1
|
de Andrade ÉV, Oliveira LM, Dos Santos Felix MM, Raponi MBG, de Faria MF, Calegari IB, da Silva KFN, Barbosa MH. Nonpharmacologic Therapies for Postoperative Pain in Cardiac Surgery: A Systematic Review. Pain Manag Nurs 2024; 25:e59-e75. [PMID: 38336527 DOI: 10.1016/j.pmn.2023.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 11/30/2023] [Accepted: 12/20/2023] [Indexed: 02/12/2024]
Abstract
OBJECTIVES To search for studies that address the efficacy of nonpharmacologic methods for pain relief in adults undergoing cardiac surgeries. DESIGN A systematic review registered in the International Prospective Register of Systematic Reviews (PROSPERO) under number CRD42020168681. DATA SOURCE PubMed, LILACS, CINAHL, the Web of Science, Scopus, and the Cochrane Central Register of Controlled Trials. REVIEW/ANALYSIS METHODS The review used a PRISMA guideline that selected primary randomized controlled trials on the efficacy of nonpharmacologic pain relief therapies in patients undergoing cardiac surgery, with no time or language restrictions. The Joanna Briggs Institute Critical Appraisal Checklist for Randomized Clinical Trials was used to assess methodological rigor. RESULTS After screening, 23 of the 140 studies found in the databases were selected. The studies examined the efficacy of 13 different nonpharmacologic therapies, as well as a combination of therapies, with massage therapy being the most commonly examined, followed by musical intervention and hypnosis. CONCLUSIONS Some interventions, when combined with pharmacologic therapy, were effective in relieving postoperative pain after cardiac surgeries, according to the studies analyzed. However, most studies had significant methodological flaws, and further studies with high methodological quality are needed.
Collapse
Affiliation(s)
- Érica Vieira de Andrade
- Stricto sensu Graduate Program Health Care, Federal University of Triângulo Mineiro. Av. Getúlio Guaritá, Uberaba, Minas Gerais, Brazil
| | - Letícia Modesto Oliveira
- Undergraduate Program in Nursing, Federal University of Triângulo Mineiro, Praça Manoel Terra, Uberaba, Minas Gerais, Brazil
| | - Márcia Marques Dos Santos Felix
- Stricto sensu Graduate Program Health Care, Federal University of Triângulo Mineiro. Av. Getúlio Guaritá, Uberaba, Minas Gerais, Brazil
| | | | - Maíla Fidalgo de Faria
- Stricto sensu Graduate Program Health Care, Federal University of Triângulo Mineiro. Av. Getúlio Guaritá, Uberaba, Minas Gerais, Brazil
| | - Isadora Braga Calegari
- Stricto sensu Graduate Program Health Care, Federal University of Triângulo Mineiro. Av. Getúlio Guaritá, Uberaba, Minas Gerais, Brazil
| | - Karla Fabiana Nunes da Silva
- Professional Education Center, Federal University of Triângulo Mineiro. Av. Getúlio Guaritá, Minas Gerais, Brazil
| | - Maria Helena Barbosa
- Teaching and Scientific Department of Nursing in Hospital Care, Institute of Health Sciences, Federal University of Triângulo Mineiro. Av. Getúlio Guaritá, Minas Gerais, Brazil.
| |
Collapse
|
2
|
Mutlu S, Yılmaz E, Şahin ST. The effect of position change and abdominal massage on anxiety, pain and distension after colonoscopy: A randomized clinical trial. Explore (NY) 2024; 20:89-94. [PMID: 37391282 DOI: 10.1016/j.explore.2023.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 06/15/2023] [Accepted: 06/19/2023] [Indexed: 07/02/2023]
Abstract
CONTEXT Pain, abdominal distention, and anxiety are major risk factors encountered after colonoscopy. Complementary and alternative treatments, such as abdominal massage and position change, are used to reduce the associated risk factors. OBJECTIVE To determine the effect of position change and abdominal massage on anxiety, pain, and distension after colonoscopy. DESIGN A randomized three-group experimental trial. SETTING AND PARTICIPANTS This study was conducted with 123 patients who underwent colonoscopy at the endoscopy unit of a hospital located in western Turkey. METHODS Three groups were formed: two interventional (abdominal massage and position change) and one control, each including 41 patients. Data were gathered using a personal information form, pre- and post-colonoscopy measurement form, the Visual Analog Scale (VAS), and the Spielberger State-Trait Anxiety Inventory. Pain and comfort levels, abdominal circumference values, and vital signs of the patients were measured at four evaluation times. RESULTS In the abdominal massage group, the VAS pain scores and abdominal circumference measurements decreased the most and the VAS comfort scores increased the most 15 min after the patients were taken to the recovery room (p<0.05). Furthermore, bowel sounds were heard, and bloating was relieved in all patients in both intervention groups 15 min after they were taken to the recovery room. CONCLUSIONS Abdominal massage and position change can be considered effective interventions for relieving bloating and facilitating flatulence after colonoscopy. Moreover, abdominal massage can be a powerful method for reducing pain and abdominal circumference and increasing patient comfort.
Collapse
Affiliation(s)
- Senan Mutlu
- Faculty of Health Science, Department of Surgical Nursing, Manisa Celal Bayar University, Manisa, Turkey; Faculty of Health Science, Department of Surgical Nursing, Manisa Celal Bayar University, Uncubozköy Sağlık Yerleşkesi (İİBF Eski Binası) Yunusemre, Manisa 45030, Turkey
| | - Emel Yılmaz
- Faculty of Health Science, Department of Surgical Nursing, Manisa Celal Bayar University, Manisa, Turkey.
