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Lam N, Green J, Hallas S, Forster A, Crocker TF, Andre D, Ellwood A, Clegg A, Brown L. Mapping review of pain management programmes and psychological therapies for community-dwelling older people living with pain. Eur Geriatr Med 2024; 15:33-45. [PMID: 37853269 PMCID: PMC10876761 DOI: 10.1007/s41999-023-00871-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 09/19/2023] [Indexed: 10/20/2023]
Abstract
PURPOSE Persistent pain is common in older people and people living with frailty. Pain or the impact of pain on everyday life is potentially modifiable. We sought to map research evidence and information from randomised controlled trials (RCTs) of pain management programmes and psychological therapies targeting community-dwelling older people, and explore appropriate strategies and interventions for managing or reducing the negative impact of pain for older people, particularly those with frailty. METHOD A mapping review of pain management programmes and psychological therapies for community-dwelling older people living with chronic pain. We searched for systematic reviews of randomised controlled trials and for individual randomised controlled trials and extracted data from eligible studies. RESULTS Searches resulted in 3419 systematic review records and 746 RCT records from which there were 33 eligible interventions identified in 31 eligible RCTs (48 reports). Broad aims of the interventions were to: improve physical, psychological, or social functioning; adjust the effects or sensation of pain psychologically; enhance self-care with self-management skills or knowledge. Common mechanisms of change proposed were self-efficacy enhanced by self-management tasks and skills, using positive psychological skills or refocusing attention to improve responses to pain, and practising physical exercises to improve physiological well-being and reduce restrictions from pain. Content of interventions included: skills training and activity management, education, and physical exercise. Interventions were delivered in person or remotely to individuals or in groups, typically in 1-2 sessions weekly over 5-12 weeks. CONCLUSION All the evaluated interventions appeared to show potential to provide some benefits to older people. None of the included studies assessed frailty. However, some of the included interventions appear appropriate for community-dwelling older people living with both frailty and pain.
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Affiliation(s)
- Natalie Lam
- Academic Unit for Ageing and Stroke Research (University of Leeds), Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford Teaching Hospitals NHS Foundation Trust, Duckworth Lane, Bradford, BD9 6RJ, UK
- Department of Health Sciences, University of York, York, UK
| | - John Green
- Academic Unit for Ageing and Stroke Research (University of Leeds), Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford Teaching Hospitals NHS Foundation Trust, Duckworth Lane, Bradford, BD9 6RJ, UK
| | - Sarah Hallas
- Academic Unit for Ageing and Stroke Research (University of Leeds), Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford Teaching Hospitals NHS Foundation Trust, Duckworth Lane, Bradford, BD9 6RJ, UK
| | - Anne Forster
- Academic Unit for Ageing and Stroke Research (University of Leeds), Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford Teaching Hospitals NHS Foundation Trust, Duckworth Lane, Bradford, BD9 6RJ, UK
- University of Leeds, Leeds, UK
| | - Thomas F Crocker
- Academic Unit for Ageing and Stroke Research (University of Leeds), Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford Teaching Hospitals NHS Foundation Trust, Duckworth Lane, Bradford, BD9 6RJ, UK.
- University of Leeds, Leeds, UK.
| | | | - Alison Ellwood
- Born in Bradford, Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Andrew Clegg
- Academic Unit for Ageing and Stroke Research (University of Leeds), Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford Teaching Hospitals NHS Foundation Trust, Duckworth Lane, Bradford, BD9 6RJ, UK
- University of Leeds, Leeds, UK
| | - Lesley Brown
- Academic Unit for Ageing and Stroke Research (University of Leeds), Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford Teaching Hospitals NHS Foundation Trust, Duckworth Lane, Bradford, BD9 6RJ, UK
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Tse MMY, Yan E, Tang ASK, Cheung D, Ng S. A music-with-movement exercise programme for community-dwelling older adults suffering from chronic pain: A pilot randomized controlled trial. Nurs Open 2023; 10:6566-6574. [PMID: 37415289 PMCID: PMC10416030 DOI: 10.1002/nop2.1915] [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: 05/12/2022] [Revised: 02/14/2023] [Accepted: 05/29/2023] [Indexed: 07/08/2023] Open
Abstract
AIM This study developed, implemented and tested the effectiveness of a music-with-movement exercise programme in improving the pain situations of older adults with chronic pain. DESIGN A pilot randomized controlled trial. METHODS This was a pilot randomized controlled trial. The intervention was an 8-week music-with-movement exercise (MMEP) programme for older adults with chronic pain recruited in elders' community centres. The control group received the usual care and a pain management pamphlet. Outcome variables were pain intensity, pain self-efficacy and pain interference, depression and loneliness. RESULTS Seventy-one participants joined this study. Pain intensity was significantly reduced between the experimental group compared to the control group. The experimental group participants reported significant improvements in pain self-efficiency, pain interference and reduced loneliness and depressive symptoms. However, no significant difference was observed between groups.
