Sjuksköterskan har en viktig roll, vad gäller den postoperativa smärtbehandlingen och ansvarar för att smärtbehandlingen överensstämmer med patientens önskemål och behov. Kirurgiska ingrepp kan leda till långvarig postoperativ smärta som orsakar patienten förlängd vårdtid och begränsar individen i vardagen. Syftet med litteratur-studien var att belysa faktorer av betydelse vid smärtbedömning och dokumentation i samband med postoperativ smärtbehandling. Analys av 14 vetenskapliga artiklar sammanställdes. I resultatet framkom två kategorier: utbildning och erfarenhet, smärtskattning och dokumentation.

AbstractPURPOSE: The aim of this study was to describe and compare possible differences regarding selected prognostic factors for disability between patients with non-specific chronic pain who were about to start a multidisciplinary treatment program (MMR), either within primary care (MMR1) or hospital care (MMR2).METHODS: The study had a descriptive and comparative cross sectional design. Eighty-nine patients were recruited consecutively when they were about to start their team treatment (50 in MMR1,39 in MMR2). The measurements were; Evaluation of self-reported self-efficacy for eight daily activities (STIVA-8), The Pain Belief Screening Instrument (PBSI) and Hospital Anxiety and Depression Scale (HADS).RESULTS: The study found some significant differences between the answers from patients in MMR1 and those from patients in MMR2. For instance, patients in MMR2 estimated lower self-efficacy according to STIVA-8 than patients in MMR1. Also, there were fewer low risk patients and more high risk patients in MMR2 than in MMR1 regarding pain intensity according to PBSI.

The purpose of this study was to investigate the association between physical activity and perceived stress, energy and musculoskeletal disorders among office-workers and warehouse-workers and also to see if there were any differences depending on work-place and gender. The method that was used to collect data was three different validated questionnaires that measured stress and energy (the Stress-Energy questionnaire), musculoskeletal disorders (intensity and localization of pain, a Pain Drawing questionnaire with a VAS-scale) and physical activity (IPAQ ? the short version). Eighty-eight workers participated in the study. Forty-seven of them were office-workers and forty-one were warehouse-workers.

Background: Patients with leg ulcer suffers often of woundpain. Healthcare professionals will strive after having knowledge and understanding for how woundpain influences the patient's quality of life. Aim: The aim is to elucidate the patient's experiences of pain at venous leg ulcer and the effects on their daily life. Method: The procedure has been a systematic literature overview with a systematic search in different databases. The search resulted in nine scientific articles.

AbstractAim: The aim of this study was to investigate if treatment with ?dry needling? in myofascial triggerpoints (MTrPs) in the rotatorcuff muscles may affect impingement symptoms such as pain during provocative tests, shoulder mobility, and function. The research questions were: Does the value of pain change on the Visual Analog Pain Scale (VAS) between before and after treatment? Do the positive provocative tests for impingement change between before and after treatment? Does the active shoulder mobility change between before and after treatment? Does the self-rated function change between before and after treatment?Method: The study was a prospective randomized intervention study and 19 persons with impingement symptoms (mean ± standard deviation; 58 ± 18 years, and shoulder pain duration 3.9 ± 1.6 months) were randomized into two groups. The groups were tested before, directly after and 3 weeks after treatment.

One of the bigger national diseases that belongs to the field of rheumatology is rheumatoid arthritis and it is three to four times more usual among women. The purpose of this study was to describe female patients' experience of living with rheumatoid arthritis. The method, was a review of the literature with eight articles accomplished the criteria for scientific quality done in the accordance to Polit, Beck & Hungler (2001) and are the bases to the conclusions of this study. The result shows five main themes and ten sub themes that illuminate the female patient's experience of living with rheumatoid arthritis. The main themes are: a) the pain, b) the development, c) the relation, d) the well-being and e) the future.

Objectives: The purpose of the study was to examine if a pre- and post-operative difference could be seen in self-reported pain disability and self-efficacy among patients undergoing surgery as treatment for spinal disc herniation in order to improve process of rehabilitation.Method: A quantitative and descriptive design was used. 10 patients awaiting surgical treatment for spinal disc herniation were included at Akademiska sjukhuset (The Academic Hospital) in Uppsala. Participation was voluntary and the selection was made by convenience. Data was collected using The Pain Disability Index and Self-Efficacy Scale by which the patient would estimate how hindered they felt because of their pain in everyday activities and their self-efficacy to perform everyday activities. This was done the day before surgery and two weeks after surgery.

AimThe purpose of this study is to investigate whether there is scientific evidence that exercise and/or manual therapy can improve function, in terms of increased mobility and strength on shoulder impingement-like symptoms among athletes. Another aim is to investigate whether these interventions can reduce shoulder pain.MethodA systematic review was conducted in the databases PubMed, CINAHL, PEDro and Amed. A total of thirteen articles were selected for further review and compilation. They were then graded for level of evidence according to the PEDro scale and the Swedish Council on Technology Assessment (SBU).ResultsThe systematic review shows that there is strong scientific evidence that acupuncture and heat can reduce pain in athletes diagnosed with supraspinatus-tendiopathy. There is limited scientific evidence that exercise increases strength, limited scientific evidence that stretching increases mobility and insufficient scientific evidence that a combination of treatments, with both exercise and stretching, reduces pain and increases function in overhead athletes.ConclusionsExercise and manual therapy can reduce pain and/or improve function in terms of increased mobility and strength in athletes with shoulder impingement-like symptoms.

