Non-pharmacological Methods Research Articles

Pengaruh Kompres Bawang Merah Plus Virgin Coconut Oil (VCO) Terhadap Penurunan Suhu Tubuh Pasca Imunisasi Difteri Pertusis Tetanus (DPT)

The incidence of fever following DPT (Difteri Pertusis Tetanus) immunisation is relatively high, often necessitating treatment with fever-reducing drugs, which may have adverse effects on infants. Therefore, non-pharmacological methods that are effective, safe, economical, and practical are essential. This research aims to investigate the effectiveness of an onion compress combined with virgin coconut oil (VCO) in reducing body temperature in infants following DPT immunization. The study employed a quasi-experimental method with a one-group pre-test and post-test design. The study population consisted of infants who received DPT immunization in the midwife's independent practice (PMB) working area at the Pudak Payung Health Centre, Semarang, with a total sample size of 48 infants selected via purposive sampling. Data were collected through observation, analysed using descriptive statistics, and the Wilcoxon signed-rank test. Prior to the intervention, 47 infants (45.92%) exhibited fever, and 1 infant (2.08%) had a high fever post-immunisation. Following the application of the shallot compress with VCO, all infants (100%) showed a reduction in body temperature, with none experiencing fever thereafter. The analysis indicated a significant effect of the onion compress combined with VCO on reducing body temperature (Z = -6.042, p < 0.01). The average body temperature of infants post-DPT immunisation decreased from a mean of 38.5°C before the intervention to 37°C afterwards. In conclusion, the use of an onion compress with VCO effectively reduces body temperature in infants following DPT immunization. This non-pharmacological approach presents a promising alternative to conventional fever management strategies.

“…We never considered it important…”: a qualitative study on perceived barriers on use of non-pharmacological methods in management of labour pain by nurse-midwives in eastern Tanzania

BackgroundA significant number of women experience labour without effective pain management and thus suffer from unbearable labour pain to the extent they term labour as the most agonizing event in their lives. Unresolved labour pain can lead to stress, fear, and confusion, which may compromise placental perfusion and lead to birth asphyxia. Although various pharmacological and non-pharmacological labour pain management methods exist, the use of non-pharmacological methods (NPMs) to manage labour pain has remained low in low-resource settings. This paper explored the barriers for using NPMs to manage labour pain by nurse-midwives in eastern Tanzania.MethodsWe conducted an exploratory qualitative study with 18 nurse-midwives purposefully recruited from the labour wards of two selected district hospitals in eastern Tanzania. Qualitative content analysis guided the data analysis.ResultsTwo categories illustrating barriers to using NPMs were generated: individual-level and institutional-level barriers. Individual-level barriers include (i) limited competencies of nurse-midwives on the use of NPMs for managing labour pain, (ii) inadequate exposure to labour pain management practices, (iii) misconceptions about labour pain relief, and (iv) a lack of opportunities for knowledge acquisition. The institutional barriers include (i) a critical staff shortage amidst many clients and (ii) an unfavourable healthcare facility environment.ConclusionThe implementation of NPMs for labour pain management by nurse-midwives in eastern Tanzania faces several institutional and individual barriers. We recommend addressing both supply- and demand-side barriers. Strengthening nurse midwives’ competencies in NPMs adoption and use and improving the facility environment to ensure privacy during labour can be a starting point for addressing supply-side issues. We recommend dispelling myths and misconceptions through health promotion education to address demand-side barriers.

