
Strategy Description Acceptance and commitment therapy (ACT) A type of psychotherapy that promotes acceptance to deal with negative thoughts, feelings, symptoms or circumstances
ACT also encourages increased commitment to healthy constructive activities that uphold CYP´s values or goals
More information is available at Glashofer (2022)
Biofeedback The Institute for Chronic Pain (2017) describes biofeedback as: Enabling individuals to learn how to change physiological activity for the purposes of improving health and performance
Using precise instruments to measure physiological activity, e.g. brainwaves, heart function, breathing, muscle activity and skin temperature
Using this feedback to support the desired physiological changes
Over time, these changes endure without continued use of an instrument (Schwartz and Andrasik 2016)
More information about biofeedback can be found in this video: https://www.facebook.com/watch/?v=638866001271911&extid=NS-UNK-UNK-UNK-IOS_GK0T-GK1C&ref=sharing
... Cognitive behavioural therapy (CBT) MIND (2022) describes CBT as a type of talking therapy that teaches coping skills for dealing with different problems (pain, mood, etc.)
CBT is not a single type of treatment; rather it is a class of multi-component therapies based in the cognitive behavioural theoretical model (Palsson and Ballou 2020)
CBT focuses on how your thoughts, beliefs and attitudes affect your feelings and actions
Can be delivered face to face or online (Fisher et al. 2019)
More information about CBT can be seen in this video: https://www.youtube.com/watch?v=9c_Bv_FBE-c
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