| | - Semra Tutcu Şahin
- Faculty of Medical School, Department of General Surgery, Manisa Celal Bayar University, Manisa, Turkey; Faculty of Medical School, Department of General Surgery, Manisa Celal Bayar University, Uncubozköy Mah., Mimar Sinan Bulvarı No:189Yunusemre, Manisa 45030, Turkey
| |
Collapse
|
3
|
Eid Aburuz M, Al-Dweik G, Ahmed FR. The Effect of Listening to Holy Quran Recital on Pain and Length of Stay Post-CABG: A Randomized Control Trial. Crit Care Res Pract 2023; 2023:9430510. [PMID: 37965250 PMCID: PMC10643035 DOI: 10.1155/2023/9430510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 08/02/2023] [Accepted: 10/21/2023] [Indexed: 11/16/2023] Open
Abstract
Background Nearly, 75% of patients post-CABG complain of moderate to severe pain during their hospital stay. Nonpharmacological interventions have been investigated; however, the effect of Holy Quran recital post-CABG is still not well studied, especially in developing Islamic countries. Objective To investigate the effect of listening to the Holy Quran recital on pain and length of stay post-CABG. Methods This was a randomized control trial on 132 patients recruited from four hospitals in Amman, Jordan. The intervention group listened to the Holy Quran recited for 10 minutes twice daily while the control group received the usual care. Data were analyzed using paired and independent samples t-tests. Results Paired t-test testing showed that there was a significant reduction in the pain level, (M [SD], 6.82 [2.27] vs. 4.65 [2.18], t = 23.65, p < 0.001) for the intervention group. In addition, the intervention group had shorter LoS in the ICU and in the hospital compared to the control group, (M [SD], 5.0 [4.02] vs. 6.58 [4.18], t = -2.1, p < 0.05), (M [SD], 10.15 [9.21] vs. 15.01 [13.14], t = -2.6, p < 0.05), respectively. Conclusions Listening to the Quran was significantly effective in improving pain intensity among post-CABG patients and shortening their hospital/ICU stay. This trial is registered with NCT05419554.
Collapse
Affiliation(s)
- Mohannad Eid Aburuz
- Clinical Nursing Department, Faculty of Nursing, Applied Science Private University, Amman, Jordan
| | - Ghadeer Al-Dweik
- Nursing Administration, Faculty of Nursing, Applied Science Private University, Amman, Jordan
| | - Fatma Refaat Ahmed
- Department of Nursing, College of Health Sciences, University of Sharjah, Sharjah, UAE
- Critical Care and Emergency Nursing, Alexandria University, Alexandria, Egypt
| |
Collapse
|
4
|
Srifuengfung M, Abraham J, Avidan MS, Lenze EJ. Perioperative Anxiety and Depression in Older Adults: Epidemiology and Treatment. Am J Geriatr Psychiatry 2023; 31:996-1008. [PMID: 37482501 PMCID: PMC10592367 DOI: 10.1016/j.jagp.2023.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 06/20/2023] [Accepted: 07/03/2023] [Indexed: 07/25/2023]
Abstract
The intervals before and after major surgery is a high-risk period for older adults; in this setting, anxiety and depression are common and serious problems. We comprehensively reviewed current evidence on perioperative anxiety and depression in older adults, focusing on epidemiology, impact, correlates, medication risks, and treatment. Principles of perioperative mental healthcare are proposed based on the findings. Prevalence estimates of clinically significant anxiety and depression range from 5% to 45% for anxiety and 6% to 52% for depression, depending on surgical populations and measurement tools. Anxiety and depression may increase risk for surgical complications and reduce patient participation during rehabilitation. Medical comorbidities, pain, insomnia, cognitive impairment, and delirium are common co-occurring problems. Concomitant uses of central nervous system acting medications (benzodiazepines, anticholinergics, and opioids) amplify the risks of delirium and falls. Based on these findings, we propose that anxiety and depression care should be part of perioperative management in older adults; components include education, psychological support, opioid-sparing pain management, sleep management, deprescribing central nervous system active medications, and continuation and optimization of existing antidepressants. More research is needed to test and improve these care strategies.
Collapse
Affiliation(s)
- Maytinee Srifuengfung
- Department of Psychiatry (MS, EJL), Washington University School of Medicine, St. Louis, MO; Department of Psychiatry (MS), Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
| | - Joanna Abraham
- Department of Anesthesiology (JA, MSA), Washington University School of Medicine, St. Louis, MO; Institute for Informatics (JA), Washington University School of Medicine, St. Louis, MO
| | - Michael S Avidan
- Department of Anesthesiology (JA, MSA), Washington University School of Medicine, St. Louis, MO
| | - Eric J Lenze
- Department of Psychiatry (MS, EJL), Washington University School of Medicine, St. Louis, MO
| |
Collapse
|
5
|
Maeßen T, Korir N, Van de Velde M, Kennes J, Pogatzki-Zahn E, Joshi GP. Pain management after cardiac surgery via median sternotomy: A systematic review with procedure-specific postoperative pain management (PROSPECT) recommendations. Eur J Anaesthesiol 2023; 40:758-768. [PMID: 37501517 DOI: 10.1097/eja.0000000000001881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
Abstract
BACKGROUND Pain after cardiac surgery via median sternotomy can be difficult to treat, and if inadequately managed can lead to respiratory complications, prolonged hospital stays and chronic pain. OBJECTIVES To evaluate available literature and develop recommendations for optimal pain management after cardiac surgery via median sternotomy. DESIGN A systematic review using PROcedure-SPECific Pain Management (PROSPECT) methodology. ELIGIBILITY CRITERIA Randomised controlled trials and systematic reviews published in the English language until November 2020 assessing postoperative pain after cardiac surgery via median sternotomy using analgesic, anaesthetic or surgical interventions. DATA SOURCES PubMed, Embase and Cochrane Databases. RESULTS Of 319 eligible studies, 209 randomised controlled trials and three systematic reviews were included in the final analysis. Pre-operative, intra-operative and postoperative interventions that reduced postoperative pain included paracetamol, non-steroidal anti-inflammatory drugs (NSAIDs), intravenous magnesium, intravenous dexmedetomidine and parasternal block/infiltration. CONCLUSIONS The analgesic regimen for cardiac surgery via sternotomy should include paracetamol and NSAIDs, unless contraindicated, administered intra-operatively and continued postoperatively. Intra-operative magnesium and dexmedetomidine infusions may be considered as adjuncts particularly when basic analgesics are not administered. It is not clear if combining dexmedetomidine and magnesium would provide superior pain relief compared with either drug alone. Parasternal block/surgical site infiltration is also recommended. However, no basic analgesics were used in the studies assessing these interventions. Opioids should be reserved for rescue analgesia. Other interventions, including cyclo-oxygenase-2 specific inhibitors, are not recommended because there was insufficient, inconsistent or no evidence to support their use and/or due to safety concerns.