Establishing a standardised approach for the measurement of neonatal noxious-evoked brain activity in response to an acute somatic nociceptive heel lance stimulus

BackgroundElectroencephalography (EEG) can be used in neonates to measure brain activity changes that are evoked by noxious events, such as clinically required immunisations, cannulation and heel lancing for blood tests. EEG provides an alternative approach to infer pain experience in infants compared with more commonly used behavioural and physiological pain assessments. Establishing the generalisability and construct validity of these measures will help corroborate the use of brain-derived outcomes to evaluate the efficacy of new or existing pharmacological and non-pharmacological methods to treat neonatal pain. This study aimed to test whether a measure of noxious-evoked EEG activity called the noxious neurodynamic response function (n-NRF), that was originally derived in a sample of term-aged infants at the Oxford John Radcliffe Hospital, UK, in 2017, can reliably distinguish noxious from non-noxious events in two independent datasets collected at University College London Hospital and at Royal Devon & Exeter Hospital. We aimed to reproduce three published results that use this measure to quantify noxious-evoked changes in brain activity. We used the n-NRF to quantify noxious-evoked brain activity to test (i) whether significantly larger noxious-evoked activity is recorded in response to a clinical heel lance compared to a non-noxious control heel lance procedure; (ii) whether the magnitude of the activity evoked by a noxious heel lance is equivalent in independent cohorts of infants; and (iii) whether the magnitude of the noxious-evoked brain activity increases with postmenstrual age (PMA) in premature infants up to 37 weeks PMA. Positive replication of these studies will build confidence in the use of the n-NRF as a valid and reliable pain-related outcome which could be used to evaluate analgesic efficacy in neonates. The protocol for this study was published following peer review (https://doi.org/10.17605/OSF.IO/ZY9MS). ResultsThe n-NRF magnitude to a noxious heel lance stimulus was significantly greater than to a non-noxious control heel lance stimulus in both the UCL dataset (n = 60; mean difference .88; 95% confidence interval (CI) .64–1.13; p < .0001) and the Exeter dataset (n = 31; mean difference .31; 95% CI .02–.61; p = .02). The mean magnitude and 90% bootstrap confidence interval of the n-NRF evoked by the heel lance did not meet our pre-defined equivalence bounds of 1.0 ± .2 in either the UCL dataset (n = 72; mean magnitude 1.33; 90% bootstrapped CI 1.18–1.52) or the Exeter dataset (n = 35; mean magnitude .92, 90% bootstrapped CI .74–1.22). The magnitude of the n-NRF to the noxious stimulus was significantly positively correlated with PMA in infants up to 37 weeks PMA (n = 65; one-sided Pearson's R, adjusted for site: .24; 95% CI .06–1.00; p = .03). ConclusionsWe have reproduced in independent datasets the findings that the n-NRF response to a noxious stimulus is significantly greater than to a non-noxious stimulus, and that the noxious-evoked EEG response increases with PMA. The pre-defined equivalence bounds for the mean magnitude of the EEG response were not met, though this might be due to either inter-site differences such as the lack of calibration of devices between sites (a true negative) or underpowering (a false negative). This reproducibility study provides robust evidence that supports the use of the n-NRF as an objective outcome for clinical trials assessing acute nociception in neonates. Use of the n-NRF in this way has the potential to transform the way analgesic efficacy studies are performed.

Emergence delirium: an overview with an emphasis on the use of electroencephalography in its management.

Emergence delirium remains a clinically significant issue, which often leads to distress among pediatric patients, parents, and staff in the short term; and may also result in postoperative maladaptive behaviors persisting for weeks to months. Although several diagnostic tools are available, the Pediatric Anesthesia Emergence Delirium Scale is most often utilized. Many risk factors contributing to the likelihood of a pediatric patient developing emergence delirium have been identified; however, its accurate prediction remains challenging. Recently, intraoperative electroencephalographic monitoring has been used to improve the prediction of emergence delirium. Similarly, it may also prevent emergence delirium if the anesthesiologist ensures that the at-risk patient rouses only after the onset of appropriate electroencephalogram patterns, thus indicating a change to natural sleep. Prediction of at-risk patients is crucial; preventing emergence delirium may begin early during patient preparation by using non-pharmacological methods (i.e., the ADVANCE program). Intraoperative electroencephalographic monitoring can predict emergence delirium. This review also discusses a range of pharmacological treatment options which may assist the anesthesiologist in preventing emergence delirium among at-risk patients.

