Experiences of a non-clinical set of adolescents and young adults living with persistent pain : a qualitative metasynthesis

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Experiences of a non-clinical set ofadolescents and young adults living with persistent pain: a qualitative metasynthesis

publishedVersio

Prediction of underlying atrial fibrillation in patients with a cryptogenic stroke: results from the NOR-FIB Study

Background - Atrial fibrillation (AF) detection and treatment are key elements to reduce recurrence risk in cryptogenic stroke (CS) with underlying arrhythmia. The purpose of the present study was to assess the predictors of AF in CS and the utility of existing AF-predicting scores in The Nordic Atrial Fibrillation and Stroke (NOR-FIB) Study. Method - The NOR-FIB study was an international prospective observational multicenter study designed to detect and quantify AF in CS and cryptogenic transient ischaemic attack (TIA) patients monitored by the insertable cardiac monitor (ICM), and to identify AF-predicting biomarkers. The utility of the following AF-predicting scores was tested: AS5F, Brown ESUS-AF, CHA2DS2-VASc, CHASE-LESS, HATCH, HAVOC, STAF and SURF. Results - In univariate analyses increasing age, hypertension, left ventricle hypertrophy, dyslipidaemia, antiarrhythmic drugs usage, valvular heart disease, and neuroimaging findings of stroke due to intracranial vessel occlusions and previous ischemic lesions were associated with a higher likelihood of detected AF. In multivariate analysis, age was the only independent predictor of AF. All the AF-predicting scores showed significantly higher score levels for AF than non-AF patients. The STAF and the SURF scores provided the highest sensitivity and negative predictive values, while the AS5F and SURF reached an area under the receiver operating curve (AUC) > 0.7. Conclusion - Clinical risk scores may guide a personalized evaluation approach in CS patients. Increasing awareness of the usage of available AF-predicting scores may optimize the arrhythmia detection pathway in stroke units

How school nurses experience and understand everyday pain among adolescents

Abstract Background Pain problems are a rapidly growing health problem found among both children and adolescent, and about 15–30% have reported chronic pain problems. School nurses in Norway meet adolescents with various ailments, including pain. Yet research on how school nurses perceive the pain experienced by adolescents is limited. The aim of the present study was to explore how school nurses explain and experience the everyday pain of adolescents. Method A qualitative study with an explorative design comprising five focus group interviews. Each group consisted of three to five school nurses. Seventeen female school nurses in five junior high schools in Norway, age range 29–65 years participated. To cover the issues a semi structured interview guide was used. The transcribed text was analysed with qualitative content analysis. Results The experience of school nurses with adolescents’ pain in everyday life is mainly that pain is a social, physical, and psychological phenomenon. School nurses experienced that everyday pain is reflecting: 1) high expectations, 2) difficult relationships and traumatic experiences and 3) an unhealthy lifestyle. School nurses have ambivalent attitudes to medicalisation of pain. Conclusion Despite of a biopsychosocial understanding of pain, the school nurses maintained referral practice of medical examinations, with the results that many adolescents became shuttlecocks in the health system. Although the school nurses´ were sceptical of the tendency towards medicalization in society, it appears that they actually help maintain this tendency

Teachers’ experiences of adolescents’ pain in everyday life: a qualitative study

Objectives More adolescents report pain now than previously. In Norway, episodic pain problems have been reported by 60% of children and adolescents aged 8–18 years, with 21% reporting duration of pain of more than 3 months. Since adolescents spend much time at school, the attitude and behaviour of teachers play important roles regarding the experience of pain felt by adolescents in everyday life. Yet research on how teachers perceive the pain experienced by adolescents in a school setting is limited. We therefore seek to gain insight to teachers’ classroom experiences with (1) adolescent's self-reported pain symptoms; (2) adolescents management of their pain and (3) how to help adolescents manage their pain. Setting Teachers in 5 junior high schools in Norway representing municipalities in 3 rural areas and 2 cities. Research design A qualitative study with an explorative design comprising 5 focus group interviews. Each group consisted of 3–8 junior high school teachers. A semistructured interview guide was used to cover the issues. The transcribed text was analysed with qualitative content analysis. Participants 22 teachers participated (5 men, 17 women; age range 29–62 years) with teaching experience ranging from 3 to nearly 40 years. Results The main theme describing the experience of teachers with adolescents’ pain in everyday life is that pain and management of pain is a social, physical and psychological interwoven phenomenon. Through empirical analyses, 3 subcategories emerged: (1) everyday pain—expressing strenuous life; (2) managing pain—escaping struggle and (3) strategies of teachers—support and normalisation. Conclusions Teachers have a biopsychosocial understanding and approach to pain experienced by adolescents. This understanding influences the role of teachers as significant others in the lives of adolescents with regard to pain and management of their pain in a school setting