Collapse
Affiliation(s)
- Timo Maeßen
- From the Department of Anaesthesiology, Intensive Care, and Pain Medicine, University Hospital Münster, Münster, Germany (TM, EP-Z), the Department of Cardiovascular Sciences, Section Anaesthesiology, KU Leuven and University Hospital Leuven, Leuven, Belgium (NK, MVdeV, JK), the Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Centre, Dallas, Texas, USA (GPJ)
| | | | | | | | | | | |
Collapse
|
6
|
Mottahedi M, Shamsi M, Babani SF, Goli S, Rizevandi P. Comparing the effect of transcutaneous electrical nerve stimulation and massage therapy on post laparoscopic shoulder pain: a randomized clinical trial. BMC Musculoskelet Disord 2023; 24:764. [PMID: 37759246 PMCID: PMC10537143 DOI: 10.1186/s12891-023-06905-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 09/22/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Shoulder pain is a common clinical problem after laparoscopic surgeries. The use of non-pharmacological massage and transcutaneous electrical nerve stimulation (TENS) as an adjunct to routine treatment is increasing to provide optimal pain relief. Therefore, we aimed to determine the effect of TENS and massage therapy on post laparoscopic shoulder pain (PLSP). METHODS This study was conducted on 138 patients who underwent laparoscopic cholecystectomy. Patients were randomly divided into three groups: massage plus conventional pharmacological treatment (n = 46), TENS plus conventional pharmacological treatment (n = 46), and conventional pharmacological treatment (n = 46). Massage and TENS were performed three consecutive times after the patients regained consciousness in the inpatient wards. The intensity of Shoulder pain was evaluated using a visual analog scale before and 20 min after each treatment. RESULTS Both massage therapy and TENS led to a significant reduction in the intensity of PLPS compared to the control group in all three measured times (p < 0.001). However, no significant difference was observed between TENS and massage at any of the three-time points. CONCLUSIONS This study's findings demonstrated that massage and TENS techniques could reduce PLSP. TRIAL REGISTRATION Registered in the Iranian registry of clinical trials ( www.irct.ir ) in 05/02/2022 with the following code: IRCT20200206046395N1.
Collapse
Affiliation(s)
- Mobin Mottahedi
- Department of Operating Room, School of Paramedical, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - MohammadBagher Shamsi
- Department of Physiotherapy, School of Rehabilitation Sciences, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Samira Fatahi Babani
- Department of Operating Room, School of Paramedical, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shahrbanoo Goli
- Department of Epidemiology, School of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Parisa Rizevandi
- Department of Operating Room, School of Paramedical Sciences, Kermanshah University of Medical Sciences, Kermanshah, Iran
| |
Collapse
|
7
|
Göktuna G, Dağcan N, Arslan GG. The Effect of Hand Reflexology Massage on Pain and Anxiety After Coronary Artery Bypass Graft Surgery: A Double-Blind, Randomized, Placebo-Controlled Trial. J Cardiovasc Nurs 2023:00005082-990000000-00111. [PMID: 37548394 DOI: 10.1097/jcn.0000000000001033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Abstract
BACKGROUND Pain and anxiety are common postoperative problems that impair recovery and quality of life in patients undergoing coronary artery bypass graft (CABG) surgery. Reflexology is a nonpharmacologic method used to control pain and anxiety. OBJECTIVE The aim of this study was to examine the effects of reflexology hand massage and stroking massage on pain and anxiety in patients in the immediate postoperative period after CABG. METHODS In this double-blind, randomized, placebo-controlled study, we compared the effects of a 20-minute hand-reflexology massage to placebo stroking massage on pain and anxiety in newly extubated patients in the intensive care unit who had undergone CABG surgery. Pain was measured by visual analog scale and anxiety by the State-Trait Anxiety Inventory before and at 5, 30, and 60 minutes post intervention. RESULTS A total of 48 patients were enrolled: 24 in the intervention group and 24 in the placebo. Mean pain scores were significantly reduced in the group who received reflexology compared with the placebo group (F = 36.569, P = .000). Mean anxiety scores were significantly reduced at 60 minutes for the reflexology group compared with the control group (P = .000). CONCLUSIONS We found that hand reflexology massage was effective in reducing pain and anxiety in patients during the immediate postoperative period after CABG.
Collapse
|
8
|
SevgiÜnal Aslan K, Çetinkaya F. The effects of Reiki and hand massage on pain and fatigue in patients with rheumatoid arthritis. Explore (NY) 2023; 19:251-255. [PMID: 35752581 DOI: 10.1016/j.explore.2022.06.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 06/02/2022] [Accepted: 06/09/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The present study was conducted in order to determine the effects of Reiki and hand massage on the pain and fatigue of patients with rheumatoid arthritis. METHODS This study having a randomized controlled experimental design was carried out involving 105 individuals (35 in Reiki, 37 in hand massage, and 33 in control). Study data were collected between July 2020 and December 2021 by using a personal information form, Visual Analog Scale, and Piper Fatigue Scale. RESULTS The mean pain score and the fatigue severity of patients decreased after Reiki and hand massage interventions and the difference was found to be statistically significant (p < 0.05). Reiki and hand massage reduced the pain and fatigue levels of patients having rheumatoid arthritis. CONCLUSION It is recommended to use Reiki and hand massage in managing the symptoms and providing patients with care.
Collapse
Affiliation(s)
- Kevser SevgiÜnal Aslan
- Osmaniye Korkut Ata University, Faculty of Health Sciences, Fundamentals of Nursing Department, Osmaniye, Turkey.
| | - Funda Çetinkaya
- Aksaray University, Faculty of Health Sciences, Department of Surgical Nursing, Aksaray, Turkey.
| |
Collapse
|
9
|
Liu C, Chen X, Wu S. The effect of massage therapy on pain after surgery: A comprehensive meta-analysis. Complement Ther Med 2022; 71:102892. [PMID: 36309174 DOI: 10.1016/j.ctim.2022.102892] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 08/30/2022] [Accepted: 10/17/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Findings on the usefulness of massage therapy (MT) in postoperative pain management are often inconsistent among studies. OBJECTIVES This study's aim is to conduct a meta-analysis of randomized controlled trials (RCT) to clarify the effects of massage therapy in the treatment of postoperative pain. METHODS Three databases (PubMed, Embase, and Cochrane Central Register of Controlled Trials) were searched for RCTs published from database inception through January 26, 2021. The primary outcome was pain relief. The quality of RCTs was appraised with the Cochrane Collaboration risk of bias tool. The random-effect model was used to calculate the effect sizes and standardized mean difference (SMD) with 95 % confidential intervals (CIs) as a summary effect. The heterogeneity test was conducted through I2. Subgroup and sensitivity analyses were used to explore the source of heterogeneity. Possible publication bias was assessed using visual inspection of funnel plot asymmetry. RESULTS The analysis included 33 RCTs and showed that MT is effective in reducing postoperative pain (SMD, -1.32; 95 % CI, -2.01 to -0.63; p = 0.0002; I2 = 98.67 %). A similar significant effect was found for both short (immediate assessment) and long terms (assessment performed 4-6 weeks after the MT). Remarkably, we found neither the duration per session nor the dose had an impact on the effect of MT and there seemed to be no difference in the effects of different MT types. In addition, MT seemed to be more effective for adults. Furthermore, MT had better analgesic effects on cesarean section and heart surgery than orthopedic surgery. LIMITATIONS Publication bias is possible due to the inclusion of studies in English only. Additionally, the included studies were extremely heterogeneous. Double-blind research on MT is difficult to implement, and none of the included studies is double-blind. There was some heterogeneity and publication bias in the included studies. In addition, there is no uniform evaluation standard for the operation level of massage practitioners, which may lead to research implementation bias. CONCLUSIONS MT is effective in reducing postoperative pain in both short and long terms.