Postoperative pain management is basic support of comfortable treatment in alveolar surgery

As a new clinical concept, comfortable treatment is gaining increasingly acceptance. Pain is the fifth vital sign in humans and the primary concern for patients. It is also a clinical issue that must be faced in alveolar surgery. This article summarizes pain cognition, the impact of postoperative pain and clinical pain grading. It also discusses the significance of postoperative pain management. It also categorizes commonly used analgesic medications in clinical practice; and introduces the concepts and techniques of comfortable treatment and comfortable therapy. The author suggests that in order to achieve comfortable treatment in alveolar surgery, the first step is to relieve postoperative pain. Postoperative pain management should not only be treated as temporary analgesia but should be managed around the perioperative period as the key stage. Using preemptive analgesia before the onset of pain, combined with non-pharmacological methods, provides basic support and guarantee for patients to achieve the goal of comfortable treatment. The purpose of this article is to emphasize comprehensive control of postoperative pain in alveolar surgery, guiding and promoting the popularization and promotion of corresponding technologies with the concept of comfortable treatment. This aims to reduce the adverse impact of surgery on both physical and mental well-being, facilitating physiological recovery and enhancing patient compliance. To ensure that patients undergo diagnosis, treatment, and rehabilitation processes with ease, comfort, and satisfaction.

Prevalence of use of nonpharmacological methods of pain relief among patients following onco surgeries – A prospective, observational cohort study from a single center

Abstract Background and Aims: For the aggressive treatment of postoperative pain, nonpharmacological methods (NPMs) are gaining importance complementary to routine multimodal pain management. The primary aim of the study was to assess the incidence of use of NPMs in our hospital. Secondary objectives were to correlate the pain scores, patient satisfaction, and percentage of time the patient was in severe pain within 72 h postsurgery with the use of NPMs when in pain/not in pain. The effect of NPMs on the physical and emotional outcome of patients as per the American Pain Society Patient Outcome Questionnaire (APS-POQ) was also assessed. Material and Methods: After obtaining approval from the institutional ethics committee (IEC), the trial was registered with the Clinical Trials Registry of India (CTRI). Informed consent was obtained from adult patients on the third postoperative day of elective surgeries. Their responses to the APS-POQ and to a few additional questions about their beliefs on the use of NPM were recorded. Results: Only one-fourth of the total study population were using NPMs for pain management in the hospital. After propensity matching for surgery and postoperative analgesia, two groups were made: one using NPM for pain relief (n = 49) and the other not using NPM (n = 98). There was no significant difference among the satisfaction score (P = 0.31), least pain score (P = 0.68), and worst pain score (P = 0.43) within 72 h postoperatively in either of the groups. Emotional and physical outcomes as per the APS-POQ were similar in both the groups. Conclusion: NPMs are rarely practiced and used during postoperative pain in our hospital. No difference in pain scores, patient satisfaction, and emotional and physical outcomes of the APS-POQ was seen in the group that indulged in NPMs.

Pharmacological and non-pharmacological prevention and management of delirium in critically ill and palliative patients in the inpatient setting: a review.

This review explores delirium in critically ill patients in the inpatient setting, focusing on its prevention and management. It evaluates the efficacy of both current pharmacological and non-pharmacological interventions, aiming to provide a comprehensive overview. A systematic literature search was conducted to identify relevant studies investigating the prevention and management of delirium resulting in a final sample of 26 articles for analysis. Of the 26 articles analyzed for this review (N = 8,831 participants) of controlled trials, 16 studies examined the prevention of delirium, 9 explored the treatment of delirium, and 1 investigated both prevention and treatment of delirium. Among the reviewed studies, there is evidence that non-pharmacologic methods are effective in the prevention of delirium. Evidence regarding pharmacological interventions for delirium prevention is varied and inconclusive, with some indication that atypical antipsychotics like aripiprazole and quetiapine may reduce the incidence of delirium. Regarding the treatment of delirium, there is limited evidence supporting the use of pharmacological agents. Additional double-blinded, randomized, placebo-controlled clinical trials are needed to investigate the efficacy of pharmacologic agents for diverse hospitalized populations.

