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Li C, Zhang X, Zhuang X, Zhang K, Huang Q, Ge S, Wu Y, Hu R. The effectiveness of non-pharmacological interventions on reducing pain in patients undergoing bone marrow aspiration and biopsy: A systematic review and meta-analysis of randomized controlled trials. J Clin Nurs 2024; 33:2829-2848. [PMID: 38549254 DOI: 10.1111/jocn.17121] [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: 10/27/2023] [Revised: 02/01/2024] [Accepted: 03/11/2024] [Indexed: 07/09/2024]
Abstract
BACKGROUND Patients often consider bone marrow aspiration and biopsy to be one of the most painful medical procedures. The effectiveness of non-pharmacological interventions to reduce pain during bone marrow aspiration and biopsy remains unclear. AIM To synthesize existing evidence regarding the effectiveness of non-pharmacological interventions in mitigating procedural pain among patients undergoing bone marrow aspiration and biopsy. DESIGN A systematic review and meta-analysis of randomized controlled trials. METHODS Six electronic databases, including PubMed, EMBASE, CINAHL, PsycINFO, Cochrane Library and Web of Science were searched from inception to July 15, 2023. The risk of bias was assessed using the Cochrane Risk of Bias Tool Version 2.0. Meta-analysis was conducted using STATA 16. The certainty of the evidence was assessed by the GRADE approach. RESULTS This meta-analysis included 18 studies derived from 17 articles involving a total of 1017 participants. The pooled results revealed statistically significant pain reduction effects using distraction (SMD: -.845, 95% CI: -1.344 to -.346, p < .001), powered bone marrow biopsy system (SMD: -.266, 95% CI: -.529 to -.003, p = .048), and acupoint stimulation (SMD: -1.016, 95% CI: -1.995 to -.037, p = .042) among patients undergoing bone marrow aspiration and biopsy. However, the pooled results on hypnosis (SMD: -1.228, 95% CI: -4.091 to 1.515, p = .368) showed no significant impact on pain reduction. Additionally, the pooled results for distraction did not demonstrate a significant effect on operative anxiety (MD: -2.942, 95% CI: -7.650 to 1.767, p = .221). CONCLUSIONS Distraction, powered bone marrow biopsy system and acupoint stimulation are effective in reducing pain among patients undergoing bone marrow aspiration and biopsy. PATIENT OR PUBLIC CONTRIBUTION Not applicable. RELEVANCE TO CLINICAL PRACTICE This meta-analysis highlights the effectiveness of distraction, powered bone marrow biopsy system and acupoint stimulation for reducing pain in patients undergoing bone marrow biopsy. Healthcare professionals should consider integrating these interventions into pain management practices for these patients. REGISTRATION (PROSPERO): CRD42023422854.
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Affiliation(s)
- Chengyang Li
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - Xiao Zhang
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - Xueting Zhuang
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - Kun Zhang
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - Qiyuan Huang
- The School of Nursing, Fujian Medical University, Fuzhou, China
| | - Song Ge
- Department of Natural Sciences/Nursing, University of Houston-Downtown, Houston, Texas, USA
| | - Yong Wu
- Fujian Medical University Union Hospital, Fuzhou, China
| | - Rong Hu
- The School of Nursing, Fujian Medical University, Fuzhou, China
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Şahan S, Korkmaz E, Korkmaz S. The effect of music on comfort, pain, and anxiety in patients with bone marrow aspiration and biopsy in Turkey: a mixed-methods study. BMC Complement Med Ther 2024; 24:228. [PMID: 38867235 PMCID: PMC11167734 DOI: 10.1186/s12906-024-04531-0] [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: 12/02/2023] [Accepted: 05/30/2024] [Indexed: 06/14/2024] Open
Abstract
AIM This study was conducted to determine the effect of music on the pain, anxiety, and comfort levels of patients who underwent bone marrow aspiration and biopsy. METHODS This study was conducted on patients with hematological malignancies. Music was used with the intervention group. Patients' pain, anxiety, and comfort levels were measured. In addition, qualitative data were obtained through in-depth interviews with patients. RESULTS A significant difference (p < 0.05) was found between the experimental and control groups regarding pain, comfort and anxiety levels following the application of music. It was found that there was a negative correlation between comfort and pain (r=-0.442 p < 0.001) and between comfort and anxiety (r=-0.544 p < 0.001). As a result of qualitative interviews, patients mentioned the relaxing effect of music and the reduction of anxiety and pain levels. They also stated that music can be utilized as an alternative method. CONCLUSION According to the results of the present study, music reduced the pain and anxiety levels of the patients in bone marrow aspiration and biopsy and increased their comfort levels. We can say that music can be used in the clinic as a non-pharmacological method for pain, anxiety and comfort. CLINICAL TRIALS NUMBER NCT05895357 (Date:08/06/2023).