Collapse
Affiliation(s)
- Chunhua Liu
- Department of Cancer Rehabilitation, Lishui Hospital of Traditional Chinese Medicine, Affiliated to Zhejiang University of Traditional Chinese Medicine, Lishui, Zhejiang, China.
| | - Xiang Chen
- The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
| | - Simin Wu
- Department of Cancer Rehabilitation, Lishui Hospital of Traditional Chinese Medicine, Affiliated to Zhejiang University of Traditional Chinese Medicine, Lishui, Zhejiang, China.
| |
Collapse
|
10
|
Liu M, Ni R, Huang S, Yang X, Lin Q, Lin P, Yang J. Efficacy of non-pharmacological interventions in pain relief and opioid consumption after cardiac surgery: A systematic review and Bayesian network meta-analysis. J Clin Nurs 2022. [PMID: 35949177 DOI: 10.1111/jocn.16482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 07/21/2022] [Accepted: 07/25/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To investigate and rank the evidence for the efficacy of non-pharmacological interventions in relieving pain after cardiac surgery using comprehensive comparisons. BACKGROUND Although several previous systematic reviews and meta-analyses showed that non-pharmacological interventions effectively control and reduce pain after cardiac surgery, none quantitatively compared the effect of these different types of interventions. DESIGN Systematic review and Bayesian network meta-analysis based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Network Meta-Analysis guidelines. METHODS Six databases were searched from inception to April 2021 to collect all published evidence from randomised clinical trials. One author extracted the relevant information from the eligible trials; a second author independently reviewed the data. Before analysing the extracted data, two investigators independently assessed the quality of the included studies. Conventional meta-analysis was conducted using either fixed- or random-effects models according to statistical heterogeneity. The Bayesian network meta-analysis was conducted using the consistency model. RESULTS We identified 42 randomised clinical trials comparing 14 groups with 4253 patients. Transcutaneous electrical nerve stimulation, acupressure, music and massage were effective for pain relief, with transcutaneous electrical nerve stimulation being associated with the best probability of successful pain relief after cardiac surgery (cumulative ranking curve surface, 0.97; probability, 77.03%). Acupressure (cumulative ranking curve surface, 0.79; probability, 30.69%) was the second-best option. However, there was no evidence that any pair-up intervention significantly reduced opioid use or anxiety. CONCLUSIONS These findings suggest that transcutaneous electrical nerve stimulation, acupressure, music and massage may effectively alleviate postoperative cardiac pain, with transcutaneous electrical nerve stimulation representing the best choice for pain relief. RELEVANCE TO CLINICAL PRACTICE The results of this network meta-analysis can guide patients after cardiac surgery and healthcare providers to make optimal decisions in managing postoperative cardiac pain. TRIAL REGISTRATION PROSPERO CRD42021246183.
Collapse
Affiliation(s)
- Maobai Liu
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, China.,College of Pharmacy, Fujian Medical University, Fuzhou, China
| | - Ruping Ni
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, China.,College of Pharmacy, Fujian Medical University, Fuzhou, China
| | - Shunmin Huang
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, China.,College of Pharmacy, Fujian Medical University, Fuzhou, China
| | - Xin Yang
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, China.,College of Pharmacy, Fujian Medical University, Fuzhou, China
| | - Qinghua Lin
- Department of Nursing, Fujian Medical University Union Hospital, Fuzhou, China
| | - Pengtao Lin
- Department of Anesthesiology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Jing Yang
- Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, China.,College of Pharmacy, Fujian Medical University, Fuzhou, China
| |
Collapse
|
11
|
Richard-Lalonde M, Feeley N, Cossette S, Chlan LL, Gélinas C. Acceptability and Feasibility of a Patient-Oriented Music Intervention to Reduce Pain in the Intensive Care: Protocol for a Randomized Crossover Pilot Trial (Preprint). JMIR Res Protoc 2022; 12:e40760. [PMID: 37163350 DOI: 10.2196/40760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 02/20/2023] [Accepted: 03/09/2023] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND Many patients experience pain in the intensive care unit (ICU) despite receiving pain medication. Research has shown that music can help reduce pain. Music interventions studied so far have not used music streaming to generate playlists based on patient preferences while incorporating recommended tempo and duration. Previous research has focused on postoperative ICU patients able to self-report, which is underrepresentative of the ICU population that might benefit from a music intervention for pain management. We developed a new patient-oriented music intervention (POMI) that incorporates features based on theoretical, empirical, and experiential data intended to be used in the ICU. Such a music intervention should consider the expertise of ICU patients, family members, and nursing staff, as well as the practicality of the intervention when used in practice. OBJECTIVE The primary objectives of this study are to (1) evaluate the acceptability and feasibility of the POMI to reduce pain in ICU patients and (2) evaluate the feasibility of conducting a crossover pilot randomized controlled trial (RCT) for intervention testing in the ICU. A secondary objective is to examine the preliminary efficacy of the POMI to reduce pain in ICU patients. METHODS A single-blind 2×2 crossover pilot RCT will be conducted. Patients will undergo 1 sequence of 2 interventions: the POMI which delivers music based on patients' preferences via headphones or music pillow for 20-30 minutes and the control intervention (headphones or pillow without music). The sequence of the interventions will be inverted with a 4-hour washout period. Timing of the interventions will be before a planned bed turning procedure. Each patient will undergo 1 session of music. Twenty-four patients will be recruited. Patients able to self-report (n=12), family members of patients unable to self-report (n=12), and nursing staff (n=12) involved in the bed turning procedure will be invited to complete a short questionnaire on the POMI acceptability. Data will be collected on the feasibility of the intervention delivery (ie, time spent creating a playlist, any issue related to headphones/pillow or music delivery, environmental noises, and intervention interruptions) and research methods (ie, number of patients screened, recruited, randomized, and included in the analysis). Pain scores will be obtained before and after intervention delivery. RESULTS Recruitment and data collection began in March 2022. As of July 5, 2022, in total, 22 patients, 12 family members, and 11 nurses were recruited. CONCLUSIONS Methodological limitations and strengths are discussed. Study limitations include the lack of blinding for patients able to self-report. Strengths include collecting data from various sources, getting a comprehensive evaluation of the intervention, and using a crossover pilot RCT design, where participants act as their own control, thus reducing confounding factors. TRIAL REGISTRATION ClinicalTrials.gov NCT05320224; https://clinicaltrials.gov/ct2/show/NCT05320224. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/40760.
