1
|
Li Y, He W, Jiang J, Zhang J, Ding M, Li G, Luo X, Ma Z, Li J, Ma Y, Shen Y, Han X. Non-Pharmacological Interventions in Patients With Heart Failure With Reduced Ejection Fraction: A Systematic Review and Network Meta-analysis. Arch Phys Med Rehabil 2024; 105:963-974. [PMID: 37499852 DOI: 10.1016/j.apmr.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 06/15/2023] [Accepted: 07/05/2023] [Indexed: 07/29/2023]
Abstract
OBJECTIVE To determine the effectiveness of non-pharmacologic interventions and the additional benefits of their combination in patients with heart failure with reduced ejection fraction (HFrEF). DATA SOURCES We searched PubMed, Embase, and the Cochrane Clinical Trials Register from the date of database inception to April 22, 2023. STUDY SELECTION Randomized controlled trials involving non-pharmacologic interventions conducted in patients with HFrEF were included. DATA EXTRACTION Data were extracted by 2 independent reviewers based on a pre-tested data extraction form. The quality of evidence was assessed using the Cochrane Risk of Bias tool and the Grading of Recommendations Assessment, Development, and Evaluation method. DATA SYNTHESIS A total of 82 eligible studies (4574 participants) were included. We performed a random-effects model within a Bayesian framework to calculate weighted mean differences (WMDs) and 95% credibility intervals. High or moderate certainty evidence indicated that high-intensity aerobic interval training (HIAIT) was best on improving 6-minute walk distance (6MWD; 68.55 m [36.41, 100.47]) and left ventricular ejection fraction (6.28% [3.88, 8.77]), while high-intensity aerobic continuous training (HIACT) is best on improving peak oxygen consumption (Peak VO2; 3.48 mL/kg•min [2.84, 4.12]), quality of life (QOL; -17.26 [-29.99, -7.80]), resting heart rate (-8.20 bpm [-13.32, -3.05]), and N-terminal pro-B-type natriuretic peptide (-600.96 pg/mL [-902.93, -404.52]). Moderate certainty evidence supported the effectiveness of inspiratory muscle training to improve peak oxygen consumption and functional electrical stimulation to improve QOL. Moderate-intensity aerobic continuous training (MIACT) plus moderate-intensity resistance training (MIRT) had additional benefits in Peak VO2, 6MWD, and QOL. This review did not provide a comprehensive evaluation of adverse events. CONCLUSIONS Both HIAIT and HIACT are the most effective single non-pharmacologic interventions for HFrEF. MIACT plus MIRT had additional benefits in improving peak oxygen consumption, 6MWD, and QOL.
Collapse
Affiliation(s)
- Yilun Li
- School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Wenbo He
- Institute of Hospital Management, West China Hospital of Sichuan University, Chengdu, Sichuan, China; Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Jingwen Jiang
- School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Jiawen Zhang
- School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Mingfeng Ding
- School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Gaiyun Li
- School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Xiaolei Luo
- School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Ziyuan Ma
- School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Jingyi Li
- School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Yichen Ma
- School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Yanfei Shen
- Office of Legal Affairs, Gansu Provincial Hospital, Lanzhou, Gansu, China
| | - Xuemei Han
- School of Public Health, Lanzhou University, Lanzhou, Gansu, China.
| |
Collapse
|
2
|
Mazzoleni B, Ferrari G, Savioni F, Gravante F, Lopane D, Dacomi A, Coldani C, Tomaiuolo G, Cattani D, Anastasi G, Mancin S. Non-pharmacological strategies to alleviate dysgeusia in patients undergoing chemotherapy: A systematic review. Eur J Oncol Nurs 2024; 70:102569. [PMID: 38593535 DOI: 10.1016/j.ejon.2024.102569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Revised: 03/10/2024] [Accepted: 03/16/2024] [Indexed: 04/11/2024]
Abstract
PURPOSE Dysgeusia is a common side effect in oncology patients, significantly impacting their quality of life. This systematic review aims to evaluate the effectiveness of non-pharmacological strategies in treating dysgeusia in patients undergoing chemotherapy or radiotherapy. METHODS Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a comprehensive literature search across five databases: PubMed, Embase, Cochrane Library, CINAHL, and the British Nursing Database. We used the Joanna Briggs Institute Critical Appraisal Tools to assess the quality of the included studies. A harvest plot was used to synthesise evidence about the differential effects of population-level interventions. RESULTS Nine studies of non-pharmacological strategies to manage dysgeusia were included. These studies encompassed a variety of interventions, including oral applications and supplements, instrumental techniques, and educational programs. The review identified promising interventions such as cryotherapy and Miraculine supplementation, which showed potential in mitigating taste alterations. Instrumental techniques like photobiomodulation therapy and complementary and integrative medicine approaches, including acupuncture and herbs, were also found to be beneficial. Educational and self-management strategies emerged as effective interventions for empowering patients to manage dysgeusia. Despite the diversity of interventions and the limitations of the included studies, such as small sample sizes and geographical differences, these findings underscore the potential of non-pharmacological strategies in managing dysgeusia. CONCLUSION The results support the integration of these strategies into clinical practice, highlighting the importance of multidisciplinary approaches to improve patient care. Further research should prioritize rigorous studies to enhance evidence and explore long-term effects.