Effect of physical activity on the severity of irritable bowel syndrome (IBS) symptoms

Irritable bowel syndrome is a chronic gastrointestinal disease whose symptoms affect patients' daily lives. Exacerbation of symptoms can worsen patients' quality of life and lead to depressive-anxiety and somatoform disorders. The associated costs burden not only the patients, but also those around them. The etiology of IBS is multifactorial and not fully understood. The brain-gut axis remains a subject of research, which may involve the development of new, effective therapies for the treatment of IBS in the future. Pharmacological and non-pharmacological methods are used to treat IBS. In order to provide the patient with the best possible treatment results in the absence of significant side effects, research is being conducted on the possibilities of non-pharmacological patient management. Currently, there are numerous studies on the effect of physical activity on the severity of symptoms in IBS patients. The results show that the introduction of moderate-intensity physical activity has positive effects in terms of alleviating gastrointestinal symptoms, reducing the severity of psychological and somatoform symptoms, and improving patients' well-being as well as quality of life. Appropriate physical activity is acceptable to patients and rated by them as positive and having a beneficial effect on IBS symptoms. The lack of patient-reported significant side effects is important. Given the results of the study, it seems beneficial to recommend that IBS patients perform moderate physical activity to alleviate and control symptoms. It is necessary to educate patients and individualize physical activity recommendations to match the type of activity to patients' abilities and needs.

PENGARUH HIDROTERAPI DAN MUSIK ALAM TERHADAP KUALITAS TIDUR PASIEN YANG MENJALANI KEMOTERAPI KANKER PAYUDARA

Breast cancer refers to the cellular malignant growth in breast tissue. Chemotherapy is an applicable treatment for breast cancer but this treatment causes sleeping problems as a side effect. Hydrotherapy and natural music are non-pharmacological methods to manage sleep problems. This quasi-experimental research determines the effects of hydrotherapy and natural music therapy on the quality of sleep of patients receiving breast cancer chemotherapy by applying One Group Pretest and Posttest. The research took 43 sample people using the Pittsburgh Sleep Quality Index (PSQI) questionnaire. The survey results revealed that 43 respondents, primarily aged 46 to 55 (23 respondents or 53.5%), 16 respondents with primary education (37.2%), and 32 unemployed respondents (74.4%). Most respondents received chemotherapy at Dr. Kariadi's hospital and had poor sleeping quality before the intervention. After the intervention, 32 respondents had excellent sleeping quality (74.4%). Wilcoxon's statistical results found the influence of hydrotherapy and natural music on the sleeping of patients receiving breast cancer chemotherapy at Dr. Kariadi's Hospital. The P-value value is 0.000 lower than 0.05, accepting Ha and rejecting Ho. The results also recommend the management of the intervention at the same room temperature.

Terapi Non Farmakologi Terhadap Mual Muntah dan Hiperemesis Gravidarum Pada Ibu Hamil: a Literatur Review

The incidence of nausea and vomiting affects almost 50% to 80% of pregnant women and approximately 5% of pregnant women require treatment in the form of hospitalisation for fluid replacement and correction of electrolyte imbalances. Non-pharmacological therapy is needed as an alternative or complementary treatment if pharmacological therapy causes side effects. in some cases nausea, vomiting, and hyperemesis gravidarum. This literature review aims to identify non-pharmacological therapies to help mothers overcome nausea, vomiting, and hyperemesis gravidarum in pregnancy. Five electronic databases were used for literature review research: PubMed, ProQuest, Google Scholar, Wiley Online Library, and Science Direct between 2014 and 2024. Of the 3,070 articles, 12 articles met the inclusion criteria and were analysed. This literature review provides evidence of non-pharmacological therapy methods that can be used as an alternative to treat nausea, vomiting, and hyperemesis gravidarum in pregnant women, namely oral therapy (ginger, mint leaves, and dates), inhalation therapy (lemon aromatherapy, lavender aromatherapy, and ginger aromatherapy) and therapy through massage (P6 acupressure and ST36 acupressure). The most frequently used and effective therapeutic methods for treating nausea, vomiting, and hyperemesis gravidarum in pregnant women are ginger therapy, lemon aromatherapy, and P6 acupressure.

