Evaluating the use of Snoezelen and chronic pain: the findings of an investigation into its use (Part II)

Snoezelen Room and Childbirth Outcome: A Randomized Clinical Trial

Background:

One of the strategies for a good outcome and pain free childbearing is to design the delivery room.

Objectives:

The aim of this study was to evaluate the effects of snoezelen room on childbearing outcome such as pain intensity, duration of labor, and perinea status in nulliparous women.

Patients and Methods:

This study was a randomized controlled clinical trial consists of 100 childbearing women. They were randomly divided into 2 groups. The experimental group went to snoezelen room when their cervix dilation was 4 cm, while the control group went to physiologic delivery room with the same cervix dilation.

Results:

The mean ± SD of VAS (Visual Analogue Scale) pain intensity of the experimental and control groups before the intervention were 5.1 ± 1.95 and 5.58 ± 1.62, respectively (P = 0.13). The mean ± SD of VAS pain intensity scores of the experimental and control groups after 3 hours spending in their assigned rooms were 5.26 ± 0.86 and 9.56 ± 1.48, respectively (P = 0.01). The mean ± SD of the first stage scores of the experimental and control groups were 6.95 ± 0.97 and 8.41 ± 0.67, respectively (P = 0.042). About 92% of participants’ intervention vs. 66% of control participants had perinea laceration (P = 0.041).

Conclusions:

According to the findings of the present study, distracting senses in snoezelen room decreases mother’s pain intensity, the length of labor, and incidence of episiotomy.

Effectiveness of nursing intervention for adult patients experiencing chronic pain: a systematic review

OBJECTIVES

To determine the best available evidence regarding the effectiveness of nursing interventions for adult patients experiencing chronic pain.

TYPES OF STUDIES

Randomized Controlled Trials (RCT) and Quasi-Randomized Controlled Trials.

TYPES OF PARTICIPANTS

Participants were adults, aged at least 18 years, suffering from chronic pain (lasting for longer than six months). Pain of oncological origin and patients admitted in a hospital, were excluded.

TYPES OF INTERVENTIONS

Non pharmacological nursing interventions for chronic pain.

TYPES OF OUTCOME MEASURES

The primary outcome measure was chronic pain, and secondary outcome measures were: disability, depression, dependence and health related quality of life.

SEARCH STRATEGY

All studies, published and unpublished, in English and Spanish, carried out between January 1997 and December 2007 were retrieved..

SELECTION OF STUDIES

The methodological quality of included articles was assessed by two independent reviewers using appropriate critical appraisal tools from the Joanna Briggs Institute.

DATA EXTRACTION AND ANALYSIS

Data were independently extracted by two reviewers, using the standardised data extraction tool from the Joanna Briggs Institute.A meta-analysis was not possible as the trials were heterogeneous in their interventions, characteristics of the populations, intervention duration measurement instruments and outcomes measures.

RESULTS

1,666 references were identified that fit the aim of the review. 92 articles were retrieved, of which 13 were chosen to be critically appraised for their methodological quality. In the end, eight controlled trials were included.The main results were:Other outcome measures showed an improvement in the quality of life (sensorial stimulation and guided imagery), in depression, disability and empowerment (music therapy) and physical functioning (program of psycho-education).The main limitations of this review were: excluding studies were the professional performing the interventions were not detailed or the intervention was not carried out by a nurse and that the search strategy was limited up to 2007.

IMPLICATIONS FOR PRACTICE

Listening to music, a cognitive-behavioural treatment programme, magnetic therapy, sensorial stimulation, a psychoeducation programme and guided imagery are nursing interventions that helps to reduce the chronic pain in adults and may be used as contributory to the pharmacological treatment. Short exercises for increasing endurance does not reduce pain.

IMPLICATIONS FOR RESEARCH

For future reviews we do not recommend the inclusion of different interventions for the reduction of chronic pain, due to the great number and variability of intervention, but the development of a SR on specific interventions.