Collapse
|
12
|
van der Heijden MJE, O’Flaherty L, van Rosmalen J, de Vos S, McCulloch M, van Dijk M. Aromatherapy massage seems effective in critically ill children: an observational before‐after study. PAEDIATRIC AND NEONATAL PAIN 2022; 4:61-68. [PMID: 35719220 PMCID: PMC9189908 DOI: 10.1002/pne2.12073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 01/11/2022] [Accepted: 01/24/2022] [Indexed: 11/29/2022]
Abstract
Children treated in a pediatric intensive care unit (PICU) are at risk of distress and pain. This study investigated if aromatherapy massage can reduce children's distress and improve comfort. This observational before‐after study was performed in a 22‐bed PICU in Cape Town, South Africa. The aromatherapy massage consisted of soft massaging using the “M‐technique” and a 1% blend of essential oils of Lavender (Lavandula angustifolia), German Chamomile (Matricatia recutita) and Neroli (Citrus aurantium) mixed with a grapeseed carrier oil. All present children were eligible, except those who had recently returned, were asleep or deemed unstable. The primary outcome was distress measured with the COMFORT‐Behavior scale (COMFORT‐B). Secondary outcomes were heart rate, oxygen saturation (SatO2), the Numeric Rating Scale (NRS)‐Anxiety and pain assessed by the NRS‐Pain scale. Outcomes variables were evaluated with Wilcoxon signed‐rank test and multiple regression analysis. The intervention was applied to 111 children, fifty‐one of whom (45.9%) were younger than three years old. The group median COMFORT‐B score before intervention was 15 (IQR 12–19), versus 10 (IQR 6–14) after intervention. Heart rate and NRS‐Anxiety were significantly lower after the intervention (P < 0.001). Multiple regression analysis showed that interrupted massages were less effective than the uninterrupted massages. Parental presence did not influence the outcome variables. We did not find a significant change on the NRS‐Pain scale or for SatO2. Aromatherapy massage appears beneficial in reducing distress, as measured by the COMFORT‐B scale, heart rate and the NRS‐Anxiety scale, in critically ill children. Thus, the potential of aromatherapy in clinical practice deserves further consideration.
Collapse
Affiliation(s)
- Marianne J. E. van der Heijden
- Department of Internal Medicine and Department of Paediatric Surgery Erasmus MC Sophia Children’s Hospital Rotterdam the Netherlands
| | - Linda‐Anne O’Flaherty
- Division of Pain Management Red Cross War Memorial Children’s Hospital Cape Town South Africa
| | | | - Simone de Vos
- Department of Paediatric Surgery Erasmus MC‐Sophia Children’s Hospital Rotterdam the Netherlands
| | - Mignon McCulloch
- Division of Paediatric Nephrology Red Cross War Memorial Children’s Hospital Cape Town South Africa
| | - Monique van Dijk
- Department of Internal Medicine and Department of Paediatric Surgery Erasmus MC Sophia Children’s Hospital Rotterdam the Netherlands
- Department of Paediatric Surgery Red Cross Children’s Hospital Cape Town South Africa
| |
Collapse
|
13
|
Wang R, Huang X, Wang Y, Akbari M. Non-pharmacologic Approaches in Preoperative Anxiety, a Comprehensive Review. Front Public Health 2022; 10:854673. [PMID: 35480569 PMCID: PMC9035831 DOI: 10.3389/fpubh.2022.854673] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 03/14/2022] [Indexed: 02/03/2023] Open
Abstract
During the pre-operation period, surgical candidates experience situations that stimulate psychological anxiety leading to stress during and after surgery which is known as preoperative anxiety. This condition can cause psychological and physiological adverse effects on both children and adults. Due to the high prevalence and adverse effects of preoperative anxiety, different treatments have been evaluated including pharmacological and non-pharmacological approaches. As pharmacological treatments may cause adverse effects such as breathing problems, drowsiness, interfering with anesthetic drugs, and prolonged recovery, non-pharmacological interventions are becoming more popular. These methods include cognitive-behavioral therapy, music therapy, pre-op preparation video, aromatherapy, hypnosis, guided imagery relaxation therapy, and massage. In this study, the most popular non-pharmacological approaches to preoperative anxiety are reviewed focusing on more recent evidence provided by clinical studies. The reviewed clinical evidence on the mentioned methods shows the efficacy of non-pharmacological interventions for the treatment of preoperative anxiety, so they can be used in patients of different ages and types of disease and surgery.
Collapse
Affiliation(s)
- Rulin Wang
- Medical College, Xijing University, Xi'an, China
| | - Xin Huang
- Department of Psychiatry, Wuhan Fourth Hospital, Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yuan Wang
- Department of Psychiatry, Wuhan Fourth Hospital, Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Yuan Wang
| | - Masod Akbari
- Research Center for Psychiatric Diseases, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
14
|
Leutualy V, Madiuw D, Tasijawa FA, Sumah DF, Manuhutu F, Maelissa S. Non-pharmacology Interventions on Pain in Critically Ill Patient: A Scoping Review. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.7985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
treatment process. The cause of pain in critically ill patients is caused by the accompanying disease process or the treatment procedures carried out. Pharmacological therapies such as analgesics and opioids are often given to critically ill patients but cannot progressively manage pain. Another impact arising from pharmacological treatment is the side effects that can affect the care and healing of critically ill patients. This Scoping Review provides evidence on non-pharmacological interventions that can be used to prevent and reduce pain intensity in critically ill patients admitted to the ICU. This scoping review aims to identify non-pharmacological therapies that can be used as alternative or adjunct therapies to help manage pain in critically ill patients. Three electronic databases were used to conduct article searches: Science Direct, Pubmed, and CINAHL Ebsco. The inclusion criteria used were articles with RCT research, peer review articles, English articles, and publication of research articles between 2009 and 2020. The search results obtained 1875 articles and 11 articles that met the inclusion criteria and were analyzed. Found several non-pharmacological interventions to prevent and reduce pain intensity in critically ill patients, including music therapy, massage, reflexology, cold therapy, and topical heat therapy.
