ABSTRACT
BACKGROUND: Nurses work at headache centres throughout Europe, and their care for migraine patients is acknowledged. However, the specific roles and tasks of nursing vary, and a unified understanding is lacking, posing challenges to knowledge sharing and research. OBJECTIVES: Using an e-Delphi study method, the objective is to obtain healthcare professional headache experts' opinions on nursing-specific roles and tasks and combine this into consensus statements for nurse recommendations for migraine treatment. METHODS: A three-round questionnaire study was conducted with nurses and neurologists from 18 specialised headache centres in 10 countries. In round 1, statements were compiled from a systematic examination of existing literature and expert opinions. In rounds 2 and 3, the experts rated the importance of statements (from round 1) on a 5-point Likert scale. Statements were analysed using a content analysis method, and the consensus of pre-defined statements was evaluated with gradually increased predetermined criteria using descriptive statistics. RESULTS: Twenty-one experts, representing all 10 countries, participated. The predetermined consensus of ≥70% agreement was reached for 42 out of the initial 63 statements. These statements formed the final recommendations within two themes: "The nurses' roles and tasks in the clinical setting" and "The nurses' roles and tasks in educating patients and colleagues." The consensus level of statements was strong, with 40% receiving unanimous agreement (100%) and 97% achieving relatively high agreement (>80%). CONCLUSION: Nursing plays a vital role with diverse tasks in migraine care. This study offers practical recommendations and a framework for nurses, equipping them with a clinical tool to enhance care and promote a coordinated approach to migraine treatment.
Subject(s)
Consensus , Delphi Technique , Nurse's Role , Humans , Europe , Headache/therapy , Headache/nursing , Surveys and Questionnaires , Female , Male , Adult , Migraine Disorders/nursing , Migraine Disorders/therapy , Nurses , Middle AgedABSTRACT
The purpose of the Research to Practice column is to review and critique current research articles that directly affect the practice of the advanced practice nurse (APN) in the emergency department. This review examines the findings of M. from their article, "Practice guideline update summary: Acute treatment of migraine in children and adolescents: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology and the American Headache Society." The authors completed an extensive literature review and created eight recommendations for the acute treatment of pediatric migraine focusing on medication selection, dosing, patient education, and patient counseling. By applying the evidence-based guidelines presented in this study, the urgent care or emergency department APN can confidently recognize and treat acute migraine symptoms and reduce patient risks from unnecessary testing and overuse of acute migraine medications.
Subject(s)
Analgesics/therapeutic use , Migraine Disorders/drug therapy , Practice Guidelines as Topic , Child , Counseling , Education, Continuing , Humans , Migraine Disorders/nursing , Patient Education as TopicABSTRACT
Migraine headaches account for approximately 1.2 million emergency department (ED) visits annually. Despite the prevalence of this condition, there is little consensus on the best pharmacotherapeutic interventions to use in the ED setting. Guidelines published by the American Headache Society and the Canadian Headache Society offer some direction to ED providers but are not widely utilized. This article reviews the best evidence behind some of the medications frequently used to treat acute migraines in the ED setting, including dopamine receptor antagonists, serotonin receptor agonists, anti-inflammatory medications, opioids, magnesium, valproate, and propofol. The evaluation of patients presenting to the ED with an acute headache, the diagnostic criteria for migraines, and implications for advanced practice are also discussed.
Subject(s)
Acute Pain/diagnosis , Acute Pain/drug therapy , Emergency Service, Hospital , Migraine Disorders/diagnosis , Migraine Disorders/drug therapy , Acute Pain/nursing , Acute Pain/physiopathology , Adrenal Cortex Hormones/therapeutic use , Analgesics, Opioid/therapeutic use , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Dopamine Antagonists/therapeutic use , Humans , Magnesium/therapeutic use , Migraine Disorders/nursing , Migraine Disorders/physiopathology , Pain Measurement , Propofol/therapeutic use , Serotonin Receptor Agonists/therapeutic use , Valproic Acid/therapeutic useABSTRACT
Migraine is a chronic episodic disorder typically characterized by a debilitating headache. This article offers tools to identify potential triggers and prevent or reduce the occurrence of attacks.