Collapse
Affiliation(s)
- Beatrice Mazzoleni
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Giulia Ferrari
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | | | - Francesco Gravante
- Department of Anaesthesiology, Intensive Care Unit, Local Health Autority of Caserta, Caserta, Italy
| | - Diego Lopane
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Alessandra Dacomi
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Chiara Coldani
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Giuseppina Tomaiuolo
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Daniela Cattani
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Giuliano Anastasi
- Department of Trauma, AOU G. Martino University Hospital, Messina, Italy
| | - Stefano Mancin
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy.
| |
Collapse
|
3
|
Ogundele MO, Yemula C. Management of sleep disorders among children and adolescents with neurodevelopmental disorders: A practical guide for clinicians. World J Clin Pediatr 2022; 11:239-252. [PMID: 35663001 PMCID: PMC9134149 DOI: 10.5409/wjcp.v11.i3.239] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 08/09/2021] [Accepted: 03/27/2022] [Indexed: 02/06/2023] Open
Abstract
There is a complex relationship between sleep disorders and childhood neurodevelopmental, emotional, behavioral and intellectual disorders (NDEBID). NDEBID include several conditions such as attention deficit/hyperactivity disorder, autism spectrum disorder, cerebral palsy, epilepsy and learning (intellectual) disorders. Up to 75% of children and young people (CYP) with NDEBID are known to experience different types of insomnia, compared to 3% to 36% in normally developing population. Sleep disorders affect 15% to 19% of adolescents with no disability, in comparison with 26% to 36% among CYP with moderate learning disability (LD) and 44% among those with severe LD. Chronic sleep deprivation is associated with significant risks of behavioural problems, impaired cognitive development and learning abilities, poor memory, mood disorders and school problems. It also increases the risk of other health outcomes, such as obesity and metabolic consequences, significantly impacting on the wellbeing of other family members. This narrative review of the extant literature provides a brief overview of sleep physiology, aetiology, classification and prevalence of sleep disorders among CYP with NDEBIDs. It outlines various strategies for the management, including parenting training/psychoeducation, use of cognitive-behavioral strategies and pharmacotherapy. Practical management including assessment, investigations, care plan formulation and follow-up are outlined in a flow chart.
Collapse
Affiliation(s)
- Michael O Ogundele
- Department of Community Paediatrics, Bridgewater Community Healthcare NHS Foundation Trust, Halton District, Runcorn WA7 1TW, United Kingdom
| | - Chinnaiah Yemula
- Department of Community Paediatrics, Bedfordshire Community Health Services, Cambridgeshire Community Services NHS Trust, St Ives PE27 4LG, United Kingdom
| |
Collapse
|
4
|
Cohen-Mansfield J, Meschiany G. Israeli nursing home staff perspectives on challenges to quality care for residents with dementia. Geriatr Nurs 2022; 44:15-23. [PMID: 34999367 DOI: 10.1016/j.gerinurse.2021.12.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 12/14/2021] [Accepted: 12/15/2021] [Indexed: 11/29/2022]
Abstract
This study examines nursing home employees' perspectives concerning barriers to quality care for people with dementia. Data were derived from observations of care units and interviews with forty-one employees, including chief executive officers, social workers, nurses, occupational therapists, activity workers and nursing assistants at five Israeli nursing homes. Residents' behavior was reported as challenging for staff. Physical restraints and psychotropic medication were commonly used to address behavioral challenges, while few staff acknowledged these practices as problematic. Staff complained that some co-workers were insufficiently caring and wages and overall funding were inadequate, resulting in unsatisfactory staffing levels and insufficient activities for residents. Rigid care routines failed to meet resident needs, and staff failed to notice the relationship between care practices and resident behavior. While problems were described concerning multiple aspects of care, the root causes seemed to include the need for additional funding and for greater expertise in dementia care.
