Nursing Assessment of Wound-Related Pain: An Italian Learning Survey

Assessment of Wound-Related Pain Experiences of Patients With Chronic Wounds: A Multicenter Cross-Sectional Study in Eastern China

PURPOSE

The primary aims of this study were to evaluate the prevalence of wound-related pain (WRP) in patients with chronic wounds and assess the use of pain relief measures.

DESIGN

A cross-sectional study.

SUBJECTS AND SETTING

A convenience sample of patients with chronic wounds was recruited from outpatient clinics of 12 hospitals covering 7 of 13 cities in the Jiangsu province located in eastern China from July 10 to August 25, 2020. The sample comprised 451 respondents, and their mean age was 54.85 (SD 19.16) years; 56.1% (253/451) patients were male.

METHODS

An investigator-designed questionnaire was used to collect pain-related information from patients. The questionnaire consisted of 4 parts: (1) basic demographic and clinical information (patient and wound characteristics); (2) wound baseline pain; (3) wound-related procedural pain and pain relief method; and (4) the effect of WRP on the patient. Pain was assessed using the Numerical Rating Scale (NRS) scored from 0 (no pain) to 10 (worst pain). Severity of pain was based on NRS scores' classification as mild (1-3), moderate (4-6), and severe (7-10). The survey was conducted from July 10 to August 25, 2020. Participants were instructed on use of the NRS and then completed the questionnaire following dressing change independently.

RESULTS

The 3 most common types of chronic wounds were traumatic ulcers, surgical wounds, and venous leg ulcers. The 3 most prevalent locations were lower limbs, feet, and thorax/abdomen. Of all patients, 62.5% (282/451) and 93.8% (423/451) patients experienced wound baseline pain and wound-related procedural pain, respectively. The mean score of wound baseline pain was 3.76 (SD 1.60) indicating moderate pain. During wound management, the highest pain score was 6.45 (SD 2.75) indicating severe pain; the most severe pain scores were associated with debridement. The use of drugs to relieve wound pain was low, while the use of nondrug-based analgesia was relatively high. Because of WRP, patients with chronic wounds feared dressing changes, hesitated to move, and showed a decline in sleep quality.

CONCLUSIONS

Wound baseline pain and wound-related procedural pain were very common in patients with chronic wounds. In the future, targeted intervention plans should be developed by combining drug-based and nondrug-based analgesia according to pain severity.

The effects of virtual reality technology on reducing pain in wound care: A meta-analysis and systematic review

Virtual reality (VR) technology has been widely used in clinical nursing care in recent years. We aimed to systematically evaluate the effect and safety of VR technology on pain control in wound care, to provide evidence and support for clinical wound care. We searched PubMed, EMBASE, Cochrane Library, Web of Science, CINAHL, China Biomedical Literature Database, China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service Platform, and Chinese Science and Technology Journal databases for randomised controlled trials (RCTs) on the application of VR technology in wound care up to December 20, 2021. Two researchers independently assessed the quality of the included RCTs and extracted associated data. RevMan5.3 statistical software was used for data analysis. 13 RCTs involving 1258 adult patients were included, of whom 588 patients underwent VR intervention. VR technology intervention could reduce the VAS score(MD = -1.13, 95%CI:-2.01~-0.26, P < .001), pain cognition score(MD = -3.94, 95%CI:-4.59 ~ -3.30, P < .001), pain emotion score(MD = -5.21, 95%CI: -10.46 ~ -0.04, P < .001), pain sensation score (MD = -4.94, 95%CI: -9.46 ~ -0.42, P = .03) and blood pressure(MD = -4.66, 95%CI: -8.63 ~ -0.69, P = .02) during would care. There were no significant differences on the heart rate (MD = -1.85, 95%CI: -5.71 ~ -2.01, P = .45) and VR interestingness (MD = 28.96, 95%CI: -22.10 ~ 80.02, P = .27) of the VR group and control group. No publication biases among the synthesised outcomes were found (all P > .001). VR technology can effectively reduce the pain degree and sensation of patients during wound care, which may be an effective auxiliary non-drug method used for pain relief during wound care.