Subject(s)
Migraine Disorders , Adult , Humans , Migraine Disorders/epidemiology , Migraine Disorders/genetics , Migraine Disorders/nursing , Migraine Disorders/physiopathology , Nursing Assessment , Nursing Diagnosis , Patient Education as Topic , Risk FactorsABSTRACT
OBJECTIVES: Nitroglycerin (NTG)-induced migraine-type headache is the most prominent side effect of nitrate therapy. Therefore, the aim of this study was to clarify the effectiveness of reflexology massage on intravenous NTG-induced headache in coronary care unit (CCU) inpatients. METHODS: This was a randomized clinical trial. The study sample included 75 patients that were randomly divided into three groups: control, intervention, and placebo groups. The intensity of baseline headache in patients who received NTG was measured by the numeric rating scale for pain (NRS Pain). Patients in the intervention group received reflexology massage two times for 20 min (at 3-h interval), wherein the upper part of patient's both foot thumbs, which is the reflection point of the head, was massaged. In the placebo group, an unspecified point on the foot (heel), which was not related to the head, was massaged. Patients in the control group did not receive any massage. RESULTS: No baseline differences existed among the three groups for the mean pain scale score (p=0.66) before the study; but the difference between the groups after the application was statistically significant (p=0.000). CONCLUSION: Reflexology massage can reduce the intensity of NTG-induced headache.
Subject(s)
Massage , Migraine Disorders/therapy , Nitroglycerin/adverse effects , Vasodilator Agents/adverse effects , Angina Pectoris/drug therapy , Female , Humans , Infusions, Intravenous , Male , Middle Aged , Migraine Disorders/chemically induced , Migraine Disorders/nursing , Nitroglycerin/administration & dosage , Pain Measurement , Placebos , Treatment Outcome , Vasodilator Agents/administration & dosageSubject(s)
Migraine Disorders/nursing , Acute Disease , Adolescent , Child , Holistic Nursing , Humans , Migraine Disorders/complications , Migraine Disorders/physiopathology , Nursing Assessment , Nursing Diagnosis , Pain Measurement/nursing , Patient Education as Topic , Pediatric Nursing , Risk FactorsABSTRACT
Introducción: la cefalea es toda sensación dolorosa que tiene lugar en la parte superior de la cabeza, desde el reborde orbitario hasta la nuca. Constituye la primera causa de acudir al neurólogo y uno de los motivos más frecuentes en consultas de Medicina Interna. La cefalea tipo tensión es frecuente en la práctica diaria y la más invalidante desde los puntos de vistas físico, social, económico y psicológico. Objetivo: mostrar la actuación de Enfermería en el alivio de la migraña y describir la efectividad de la digitopuntura en pacientes con cefalea migrañosa, del Policlínico Contreras, primer trimestre de 2014. Materiales y métodos: estudio observacional, descriptivo y transversal. El grupo de estudio, 120 pacientes que acudieron a la consulta de Medicina Natural y Tradicional. Resultados: la edad de mayor incidencia 25-34 años, con 47.4 %. Prevaleció el sexo femenino, en un 70 %; la duración del dolor mostró un 43.3 % de afectación. Transcurrió entre las 4 y 8 horas, y siempre tuvo relación con el estrés, en 44.2 %; en un 69.2 % existió relación del dolor con la ingestión de alimentos. Se alivió con el sueño el 61.7 %, y el 52,5 % alcanzaron estado evolutivo excelente. Conclusiones: la aplicación de la digitopuntura a pacientes con cefalea migrañosa contribuyó a que los casos estudiados evolucionaran satisfactoriamente, expresando alivio del dolor. El tratamiento demostró efectividad y contribuyó a la disminución de drogas utilizadas en esta entidad, disminución de gastos económicos que implica el consumo de las mismas; lograr reincorporar a la vida laboral y social en un menor tiempo al paciente (AU).
Introduction: cephalalgia is any painful sensation occurring in the superior part of the head, from the orbital ridge to the nape. It is the first cause of visiting a neurologist and one of the most frequent causes of Internal Medicine consultations. The tension-kind cephalalgia is frequent in daily practice and the most invaliding one from the physical, social, economic and psychological point of view. Aim: to show Nursery behavior in migraine alleviation and to describe the digitopuncture effectiveness in patients with migrainous cephalalgia from Contreras Policlinic in the first trimester of 2014. Materials and methods: observational, descriptive, cross-sectional study. The studied group was 120 patients assisting the consultation of Natural and Traditional Medicine. Outcomes: the 25-34 age group was the one that showed higher incidence, with 47.4 %. The female sex prevailed with 70 %; pain lasting had 44.3 % of affectation. It lasted between 4 and 8 hours, always related to stress in 44.2 %. There it was a relation between pain and food intake in 69.2 %. 61.7 % of the cases were lessened with sleep, and 52.5 % achieved an excellent evolving status. Conclusions: Acupuncture application to patients with migrainous cephalalgia contributed to the satisfactory evolution of the studied cases: The patients expressed pain relieve. The treatment showed effectiveness and facilitated the decrease of drug usage in this entity, also diminishing the economic expenses its use implies; the patients reincorporated to social and working life in a shorter time period (AU).