A software-based observational coding approach for evaluating paediatric dental pain, anxiety, and fear.

Dental practitioners desire non-pharmacological methods to alleviate anxiety, fear, and pain in children receiving dental care; high-quality evidence, however, is required to evaluate methods' efficacy. This study aimed to develop and validate an observation-based coding approach (paediatric dental pain, anxiety, and fear coding approach [PAFCA]) to evaluate non-pharmacological behavior management techniques for anxiety, fear, and pain. Objective (video-based) and subjective (self-reported) anxiety, fear, and pain data were collected from a pilot clinical trial evaluating animal-assisted therapy (AAT) in paediatric dentistry, in which 37 children aged 7-14 were assigned to AAT or control before dental treatment (restorations or extractions). A coding approach utilizing a codebook, a gold standard calibration video, and a user training guide was developed. Trained examiners coded the gold standard video for inter-rater agreement, and masked, calibrated examiners analyzed videos using the Noldus Observer XT software. A novel, software-based coding approach was developed, with moderately high inter-rater agreement. Using PAFCA, we found children reporting higher levels of pain, fear, and anxiety exhibited treatment-interfering behaviors, including crying/moaning, attempts to dislodge instruments, and more upper and lower body movements. PAFCA shows promise as a reliable tool for assessing anxiety, pain, and fear in behavioral research for paediatric dentistry.

The Effect of Effleurage Knee Massage Therapy on Quality of Life in Elderly Women with Osteoarthritis

Background: Aging is a feminine phenomenon, and the quality of life is less in elderly women than in elderly men due to chronic diseases being two times more prevalent. This study was conducted to investigate the effect of knee massage on the quality of life of elderly women with osteoarthritis. Methods: The present study is a crossover clinical trial of 58 elderly women with mild to moderate osteoarthritis in two intervention and examination classes and two pre-wash and post-wash phases. In the first phase of the study, we gave a massage on each knee every day for 15 minutes a week using the effleurage method with standard treatment (diclofenac 100 mg), and the control group received only standard treatment. In the second phase, the intervention was shifted into groups according to the study type after 3 weeks of washout. We analyzed the data using SPSS 20 software. Descriptive statistics were used to describe quantitative and qualitative variables, and independent and paired t-tests were used to judge the effect of the intervention. The independent t test was also used to evaluate the effects of time and treatment. Results: In the first phase of the study, the independent t test results showed no significant difference between the quality of life scores in the two groups before the intervention (P&lt;0.452); however, after the intervention, the quality of life was significantly higher in group A (the group receiving massage) than in group B (the group receiving standard treatment) (P&lt;0.001). In the second phase of the study, the independent t-test results showed no significant difference between the two groups before the intervention (P&lt;0.32); however, after the intervention, the quality of life was significantly higher in group B (the group receiving massage in the second phase of the study) than in group A (the group receiving standard treatment in the second phase of the study) (P&lt;0.001). Conclusion: Results showed that conducting one-week massage therapies would enhance the quality of life of women. This finding was validated based on the sectional design and group replacement results, considering the value of quality of life in the elderly. As a result, using massage therapy is recommended as a low-risk, low-cost, and non-pharmacological method in old age.

Intermittent Fasting Targets Osteocyte Neuropeptide Y to Relieve Osteoarthritis.

