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Saravanan A, Reagan L, Rivera R, Challa N, Lankipalle H, Sareddy VRR, Starkweather A. Non-pharmacological interventions for community-dwelling older adults with chronic pain and comorbidity: A scoping review of randomized controlled trials. Geriatr Nurs 2022; 45:205-214. [DOI: 10.1016/j.gerinurse.2022.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 04/06/2022] [Accepted: 04/08/2022] [Indexed: 11/04/2022]
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2
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Peker K, Polat R. The effects of preoperative reactions of emotional distress on headache and acute low back pain after spinal anesthesia: A prospective study. J Psychosom Res 2021; 144:110416. [PMID: 33735647 DOI: 10.1016/j.jpsychores.2021.110416] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 03/08/2021] [Accepted: 03/08/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVES To address the effect of preoperative symptoms of depression and anxiety on headache and low back pain after spinal anesthesia. METHODS This prospective observational cohort study included 370 patients who underwent spinal anesthesia before elective surgeries at a university hospital. The patients were evaluated in terms of symptoms of depression (Beck Depression Inventory) and anxiety (Beck Anxiety Scale) while in their wards. The patients were evaluated via telephone calls for headache and low back pain after the operation. RESULTS Eighty-two (82/362) (23%) patients were determined as having headache and 28 (28/362) (7.8%) were determined as having low back pain. There was a significant association between preoperative depression scores and anxiety scores and VAS scores of headache (respectively, eta-squared = 0.19, p < .001; eta-squared = 0.14, p < .001). There was a significant association between preoperative depression scores and anxiety scores and VAS scores of low back pain (respectively, eta-squared = 0.02, p = .08; eta-squared = 0.03, p = .01). CONCLUSIONS Preoperative symptoms of anxiety and symptoms of depression affect headache after spinal anesthesia. Preoperative symptoms of depression affect acute low back pain after spinal anesthesia. This trial was also registered at http://www.ClinicalTrials.gov. (Protocol Registration Receipt NCT03427372).
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Affiliation(s)
- Kevser Peker
- Kırıkkale University Faculty of Medicine, Department of Anesthesiology and Critical Care, Turkey.
| | - Reyhan Polat
- Diskapi Yildirim Beyazit Training and Research Hospital, Anesthesiology and Reanimation, TC Saglik Bakanligi, Turkey
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PEKER K, PEKER SA. Erektör spina plan bloğunun perkütan nefrolitotomi cerrahisi maliyetine etkisi. JOURNAL OF HEALTH SCIENCES AND MEDICINE 2020. [DOI: 10.32322/jhsm.774520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Peker K, Akçaboy ZN, Aydın G, Gençay I, Şahin AT, Koçak YF, Peker SA. The Effect of Erector Spinae Plane Block on Laparoscopic Cholecystectomy Anesthesia: Analysis of Opioid Consumption, Sevoflurane Consumption, and Cost. J Laparoendosc Adv Surg Tech A 2020; 30:725-729. [DOI: 10.1089/lap.2019.0809] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Affiliation(s)
- Kevser Peker
- Anesthesiology and Critical Care, Kırıkkale University Medical Faculty Hospital, Kırıkkale, Turkey
| | - Zeynep Nur Akçaboy
- Anesthesiology and Critical Care, Kırıkkale University Medical Faculty Hospital, Kırıkkale, Turkey
| | - Gülçin Aydın
- Anesthesiology and Critical Care, Kırıkkale University Medical Faculty Hospital, Kırıkkale, Turkey
| | - Işın Gençay
- Anesthesiology and Critical Care, Kırıkkale University Medical Faculty Hospital, Kırıkkale, Turkey
| | - Ahmet Tuğrul Şahin
- Anesthesiology and Critical Care, Kırıkkale University Medical Faculty Hospital, Kırıkkale, Turkey
| | - Yahya Fatih Koçak
- Anesthesiology and Critical Care, Kırıkkale University Medical Faculty Hospital, Kırıkkale, Turkey
| | - Seydi Ali Peker
- Medical Biochemistry, Kırıkkale Yuksek Ihtisas Hospital, Kırıkkale, Turkey
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Tang SK, Tse MMY, Leung SF, Fotis T. The effectiveness, suitability, and sustainability of non-pharmacological methods of managing pain in community-dwelling older adults: a systematic review. BMC Public Health 2019; 19:1488. [PMID: 31703654 PMCID: PMC6842175 DOI: 10.1186/s12889-019-7831-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 10/22/2019] [Indexed: 11/17/2022] Open
Abstract