Subject(s)
Humans , Male , Female , Adult , Acupuncture/methods , Migraine Disorders/diagnosis , Migraine Disorders/nursing , Migraine Disorders/rehabilitation , Nursing Care/methods , Epidemiology, Descriptive , Cross-Sectional Studies , Observational Study , Psychological Distress , Massage/nursing , Medicine, Chinese Traditional/methodsABSTRACT
Introducción: la cefalea es toda sensación dolorosa que tiene lugar en la parte superior de la cabeza, desde el reborde orbitario hasta la nuca. Constituye la primera causa de acudir al neurólogo y uno de los motivos más frecuentes en consultas de Medicina Interna. La cefalea tipo tensión es frecuente en la práctica diaria y la más invalidante desde los puntos de vistas físico, social, económico y psicológico. Objetivo: mostrar la actuación de Enfermería en el alivio de la migraña y describir la efectividad de la digitopuntura en pacientes con cefalea migrañosa, del Policlínico Contreras, primer trimestre de 2014. Materiales y métodos: estudio observacional, descriptivo y transversal. El grupo de estudio, 120 pacientes que acudieron a la consulta de Medicina Natural y Tradicional. Resultados: la edad de mayor incidencia 25-34 años, con 47.4 %. Prevaleció el sexo femenino, en un 70 %; la duración del dolor mostró un 43.3 % de afectación. Transcurrió entre las 4 y 8 horas, y siempre tuvo relación con el estrés, en 44.2 %; en un 69.2 % existió relación del dolor con la ingestión de alimentos. Se alivió con el sueño el 61.7 %, y el 52,5 % alcanzaron estado evolutivo excelente. Conclusiones: la aplicación de la digitopuntura a pacientes con cefalea migrañosa contribuyó a que los casos estudiados evolucionaran satisfactoriamente, expresando alivio del dolor. El tratamiento demostró efectividad y contribuyó a la disminución de drogas utilizadas en esta entidad, disminución de gastos económicos que implica el consumo de las mismas; lograr reincorporar a la vida laboral y social en un menor tiempo al paciente (AU).
Introduction: cephalalgia is any painful sensation occurring in the superior part of the head, from the orbital ridge to the nape. It is the first cause of visiting a neurologist and one of the most frequent causes of Internal Medicine consultations. The tension-kind cephalalgia is frequent in daily practice and the most invaliding one from the physical, social, economic and psychological point of view. Aim: to show Nursery behavior in migraine alleviation and to describe the digitopuncture effectiveness in patients with migrainous cephalalgia from Contreras Policlinic in the first trimester of 2014. Materials and methods: observational, descriptive, cross-sectional study. The studied group was 120 patients assisting the consultation of Natural and Traditional Medicine. Outcomes: the 25-34 age group was the one that showed higher incidence, with 47.4 %. The female sex prevailed with 70 %; pain lasting had 44.3 % of affectation. It lasted between 4 and 8 hours, always related to stress in 44.2 %. There it was a relation between pain and food intake in 69.2 %. 61.7 % of the cases were lessened with sleep, and 52.5 % achieved an excellent evolving status. Conclusions: Acupuncture application to patients with migrainous cephalalgia contributed to the satisfactory evolution of the studied cases: The patients expressed pain relieve. The treatment showed effectiveness and facilitated the decrease of drug usage in this entity, also diminishing the economic expenses its use implies; the patients reincorporated to social and working life in a shorter time period (AU).