Collapse
|
15
|
Nordness MF, Hayhurst CJ, Pandharipande P. Current Perspectives on the Assessment and Management of Pain in the Intensive Care Unit. J Pain Res 2021; 14:1733-1744. [PMID: 34163231 PMCID: PMC8214553 DOI: 10.2147/jpr.s256406] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 04/12/2021] [Indexed: 12/02/2022] Open
Abstract
Critical illness is often painful, both from the underlying source of illness, as well as necessary procedures performed for the monitoring and care of these patients. Pain is often under-recognized in the critically ill, especially among those who cannot self-report, so accurate assessment and management continue to be major consideration in their care. Pain management in the intensive care unit (ICU) is an evolving practice, with a focus on accurate and frequent pain assessment, and targeted pharmacologic and non-pharmacologic treatment methods to maximize analgesia and minimize sedation. In this review, we will evaluate several validated methods of pain assessment in the ICU and present management options. We will review the evidence-based recommendations put forth by the largest critical care societies and several high-quality studies related to both the in-hospital approach to pain, as well as the short- and long-term consequences of untreated pain in ICU patients. We conclude with future directions.
Collapse
Affiliation(s)
- Mina F Nordness
- Department of General Surgery, Section of Surgical Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
- Critical Illness, Brain Dysfunction and Survivorship (CIBS) Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Christina J Hayhurst
- Critical Illness, Brain Dysfunction and Survivorship (CIBS) Center, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Anesthesiology, Division of Anesthesiology Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Pratik Pandharipande
- Department of General Surgery, Section of Surgical Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
- Critical Illness, Brain Dysfunction and Survivorship (CIBS) Center, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Anesthesiology, Division of Anesthesiology Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| |
Collapse
|
16
|
Dusek JA, Rivard RL, Griffin KH, Finch MD. Significant Pain Reduction in Hospitalized Patients Receiving Integrative Medicine Interventions by Clinical Population and Accounting for Pain Medication. J Altern Complement Med 2021; 27:S28-S36. [PMID: 33788611 DOI: 10.1089/acm.2021.0051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Prior research has reported that integrative medicine (IM) therapies reduce pain in inpatients, but without controlling for important variables. Here, the authors extend prior research by assessing pain reduction while accounting for each patient's pain medication status and clinical population. Methods: The initial data set consisted of 7,106 inpatient admissions, aged ≥18 years, between July 16, 2012, and December 15, 2014. Patients' electronic health records were used to obtain data on demographic, clinical measures, and pain medication status during IM. Results: The final data set included first IM therapies delivered during 3,635 admissions. Unadjusted average pre-IM pain was 5.33 (95% confidence interval [CI]: 5.26 to 5.41) and post-IM pain was 3.31 (95% CI: 3.23 to 3.40) on a 0-10 scale. Pain change adjusted for severity of illness, clinical population, sex, treatment, and pain medication status during IM was significant and clinically meaningful with an average reduction of -1.97 points (95% CI: -2.06 to -1.86) following IM. Adjusted average pain was reduced in all clinical populations, with largest and smallest pain reductions in maternity care (-2.34 points [95% CI: -2.56 to -2.14]) and orthopedic (-1.71 points [95% CI: -1.98 to -1.44]) populations. Pain medication status did not have a statistically significant association on pain change. Decreases were observed regardless of whether patients were taking narcotic medications and/or nonsteroidal anti-inflammatory drugs versus no pain medications. Conclusions: For the first time, inpatients receiving IM reported significant and clinically meaningful pain reductions during a first IM session while accounting for pain medications and across clinical populations. Future implementation research should be conducted to optimize identification/referral/delivery of IM therapies within hospitals. Clinical Trials.gov #NCT02190240.
Collapse
Affiliation(s)
- Jeffery A Dusek
- UH Connor Integrative Health Network, University Hospitals, Cleveland, OH, USA.,Department of Family Medicine and Community Health, School of Medicine, Case Western Reserve University, Cleveland, OH, USA
| | - Rachael L Rivard
- UH Connor Integrative Health Network, University Hospitals, Cleveland, OH, USA.,Center for Evaluation and Survey Research, HealthPartners Institute, Minneapolis, MN, USA
| | - Kristen H Griffin
- Children's Minnesota Research Institute, Children's Minnesota, Minneapolis, MN, USA
| | - Michael D Finch
- Children's Minnesota Research Institute, Children's Minnesota, Minneapolis, MN, USA
| |
Collapse
|
17
|
Erzincanli S, Kasar KS. Effect of Hand Massage on Pain, Anxiety, and Vital Signs in Patients Before Venipuncture Procedure: A Randomized Controlled Trial. Pain Manag Nurs 2021; 22:356-360. [PMID: 33472757 DOI: 10.1016/j.pmn.2020.12.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 12/05/2020] [Accepted: 12/08/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND Massage is one of the relaxation techniques commonly used in recent years to control pain, stress, and anxiety. AIMS This study was conducted to evaluate the effect of hand massage application on pain, anxiety, and vital signs before venipuncture procedure. METHODS The sample of the study consisted of 97 individuals (48 experimental and 49 controls) who were admitted to a training and research hospital in Turkey between December 2018 and May 2019. Individuals assigned to the experimental group received hand massage. The data were obtained with an individual information form, a visual analog scale (VAS), and the State-Trait Anxiety Inventory (STAI). RESULTS The mean age of the participants was 49.52 ± 12.48 years. There was no significant difference between the pain levels of the experimental and control groups (p > .05), but the anxiety level of the experimental group was significantly less than that of the control group (p < .05). There was also a significant difference between the experimental and control groups in terms of systolic and diastolic blood pressure and heart rate. The blood pressure and heart rate of the experimental group decreased significantly (p < .05). CONCLUSION Hand massage was found to be a simple, non-pharmacologic, inexpensive, and independent nursing practice that could be used to reduce anxiety and positively affect vital signs in patients before venipuncture procedure.