Background Pain is common in older adults. To maintain their quality of life and promote healthy ageing in the community, it is important to lower their pain levels. Pharmacological pain management has been shown to be effective in older adults. However, as drugs can have various side effects, non-pharmacological pain management is preferred for community-dwelling older adults. This systematic review evaluates the effectiveness, suitability, and sustainability of non-pharmacological pain management interventions for community-dwelling older adults. Methods Five databases, namely, CINHAL, Journals@Ovid, Medline, PsycInfo, and PubMed, were searched for articles. The criteria for inclusion were: full-text articles published in English from 2005 to February 2019 on randomized controlled trials, with chronic non-cancer pain as the primary outcome, in which pain was rated by intensity, using non-pharmacological interventions, and with participants over 65 years old, community-dwelling, and mentally competent. A quality appraisal using the Jadad Scale was conducted on the included articles. Results Ten articles were included. The mean age of the older adults was from 66.75 to 76. The interventions covered were acupressure, acupuncture, guided imagery, qigong, periosteal stimulation, and Tai Chi. The pain intensities of the participants decreased after the implementation of the intervention. The net changes in pain intensity ranged from − 3.13 to − 0.65 on a zero to ten numeric rating scale, in which zero indicates no pain and ten represents the worst pain. Conclusions Non-pharmacological methods of managing pain were effective in lowering pain levels in community-dwelling older adults, and can be promoted widely in the community.
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Affiliation(s)
- Shuk Kwan Tang
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong.
| | - Mimi Mun Yee Tse
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Sau Fong Leung
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Theofanis Fotis
- School of Health Sciences, University of Brighton, Westlain House, Village Way, Brighton, BN1 9PH, UK
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Williams H. The Unspoken Importance of the Nurse in the 2016 National Pain Strategy. Pain Manag Nurs 2017; 18:123-128. [PMID: 28528934 DOI: 10.1016/j.pmn.2017.04.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Revised: 11/15/2016] [Accepted: 04/11/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Hants Williams
- Department of Pain and Translational Symptom Science, University of Maryland Baltimore, Baltimore, Maryland
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7
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Yazdkhasti M, Pirak A. The effect of aromatherapy with lavender essence on severity of labor pain and duration of labor in primiparous women. Complement Ther Clin Pract 2016; 25:81-86. [DOI: 10.1016/j.ctcp.2016.08.008] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2016] [Revised: 08/14/2016] [Accepted: 08/15/2016] [Indexed: 10/21/2022]
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Kekecs Z, Nagy T, Varga K. The effectiveness of suggestive techniques in reducing postoperative side effects: a meta-analysis of randomized controlled trials. Anesth Analg 2015; 119:1407-19. [PMID: 25289661 DOI: 10.1213/ane.0000000000000466] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Suggestive interventions such as hypnosis and therapeutic suggestions are frequently used to alleviate surgical side effects; however, the effectiveness of therapeutic suggestion intervention has not yet been systematically evaluated. In the present study, we tested the hypotheses that (1) suggestive interventions are useful for reducing postoperative side effects; (2) therapeutic suggestions are comparable in effectiveness to hypnosis; (3) live presentation is more effective than recordings; and (4) suggestive interventions would be equally effective used in minor and major surgeries. METHODS We performed random effect meta-analysis with meta-regression and sensitivity analysis by moderating factors on a pool of 26 studies meeting the inclusion criteria (N = 1890). Outcome variables were postoperative anxiety, pain intensity, pain medication requirement, and nausea. RESULTS Suggestive interventions reduced postoperative anxiety (g = 0.40; 99% confidence interval [CI] = 0.13-0.66; P < 0.001) and pain intensity (g = 0.25; 99% CI = 0.00-0.50; P = 0.010), but did not significantly affect postoperative analgesic drug consumption (g = 0.16; 99% CI = -0.16 to 0.47; P = 0.202) and nausea (g = 0.38; 99% CI = -0.06 to 0.81; P = 0.026). No significant differences were found for intervention type, presentation method, and severity of surgery; however, sensitivity analysis only supported the