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Affiliation(s)
- Mimi M. Y. Tse
- School of Nursing and Health StudiesHong Kong Metropolitan UniversityHong Kong CityHong Kong
| | - Elsie Yan
- Department of Applied Social SciencesHong Kong Polytechnic UniversityHong Kong CityHong Kong
| | - Angel S. K. Tang
- School of NursingThe Hong Kong Polytechnic UniversityHong Kong CityHong Kong
- Present address:
School of NursingCaritas Medical Centre, Hospital AuthorityHong Kong CityHong Kong
| | - Daphne Cheung
- School of NursingThe Hong Kong Polytechnic UniversityHong Kong CityHong Kong
| | - Shamay Ng
- Department of Rehabilitation SciencesThe Hong Kong Polytechnic UniversityHong Kong CityHong Kong
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Abuijlan IAM, Muthu P, Avinash MN. Nurses Experience and Perceived Challenges of Using Nonpharmacological Pain Interventions for Musculoskeletal Pain: A Qualitative Study. SAGE Open Nurs 2023; 9:23779608231215600. [PMID: 38020316 PMCID: PMC10658770 DOI: 10.1177/23779608231215600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 10/20/2023] [Accepted: 11/05/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Current musculoskeletal pain management guidelines encourage utilizing nonpharmacological pain measures. Despite their positive effect in alleviating musculoskeletal pain, nurses reported negative attitudes toward utilizing nonpharmacological pain measures. Therefore, assessing nurses' perception of nonpharmacological pain measures is essential to promote patient comfort. Objective The aim of the study was to explore the nurses' experience and perceived challenges in using nonpharmacological pain measures in caring for patients with musculoskeletal pain. Materials & Methods A descriptive qualitative design was carried out. Face-to-face semistructured interviews were conducted among 11 nurses. Colaizzi's method was employed in analyzing the data. Results Four themes emerged, namely, constant monitoring and observation, selection of nonpharmacological pain measures, and various barriers related to patients and nurses. One of the ways to overcome these barriers or challenges, we should promote interprofessional teams in planning patient-centered pain management care. Also, defining the role of the pain management nurse would be pivotal to ensuring effective pain management measures. Conclusion The nursing workforce needs to initiate and utilize these measures as a common practice in managing musculoskeletal pain and in turn create a culture that strongly supports the utilization of nonpharmacological pain measures.
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Affiliation(s)
- Israa A. M. Abuijlan
- College of Nursing, RAK Medical and Health Sciences University, Ras Al Khaimah, UAE
| | - Priyalatha Muthu
- RAK College of Nursing, Medical and Health Sciences University, Ras Al Khaimah, UAE
| | - Manju Nair Avinash
- RAK College of Nursing, Medical and Health Sciences University, Ras Al Khaimah, UAE
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Fox AL, Swink LA, Prabhu N, Fruhauf CA, Portz JD, Van Puymbroeck M, Sharp JL, Leach HJ, Schmid AA. Manual development for a multi-modal, dyadic intervention for persistent pain: A Qualitative Study. Br J Pain 2022; 16:481-489. [PMID: 36389010 PMCID: PMC9644100 DOI: 10.1177/20494637221090461] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/03/2023] Open
Abstract
Background People who experience persistent pain often require help from a family member, partner, or friend. These caregivers frequently have pain but are often not included in interventions. Caregivers and care receivers who both experience pain are more likely to be socially isolated, and experience communication conflict and decreased quality of life. Interventions should target caregiving dyads to help them manage their pain together. However, there are few intervention manuals or research protocols developed to support the dyad. Objective The purpose of this qualitative study was to explore the needs of caregiving dyads, including input from dyads and medical and allied health experts to inform the development of an intervention manual for dyads with persistent pain. Method A total of 16 caregiving dyads experiencing persistent pain, one care receiver (caregiver could not participate), and 8 health experts, recruited from the community, participated in focus groups. Data were transcribed verbatim, uploaded into NVivo software, and analyzed using constant comparison qualitative methods. Results Findings identified the importance of a new intervention to focus on modifiable approaches to managing pain as a dyad, addressing the emotional and psychological effects of experiencing pain as a dyad, and careful consideration of logistics to implement an intervention with dyads in persistent pain. Conclusion These results highlight important considerations to meet the needs of caregiving dyads with pain. This study informed the development of the MY-Skills intervention, a novel program that merges self-management education with adaptive yoga to treat persistent pain in caregiving dyads.