Osteoarthritis is a highly prevalent progressive joint disease that still requires an optimal therapeutic approach. Intermittent fasting is an attractive dieting strategy for improving health. Here this study shows that intermittent fasting potently relieves medial meniscus (DMM)- or natural aging-induced osteoarthritic phenotypes. Osteocytes, the most abundant bone cells, secrete excess neuropeptide Y (NPY) during osteoarthritis, and this alteration can be altered by intermittent fasting. Both NPY and the NPY-abundant culture medium of osteocytes (OCY-CM) from osteoarthritic mice possess pro-inflammatory, pro-osteoclastic, and pro-neurite outgrowth effects, while OCY-CM from the intermittent fasting-treated osteoarthritic mice fails to induce significant stimulatory effects on inflammation, osteoclast formation, and neurite outgrowth. Depletion of osteocyte NPY significantly attenuates DMM-induced osteoarthritis and abolishes the benefits of intermittent fasting on osteoarthritis. This study suggests that osteocyte NPY is a key contributing factor in the pathogenesis of osteoarthritis and intermittent fasting represents a promising nonpharmacological antiosteoarthritis method by targeting osteocyte NPY.

Vitamin D Levels in Growth-Paining Children

The most common cause of non-inflammatory recurrent musculoskeletal pain in children is growing pains. History and physical examination are often sufficient to diagnose these patients. Since the exact etiology is not known, different treatments can be applied. The effect of vitamin D levels on children with growing pains was investigated. Clinical and laboratory findings of 138 pediatric patients with growing pain and 30 healthy control subjects were examined and then the changes in pain scores of children and their families with follow-up and treatment were evaluated. The pain was most commonly seen in the form of lower extremity pain at night and in girls. Although growing pains can be treated with nonpharmacological methods, there were also patients who required pharmacological treatment. Vitamin D deficiency was observed in children with growing pain. Vitamin D treatment was given to 46 patients with vitamin D deficiency. Pain scores made by both themselves and their families decreased in 91.4% of the patients who came for control. After the use of vitamin D in children with growing pains, the mean pain score reported by the children decreased from 7.26±1.757 to 2.46±2.38. The mean pain score reported by families about their children decreased from 7.56±1.97 to 2.51±2.53 after vitamin D supplementation. Although most of the time growing pain is a self-limiting clinical picture, vitamin D supplementation may be necessary after a differential diagnosis was made because of the high level of anxiety in the families of children who do not respond to non-pharmacological approaches.

Use of Dexmedetomidine versus Nitroglycerine to Provide Hypotensive Anesthesia in ENT Surgeries (Functional Endoscopic Sinus Surgery)

Abstract Background controlled (deliberate/induced) hypotension is a technique by which the arterial blood pressure is lowered in a controllable manner to reduce surgical blood loss and improve the operative field visibility. There are pharmacological and nonpharmacological techniques for inducing hypotension. The nonpharmacological methods for deliberate hypotension include positioning and positive pressure ventilation to control venous return. Aim of the Work to evaluate the efficacy of dexmedetomidine (DEX) as a hypotensive agent in comparison to nitroglycerin (NTG) in FESS regarding the bloodless field, reduction of mean arterial blood pressure, decrease inhalational anesthetic requirements (MAC), decrease perioperative opioid requirements, increase the time to first postoperative analgesic request and recovery profile and increase hemodynamics stability. Patients and Methods we conducted this study on 20 patients who were planned to perform functional endoscopic sinus surgery and were randomly distributed into 2 equal groups: 10 patients received dexamedotomidine and equal number of patients received nitroglycerine. Serial measurements of mean arterial blood pressure and heart rate were obtained and records between both groups were compared. Results There were statistically significant differences between both groups regarding heart rate as mean values of heart rate were lower among dexamedotomidine group. There were no statistically significant differences between both groups regarding mean arterial blood pressure values at different time points during the operation. Regarding the period after stopping infusion, mean values of heart rate and blood pressure were lower among dexamedotomidine group than nitroglycerine group after 5 minutes and after 10 minutes and the differences had statistically significant differences. Regarding postoperative period, both groups were comparable regarding heart rate and blood pressure immediately postoperative. Conclusion From the results of this study, we could conclude that both Dexmedetomidine and Nitroglycerin can be effectively used in induced hypotensive anesthesia for ENT surgery as FESS. Both groups were comparable with intra operative MAP with no statistically significant differences. This study also show that Dexmedetomidine has added advantages as better haemodynamic stability than Nitroglycerin (No rebound HTN, no tachycardia). Has sedative and analgesic effect, reduce requirement of anesthetic agents and perioperative analgesia. Postoperative recovery score (Time to reach modified Aldert score more than nine significantly higher. Postoperative complication as nausea and vomiting is less.