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Affiliation(s)
- Seda Şahan
- Department of Nursing Fundamentals, Faculty of Health Sciences, İzmir Bakırcay University, Menemen, İzmir, 35100, Turkey.
| | - Emine Korkmaz
- Department of Nursing Fundamentals, Faculty of Health Science, Kırşehir Ahi Evran University, Kırşehir, Turkey
| | - Serdal Korkmaz
- Kayseri City Hospital, Hematology Clinic, Kayseri, Turkey
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Korkmaz E, Guler S. The Effect of Video Streaming With Virtual Reality on Anxiety and Pain During Bone Marrow Aspiration and Biopsy Procedure. Pain Manag Nurs 2023; 24:634-640. [PMID: 37246094 DOI: 10.1016/j.pmn.2023.04.014] [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: 07/09/2022] [Revised: 04/09/2023] [Accepted: 04/29/2023] [Indexed: 05/30/2023]
Abstract
BACKGROUND Pain and anxiety are among the most common symptoms in patients undergoing invasive procedures. Increased pain levels tend to worsen anxiety, and anxiety often leads to more frequent or severe pain. AIMS The study was conducted to determine the efficacy of virtual reality goggles (VRG) on pain and anxiety during bone marrow aspiration and biopsy (BMAB) procedure. DESIGN A randomized controlled experimental study. SETTINGS The outpatient unit of an adult hematology clinic of a tertiary care university hospital. PARTICIPANTS/SUBJECTS The study was conducted in patients aged 18 years and older who underwent a BMAB procedure. Thirty-five patients in the experimental (VRG) group and 40 patients in the control group. METHODS Patient identification form, visual analogue scale (VAS), state and trait anxiety inventory (STAI), and VRG were used to collect the data. RESULTS Postprocedural state anxiety mean scores were found to be statistically significantly higher in the control group than in the VRG group (p = .022). A statistically significant difference was found between groups in terms of procedure-related pain (p = .002). The postprocedural mean pain scores were found to be statistically significantly higher in the control group than in the VRG group (p < .001). A statistically significant but moderate positive correlation was found between the postprocedural pain and preprocedural state anxiety variable (r = 0.477). A statistically significant and strong positive correlation was found between the postprocedural pain and the postprocedural state anxiety variable (r = 0.657). A statistically significant but moderate positive relationship was found between preprocedural and postprocedural state anxiety variables (r = 0.519). CONCLUSIONS We determined that video streaming with VRG reduces pain and anxiety felt by adult patients during the BMAB procedure. VRG can be recommended to use in controlling pain and anxiety in patients undergoing a BMAB procedure.
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Affiliation(s)
- Emine Korkmaz
- University of Health Sciences, Kayseri City Training and Research Hospital, Division of Certified Training Coordinator, Kayseri, Turkey.