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Affiliation(s)
| | - Laura A Swink
- Eastern Colorado VA Geriatric Research
Education and Clinical Center (GRECC), Aurora, CO, USA
- University of Colorado: Anschutz
Medical Campus, Aurora, CO, USA
| | - Neha Prabhu
- Growing Self Counseling and Coaching,
Denver, CO, USA
| | | | - Jennifer D Portz
- University of Colorado: Anschutz
Medical Campus, Aurora, CO, USA
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Tse MMY, Ng SSM, Lou V, Lo R, Cheung DSK, Lee P, Tang ASK. A Dyadic Pain Management Program for Community-Dwelling Older Adults with Chronic Pain: Study Protocol for a Cluster Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12186. [PMID: 36231486 PMCID: PMC9565005 DOI: 10.3390/ijerph191912186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 09/17/2022] [Accepted: 09/20/2022] [Indexed: 06/16/2023]
Abstract
Community-dwelling older adults suffer from chronic pain. Pain negatively affects their physical and psychosocial wellbeing. The majority of pain management education and programs focus only on older adults. Their informal caregivers should be involved in pain management. A dyadic pain management program for reducing pain and psychological health symptoms, and improving pain self-efficacy, quality of life, and physical function in older adults is proposed for evaluation of its effectiveness. This will be a cluster randomized controlled trial. Community-dwelling older adults aged 60 or above and their informal caregivers will be recruited. The dyadic pain management program will be an eight-week group-based program. The participants in the experimental group will receive four weeks of center-based, face-to-face activities and four weeks of digital-based activities via a WhatsApp group. The control group will receive the usual care and a pain management pamphlet. Data will be collected at baseline, and at the eighth-week and sixteenth-week follow-up session. The outcome measurements will include pain intensity, pain self-efficacy, perceived quality of life, depression, anxiety, and stress levels. Data on the caregiver burden will be collected from the informal caregivers. Because of the COVID-19 pandemic, all social activities have been suspended. In the near future, as the pandemic subsides, the dyadic pain management program will be launched to benefit community-dwelling older adults and informal caregivers and to reduce their pain and the care burden, respectively.
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Affiliation(s)
- Mimi M. Y. Tse
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong, China
| | - Shamay S. M. Ng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Vivian Lou
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - Raymond Lo
- Geriatrics and Palliative Medicine, Shatin Hospital, Hong Kong, China
| | | | - Paul Lee
- Department of Health Sciences, University of Leicester, Leicester LE1 7RH, UK
| | - Angel S. K. Tang
- School of Nursing, Caritas Medical Centre, Hospital Authority, Hong Kong, China
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Huang L, Shen Q, Fang Q, Zheng X. Effects of Internet-Based Support Program on Parenting Outcomes for Primiparous Women: A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094402. [PMID: 33919112 PMCID: PMC8122326 DOI: 10.3390/ijerph18094402] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 04/17/2021] [Accepted: 04/18/2021] [Indexed: 12/27/2022]
Abstract
(1) Background: Some primiparous women are usually confronted with many parenting problems after childbirth, which can negatively influence the wellbeing of some mothers and infants. Evidence identified that internet interventions can include more tailored information, reach a larger research group, and supply more anonymity than face-to-face traditional interventions. Therefore, the internet-based support program (ISP) was designed to improve the parenting outcomes for Chinese first-time mothers. (2) Methods: A multicenter, single-blinded, pilot randomized controlled trial was conducted. From May to October 2020, a total of 44 participants were recruited in the obstetrical wards of two tertiary hospitals in China. Eighteen women in the control group received routine postnatal care; while eighteen women in the intervention group accessed to the ISP and routine postnatal care. The duration of intervention was not less than three months. Intervention outcomes were assessed through questionnaires before randomization (T0), immediately after intervention (T1), and three months after intervention (T2). The Self-efficacy in Infant Care Scale (SICS), Edinburgh Postnatal Depression Scale (EPDS), and Postpartum Social Support Scale (PSSS) were included to measure MSE, postpartum depression (PPD), and social support, respectively. (3) Results: No significant difference between the two groups were found in terms of the baseline social-demographic characteristics; and the scores of SICS, EPDS and PSSS at T0 (p > 0.05). Repeated measures multivariate analysis of covariance found that women in the intervention group had a higher MSE score at T1 (6.63, p = 0.007), and T2 (5.75, p = 0.020); a lower EPDS score at T1 (3.11, p = 0.003), and T2 (2.50, p = 0.005); and a higher PSSS score at T1 (4.30, p = 0.001); and no significant difference at T2 (0.35, p = 0.743), compared with women in the control group. (4) Conclusion: The effect of ISP was evaluated to significantly increase primiparous women’s MSE, social support, and to alleviate their PPD symptoms. However, the small sample in pilot study restricted the research results. Therefore, the ISP should be further investigated with a larger, diverse sample to confirm whether it should be adopted as routine postnatal care to support primiparous women on parenting outcomes and mental wellbeing in the early stage of motherhood.
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Affiliation(s)
- Lingling Huang
- Health Science Centre, Shenzhen University, Shenzhen 518060, China; (L.H.); (Q.F.)
| | - Qu Shen
- Department of Nursing, School of Medicine, Xiamen University, Xiamen 361102, China;
| | - Qiyu Fang
- Health Science Centre, Shenzhen University, Shenzhen 518060, China; (L.H.); (Q.F.)
| | - Xujuan Zheng
- Health Science Centre, Shenzhen University, Shenzhen 518060, China; (L.H.); (Q.F.)
- Correspondence:
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