effectiveness of hypnosis (g = 0.62; 99% CI = 0.31-0.92; P < 0.001) and live presentation (g = 0.55; 99% CI = 0.23-0.88; P < 0.001) for decreasing postoperative anxiety, and that of live presentation for alleviating postoperative pain (g = 0.44; 99% CI = 0.07-0.82; P = 0.002). Sensitivity analyses also suggested that suggestive interventions are only effective for decreasing pain intensity during minor surgical procedures (g = 0.39; 99% CI = 0.00-0.78; P = 0.009). CONCLUSIONS Suggestive techniques might be useful tools to alleviate postoperative anxiety and pain; however, strength of the evidence is weak because of possible bias in the reviewed articles. The lack of access to within-subjects data and the overlap between moderator conditions also limit the scope of the analysis. More methodologically correct studies are required with sensitivity to moderating factors and to within-subjects changes. For clinical purposes, we advise the use of hypnosis with live presentation to reduce postoperative anxiety and pain, until convincing evidence is uncovered for the effectiveness of therapeutic suggestions and recorded presentation. Pain management with adjunct suggestive interventions is mostly encouraged in minor rather than major surgeries.
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Affiliation(s)
- Zoltán Kekecs
- From the *Department of Affective Psychology, Faculty of Psychology and Education, Eötvös Loránd University, Budapest, Hungary; and †Faculty of Psychology and Education, Doctoral School of Psychology, Eötvös Loránd University, Budapest, Hungary
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Castillo-Bueno MD, Moreno-Pina JP, Martínez-Puente MV, Artiles-Suárez MM, Company-Sancho MC, García-Andrés MC, Sánchez-Villar I, Hernández-Pérez R. Effectiveness of nursing intervention for adult patients experiencing chronic pain: a systematic review. ACTA ACUST UNITED AC 2010; 8:1112-1168. [PMID: 27820209 DOI: 10.11124/01938924-201008280-00001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
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.
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Affiliation(s)
- M D Castillo-Bueno
- 1. Centro Tecnológico de Información y Documentación Sanitaria. Murcia. España. 2. Equipo de Atención Primaria "Profesor Jesús Marin". Murcia. España. 3. Hospital Reina Sofía. Murcia. España 4. Complejo Hospitalario Universitarios Insular Materno Infantil. Canarias. España 5. Dirección General de Programas Asistenciales. Canarias. España 6. Escuela Universitaria de Enfermería " Ntra. Sra. Candelaria". Canarias. España. 7. Hospital Universitario de Canarias. Canarias. España. 8. Equipo de Atención Primaria "Laguna San Benito ". Canarias. España. 9. Spanish Collaborating Centre of the Joanna Briggs Institute for Evidence Based Healthcare
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Westerbotn M, Hillerås P, Fastbom J, Agüero-Torres H. Pain reporting by very old Swedish community dwellers: the role of cognition and function. Aging Clin Exp Res 2008; 20:40-6. [PMID: 18283227 DOI: 10.1007/bf03324746] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND AIMS Pain is a common and unpleasant problem among elderly people and affects the possibility for them to remain living in their own homes. The aims of this study were therefore to report the prevalence of pain reporting and pain treatment, and their association with functional and cognitive status in a very old population. METHODS Cross-sectional population-based study. Participants were 333, aged 84 years or older, living at home alone or with someone in Kungsholmen, in central Stockholm, Sweden. Information on pain was obtained from interviews. The Mini- Mental State Examination (MMSE) measured cognitive status and the index of basic Activities of Daily Living (ADL) functional status. Descriptive statistics were used to describe the population and logistic regression models to investigate factors associated with pain reporting and pain treatment. RESULTS The prevalence of pain was 46%, and the prevalence of pain treatment 71%. Results from logistic regression analysis including all variables in the model showed that pain reporting was not associated with age, gender or living conditions. However, pain reporting was correlated with cognitive and functional status. There was no association between pain treatment and age, gender, living conditions, cognitive or functional status. CONCLUSIONS Pain is common among the oldest old. Our results indicate that cognitive and functional status affect pain reporting. Poor cognitive status was associated with less pain reporting, whereas poor functional status was associated with more pain reporting.