How school nurses experience and understand everyday pain among adolescents

Pain problems are a rapidly growing health problem found among both children and adolescent, and about 15–30% have reported chronic pain problems. School nurses in Norway meet adolescents with various ailments, including pain. Yet research on how school nurses perceive the pain experienced by adolescents is limited. The aim of the present study was to explore how school nurses explain and experience the everyday pain of adolescents. A qualitative study with an explorative design comprising five focus group interviews. Each group consisted of three to five school nurses. Seventeen female school nurses in five junior high schools in Norway, age range 29–65 years participated. To cover the issues a semi structured interview guide was used. The transcribed text was analysed with qualitative content analysis. The experience of school nurses with adolescents’ pain in everyday life is mainly that pain is a social, physical, and psychological phenomenon. School nurses experienced that everyday pain is reflecting: 1) high expectations, 2) difficult relationships and traumatic experiences and 3) an unhealthy lifestyle. School nurses have ambivalent attitudes to medicalisation of pain. Despite of a biopsychosocial understanding of pain, the school nurses maintained referral practice of medical examinations, with the results that many adolescents became shuttlecocks in the health system. Although the school nurses´ were sceptical of the tendency towards medicalization in society, it appears that they actually help maintain this tendency

School nurses’ and teachers’ perceptions of pain in young immigrants living in Norway

Purpose The number of adolescents experiencing pain is increasing. Pain has a major impact on several areas of daily living, such as function at school and school absenteeism, loss of appetite and socializing. One out of ten pupils in Norwegian schools is immigrants, and surveys have shown that immigrants suffer from poor health more often than the general population. The purpose of this study was to explore how school nurses and teachers experience pain in young immigrants in the school setting. Design/methodology/approach A qualitative design using focus group interviews was chosen for data collection. A total of 11 focus groups (17 school nurses and 25 teachers) consisting of school nurses and teachers in junior high schools (age: 13-16 years) in Southern Norway were conducted. Data were analyzed using a qualitative content analysis. Findings School nurses and teachers experienced communication of pain with young immigrants as characterized by cultural differences and language problems. Immigrants waiting for residency permits experienced pain more often than others. They also experienced that young immigrants often were absent from school and used pain as an excuse for not participating in classes, but this was not the case at the special school for immigrants. During Ramadan, they experienced that immigrant pupils had an increase of pain, especially headaches. Originality/value Culture affects the assessment and management of pain and different strategies may assist school nurses and teachers in their encounter with young immigrants with pain. There is a need for education in cultural competence among teachers and school nurses

Experiences of a non-clinical set ofadolescents and young adults living with persistent pain: a qualitative metasynthesis

Purpose Around 15%–30% of adolescents and young adults (AYAs) experience persistent or chronic pain. The purpose of this study was to synthesise evidence from qualitative primary studies on how AYAs in a non-clinical population experience living with persistent pain. Method A qualitative metasynthesis guided by Sandelowski and Barroso’s guidelines was used. The databases Medline, Embase, Cinahl, PsycINFO, Mednar and ProQuest were searched for studies from 1 January 2005 to 15 February 2021. Inclusion criteria were AYAs aged 13–24 years with first-hand experience of living with persistent, recurrent or episodic non-clinical pain in any body site. Pain associated with a medical diagnosis, malignant diseases, medical procedures or sport activities was excluded. Results Of 2618 screened records, data from nine studies conducted in a Western cultural context including 184 participants (127 female and 57 male aged 11–28 years) were analysed into metasummaries and a metasynthesis. Headaches was the most focused pain condition (n=5), while three of the studies did not specify type of pain. The participants’ experiences were characterised by (1) juggling pain with everyday life; (2) exploring sources of information to manage pain; (3) AYAs’ use of medication to find relief and (4) non-pharmacological strategies for pain relief. Conclusion These AYAs experience of how pain influences everyday life, and their striving to find relief from pain by support from family, friends, professionals and the Internet should be strongly respected. Public health nurses and other healthcare professionals encountering AYAs need to respect their pain experiences, and to support them in healthy coping strategies. Further studies on this issue are needed, especially research focusing on AYAs pain in exposed populations and AYAs from non-Western cultures