Collapse
Affiliation(s)
- Jiska Cohen-Mansfield
- Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Igor Orenstein Chair for the Study of Geriatrics, Tel Aviv University.; The Herczeg Institute on Aging, Tel Aviv University, Tel Aviv, Israel.; Minerva Center for Interdisciplinary Study of End of Life, Tel Aviv University, Tel Aviv, Israel..
| | - Guy Meschiany
- Minerva Center for Interdisciplinary Study of End of Life, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
5
|
Bai W, Gu Y, Liu H, Zhou L. Epidemiology Features and Effectiveness of Vaccination and Non-Pharmaceutical Interventions of Delta and Lambda SARS-CoV-2 Variants. China CDC Wkly 2021; 3:977-982. [PMID: 34804631 PMCID: PMC8598544 DOI: 10.46234/ccdcw2021.216] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Accepted: 10/04/2021] [Indexed: 12/02/2022] Open
Affiliation(s)
- Wenqing Bai
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yue Gu
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Haoliang Liu
- Nanjing Medical University, Nanjing, Jiangsu, China
| | - Lei Zhou
- Chinese Center for Disease Control and Prevention, Beijing, China
| |
Collapse
|
6
|
Soones T, Ombres R, Escalante C. An update on cancer-related fatigue in older adults: A narrative review. J Geriatr Oncol 2021; 13:125-131. [PMID: 34353750 DOI: 10.1016/j.jgo.2021.07.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 07/17/2021] [Accepted: 07/26/2021] [Indexed: 12/17/2022]
Abstract
Up to 70% of older adults report fatigue after a cancer diagnosis. For many of these patients, cancer-related fatigue (CRF) persists for years after cancer treatment and is associated with significant disability. Despite this, little has been written on the diagnosis and management of CRF in older adults. To address this gap, we performed a narrative review of the literature on CRF in older adults and used literature from the general population when evidence was lacking to provide guidance to clinical providers on how to tailor care to this population. We recommend evidence-based options for evaluating CRF and address their limitations in the assessment of older adults. We also provide guidance and a treatment algorithm on evaluating CRF using the Comprehensive Geriatrics Assessment. Lastly, we present evidence for the use of non-pharmacologic and pharmacologic therapies in the management of CRF in older adults.
Collapse
Affiliation(s)
- Tacara Soones
- Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1465, Houston, TX 77030, USA.
| | - Rachel Ombres
- Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1465, Houston, TX 77030, USA.
| | - Carmen Escalante
- Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1465, Houston, TX 77030, USA.
| |
Collapse
|
7
|
Solberg LM, Campbell CS, Jones K, Vaughn I, Suryadevara U, Fernandez C, Shorr R. Training hospital inpatient nursing to know (THINK) delirium: A nursing educational program. Geriatr Nurs 2020; 42:16-20. [PMID: 33197702 DOI: 10.1016/j.gerinurse.2020.10.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 10/26/2020] [Accepted: 10/28/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND/OBJECTIVES Recognition and documentation of delirium is a challenge in the hospital. Education programs lack standardized screening tools. The presence of dementia or depression contribute to poor recognition of delirium. Many front-line healthcare workers attribute delirium to dementia, often misidentifying or delaying a correct diagnosis and in turn, treatment. Unrecognized and untreated delirium is costly. Non-pharmacologic interventions improve patient outcomes and decrease costs. Without delirium education, nurses are vulnerable to injury and low job satisfaction when caring for delirious patients. We describe an education program improving recognition and attitudes towards patients experiencing delirium. DESIGN An education program about screening, documenting, and treating delirium. SETTING A large Veterans Health System Hospital. PARTICIPANTS Healthcare professionals(n = 389) participated in the education program. 355 Nurses and patient-care assistants took the pre and post-test, and 43 returned the post program follow-up survey. A delirium education program with three steps; 1) self-directed online module; 2) dementia simulation experience; and 3) a multi-station delirium skills fair. Pre and post-tests were conducted after step 2, as well as a four-month follow-up survey. MEASUREMENTS Changes in attitude toward patients with cognitive impairment and their abilities. Self-assessment of attitudes toward patients with delirium. RESULTS Statistically significant differences in pre and post-testing suggested increased understanding of the experience and abilities of people experiencing cognitive impairment . The four-month follow-up survey showed a continued understanding of the importance of recognizing, documenting, and treating delirium. CONCLUSION Nursing Education about delirium that includes instruction on a standardized screening tool, documentation, and non-pharmacologic interventions improved knowledge and recognition of delirium and may have changed attitudes surrounding delirium in the hospital.