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Effectiveness of nursing intervention for adult patients experiencing chronic pain: a systematic review. JBI LIBRARY OF SYSTEMATIC REVIEWS 2008; 6:1-13. [PMID: 27820466 DOI: 10.11124/01938924-200806121-00003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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12
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Abstract
AIM This paper presents a literature review examining the implications of previous research in order to make evidence-based decisions about the possible use of breathing exercises with adult patients with burns for pain management during wound care. BACKGROUND Adult patients with burns experience pain during wound care despite pharmacological interventions. Additional interventions are needed to improve the effectiveness of pain management. Relaxation techniques can be considered, for example breathing exercises, music and distraction. A simple breathing relaxation technique is especially relevant because it involves no risk, is easy and quick to learn, equipment does not need to be purchased and it can be employed immediately by the often exhausted and ill patient. However, the effect of breathing exercises on procedural pain during burn wound care has not been investigated. METHOD The CINAHL, PubMed and Cochrane databases were searched in 2004 in order to answer two questions: are breathing exercises effective in the management of procedural pain in adult burn patients, and what are the implications of previous investigations for future research concerning pain reduction in adult patients with burns during wound care? Eleven papers were included in the review. FINDINGS The effect of breathing exercises for pain management in patients with burns has not been investigated. Prior to undertaking an effect study, additional basic research is needed. The number of sessions necessary to learn to use the technique should be clarified. A valid and reliable instrument to assess relaxation must be developed. The adequacy of the proposed data collection procedure needs to be assessed. CONCLUSION It is not possible at this time to base decisions about the use of breathing exercises during wound care in adult patients with burns on research specific to the procedure and patient group. The most suitable relaxation technique for future investigation is concentration on breathing, in combination with jaw relaxation.
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Abstract
Nurses are in a key position to learn and use hypnosis with patients to reduce pain and enhance self-esteem. However, most nurses lack knowledge about the clinical effectiveness of hypnosis and may seek continuing education to become skilled in its use. Painful procedures, treatments, or diseases remain a major nursing challenge, and nurses need complementary ways to relieve pain from surgery, tumors, injuries, and chemotherapy. This article examines the evidence base related to hypnosis for pain management, as well as how to assess and educate patients about hypnosis.
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Affiliation(s)
- Sharon M Valente
- Research and Education, Department of Veteran Affairs, Los Angeles, California, USA.
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Abstract
This article is the second in a two-part series which explores pain and its management from a physiological perspective. Nurses play an important role in assessing and managing pain. Effective pain management by nurses requires them to have an understanding of the biological basis of the pain interventions which may be used to control pain. This article emphasizes the importance of pain assessment as a precursor for effective pain management and explores the biological basis of pain interventions which contribute to pain control. The role of non-pharmacological approaches in alleviating pain and their actions which contribute to pain relief are explored. The three main types of pharmaceutical agents used, non-opioids, opioids and adjuvant drugs, are introduced and their mechanisms of actions discussed.
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Affiliation(s)
- Helen Godfrey
- Faculty of Health and Social Care, University of the West of England, Bristol, UK
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15
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Jakobsson U. Pain management among older people in need of help with activities of daily living. Pain Manag Nurs 2004; 5:137-43. [PMID: 15616483 DOI: 10.1016/j.pmn.2004.09.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The aim of this study was to investigate the use of various pain relief methods among older people in chronic pain and in need of help to manage activities of daily living. People who reported pain and were in need of help to manage activities of daily living were included in the study. The Multidimensional Pain Inventory-Swedish version and a modified version of the Pain Management Inventory were used to study pain and methods of pain relief. The respondents used a variety of methods (median = 3) to relieve their pain; pharmacologic methods, rest, and distraction were the predominant strategies employed. A cluster analysis identified 2 main groups of people: people who used a few well-known methods and were significantly older and people who used a larger repertoire of methods to relieve their pain and reported higher pain severity and interference with daily life. About a third of older people reported inadequate pain relief. These findings stress the need for nurses to inform older people about available methods for pain relief and to do systematic pain assessments to evaluate the effectiveness of various pain relief methods.