Subject(s)
Humans , Male , Female , Adult , Acupuncture/methods , Migraine Disorders/diagnosis , Migraine Disorders/nursing , Migraine Disorders/rehabilitation , Nursing Care/methods , Epidemiology, Descriptive , Cross-Sectional Studies , Observational Study , Psychological Distress , Massage/nursing , Medicine, Chinese Traditional/methodsSubject(s)
Feeding Behavior , Food Hypersensitivity/complications , Food Hypersensitivity/nursing , Headache/etiology , Headache/nursing , Migraine Disorders/etiology , Migraine Disorders/nursing , Nursing Assessment , Nursing Diagnosis , Biogenic Amines/adverse effects , Food Additives/adverse effects , Food Hypersensitivity/diagnosis , Humans , Risk FactorsABSTRACT
Exploring, selecting, and utilizing an appropriate conceptual framework is a vital step in development of a research work. This article discusses the application of "Engel's model on biopsychosocial well-being," in exploring the relationship between biopsychosocial well-being and disability of patients with migraine headaches.
Subject(s)
Migraine Disorders/nursing , Migraine Disorders/psychology , Models, Nursing , Models, Psychological , Nursing Research , Adult , Female , Humans , Male , Middle AgedABSTRACT
Background Migraine is one of the most common pain symptoms in childhood, a chronic disease with recurrent symptoms that lead to a reduction of daily activities during the intercritical periods, with an impact of the quality of life. Objective The aim of this publication is to investigate, in which extent migraine affects the quality of life of children and adolescents, how strong they are restricted in everyday life and in which areas such restrictions can be found. Results The parents of children with FSH (frequent or severe headaches) reported that the children had difficulties with emotions, concentration, behaviour, and were unable to get along with others. Children with FSH were significantly more likely to be upset or distressed by their difficulties, while experiencing disappointments, and to have these difficulties interfere with home life, friendships and classroom learning (Strine et al., 2006). Moreover, mothers described children with migraine as evidencing higher levels of internalizing behaviour and symptoms of anxiety and depression. Children with migraine indicated more negative self-perceptions of their physical appearance (Vannatta et al., 2008). Children with migraine lost school activity and performance, household tasks and leisure. Furthermore, it was observed that children with migraine went to school but didn't show a good performance because of physical or mental health problems (Ferracini, Dach & Speciali, 2013). Conclusion Compared to children without migraine, children and adolescents with migraine have generally poorer qualities of life in different areas.
Subject(s)
Migraine Disorders/nursing , Migraine Disorders/psychology , Quality of Life/psychology , Activities of Daily Living/classification , Activities of Daily Living/psychology , Adolescent , Child , Cross-Sectional Studies , Humans , Internal-External Control , Interpersonal Relations , Migraine Disorders/epidemiology , Migraine Disorders/etiology , Parent-Child Relations , Risk Factors , Social AdjustmentABSTRACT
INTRODUCTION: Migraine is a common disorder with a high burden. Adequate treatment results in improvement of quality of life. Migraine patients are mainly treated by general practitioners (GPs), but there is still room for improvement. This study investigated whether primary care nurses could improve the treatment of migraine patients compared to usual care as provided by the GPs. PARTICIPANTS AND METHODS: We conducted a non-randomized controlled prospective trial in 235 patients diagnosed with migraine with or without aura according to ICHD-II criteria, aged between 18 and 65 years. Patients with migraine treated only by their GP were compared to management by a nurse supervised by a GP. RESULTS: In the intervention group, fewer migraine patients were referred to a neurologist (p < 0.001). The reduction in monthly migraine days compared to baseline was more apparent in the intervention group at six (p = 0.09) and nine months (p = 0.006). There was no significant change in dichotomized HIT score (p = 0.076). Change in satisfaction of patients did not differ significantly (p = 0.070). CONCLUSIONS: The care administered by a headache nurse in the primary care setting supervised by a GP resulted in fewer referrals to the neurologist and more migraine-free days per month, but no change in HIT score. There was no difference in satisfaction scores between both groups.
