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Study has shown that the prevalence and severity of pain among hospitalized patients differ with up to 75 % patients experiencing moderate to severe pain, which is not relieved adequately. Pain management by nurses employs the use of two therapies, namely pharmacological and non-pharmacological therapies. Traditional pain management has made use of pharmacological therapies, but since pain is influenced by an array of physical and physiological factors patients tend to differ in their response to analgesics and pain. Some of the identified non-pharmacological pain relieving therapies includes massage, relaxation, distraction, heat, counseling, cold, aromatherapy, therapeutic touch, acupuncture, touch, visualization and positioning therapies.
The World Health Organization (WHO) and Agency for Health Care Policy and Research (AHCPR) have noted the persistence of unrelieved pain and potential benefits of using non-pharmacological therapies to relieve pain. They have, therefore, recommended the use of non-pharmacological therapies where appropriate to relieve pain. This has not been the case due a number of constraints faced by nurses as discussed in this paper.
Nurses' management of pain in hospitalized patients using pharmacological therapies has been shown to be ineffective in up to 75 % percent of the cases. This has necessitated the use of non-pharmacological which has been documented to be more effective in relieving pain to relieve this pain. Studies have gone on to show that 89.2 % of nurses have at one time used non-pharmacological therapies to relieve pain with better results than pharmacological therapies. The use of non-pharmacological therapies by nurses in the management of pain has not been as extensive as would be expected due to a number of constraints as that include predisposing, enabling and reinforcing factors as discussed below.
Predisposing factors are those factors which may predispose a nurse to engage in a particular behavior. They include knowledge, attitudes, values and perception. Belief of the nature of pain has been identified as the main predisposing factor influencing nurses' use of non-pharmacological therapies to relieve pain. The tenet held by some nurses that non-pharmacological therapies must only be used with pharmacological therapies has greatly restricted their use of these therapies(Helmrich et. al. 2001, p. 30).
Beliefs about the benefits of non-pharmacological therapies also influence the use of these therapies. While some nurses believe that these therapies are effective in pain, others are of a contrary opinion. These nurses who are of opinion that [url=http://www.teatrodeoro.com/hollisterde.php]hollister deutschland[/url] these therapies are ineffective and have unpleasant side effects have advocated for [url=http://www.jeremyparendt.com/Barbour-Paris.php]barbour pas cher soldes[/url] a stop to the use of these therapies in the management of pain. They believe that though pharmacological therapies may not be effective in some cases they are at the least quantifiable(Helmrich et. al. 2001, p. 30).
Enabling factors that include availability and accessibility of resources and the skills of the [url=http://www.jeremyparendt.com/Barbour-Paris.php]barbour france paris[/url] nurses have also been identified as constraining the use of non-pharmacological therapies in management of pain [url=http://www.rtnagel.com/airjordan.php]nike air jordan pas cher[/url] by nurses. Time and resource allocation have been identified by nurses as one of the enabling factors. The time needed to implement non-pharmacological therapies is long, therefore, discouraging most nurses from its use. Since these therapies are not considered standard practice there use is, therefore, not considered a priority. Though the nurse may be supportive of the use of non-pharmacological therapies [url=http://www.mxitcms.com/abercrombie/]abercrombie[/url] there use of these therapies is counterbalanced by perceived restrictions of lack of time and resource allocation(Helmrich et. al. 2001, p. 31). Inadequate nurses' skills in the administration of non-pharmacological therapies have negatively influenced their use of these therapies. The use of basic forms of these therapies already forms a part of the nurses' practice like hot and cold packs their knowledge [url=http://www.rtnagel.com/louboutin.php]louboutin[/url] of more specialized therapies was inadequate thus restricting their use of these technologies. Specialized training for nurses [url=http://www.mnfruit.com/airjordan.php]jordan[/url] is, therefore, required before they can administer these therapies to patients.
Reinforcing factors have a negative impact in the nurses' administration of non-pharmacological therapies. Reinforcing therapies are the attitudes and behaviors of peers, family and other healthcare professionals. They include patient attitudes, health care professionals and organizational factors.
Patient attitudes influence a nurse's use of non-pharmacological therapies. A nurse may feel that these therapies may offer patients many benefits in terms of pain relief, distraction, emotional and comfort measures but their efficacy and value would only be as much as the patients belief in the therapy. The patient's acceptance of these therapies is, therefore, crucial for the nurse's use and implementation of these therapies.
Health [url=http://www.osterblade.com]moncler sito ufficiale[/url] care professionals also influence the nurse's use of non-pharmacological therapies. Some health care professionals, like nursing peers, medical officers and hospital, have been a major deterrent in use by nurses of these therapies. These professionals express a lack of confidence in the incorporation of these therapies in nursing [url=http://www.shewyne.com/hoganoutlet.html]hogan sito ufficiale[/url] practice and have, therefore, not placed a priority in the administration of these therapies (Helmrich et. al. 2001, p. 32). Organization factors refer to how a nurse organizes their time and the patient's time. Some nurses have found it difficult to justify the time spent in the implementation of non-pharmacological therapies, which are not considered a priority by most health care professionals.
Pain management of hospitalized patients by nursing [url=http://www.shewyne.com/moncleroutlet.html]moncler outlet[/url] staff has not been effective with 75 % of patients experiencing moderate to severe pain. Pharmacological therapies, which are the standard therapies for management of pain, have been shown to be ineffective. This has necessitated the use of non-standardized non-pharmacological therapies. The use of these therapies has not [url=http://www.gotprintsigns.com/abercrombiepascher/‎]abercrombie pas cher[/url] been as extensive as expected due to the discussed factors. To enable nurses efficiently and effective relieve pain in hospitalized patients they must address the discussed constraints. Hospital administrators and health care professionals should attend training on [url=http://www.shewyne.com/peutereyoutlet.html]peuterey sito ufficiale[/url] the use of these therapies, educate the patients on their safe and effective use and standardize their use.
To improve the nurses' management of pain, the following issues should be addressed. Education of health care professionals, supportive decision making, setting and auditing of pain standards, pain management services, organizational prioritization of pain and pain linking nurses.

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