Pain management outcomes for hospitalized Hispanic patients.

The purposes of the study were to describe outcomes of pain management and predictors of patient satisfaction in a minority sample. By using a survey design, 3 instruments were used to collect data: (1) The American Pain Society's Patient Outcome Questionnaire-Modified, a 16-item self-report tool about pain and patient satisfaction; (2) a demographic form; and (3) the Pain Management Index. The sample consisted of 104 hospitalized Hispanic inpatients in a Rio Grande Valley hospital. Mean ratings for current and average pain were moderate, whereas severe mean ratings were reported for worst pain. High interference caused by pain was found for walking and sleep. Patients were satisfied with pain management. However, a negative correlation was found between satisfaction and current pain intensity (r = -.49, p = .001). Pain Management Index scores revealed that 36% of the participants were inadequately treated for pain; also, negative correlations with age indicated less effective management for elders. Reliability estimates for tool subscales were greater than 0.70 except for the Beliefs subscale (0.63). By using logistic regression, satisfaction with pain management was predicted by general pain in the last 24 hours (odds ratio = 4.02), pain-related interference with mood (odds ratio = 7.31), and age (odds ratio = 1.8). Clinical implications include the need to apply standardized guidelines, such as those from the Agency for Health Care Policy and Research, and to educate patients, particularly minority elders, about pain management approaches. The emergence of Hispanics as the fastest growing minority group increases the need for research regarding pain management outcomes to plan more effective intervention.

Using collaborative research to facilitate student learning.

Developing research partnerships between academia and the service sector is an innovative way to meet the demand for high-quality, cost-effective, and clinically oriented research. Undergraduate student participation in clinical research is an educational strategy to facilitate positive mindsets toward research. This article outlines the methodological steps in recruiting and training undergraduate students for clinical research teams to benefit nurse educators, nurse researchers, students, and institutional partners. Student volunteers collected data for a study examining patient satisfaction with pain management practices. The research proposal was used to demonstrate principles of the research process and to familiarize the students with the study. A detailed study protocol guided the entire team through the project. Student sensitivity to pain assessment and management was enhanced. Learning the research process and the students' appreciation for the rigors of research were reinforced using this experiential model. Student evaluation of the research experience is presented.

Assessing clinical outcomes: patient satisfaction with pain management.

The problem of unresolved pain in hospitalized patients is costly both in monetary terms and in patient comfort. Concern about patients' satisfaction and well-being led to a study to determine the characteristics of the pain experience as reported by the hospitalized patients. This study also examined the recently revised American Pain Society Patient Outcome Questionnaire (APS-POQ), particularly in regard to results from newly added items and overall reliability and validity. The data provide a cross-sectional description of patients' experience with pain in a large, urban teaching hospital. One hundred fifty-seven adult subjects reported moderate to high levels of current pain intensity, worst pain, and general level of pain in the last 24 hr, as well as moderate to high rates of pain-related interference with care activities. While patients indicated that they were satisfied with their pain management and with the responses of physicians and nurses to complaints of pain, patient satisfaction was inversely and significantly correlated with pain now and general level of pain in the last 24 hr. When patients with high pain intensity (> 7) were separated into satisfied and dissatisfied groups for analysis, no significant differences were found regarding pain-related interference with various activities including mood, relationships, sleep, etc. The majority of patients indicated that they were still in pain, but 41% did not wish to receive a stronger dose of pain medication. Significant differences between those who did and did not want more pain medication were found in that younger patients were more likely to want more pain medication. Additionally, analysis of these two groups found that patients who were still in pain and desired more pain medication reported significantly higher levels of pain-related interference with activity and sleep. The inverse correlation of current pain intensity and general level of pain with overall satisfaction with pain management differs from findings of previous studies. One added item queried patients regarding approaches they had used to manage pain in the last 24 hr. Oral pain medications, prayer, intravenous and intramuscular injections were the top-ranked methods. The findings guide further analysis of the APS-POQ questionnaire. Recommendations of items to be retained in the questionnaire are made based on data analysis. Refining the questionnaire will allow health-care providers to increase their understanding of issues related to pain management. The findings provoke several questions for further study, such as what are age and ethnic differences regarding pain intensity and satisfaction, as well as the predictors of aversion of receiving more pain medication when pain persists.

Dose independent pharmacokinetics of mexiletine in healthy volunteers.

In 12 healthy volunteers who received orally 100, 200, 300, 400 and 600 mg mexiletine at weekly intervals, the maximum plasma concentration of mexiletine and AUC increased linearly with the dose of mexiletine. Between doses there were no significant differences in the values for clearance and volume of distribution of mexiletine but there were for plasma elimination half-life. These results indicate that the kinetics of mexiletine are linear.

Innocent intramural gastric uptake of gallium-67 in a case of AIDS.

In a patient with AIDS, marked uptake of Ga-67 in the stomach walls initially was regarded with a high degree of suspicion for gastric involvement. Results of subsequent intragastric tests, including biopsy and culture, proved negative. Caution should be exercised when considering further costly and/or invasive procedures after gastric visualization on Ga-67 scintigraphy.

A comparison of the cardiovascular effects of (+)-sotalol and (+/-)-sotalol following intravenous administration in normal volunteers.

In a placebo controlled open study in six healthy male volunteers (+)-sotalol in the dose range 0.125 mg kg-1-2.0 mg kg-1 intravenously, was found to have little or no beta-adrenoceptor blocking activity in comparison to the racemic mixture (+/-)-sotalol. The repolarization effects of (+)- and (+/-)-sotalol on the QTc interval however were comparable over the same dose range. The beta-adrenoceptor blocking activity and repolarization effects of sotalol appear to be unrelated.