Subject(s)
Migraine Disorders/nursing , Pain Management/methods , Primary Care Nursing/methods , Adult , Female , Humans , Male , Middle AgedSubject(s)
Headache/etiology , Headache/nursing , Migraine Disorders/nursing , Students/psychology , Adolescent , Child , Cross-Sectional Studies , Germany , Headache/epidemiology , Headache/prevention & control , Humans , Migraine Disorders/epidemiology , Migraine Disorders/etiology , Migraine Disorders/prevention & controlSubject(s)
Anxiety Disorders/drug therapy , Anxiety Disorders/nursing , Depressive Disorder/drug therapy , Depressive Disorder/nursing , Migraine Disorders/drug therapy , Migraine Disorders/nursing , Selective Serotonin Reuptake Inhibitors/pharmacokinetics , Selective Serotonin Reuptake Inhibitors/therapeutic use , Adult , Anxiety Disorders/blood , Comorbidity , Cytochrome P-450 Enzyme System/physiology , Depressive Disorder/blood , Drug Interactions , Drug Therapy, Combination/adverse effects , Drug Therapy, Combination/nursing , Female , Humans , Migraine Disorders/blood , Serotonin Syndrome/diagnosis , Serotonin Syndrome/nursing , Selective Serotonin Reuptake Inhibitors/adverse effectsABSTRACT
New strategies are needed to improve access to cognitive and behavioral therapies for patients with persistent pain. The purpose of this randomized, controlled trial was to determine the effectiveness of the Chronic Pain Management Program, an 8-week online intervention targeting cognitive, emotional, behavioral, and social pain determinants. Program efficacy and engagement was evaluated for 92 individuals with a diagnosis of chronic noncancer pain who had a current opioid prescription. Participants were recruited from primary care practices and Internet sites, then randomly assigned to receive access to the intervention either immediately (treatment group) or after an 8-week delay (wait-list comparison). Biweekly self-report measurements were collected using online surveys on pain, depressive symptoms, pain self-management behaviors, and health care utilization during the 8-week trial. Additional measurements of opioid misuse behaviors, pain self-efficacy, and medicine regimens were completed at baseline and week 8. Engagement was evaluated by examining completion of program learning modules. The results from analysis of variance showed that at week 8, the treatment group had significantly greater improvements on pain self-efficacy and opioid misuse measures than the wait-list comparison group. Engagement level was positively associated with improvements in pain intensity, pain interference, and pain self-efficacy. In conclusion, patients on opioids were able to engage and demonstrate positive outcomes using an Internet-based self-management program. Future efforts toward heightening engagement could further maximize impacts.
Subject(s)
Analgesics, Opioid/therapeutic use , Chronic Pain/nursing , Internet , Pain Management/methods , Self Care/methods , Adult , Back Pain/drug therapy , Back Pain/nursing , Back Pain/psychology , Chronic Pain/drug therapy , Chronic Pain/psychology , Depression/psychology , Female , Fibromyalgia/drug therapy , Fibromyalgia/nursing , Fibromyalgia/psychology , Humans , Male , Middle Aged , Migraine Disorders/drug therapy , Migraine Disorders/nursing , Migraine Disorders/psychology , Osteoarthritis/drug therapy , Osteoarthritis/nursing , Osteoarthritis/psychology , Patient Participation , Prescription Drug Misuse , Self Efficacy , Therapy, Computer-AssistedABSTRACT
PURPOSE: The purpose of this project was to survey nurses' knowledge of pain management for patients with combat-related traumatic brain injuries (TBI). DESIGN/METHODS: A survey was used to collect data regarding nurses' knowledge of pain assessment and management for patients with combat-related TBI. Nurses were invited to participate in the study via email and provided with a link to the electronic survey. FINDINGS: Twenty-five surveys were returned (52% response rate). A total of 76% of nurse respondents perceived that TBI patients over report pain intensity. Only 40% of nurses were able to correctly identify the appropriate medication to treat migraine-type headache pain in TBI patients. CONCLUSION: This study identified gaps in knowledge regarding pain management for patients with combat related TBIs. CLINICAL RELEVANCE: Nurses need additional education regarding common pain syndromes, available treatments, and a better understanding of addiction in order to provide optimal care to these patients.
Subject(s)
Brain Injuries/nursing , Brain Injuries/rehabilitation , Health Knowledge, Attitudes, Practice , Pain Management/nursing , Rehabilitation Nursing/organization & administration , Adult , Analgesics/therapeutic use , Brain Injuries/complications , Clinical Competence , Cross-Sectional Studies , Education, Nursing, Continuing , Female , Humans , Male , Middle Aged , Migraine Disorders/drug therapy , Migraine Disorders/nursing , Migraine Disorders/rehabilitation , Multiple Trauma/nursing , Multiple Trauma/rehabilitation , Pain/etiology , Pain/nursing , Pain/rehabilitation , Practice Guidelines as Topic , United States , WarfareABSTRACT
Migraine headache is a common problem among children and adolescents that is now recognized as a significant and often debilitating condition in this population. Improved recognition and management of pediatric migraine in primary care is necessary, as there is a knowledge gap in understanding the unique features of this condition and a general reluctance to treat children.