Crawford, C.L., Boller, J., Jadalla, A.J., & Cuenca, E. (January 2016). An Integrative Review of Pain Resource Nurse Programs. Crit Care Nurs Q Vol. 39, No. 1, pp. 64–82. Mismanaged pain challenges health care systems. In the early 1990s, pain resource nurse programs were developed by Ferrell and colleagues. Variations of the model have existed for more than 20 years. While results of these programs have been disseminated, conclusive evidence has not been examined via a synthesis of the literature. A structured systematic search using multiple databases was conducted for research studies published 2005-2012. The search identified 11 studies on effective use of a pain resource nurse and/or a pain resource nurse program. The results revealed wide variations existing in program design, research methodology, practice settings, and reported outcomes. Overall, the strength of the evidence on pain resource nurse programs was determined to range from low to moderate quality for making generalizable conclusions. However, 4 key elements were identified as integral to effective pain resource nurse programs and useful for the program design and development: leadership commitment and active involvement in embedding a culture of effective pain management throughout the organization; addressing staff-related and organization-related challenges and barriers to pain management; a combination of strategies to overcome these barriers; and collaborative multidisciplinary teamwork and communication. Specific recommendations are provided for program implementation. Although the evidence was inconclusive, useful information exists to create the design of effective pain resource nurse programs. Collaborative multisite studies on the long-term effects of pain resource nurse programs are recommended.  Click here to view

Wynne-Jones G, et al (2013) Absence from work and return to work in people with back pain: a systematic review and meta-analysis.Occup Environ Med. 2013 Nov 1. doi: 10.1136/oemed-2013-101571. To investigate the extent to which differences in setting, country, sampling procedures and methods for data collection are responsible for variation in estimates of work absence and return to work. Pooled estimates suggest high return to work rates, with wide variation in estimates of return to work only partly explained by a priori defined study-level variables. The estimated 32% not back at work at 1 month are at a crucial point for intervention to prevent long term work absence. Click here to view

Vachon–Presseau E, et al (2013)The two sides of pain communication: effects of pain expressiveness on vicarious brain responses revealed in chronic back pain patients. The Journal of PainVolume 14, Issue 11 , Pages 1407-1415.  Activity in the right insula correlated positively with both the patients’ expressiveness (encoding) and the intensity of the pain perceived in the images (decoding), suggesting that this structure linked the dispositional expressiveness with vicarious pain perception. Importantly, these effects were independent from dispositional empathy and were found with both communicative (facial expression) and noncommunicative (hand and foot) cues. These results suggest that dispositional expressiveness is a self–related factor that facilitates vicarious pain processing and might reflect individual tendencies to rely on social coping strategies. Click here to view

 Linde, Sandra M., et al. (2013) Reevaluation of the Critical-Care Pain Observation Tool in Intubated Adults After Cardiac Surgery. Am J Crit Care. 2013 Nov;22(6):491-7. Background Pain assessment in critically ill patients who are intubated, sedated, and unable to verbalize their needs remains a challenge. No universally accepted pain assessment tool is used in all intensive care units. Objectives To examine concurrent validation of scores on the Critical-Care Pain Observation Tool for a painful and a non-painful procedure and to examine interrater reliability of the scores between 2 nurse raters. Methods A prospective, repeated-measures within-subject design was used. A convenience sample of 35 patients was recruited to achieve enrollment of 30 patients during a 5-month period. Observational data were collected on patients intubated after cardiac surgery during routine turning and during dressing changes for central catheters. Results Raters’ mean scores did not increase significantly during dressing changes (increase, +0.25; 95% CI, -0.07 to 0.57; P = .12) but did increase significantly during turning (increase, +3.04; 95% CI 2.11-3.98; P < .001). The degree to which mean scores increased was significantly greater during turning than during dressing changes (increase, +2.80; 95% CI, 1.84-3.75; P < .001). The Fleiss-Cohen weighted κ for the inter-rater reliability of the ratings of research nurses was 0.87 (95% CI, 0.79-0.94). Conclusion The results support previous research investigations on validity and reliability of the Critical-Care Pain Observation Tool for evaluating pain in intubated, critically ill adults.  Click here to view