Intresset och användandet av komplementärmedicinska behandlingsmetoder växer bland både patienter och sjukvårdspersonal. Syftet med denna litteraturstudie var att undersöka effekten av tre komplementärmedicinska behandlingsmetoder vid postoperativ smärta. Centrala frågeställningar var om transkutan elektrisk nerv-stimulering, massage och musik har smärtlindrande effekt postoperativt. Good-mans sju steg (Willman m fl, 2006) följdes genom processen i denna litteratur-studie. 11 artiklar inkluderades totalt efter sökningar i databaserna PubMed och CINAHL.

AbstractAim: The aim of this study was to investigate if treatment with ?dry needling? in myofascial triggerpoints (MTrPs) in the rotatorcuff muscles may affect impingement symptoms such as pain during provocative tests, shoulder mobility, and function. The research questions were: Does the value of pain change on the Visual Analog Pain Scale (VAS) between before and after treatment? Do the positive provocative tests for impingement change between before and after treatment? Does the active shoulder mobility change between before and after treatment? Does the self-rated function change between before and after treatment?Method: The study was a prospective randomized intervention study and 19 persons with impingement symptoms (mean ± standard deviation; 58 ± 18 years, and shoulder pain duration 3.9 ± 1.6 months) were randomized into two groups. The groups were tested before, directly after and 3 weeks after treatment.

Objective: The objective was to examine the incidence of constipation, and the preventive measures taken in relation with Postoperative pain treatment with opioids at two orthopaedic surgery wards.Methods: The participants were patients that had undergone surgery in the back, hip or thigh. They were selected through systematic selection and a total of 46 electronic health records were examined. The factors investigated and tested for correlation with constipation were the usage of laxatives, daily fluid-intake and early mobilisation.Results: Totally, 26.1 % of the patients became constipated, and laxatives were prescribed to 65.2 % of the patients. Doctors prescribed 53.3 % of the laxatives, nurses 33.3 % and for the remaining 13.3 % it was uncertain who had written the prescription. Usage of laxatives seemed to cause constipation (p=0,025), whereas there was no correlation between constipation and early mobilization.

ABSTRACTBackground: Most cases of lumbar disc herniation are asymptomatic. When symptomatic, LDH may cause a significant physical and mental distress. Initially, most patients are treated conservative but sometimes operations may be required.Aim: The aim of this study was to provide a review of the scientific basis of physiotherapy, including behavioural therapy, as a treatment to lumbar disc herniation regarding pain, function and the size of disc herniation in people suffering from lumbar disc herniation.Method: Four databases were used in the searches of literature. Assessment of the validity of the studies was done with the PEDro-scale and valuation of evidence rate was made according to guidelines made by the Swedish Council on Health Technology Assessment (SBU).Result: Nine RCT-studies were included with a total of 713 participants. The scientific basis is moderate to support a pain reduction and limited regarding improvement of physical function when it comes to physical exercises, including MDT.

Bakgrund: Att förebygga, bedöma och behandla smärta är centralt i anestesisjuksköterskans arbete. Barns upplevelser och uttryckssätt vid smärta skiljer sig mycket från vuxnas. Det är därför en stor utmaning för anestesisjuksköterskor att tolka barns uttryck och känslor för att förstå barnet och kunna erbjuda trygghet och smärtlindring. Forskning har visat att barns postoperativa smärta underbehandlas, trots att kunskaperna om barns smärta ökat. Genom att belysa anestesisjuksköterskans upplevelser kan förståelsen för vad som bidrar till en god respektive mindre god postoperativ smärtlindring av barn öka.Syfte: Syftet med denna studie var att beskriva anestesisjuksköterskors erfarenheter i samband med postoperativ smärtlindring av barn.Metod: Semistrukturerade intervjuer genomfördes med åtta anestesisjuksköterskor från ett svenskt länssjukhus i mellersta Norrland.  Insamlad data analyserades med manifest innehållsanalys.Resultat: Utifrån analysen framkom tre kategorier och sju subkategorier.

Bakgrund: Smärta är för intensivvårdspatienten en unik, subjektiv, obehaglig och flerdimensionell upplevelse. Intensivvårdssjuksköterskan har ett moraliskt ansvar att lindra patienternas smärta. Verbalt icke-kommunicerandepatienter kan inte skatta sin smärta med hjälp av Numeric Rating Scale (NRS). På en neurointensivvårdsavdelning (NIVA) i Stockholm har det beteendebaserade smärtskattningsverktyget- the Critical-Care Pain Observation Tool (CPOT), implementerats. Intensivvårdssjuksköterskorna på NIVA använder CPOT dagligen i sitt arbete.

Background: Low back pain (LBP) is a common disorder in the western world. A majority of those afflicted by a first acute episode is at high risk of developing sub-acute or persistent symptoms. Persistent LBP can be caused by pathological changes in the discs and disturbed neuromuscular activation, which can cause hypotrophy of the extensors strong type-2 muscle fibres. Deadlift (DL) is an exercise that may correct all these pathological transformations. Aim: To investigate the effect of DL-training on patients with persistent LBP.