Collapse
Affiliation(s)
- Saadet Erzincanli
- Department of Nursing, Faculty of Health Sciences, Aksaray University, Aksaray, Turkey.
| | - Kadriye Sayin Kasar
- Department of Nursing, Faculty of Health Sciences, Aksaray University, Aksaray, Turkey
| |
Collapse
|
18
|
Motamedfar A, Nazarinasab M, Ahmadzadeh A, Seyedhoseini M. Comparison of anxiety level in patients under uterine fibroid treatment by myomectomy and uterine artery embolization (UAE) and its relationship with pain and duration of postoperative hospitalization in Ahvaz educational hospitals in 2018. J Family Med Prim Care 2021; 10:4586-4593. [PMID: 35280616 PMCID: PMC8884290 DOI: 10.4103/jfmpc.jfmpc_1213_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 09/20/2021] [Accepted: 10/25/2021] [Indexed: 11/04/2022] Open
Abstract
Introduction: Methods: Results: Conclusion:
Collapse
|
19
|
Guo PP, Fan SL, Li P, Zhang XH, Liu N, Wang J, Chen DD, Sun WJ, Yu L, Yang S, Zhang W. The effectiveness of massage on peri-operative anxiety in adults: A meta-analysis of randomized controlled trials and controlled clinical trials. Complement Ther Clin Pract 2020; 41:101240. [PMID: 32977216 DOI: 10.1016/j.ctcp.2020.101240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 09/05/2020] [Accepted: 09/14/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE and purpose: Massage has gained increasing attention for reducing peri-operative anxiety. We aimed to investigate the effectiveness of massage for peri-operative anxiety in adults. METHODS Six English electronic databases were comprehensively searched from their inception to February 2020. Subgroup analysis, quality assessment, sensitivity analysis, meta-regression and publication bias assessment were performed. RESULTS Twenty-five controlled trials comprising 2494 participants were included. The meta-analysis indicated that massage could significantly reduce peri-operative anxiety for most types of surgical patients. Specifically, it was effective for pre-, intra- and post-operative anxiety. Acupoint or specific body reflex area massage showed a larger effect than general massage did. Massage delivered by professionals and non-professionals were both effective. Massage lasting 10-20 min per session was the most worthy of recommendation. Massage was concomitant with the improvement of peri-operative vital signs and post-operative pain. CONCLUSION Massage is a promising complementary therapy for ameliorating peri-operative anxiety in adults.
Collapse
Affiliation(s)
- Ping-Ping Guo
- Nursing School, Jilin University, Changchun, Jilin province, 130021, China.
| | - Shu-Li Fan
- Department of Obstetrics, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang province, 325006, China.
| | - Ping Li
- Department of Developmental Pediatrics, The Second Hospital of Jilin University, Changchun, Jilin province, 130041, China.
| | - Xue-Hui Zhang
- Nursing School, Jilin University, Changchun, Jilin province, 130021, China.
| | - Na Liu
- Nursing School, Jilin University, Changchun, Jilin province, 130021, China.
| | - Jie Wang
- Nursing School, Jilin University, Changchun, Jilin province, 130021, China.
| | - Dan-Dan Chen
- Nursing School, Jilin University, Changchun, Jilin province, 130021, China.
| | - Wei-Jia Sun
- Nursing School, Jilin University, Changchun, Jilin province, 130021, China.
| | - Lin Yu
- Nursing School, Jilin University, Changchun, Jilin province, 130021, China.
| | - Shu Yang
- Nursing School, Jilin University, Changchun, Jilin province, 130021, China.
| | - Wei Zhang
- Nursing School, Jilin University, Changchun, Jilin province, 130021, China.
| |
Collapse
|
20
|
Li Z, Bauer B, Aaberg M, Pool S, Van Rooy K, Schroeder D, Finney R. Benefits of hand massage on anxiety in preoperative outpatient: A quasi-experimental study with pre- and post-tests. Explore (NY) 2020; 17:410-416. [PMID: 32919894 DOI: 10.1016/j.explore.2020.08.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 08/26/2020] [Accepted: 08/29/2020] [Indexed: 11/19/2022]
Abstract
CONTEXT Surgical patients experience procedure-related anxiety preoperatively. With delays and long waiting periods, surgical patients can experience increased anxiety and decreased satisfaction with their hospital visit. MAIN OBJECTIVES To evaluate whether a 15-minute non-therapeutic hand massage provided by the Caring Hands massage volunteers would reduce anxiety levels, increase satisfaction, and decrease physiological parameters among preoperative surgical patients. DESIGN This research study has a quasi-experimental design, with control and intervention groups, and pre and post-tests. SETTING This research study was conducted at Same Day Surgical Stations 53 and 63 at the Mayo Clinic Hospital, Methodist Campus, in Rochester Minnesota. PATIENTS One hundred and thirty-eight surgical outpatients were recruited preoperatively, with 31 participants in the control group and 107 in the intervention group. INTERVENTIONS Patients in the control group were asked to rest for 15 min. Patients in the intervention group received a 15-minute non-therapeutic hand massage administered by the Caring Hands massage volunteers from the Mayo Clinic Volunteer Program. MAIN OUTCOME MEASURES Patient anxiety level and physiological parameters were measured and recorded before and after a resting session (control group) or a 15-minute non-therapeutic hand massage session (intervention group). Patients in the intervention group were also surveyed for satisfaction. The feasibility of incorporating a 15-minute non-therapeutic hand massage into the preoperative routine was also analyzed. RESULTS After receiving a 15-minute non-therapeutic hand massage, patients experienced reduced anxiety levels and increased satisfaction. It was also found that it is feasible to add a 15-minute non-therapeutic hand massage to the routine of a same-day surgical station.