Collapse
Affiliation(s)
- Laurence M Solberg
- North Florida/South Georgia Veterans Health System, Malcom Randall VAMC, Geriatrics Research, Education, and Clinical Center (GRECC), Gainesville, FL, United States; University of Florida College of Nursing, FL, United States.
| | - Colleen S Campbell
- North Florida/South Georgia Veterans Health System, Malcom Randall VAMC, Geriatrics Research, Education, and Clinical Center (GRECC), Gainesville, FL, United States
| | - Kimberly Jones
- North Florida/South Georgia Veterans Health System, Malcom Randall VAMC, Geriatrics Research, Education, and Clinical Center (GRECC), Gainesville, FL, United States
| | - Ivana Vaughn
- North Florida/South Georgia Veterans Health System, Malcom Randall VAMC, Geriatrics Research, Education, and Clinical Center (GRECC), Gainesville, FL, United States; University of Florida College of Public Health and Health Professions, Department of Health Services Research, Management and Policy, FL, United States
| | - Uma Suryadevara
- North Florida/South Georgia Veterans Health System, Malcom Randall VAMC, Department of Mental Health Services, Gainesville, FL, United States; University of Florida College of Medicine, Department of Psychiatry, Gainesville, FL, United States
| | - Carmen Fernandez
- North Florida/South Georgia Veterans Health System, Malcom Randall VAMC, Geriatrics Research, Education, and Clinical Center (GRECC), Gainesville, FL, United States
| | - Ronald Shorr
- North Florida/South Georgia Veterans Health System, Malcom Randall VAMC, Geriatrics Research, Education, and Clinical Center (GRECC), Gainesville, FL, United States
| |
Collapse
|
8
|
Surapaneni P, Scherber RM. Integrative Approaches to Managing Myeloproliferative Neoplasms: the Role of Nutrition, Exercise, and Psychological Interventions. Curr Hematol Malig Rep 2020; 14:164-170. [PMID: 31093888 DOI: 10.1007/s11899-019-00516-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE OF REVIEW Myeloproliferative neoplasms (MPNs) have a high symptom burden that affects functional status, emotional well-being, and quality of life for patients. Symptom control continues to be a challenging therapeutic goal despite available pharmacologic interventions. The goal of this review is to detail recent efforts that have focused on non-pharmacologic interventions, such as wholistic or integrative medicine, as an adjunctive method to alter symptom burden in this population. RECENT FINDINGS We discuss the ongoing physical, nutritional, and psychological interventional efforts which represent promising non-traditional interventions to date to help reduce symptom in MPN patients. In this article, we highlight the early promising data and importance of these various non-pharmacological interventions to dampen symptom burden and reduce disease-related inflammation. Nonpharmacologic interventions represent promising therapeutic strategies to alter traditional MPN treatment paradigms and improve MPN patient care.
Collapse
Affiliation(s)
- Prathibha Surapaneni
- Department of Hematology and Oncology, Mays MD Anderson Cancer Center at UT Health San Antonio, Urschel Tower #U623, 7979 Wurzbach Rd., San Antonio, TX, 78229, USA
| | - Robyn M Scherber
- Department of Hematology and Oncology, Mays MD Anderson Cancer Center at UT Health San Antonio, Urschel Tower #U623, 7979 Wurzbach Rd., San Antonio, TX, 78229, USA.