| | - Sevil Guler
- Erciyes University, Faculty of Health Sciences, Department of Nursing, Kayseri, Turkey
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Barlas T, Sodan HN, Avci S, Cerit ET, Yalcin MM. The impact of classical music on anxiety and pain perception during a thyroid fine needle aspiration biopsy. Hormones (Athens) 2023; 22:581-585. [PMID: 37495823 DOI: 10.1007/s42000-023-00473-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 07/20/2023] [Indexed: 07/28/2023]
Abstract
AIM To determine the impact of classical music on the anxiety and pain perception of patients who underwent thyroid fine-needle aspiration biopsy (TFNAB) for the first time. METHODS In a prospective randomized controlled design, TFNAB patients were randomized into the intervention and control groups. The State Anxiety Inventory (SAI) before and after the procedure and the visual analog scale (VAS) after procedure were used for measuring anxiety and pain. RESULTS A total of 82 patients were included. There was no significant difference between the music intervention group (n = 41) and control group (n = 41) in terms of age, gender, work status, highest education level, SAI score before TFNAB, and duration of the procedure (p > 0.05). It was observed that the anxiety level before TFNAB was higher in women in all patient groups (p = 0.009). While the SAI score decreased significantly in the music intervention group (Z = - 3.62, p < 0.001), there was no significant difference in the control group (Z = - 1.41, p = 0.157) after TFNAB. However, no significant difference was found in terms of VAS between two groups (p = 0.075). The duration of the TFNAB procedure was correlated with the change in the SAI score (r = 0.382, p < 0.001). CONCLUSION This is the first study to examine the impact of music on patients' anxiety and pain perception during the TFNAB procedure. Despite the fact that classical music intervention did not decrease pain perception, it significantly reduced patient anxiety. Music is an easy-to-implement intervention that can be considered as an effective method for reducing patient anxiety during TFNAB.
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Affiliation(s)
- Tugba Barlas
- Department of Endocrinology and Metabolism, Gazi University Faculty of Medicine, Ankara, Turkey.
| | - Hulya Nur Sodan
- Department of Endocrinology and Metabolism, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Selma Avci
- Gazi University Faculty of Medicine, Ankara, Turkey
| | - Ethem Turgay Cerit
- Department of Endocrinology and Metabolism, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Mehmet Muhittin Yalcin
- Department of Endocrinology and Metabolism, Gazi University Faculty of Medicine, Ankara, Turkey
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Dogan S, Ceylan C. The effect of music on state anxiety in patients undergoing extracorporeal shockwave lithotripsy. Int J Clin Pract 2021; 75:e14293. [PMID: 33930234 DOI: 10.1111/ijcp.14293] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 04/27/2021] [Indexed: 11/29/2022] Open
Abstract
AIM Extracorporeal shockwave lithotripsy is a commonly used method to break down kidney stones in urology clinics. This study aims to investigate whether or not listening to music is effective against state anxiety in patients undergoing kidney stone treatment with this method. METHODS A total of 80 patients (50 males, 30 females) undergoing extracorporeal shockwave lithotripsy for the first time at our clinic were included in the study. The first group (24 patients) listened to instrumental classical music through headphones 20 minutes before the procedure, while the second group (28 patients) listened to instrumental classical music during the procedure. The third group (28 patients) was the control group and consisted of patients who did not listen to music before or during the procedure. Patients were administered a state-trait anxiety inventory test to measure state anxiety after the process, and their results were compared. RESULTS While there was a significant difference in state-trait anxiety inventory scores between patients who listened to music before/during the procedure and the control group, there was no significant difference between patients who listened to music before and those who listened to music during the procedure. Assessment of randomisation showed groups achieved homogeneity. CONCLUSION Among the groups homogeneously distributed according to age and gender, significantly lower anxiety scores of groups that listened to music compared with the control group have provided supporting data to be open-minded and exploratory about increasing patient tolerability and comfort during these potentially pain-inducing procedures.
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Affiliation(s)
- Serkan Dogan
- Urology Department, Sancaktepe Sehit Prof Dr Ilhan Varank Education and Research Hospital, Istanbul, Turkey
| | - Cavit Ceylan
- Urology Department, Turkey Yüksek İhtisas Education and Research Hospital, Ankara, Turkey
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Schandert LC, Affronti ML, Prince MS, Schneider SM. Music Intervention: Nonpharmacologic Method to Reduce Pain and Anxiety in Adult Patients Undergoing Bone Marrow Procedures. Clin J Oncol Nurs 2021; 25:314-320. [PMID: 34019034 DOI: 10.1188/21.cjon.314-320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Bone marrow procedures cause anxiety and pain in adult patients with cancer. Music is a safe, inexpensive, noninvasive intervention that is easy to implement and is well received by patients and providers. OBJECTIVES The purpose of this quality improvement project was to develop, implement, evaluate, and sustain a music protocol during bone marrow biopsy and aspiration procedures for adult patients with hematologic malignancies. In addition, this project sought to decrease pain, anxiety, heart rate, and blood pressure in patients undergoing bone marrow procedures. METHODS The project coordinator collected baseline data regarding toleration of bone marrow procedures and then implemented a music protocol during the procedures during a six-month intervention phase. Comparison variables included pain, anxiety, heart rate, blood pressure, and subjective impressions. FINDINGS The music protocol resulted in improved patient anxiety, decreased procedure time, and decreased medication use during bone marrow procedures. All patients who used the music intervention indicated they would use it again.