PENGARUH AROMATERAPI TERHADAP PENURUNAN NYERI PADA PASIEN DENGAN KANKER KOLOREKTAL : A SCOPING REVIEW

Pain is a prevalent symptom among cancer patients, accompanied by fatigue, sleep disturbances, anxiety, and depression. Aromatherapy, a non-pharmacological method, can safely reduce pain without negative side effects. It involves the use of essential oils as therapeutic agents, absorbed through the skin or olfactory system. This study aims to evaluate the impact of aromatherapy on pain reduction in colorectal cancer patients. This study uses a scoping review methodology based on PRISMA guidelines. The review encompasses three databases: PubMed, Sage, and ScienceDirect, covering the period from 2019 to 2024. Specific search terms were utilized based on inclusion criteria for article selection. Out of 2403 research articles, six were chosen after screening abstracts and full texts to identify studies meeting the inclusion criteria. The analysis identified various types of aroma therapy used for pain reduction. The studies reviewed indicated that aromatherapy was administered through massage and inhalation using essential oils like lavender, lemon, peppermint, geranium, and others. Aromatherapy showed significant positive effects in reducing pain compared to placebo or usual care control groups, as measured by the visual analog scale (VAS). The study's findings suggest that aromatherapy effectively reduces stress, depression, and pain perception in patients with colorectal cancer. Keywords: Aroma therapy; Colorectal Cancer; Pain

The effect of non-pharmacological methods on pain in patients undergoing open heart surgery: A systematic review and meta-analysis.

In this meta-analysis, we aimed to determine the effect of non-pharmacological methods on pain in patients undergoing open heart surgery. Scientific articles published between January 2002 and April 2022 were scanned in ScienceDirect, Scopus, PubMed, Web of Science, Google Scholar, Mendeley, Wiley Online Library databases. The keywords "open heart surgery," "cardiovascular surgery," "non-pharmacological," "complementary medicine," and "pain" were used in Turkish and English language. As a result of the search, 7,952 studies were identified and analyzed. Research data were obtained from 49 scientific articles. The total sample size of the studies included in the analysis was 3,097. The total effect size was found to be 3.070, with a 95% confidence interval of 2.522 at the lower limit and 3.736 at the upper limit. Non-pharmacological pain methods in open heart surgery included positive environmental experience, distraction, massage therapy, hand massage, foot massage, acupuncture therapy, lavender essential oil inhalation, cold application, music therapy, breathing and relaxation exercises, neurolinguistic programming, guided visualization, imagery, therapeutic touch, osteopathic treatment, and transcutaneous electrical nerve stimulation. The pain of patients who underwent open heart surgery with non-pharmacological methods combined with pharmacological methods was three times less than those without non-pharmacological methods. Based on these findings, non-pharmacological methods are recommended for use due to their ease of application, and low side effects.

The Effect of Foot Reflexology on Pain and Kinesiophobia in Patients Following Total Knee Arthroplasty: A Double-Blind Randomized Controlled Study.