| |
Collapse
|
9
|
Rolandi E, Dodich A, Galluzzi S, Ferrari C, Mandelli S, Ribaldi F, Munaretto G, Ambrosi C, Gasparotti R, Violi D, Canessa N, Iannaccone S, Marcone A, Falini A, Hampel H, Frisoni GB, Cerami C, Cavedo E. Randomized controlled trial on the efficacy of a multilevel non-pharmacologic intervention in older adults with subjective memory decline: design and baseline findings of the E.Mu.N.I. study. Aging Clin Exp Res 2020; 32:817-826. [PMID: 31749018 DOI: 10.1007/s40520-019-01403-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 10/30/2019] [Indexed: 01/19/2023]
Abstract
BACKGROUND Alzheimer's Disease (AD) is a multifactorial disorder driven by genetic and modifiable lifestyle risk factors. Lifestyle primary prevention initiatives may reduce the prevalence and incidence of dementia in older adults. OBJECTIVES The E.Mu.N.I study is a randomized controlled trial investigating the effect of multilevel non-pharmacologic interventions on cognitive performances (primary outcome) and structural and vascular brain MRI markers (secondary outcome), as well as markers of brain functional connectivity change (exploratory outcome), in older adults with subjective memory decline (SMD). Here, we present the study design and the baseline features of the sample. METHODS Cognitively intact older adults with SMD, enrolled between February 2016 and June 2017, were randomly assigned to one of the 3 interventions for 1 year: Active Control Intervention (ACI), i.e., educational lessons; Partial Intervention (PI), i.e., homotaurine administration (100 mg/die) and lessons on the Mediterranean diet; Multilevel Intervention (MI), i.e., PI plus computerized cognitive training and physical exercise training. RESULTS One-hundred and twenty-eight eligible participants were enrolled (66% female; age: 68 ± 5 years). Eighty-two percent of the sample was composed of volunteers with SMD from the community. Participants were randomly allocated to the interventions as follows: ACI (N = 40), PI (N = 44), MI (N = 44). No significant differences among groups emerged on socio-demographic, clinical-neuropsychological variables and MRI markers at baseline. CONCLUSIONS The outcomes obtained from the E.Mu.N.I. study will clarify the efficacy of multilevel non-pharmacologic interventions on cognitive and neuroimaging markers in SMD individuals. This is a crucial step forward for the development of cost-effective non-pharmacologic primary prevention initiatives for AD.
Collapse
Affiliation(s)
- Elena Rolandi
- Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, 25125, Brescia, Italy
| | - Alessandra Dodich
- NIMTlab, Neuroimaging and Innovative Molecular Tracers Laboratory, University of Geneva, Geneva, Switzerland
| | - Samantha Galluzzi
- Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, 25125, Brescia, Italy
| | - Clarissa Ferrari
- Statistics Service, IRCCS Centro San Giovanni di Dio Fatebenefratelli, 25125, Brescia, Italy
| | - Sara Mandelli
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Federica Ribaldi
- Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, 25125, Brescia, Italy
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
- Memory Clinic and LANVIE-Laboratory of Neuroimaging of Ageing, University Hospitals and University of Geneva, Geneva, Switzerland
| | - Giulio Munaretto
- Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, 25125, Brescia, Italy
- Department of Life Sciences, University of Trieste, Trieste, Italy
| | - Claudia Ambrosi
- Department of Diagnostic Imaging, Neuroradiology Unit, University of Brescia, Brescia, Italy
| | - Roberto Gasparotti
- Department of Diagnostic Imaging, Neuroradiology Unit, University of Brescia, Brescia, Italy
| | - Davide Violi
- Millennium Sport and Fitness, 25124, Brescia, Italy
| | - Nicola Canessa
- NEtS Center, Scuola Universitaria Superiore IUSS Pavia, 27100, Pavia, Italy
- Cognitive Neuroscience Laboratory, IRCCS ICS Maugeri, 27100, Pavia, Italy
| | - Sandro Iannaccone
- Department of Clinical Neuroscience, San Raffaele Turro Hospital, 20132, Milan, Italy
| | - Alessandra Marcone
- Department of Clinical Neuroscience, San Raffaele Turro Hospital, 20132, Milan, Italy
| | - Andrea Falini
- Division of Neuroscience, Department of Neuroradiology and CERMAC, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Harald Hampel
- Alzheimer Precision Medicine (APM), Établissements Publics à Caractère Scientifique et Technologique (E.P.S.T.), AP-HP, Pitié-Salpêtrière Hospital, Sorbonne University Clinical Research Group (GRC n°21), Boulevard de l'hôpital, 75013, Paris, France
- Brain and Spine Institute (ICM), INSERM U 1127, CNRS UMR 7225, Boulevard de l'hôpital, 75013, Paris, France
- Department of Neurology, Pitié-Salpêtrière Hospital, AP-HP, Institute of Memory and Alzheimer's Disease (IM2A), François Lhermitte Building, 47 Boulevard de l'hôpital, 75013, Paris Cedex 13, France
| | - Giovanni B Frisoni
- Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, 25125, Brescia, Italy
- Memory Clinic and LANVIE-Laboratory of Neuroimaging of Ageing, University Hospitals and University of Geneva, Geneva, Switzerland
| | - Chiara Cerami
- Cognitive Neuroscience Laboratory, IRCCS ICS Maugeri, 27100, Pavia, Italy
| | - Enrica Cavedo
- Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, 25125, Brescia, Italy.