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Lee SH, Kim CG, Kwon J, Lee KH, Han HS, Roh SY, Shin BJ, Choi EH. Comparison of Bleeding, Hematoma, Pain, and Discomfort After Bone Marrow Examination With or Without Sandbag Compression. Asian Nurs Res (Korean Soc Nurs Sci) 2021; 15:150-156. [PMID: 33609762 DOI: 10.1016/j.anr.2021.02.004] [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: 06/29/2020] [Revised: 01/11/2021] [Accepted: 02/08/2021] [Indexed: 10/22/2022] Open
Abstract
PURPOSE A safe and effective hemostatic care is necessary after bone marrow examination to minimize bleeding, pain, and discomfort. However, a standardized hemostatic care protocol following bone marrow examination has not been established. The purpose of this study was to investigate the differences in bleeding, hematoma, pain, and discomfort by the hemostatic method used following bone marrow examination. METHODS This study was carried out with a pre-test/post-test nonequivalent control group design. Sixty-four patients undergoing bone marrow examination at the hemato-oncology ward in a tertiary hospital in South Korea were assigned to an intervention (n = 30) and comparison group (n = 34). The intervention group was treated using a compression dressing alone, while the comparison group received a compression dressing followed by sandbag compression. Both groups received two hours of bedrest. Bleeding, hematoma, pain, and discomfort were measured at one and two hours after the biopsy. RESULTS No significant differences in the occurrence of bleeding between the groups at one and two hours after bone marrow examination were observed, and no participant developed hematoma. The intervention group had significantly lower pain than the comparison group two hours after the bone marrow examination as well as lower discomfort one hour and two hours after the bone marrow examination (p < .05). CONCLUSION Applying only compression dressing after a bone marrow examination is effective in reducing pain and discomfort without measurable differences in bleeding and hematoma, suggesting that compression dressings alone could be effective in lowering pain and discomfort following bone marrow examination.
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Affiliation(s)
- Seung Hee Lee
- Department of Internal Medicine, Chungbuk National University Hospital, Republic of Korea; Department of Nursing, Chungbuk National University, Republic of Korea.
| | - Chul-Gyu Kim
- Department of Nursing, Chungbuk National University, Republic of Korea.
| | - Jihyun Kwon
- Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Republic of Korea.
| | - Ki Hyeong Lee
- Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Republic of Korea.
| | - Hye Sook Han
- Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Republic of Korea.
| | - So Youen Roh
- Department of Internal Medicine, Chungbuk National University Hospital, Republic of Korea.
| | - Beom Jin Shin
- Department of Internal Medicine, Chungbuk National University Hospital, Republic of Korea.
| | - Eun Ha Choi
- Department of Nursing, Chungbuk National University Hospital, Republic of Korea.
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Gurbuz-Dogan RN, Ali A, Candy B, King M. The effectiveness of Sufi music for mental health outcomes. A systematic review and meta-analysis of 21 randomised trials. Complement Ther Med 2021; 57:102664. [PMID: 33465384 DOI: 10.1016/j.ctim.2021.102664] [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: 09/12/2019] [Revised: 12/28/2020] [Accepted: 01/12/2021] [Indexed: 10/22/2022] Open
Abstract
BACKGROUND There is some evidence that Sufi music therapy might improve physical and mental well-being; however, no systematic review or meta-analysis has pooled and critiqued the evidence. The aim of this systematic review was to evaluate the effects of Sufi music therapy on mental health outcomes. METHODS We searched Medline, PsycINFO, the Web of Science, Science Direct, PsycARTICLES, Cochrane Library, SCOPUS, CINAHL Plus, AMED, and ULAKBIM databases, and the reference lists of the studies found. Papers published in academic peer-reviewed journals were included, as well as from other sources such as chapters in edited books, the grey literature, or conference presentations. Articles published up to March 2020 in Turkish and English were included. Our primary outcome of interest was anxiety and secondary outcomes of interest were other mental health outcomes such as depression. To assess the methodological quality of the articles, the Cochrane Risk of Bias Tool was used. The quality of evidence was assessed using the GRADEpro GDT system. RESULTS This search yielded 21 clinical trials that were eligible for inclusion. A meta-analysis, using a random effects model, of 18 randomised controlled trials involving 1454 participants showed that Sufi music therapy with makams, compared with treatment as usual (TAU) or a no-music control group, reduced symptoms of anxiety in the short term in patients undergoing an operation or treatments such as chemotherapy or haemodialysis (standardised mean difference SMD= -1.15, 95 % CI, -1.64 to -0.65; very low-quality evidence). The evidence of Sufi music with makam's effect on anxiety is rated as very low. Qualitative synthesis of secondary outcomes revealed significant effects for depression, positive symptoms in schizophrenia, stress, which however were based on fewer studies. Trials were of moderate methodological quality, and there was significant heterogeneity across the studies. CONCLUSION Sufi music may reduce anxiety of patients undergoing medical procedures like haemodialysis, coronary artery surgery, angiography, colonoscopy, bone marrow aspiration and biopsy procedures. Evidence from single studies suggests effects on depression and stress as well. However, due to methodological limitations of the studies, further, higher quality studies are required in other cultures.