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Affiliation(s)
- Ulf Jakobsson
- Departmrent of Nursing, Faculty of Medicine, PO Box 157, Lund University, SE-221 00 Lund, Sweden.
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Abstract
As a result of the Joint Commission on Accreditation of Healthcare Organizations accreditation standards for 2001, pain management for hospitalized patients has become a top priority of healthcare facilities. In addition to using the traditional pharmacological approach to pain management, many patients also use complementary or alternative medicine (CAM) treatments. However, CAM treatments may not be discussed or offered to patients by healthcare providers who lack awareness about these alternatives. The purpose of this study was to assess patients' perceptions of pain, their beliefs about the use of pharmacological and CAM pain management techniques, and their satisfaction with pain management. Researchers verbally administered a survey to patients by using a combination of open-ended questions and a 0-10 rating scale, and they recorded their responses. This study was conducted in a not-for-profit teaching hospital in the southeast United States. Convenience sampling was used to select the 137 patients who completed the surveys. No treatment intervention was provided. Pharmacological treatment was the primary method expected and used by the majority of patients for pain management. Chi-squared statistics were used to analyze nonparametric data. An analysis of variance was used to analyze parametric data. The frequency with which nonpharmacological CAM options were used ranged from 6 to 34 percent. The most commonly used CAM method was distraction, such as watching television or reading.
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Affiliation(s)
- Kay Tasso
- Department of Athletic Training & Physical Therapy at the University of North Florida, Jacksonville, USA
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Schwarzer G, Antes G, Schumacher M. Inflation of type I error rate in two statistical tests for the detection of publication bias in meta-analyses with binary outcomes. Stat Med 2002; 21:2465-77. [PMID: 12205693 DOI: 10.1002/sim.1224] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The use of meta-analysis to combine results of several trials is still increasing in the medical field. The validity of a meta-analysis may be affected by various sources of bias (for example, publication bias, language bias). Therefore, an analysis of bias should be an integral part of any systematic review. Statistical tests and graphical methods have been developed for this purpose. In this paper, two statistical tests for the detection of bias in meta-analysis were investigated in a simulation study. Binary outcome data, which are very common in medical applications, were considered and relative effect measures (odds ratios, relative risk) were used for pooling. Sample sizes were generated according to findings in a survey of eight German medical journals. Simulation results indicate an inflation of type I error rates for both tests when the data are sparse. Results get worse with increasing treatment effect and number of trials combined. Valid statistical tests for the detection of bias in meta-analysis with sparse data need to be developed.
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Affiliation(s)
- Guido Schwarzer
- Freiburg Center for Data Analysis and Modelling, University of Freiburg, Germany.
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McCaffery M. What is the role of nondrug methods in the nursing care of patients with acute pain? Pain Manag Nurs 2002; 3:77-80. [PMID: 12198637 DOI: 10.1053/jpmn.2002.127571] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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McMillan C. Breakthrough pain: assessment and management in cancer patients. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2001; 10:860-6. [PMID: 11927886 DOI: 10.12968/bjon.2001.10.13.860] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/01/2001] [Indexed: 11/11/2022]
Abstract
This article provides an overview of breakthrough pain in cancer patients, what causes it, current treatment options and the impact it has on individuals. It considers the importance of accurate assessment, the use of assessment tools and the growing role of nurses in managing this challenging pain syndrome. The article aims to open the debate on the need for new choices in pain management. While many advances have been made in the treatment of pain, there is still room for improvement in both the pharmaceutical and general management of the condition. Suggestions are made as to how these may be met.
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Affiliation(s)
- C McMillan
- Prince and Princess of Wales Hospice, Glasgow, Scotland, UK
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Lewis S, Clarke M. Forest plots: trying to see the wood and the trees. BMJ (CLINICAL RESEARCH ED.) 2001; 322:1479-80. [PMID: 11408310 PMCID: PMC1120528 DOI: 10.1136/bmj.322.7300.1479] [Citation(s) in RCA: 434] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- S Lewis
- Neurosciences Trials Unit, Department of Clinical Neurosciences, University of Edinburgh, Western General Hospital, Edinburgh EH4 2XU.