- Alzheimer Precision Medicine (APM), Établissements Publics à Caractère Scientifique et Technologique (E.P.S.T.), AP-HP, Pitié-Salpêtrière Hospital, Sorbonne University Clinical Research Group (GRC n°21), Boulevard de l'hôpital, 75013, Paris, France.
- Brain and Spine Institute (ICM), INSERM U 1127, CNRS UMR 7225, Boulevard de l'hôpital, 75013, Paris, France.
- Department of Neurology, Pitié-Salpêtrière Hospital, AP-HP, Institute of Memory and Alzheimer's Disease (IM2A), François Lhermitte Building, 47 Boulevard de l'hôpital, 75013, Paris Cedex 13, France.
| |
Collapse
|
10
|
Thrane SE, Wanless S, Cohen SM, Danford CA. The Assessment and Non-Pharmacologic Treatment of Procedural Pain From Infancy to School Age Through a Developmental Lens: A Synthesis of Evidence With Recommendations. J Pediatr Nurs 2016; 31:e23-32. [PMID: 26424196 PMCID: PMC4724566 DOI: 10.1016/j.pedn.2015.09.002] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Revised: 08/13/2015] [Accepted: 09/01/2015] [Indexed: 12/28/2022]
Abstract
UNLABELLED The 2011 IOM report stated that pain management in children is often lacking especially during routine medical procedures. The purpose of this review is to bring a developmental lens to the challenges in assessment and non-pharmacologic treatment of pain in young children. METHOD A synthesis of the findings from an electronic search of PubMed and the university library using the keywords pain, assessment, treatment, alternative, complementary, integrative, infant, toddler, preschool, young, pediatric, and child was completed. A targeted search identified additional sources for best evidence. RESULTS Assessment of developmental cues is essential. For example, crying, facial expression, and body posture are behaviors in infancy that indicate pain: however in toddlers these same behaviors are not necessarily indicative of pain. Preschoolers need observation scales in combination with self-report while for older children self-report is the gold standard. Pain management in infants includes swaddling and sucking. However for toddlers, preschoolers and older children, increasingly sophisticated distraction techniques such as easily implemented non-pharmacologic pain management strategies include reading stories, watching cartoons, or listening to music. DISCUSSION A developmental approach to assessing and treating pain is critical. Swaddling, picture books, or blowing bubbles are easy and effective when used at the appropriate developmental stage and relieve both physical and emotional pain. Untreated pain in infants and young children may lead to increased pain perception and chronic pain in adolescents and adults. Continued research in the non-pharmacological treatment of pain is an important part of the national agenda.
Collapse
Affiliation(s)
- Susan E. Thrane
- Assistant Professor, College of Nursing, Ohio State University, 322 Newton Hall, 1585 Neil Avenue, Columbus, OH 43210
| | - Shannon Wanless
- Assistant Professor, School of Education, University of Pittsburgh, 5937 Wesley W. Posvar Hall, 230 South Bouquet Street, Pittsburgh, PA 15260
| | - Susan M. Cohen
- Associate Professor, School of Nursing, University of Pittsburgh, 440 Victoria Building, 3500 Victoria Street, Pittsburgh, PA 15261
| | - Cynthia A. Danford
- Assistant Professor, School of Nursing, University of Pittsburgh, 458 Victoria Building, 3500 Victoria Street, Pittsburgh, PA 15261
| |
Collapse
|