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Affiliation(s)
| | - A Ali
- Division of Psychiatry, University College London, London, UK
| | - B Candy
- Division of Psychiatry, University College London, London, UK
| | - M King
- Division of Psychiatry, University College London, London, UK
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MUZ G, ERAT A, ŞAMDANLI Ş, YAVUZER N. Kronik obstrüktif akciğer hastalığı tanısı almış bireylerin integratif yöntemleri kullanma durumu ve umutsuzluk düzeyleri ile ilişkisi. CUKUROVA MEDICAL JOURNAL 2020. [DOI: 10.17826/cumj.742875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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BEKTAŞ AKPINAR N, CERAN M, ÖZKALP B. The effect of classıcal Turkish and Western music on university students' exam stress level, blood pressure and pulse rate: a randomized controlled trial. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2020. [DOI: 10.32322/jhsm.681640] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Abbaszadeh R, Tabari F, Asadpour A. The Effect of Lavender Aroma on Anxiety of Patients Having Bone Marrow Biopsy. Asian Pac J Cancer Prev 2020; 21:771-775. [PMID: 32212806 PMCID: PMC7437323 DOI: 10.31557/apjcp.2020.21.3.771] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Indexed: 11/25/2022] Open
Abstract
Introduction: Bone marrow biopsy is a common procedure for the diagnosis and treatment of hematologic diseases and tumors, which are associated with anxiety. The purpose of this study was to examine the effect of lavender aroma on anxiety of patients having bone marrow biopsy. Materials and Methods: This study was performed on 80 patients referred to Vali-e-Asr Hospital for bone marrow biopsy. Samples were selected by convenience method and were assigned into intervention and control groups using randomized blocks of 4. Random sequence was generated by RAS software. Several drops of distilled water on a cotton ball was used in the control group and same amount of lavender essential oil on a cotton ball was used in the intervention group. Then, participants in both groups were asked to smell the cotton ball for 15 minutes and then, their anxiety level was measured immediately. The results were analyzed by SPSS software version 25 using covariance analysis and rank regression. Results: The results showed that, the mean scores of anxiety in the control and intervention groups were 6.3 ± 1.92 and 3.75 ± 1.05, respectively. There was a significant difference (p <0.05) between the two groups in terms of anxiety score.The results showed that there was a significant difference in anxiety score between two groups in terms of variables such as age, gender, physician experience, biopsy history and biopsy site (P <0.05). The results also showed no significant difference between the (p >0.05). Conclusion: The results of this study showed that bone marrow biopsy is associated with anxiety, and smelling of lavender aroma is effective in reducing anxiety in patients undergoing this procedure. This fragrance can be used by treatment team in hematology and oncology clinics to reduce anxiety caused by bone marrow biopsy.