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Spilsbury K, Meyer J. Defining the nursing contribution to patient outcome: lessons from a review of the literature examining nursing outcomes, skill mix and changing roles. J Clin Nurs 2001; 10:3-14. [PMID: 11820235 DOI: 10.1046/j.1365-2702.2001.00423.x] [Citation(s) in RCA: 72] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A review of the evidence to define the nursing contribution to patient outcome is presented. The review relies on work related to nursing sensitive outcomes, skill mix and changing roles. Methodological difficulties associated with these studies are highlighted. Areas requiring further research are discussed. It is suggested that experimental evidence is not always appropriate, when attempting to describe nursing activity. The authors advocate that new methodologies, in particular practitioner-centred research, are needed to unpack the nature of nursing.
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Affiliation(s)
- K Spilsbury
- St Bartholomew School of Nursing and Midwifery, City University, London, UK.
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Kanji N. Management of pain through autogenic training. COMPLEMENTARY THERAPIES IN NURSING & MIDWIFERY 2000; 6:143-8. [PMID: 11858472 DOI: 10.1054/ctnm.2000.0473] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Physical and emotional pain are an inevitable part of human existence and are without natural antidotes. In view of this, and in the light of increasing professional reluctance to depend on analgesics, this paper proposes the widespread application of autogenic training, a relaxation technique which has been seen to confront pain very effectively, and also to reduce substantially drugs dependency. It analyses autogenic training in respect of some of the more common pain-allied disorders such as childbirth, headaches and migraines, back pain, cancer and palliative care, and cardiology.
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Affiliation(s)
- N Kanji
- Faculty of Health Studies, Buckinghamshire Chilterns University College, Chalfont St Giles, Buckinghamshire, UK.
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Newman K, Pyne T, Leigh S, Rounce K, Cowling A. Personal and organizational competencies requisite for the adoption and implementation of evidence-based healthcare. Health Serv Manage Res 2000; 13:97-110. [PMID: 11184014 DOI: 10.1177/095148480001300204] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- K Newman
- Middlesex University Business School, London, UK
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Affiliation(s)
- Kathy Redmond
- School of Nursing and Midwifery, University College Dublin, Earlsfort Terrace, Dublin 2, Ireland
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Newman K, Pyne T, Cowling A. Managing evidence-based health care: a diagnostic framework. JOURNAL OF MANAGEMENT IN MEDICINE 1997; 12:151-67, 138. [PMID: 10185767 DOI: 10.1108/02689239810231989] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This paper proposes a diagnostic framework useful to Trust managers who are faced with the task of devising and implementing strategies for improvements in clinical effectiveness, and is based on a recent study incorporating clinicians, managers, and professional staff in four NHS Trusts in the North Thames Region. The gap framework is inspired by the gap model developed by Zeithaml, Parasuraman and Berry from their research into service quality and incorporates Dave Sackett's schema as well as a personal competency profile needed for the practice of evidence based health-care (EBHC). The paper highlights the four organisational and personal failures (gaps) which contribute to the fifth gap, namely the discrepancy between clinically relevant research evidence and its implementation in health care. To close the gaps, Trusts need to set the goal and tackle the cultural, organisational, attitudinal and more material aspects such as investment in the information infrastructure, education and training of doctors. Doctors need to go through a process from awareness to action facilitated through a combination of personal and organisational incentives and rewards as well as training in the requisite skills. Researchers should take steps to improve the quality of the evidence and its accessibility and purchasers should reinforce the use of EBHC by withdrawing funding for care which has proved to be ineffective, inappropriate or inferior.
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Affiliation(s)
- K Newman
- Middlesex University Business School, London, UK
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Abstract
The science of systematically reviewing literature has become a research process in its own right. The key word of course, is systematic. In the context of a systematic review this indicates that all possible sources have been comprehensively searched using a pre-defined search strategy designed to identify all relevant published and unpublished work. This paper illustrates the components of a comprehensive search, examines the yield of this approach and discusses the time and resource requirements for conducting the search. It uses as an example a recently completed systematic review. The paper goes on to discuss ways in which nurses can become more involved in conducting and using the results of good quality reviews.
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Affiliation(s)
- F Sindhu
- National Audit Office, London, United Kingdom
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