Nonpharmacological methods are used in the management of pain and kinesiophobia following total knee arthroplasty. The aim of this double-blind randomized controlled trial was to examine the effect of foot reflexology on pain and kinesiophobia in patients following total knee arthroplasty. A total of 40 patients (20 in the control group and 20 in the intervention group) were randomly assigned to either of two groups for the study. The intervention group was exposed to foot reflexology. Postoperative Visual Analog Scale scores decreased faster in the intervention group compared to the control group (F =80.417; p <.001; η2=0.685). The Western Ontario and McMaster Universities Osteoarthritis Index scores decreased in the intervention group over time, while they increased in the control group (p <.05). While a gradual increase was observed in the Tampa Scale for Kinesiophobia scores in the control group, there was a decrease in the intervention group (F =84.860; p <.001; η2=0.696). The amount of analgesics used was lower in the intervention group (p <.05). Foot reflexology can be applied as an effective and safe method to manage pain and kinesiophobia in total knee arthroplasty patients.

The comparison of effectiveness of acupressure on Spleen 6 and Hugo points on the severity of postpartum pain: A randomized clinical trial.

Postpartum pain poses a significant challenge for new mothers. Various nonpharmacological methods are employed to manage postpartum pain. This study aimed to compare the effectiveness of acupressure on Spleen 6 and Hugo points on the severity of postpartum pain. In this parallel randomized trial study, 68 eligible primiparous women who had vaginal deliveries and experienced postpartum pain at Farabi Hospital in Malekan (a city in East Azarbaijan Province in Iran) were selected according to inclusion/exclusion criteria and then allocated to the Hugo (n = 34) and Spleen 6 (n = 34) acupressure groups using a randomized block design (six blocks). The data collection process took place from November 2022 to April 2023. The participants were blinded; however, the analysts and investigators were not blinded. Acupressure interventions were applied bilaterally for 20 min, consisting of 10 s of pressure followed by 2 s of rest. Pain intensity was assessed using a visual pain scale before, immediately after, and 1 h after the intervention. In total, 68 participants fulfilled the study. Data were analyzed using Statistical Package for the Social Sciences version 25 with chi-square, Mann-Whitney, and Friedman tests. Both groups exhibited a statistically significant reduction in postpartum pain intensity across all periods (p < 0.001). Although there was a significant difference in pain intensity between the groups before the intervention (p = 0.039), this distinction was not observed immediately and 1 h after the intervention (p ≥ 0.05). Both Hugo and Spleen's 6 acupressure interventions reduced postpartum pain intensity. No significant adverse events or side effects were observed. Acupressure on Spleen 6 and Hugo points helped decrease the severity of postpartum pain in primiparous women who had vaginal deliveries. Healthcare providers are encouraged to consider acupressure for postpartum pain management.

Acoustic Stimulation to Improve Slow-Wave Sleep in Alzheimer's Disease: A Multiple Night At-Home Intervention

ObjectivesTo investigate the efficacy of closed-loop acoustic stimulation (CLAS) during slow-wave sleep (SWS) to enhance slow-wave activity (SWA) and SWS in patients with Alzheimer's disease (AD) across multiple nights and to explore associations between stimulation, participant characteristics, and individuals’ SWS response. DesignA 2-week, open-label at-home intervention study utilizing the DREEM2 headband to record sleep data and administer CLAS during SWS. Setting and participantsFifteen older patients with AD (6 women, mean age: 76.27 [SD = 6.06], mean MOCA-score: 16.07 [SD = 6.94]), living at home with their partner, completed the trial. InterventionPatients first wore the device for two baseline nights, followed by 14 nights during which the device was programmed to randomly either deliver acoustic stimulations of 50 ms pink noise (± 40 dB) targeted to the slow-wave up-phase during SWS or only mark the wave (sham). ResultsOn a group level, stimulation significantly enhanced SWA and SWS with consistent SWS enhancement throughout the intervention. However, substantial variability existed in individual responses to stimulation. Individuals received more stimulations on nights with increased SWS compared to baseline than on nights with no change or a decrease. In individuals, having lower baseline SWS correlated with receiving fewer stimulations on average during the intervention. ConclusionCLAS during SWS is a promising nonpharmacological method to enhance SWA and SWS in AD. However, patients with lower baseline SWS received fewer stimulations during the intervention, possibly resulting in less SWS enhancement. Individual variability in response to stimulation underscores the need to address personalized stimulation parameters in future research and therapy development.