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Affiliation(s)
- Reyhaneh Abbaszadeh
- School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Fariba Tabari
- School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Atefeh Asadpour
- School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
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Gendron N, Zia Chahabi S, Poenou G, Rivet N, Belleville-Rolland T, Lemaire P, Escuret A, Ciaudo M, Curis E, Gaussem P, Siguret V, Darnige L. Pain assessment and factors influencing pain during bone marrow aspiration: A prospective study. PLoS One 2019; 14:e0221534. [PMID: 31465426 PMCID: PMC6715342 DOI: 10.1371/journal.pone.0221534] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 08/08/2019] [Indexed: 11/29/2022] Open
Abstract
Although bone marrow aspiration (BMA) is still considered a painful procedure, pain level remains poorly documented. We therefore conducted a prospective study intended to evaluate pain level in adult patients undergoing BMA at the sternal or iliac crest site to identify factors associated with pain. We enrolled a total of 448 patients who underwent 461 BMA and asked those patients to score their pain intensity after BMA using numerical pain rating scale (NPRS). The following factors: level of anxiety, quality of the information given to the patient, operator’s experience, and bone texture were recorded using a standardized questionnaire. The median NPRS score was 3.5 (IQR [2.0; 5.0]) the sternal site (n = 405) was associated with an increased median NPRS score (3.5 [2.0; 5.0]) compared to the iliac crest (n = 56, 2.5 [1.0; 4.0]; p<0.0001). For those patients who underwent sternal BMA, the median NPRS score was significantly lower when using lidocaine infiltration (p = 0.0159) as compared with no anesthetic use. Additionally there was no significant effect of anesthetic cream found. After multivariate analysis, the model of NPRS score at the sternal site included patient anxiety (p<0.0001) and the use of lidocaine infiltration (0.0378). This study underlines the usefulness of a comprehensive management including pain relief and efforts to reduce anxiety including appropriate information given to the patient during BMA.
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Affiliation(s)
- Nicolas Gendron
- AP-HP, Hôpital Européen Georges Pompidou, Service d’Hématologie Biologique, Paris, France
- Université de Paris, Paris, France
- INSERM UMR-S1140, Paris, France
| | - Sara Zia Chahabi
- AP-HP, Hôpital Européen Georges Pompidou, Service d’Hématologie Biologique, Paris, France
- Université de Paris, Paris, France
- AP-HP, Hôpital Lariboisière, Paris, France
| | - Géraldine Poenou
- AP-HP, Hôpital Européen Georges Pompidou, Service d’Hématologie Biologique, Paris, France
- Université de Paris, Paris, France
| | - Nadia Rivet
- AP-HP, Hôpital Européen Georges Pompidou, Service d’Hématologie Biologique, Paris, France
- Université de Paris, Paris, France
- INSERM UMR-S1140, Paris, France
| | - Tiphaine Belleville-Rolland
- AP-HP, Hôpital Européen Georges Pompidou, Service d’Hématologie Biologique, Paris, France
- Université de Paris, Paris, France
- INSERM UMR-S1140, Paris, France
| | - Pierre Lemaire
- AP-HP, Hôpital Européen Georges Pompidou, Service d’Hématologie Biologique, Paris, France
| | - Antoine Escuret
- AP-HP, Hôpital Européen Georges Pompidou, Service d’Hématologie Biologique, Paris, France
- Université de Paris, Paris, France
| | - Michèle Ciaudo
- AP-HP, Hôpital Européen Georges Pompidou, Service d’Hématologie Biologique, Paris, France
| | - Emmanuel Curis
- Université de Paris, Paris, France
- Laboratoire de Biomathématiques, plateau iB, Faculté de Pharmacie de Paris, Université Paris Descartes, Paris, France
- Service de Biostatistiques et Informatique Médicale, AP-HP, Hôpital Saint-Louis, Paris, France
| | - Pascale Gaussem
- AP-HP, Hôpital Européen Georges Pompidou, Service d’Hématologie Biologique, Paris, France
- Université de Paris, Paris, France
- INSERM UMR-S1140, Paris, France
| | - Virginie Siguret
- AP-HP, Hôpital Européen Georges Pompidou, Service d’Hématologie Biologique, Paris, France
- Université de Paris, Paris, France
- INSERM UMR-S1140, Paris, France
- AP-HP, Hôpital Lariboisière, Paris, France
| | - Luc Darnige
- AP-HP, Hôpital Européen Georges Pompidou, Service d’Hématologie Biologique, Paris, France
- Université de Paris, Paris, France
- INSERM UMR-S1140, Paris, France
- * E-mail:
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