Women's experiences of using a Snoezelen room during labour in Western Australia

OBJECTIVE

to explore women's experience of using a Snoezelen room during their labour.

DESIGN

a qualitative exploratory design was conducted to provide insight into the phenomenon of using a Snoezelen room for labouring women and to identify factors that could facilitate or inhibit use of this environment. The constant comparison method modified from the grounded theory methodology was used to analyse data from in-depth interviews.

SETTING

Osborne Park Hospital, the second largest public provider of obstetric services in Western Australia, was the study setting.

PARTICIPANTS

sixteen women, recruited from July 2005 to June 2006, agreed to participate in an in-depth interview and share their experience of using the Snoezelen room during a recent labour.

FINDINGS

six themes were extracted from the data providing insight into what a Snoezelen environment can offer a labouring woman: distraction; relaxation; comfort; environmental control; choice of complementary therapies; and safety in a home-like atmosphere. Additional categories revealed factors that facilitated and/or detracted use of the room such as familiarity with features, being offered information and choice, timing in labour, the support person's response and working order of the room's features.

IMPLICATIONS FOR PRACTICE

when sharing their experience, women focused upon the process of their labour and how they managed this process rather than specific outcomes such as analgesic used or type of birth. Although outcomes such as type of birth may not have been their preferred choice, these women were able to achieve satisfaction with how they managed their labour while in the Snoezelen room. This midwifery-led initiative contributed to these women's labour experiences, by offering a combination of complementary therapies within the safety of a hospital environment.

A qualitative study of Western Australian women's perceptions of using a Snoezelen room for breastfeeding during their postpartum hospital stay

BACKGROUND

There is limited evidence on the use of the Snoezelen concept for maternity clients. Snoezelen, a Dutch concept, initiated in the 1970s as a leisure activity for severely disabled people, involves creating an indoor environment using controllable stimuli to enhance comfort and relaxation. These specially designed rooms expose the user to multiple sensory stimulations combining vision, touch, sounds and aromas. The aim of this study was to provide insight into breastfeeding women's experience of using a Snoezelen room during hospitalisation.

METHODS

A qualitative exploratory design was chosen to reveal women's perceptions of using the Snoezelen room. Osborne Park Hospital, the study setting is the second largest public provider of obstetric services in Western Australia. A purposive sample was drawn from breastfeeding women who used the Snoezelen room during their postpartum stay from March 2006 to March 2007. Saturation was achieved after eleven breastfeeding women were interviewed six weeks post discharge. Data analysis involved the constant comparison method.

RESULTS

Participants entered the room feeling tired and emotional with an unsettled baby and breastfeeding issues aggravated by maternal stress and anxiety. All women indicated they were able to achieve relaxation while in the room and would recommend its use to other breastfeeding mothers. Two key themes revealed how the Snoezelen room facilitated maternal relaxation, which ultimately enhanced the breastfeeding experience. The first theme, "Finding Relaxation for the Breastfeeding Mother" incorporates three subthemes: 'Time out' for mother; Control in own personal space; and a Quiet/calm environment with homelike atmosphere. The second theme, "Enabling Focus on Breastfeeding", occurred after relaxation was achieved and involved four subthemes: Able to get one-on-one attention; Not physically exposed to others; Away from prying, judgemental eyes and Able to safely attempt breastfeeding alone knowing help is nearby.

CONCLUSION

Insight into how the Snoezelen room promoted relaxation also highlights what contributes to maternal anxiety during breastfeeding experiences in hospital. The findings offer health professionals the opportunity to consider adopting strategies such as a Snoezelen room in their hospital or being innovative in modifying the postpartum setting to promote relaxation for breastfeeding women.

Creating a Multisensory Environment for Dementia

The MR provides a means for a variety of sensory experiences that can increase the quality of life for an individual with dementia. It is an example of an innovative approach to meeting the social and recreational needs of individuals with dementia. In addition, the MR enables staff and family members to communicate and build relationships with residents on a new and different level.