Collapse
Affiliation(s)
- Zhihong Li
- Mayo Clinic School of Health Sciences, Doctorate of Nurse Anesthesia Practice Program, Seibens 10, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
| | - Brent Bauer
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Marie Aaberg
- Division of Volunteer Program, Mayo Clinic, Rochester, MN, USA
| | - Sarah Pool
- Same Day Surgical Stations 53 and 63, Mayo Clinic, Rochester, MN, USA
| | | | - Darrell Schroeder
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA
| | - Robyn Finney
- Mayo Clinic School of Health Sciences, Doctorate of Nurse Anesthesia Practice Program, Seibens 10, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| |
Collapse
|
21
|
Martorella G. Characteristics of Nonpharmacological Interventions for Pain Management in the ICU: A Scoping Review. AACN Adv Crit Care 2020; 30:388-397. [PMID: 31951665 DOI: 10.4037/aacnacc2019281] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Pain relief in the intensive care unit (ICU) is of particular concern since patients are exposed to multiple painful stimuli associated with care procedures. Considering the adverse effects of pharmacological approaches, particularly in vulnerable populations such as the elderly, the use of non-pharmacological interventions has recently been recommended in the context of critical care. The main goal of this scoping review was to systematically map the research done on non-pharmacological interventions for pain management in ICU adults and describe the characteristics of these interventions. A wide variety of non-pharmacological interventions have been tested, with music and massage therapies being the most frequently used. An interesting new trend is the use of combined or bundle interventions. Lastly, it was observed that these interventions have not been studied in specific subgroups, such as the elderly, women, and patients unable to self-report.
Collapse
Affiliation(s)
- Geraldine Martorella
- Geraldine Martorella is Assistant Professor, College of Nursing, Florida State University, Office 104F - Vivian M. Duxbury Hall, TMH Center for Research and Evidence-Based Practice, 98 Varsity Way, Tallahassee, FL 32306
| |
Collapse
|
22
|
Demir B, Saritas S. Effect of hand massage on pain and anxiety in patients after liver transplantation: A randomised controlled trial. Complement Ther Clin Pract 2020; 39:101152. [DOI: 10.1016/j.ctcp.2020.101152] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 03/12/2020] [Accepted: 03/17/2020] [Indexed: 01/15/2023]
|
23
|
Boitor M, Martorella G, Maheu C, Laizner AM, Gélinas C. Does Hand Massage Have Sustained Effects on Pain Intensity and Pain-Related Interference in the Cardiac Surgery Critically Ill? A Randomized Controlled Trial. Pain Manag Nurs 2019; 20:572-579. [PMID: 31103505 DOI: 10.1016/j.pmn.2019.02.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 01/28/2019] [Accepted: 02/23/2019] [Indexed: 01/10/2023]
Abstract
BACKGROUND Despite the promising short-term pain relief effect of massage, little is known regarding its sustained effects on pain intensity and pain-related interference with functioning. AIMS To evaluate the sustained effect of hand massage on the pain intensity and pain-related interference with functioning of cardiac surgery patients. DESIGN A randomized controlled trial. SETTINGS A medical-surgical intensive care unit in Canada. PARTICIPANTS/SUBJECTS Adult patients undergoing cardiac surgery and at low risk for postoperative complications were eligible. METHODS In the intensive care unit, patients were randomly assigned to either 20-minute hand massage, hand holding, or rest. Pain intensity and pain-related interference with functioning were assessed on the second postoperative day. RESULTS A total of 60 patients were randomly allocated and 46 completed data collection on the second postoperative day. Although no significant differences were identified across groups, the hand massage group reported a maximum pain intensity (median 5.75, range: 2-10) that was lower than the hand-holding (median 6.50, range: 1-10) and standard care groups (median 6.25, range: 0-10). The hand massage group could reach 0 pain intensity throughout a 24-hour period (median 0, range: 0-7), contrary to the hand-holding (median 2, range: 0-5) and standard care groups (median 2, range: 0-4.5). A trend for statistical significance was noted for dichotomized ratings on pain interference with walking (p = .176) and sleep (p = .050). CONCLUSIONS Hand massage could help patients experience longer periods without pain and lower levels of maximum pain intensity. When coupled with recovery activities, hand massage could reduce pain-related interference with functioning.
Collapse
Affiliation(s)
- Madalina Boitor
- Ingram School of Nursing, McGill University, 680 Sherbrooke West, Montréal, Québec, Canada.
| | | | - Christine Maheu
- Ingram School of Nursing, McGill University, 680 Sherbrooke West, Montréal, Québec, Canada
| | - Andréa Maria Laizner
- Ingram School of Nursing, McGill University, 680 Sherbrooke West, Montréal, Québec, Canada
| | - Céline Gélinas
- Ingram School of Nursing, McGill University, 680 Sherbrooke West, Montréal, Québec, Canada
| |
Collapse
|
24
|
Richard-Lalonde M, Boitor M, Mohand-Saïd S, Gélinas C. Family members’ perceptions of pain behaviors and pain management of adult patients unable to self-report in the intensive care unit: A qualitative descriptive study. CANADIAN JOURNAL OF PAIN-REVUE CANADIENNE DE LA DOULEUR 2018; 2:315-323. [PMID: 35005388 PMCID: PMC8730585 DOI: 10.1080/24740527.2018.1544458] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background Current guidelines suggest that family members be consulted in the pain assessment process of patients unable to self-report. However, little is known regarding family members’ perceptions of their loved one’s pain behaviors and pain management. Aims This qualitative descriptive study aimed to describe family members’ perceptions of pain behaviors and pain management in critically ill hospitalized patients admitted to an intensive care unit and unable to self-report. Methods A qualitative descriptive design was used. This study was conducted in a medical–surgical intensive care unit in Canada. Family members of nonverbal adult patients participated in a semistructured interview regarding their perceptions of pain behaviors and pain management in the intensive care unit. Results Ten family members with a nonverbal loved one admitted to the intensive care unit participated. Family members agreed on the presence of pain in the intensive care unit and reported being proactive and applying nonpharmacological interventions to help palliate pain of their loved one. Although family members identified behavioral indicators such as grimace, limb movement, and verbal complaints to assess pain in their loved one, the majority were unsure of their ability to detect pain. Conclusions Family members have intimate knowledge of their loved one and could be invited to share their perceptions of their loved one’s pain when they feel confident to do so.
Collapse
Affiliation(s)
- Melissa Richard-Lalonde
- Ingram School of Nursing, McGill University , Montreal, Quebec, Canada
- Centre for Nursing Research and Lady Davis Institute, Jewish General Hospital , Montreal, Quebec, Canada
| | - Madalina Boitor
- Ingram School of Nursing, McGill University , Montreal, Quebec, Canada
- Centre for Nursing Research and Lady Davis Institute, Jewish General Hospital , Montreal, Quebec, Canada
| | | | - Céline Gélinas
- Ingram School of Nursing, McGill University , Montreal, Quebec, Canada
- Centre for Nursing Research and Lady Davis Institute, Jewish General Hospital , Montreal, Quebec, Canada
| |
Collapse
|