Non-pharmacological Pain Management Research Articles

PAIN MEDICATION AND FALL RISKS AMONG COMMUNITY-DWELLING OLDER ADULTS WITH ARTHRITIS

Abstract Pain medication is commonly used among older adults with arthritis. Research indicates an elevated fall risk among older adults with arthritis, yet this association among those who take medication for pain is not fully studied. This population-based study investigated the association of falls with pain medication use by arthritis status. A sample of community-dwelling Medicare beneficiaries in the 2015 National Health and Aging Trends Study, representing older adults who reported arthritis (n = 4,229) and no arthritis (n = 3,258), were analyzed using survey-weighted logistic regression analysis. Sensitivity analysis was performed to investigate differences in associations by the frequency of taking pain medication. All analyses were controlled for sociodemographic characteristics, living arrangements, balance problems, and chronic conditions. The majority of participants was 70 years or older (70.7%), female (55.3%), White (80.1%), had a high school or higher education (58.4%) and had two or more chronic conditions (53.6%). Significantly higher proportions of those with arthritis reported pain (67.9% vs. 32.1%) and pain medication use (63.1% vs. 36.9%) than those with no arthritis. Pain medication use (OR = 1.11, 95% CI: 1.03, 1.20) and balance problems (OR = 4.39, 95% CI 3.45, 5.59) were associated with falls among those with arthritis. Taking medication for pain every day a week (OR = 1.48, 95% CI: 1.05, 2.09) was associated with falls among those with arthritis. Findings suggest that the heavy use of pain medication may increase fall risk. Nonpharmacological pain management education is encouraged for supporting active living among older adults with arthritis.

Mapping Evidence-Based Non-Opioid and Non-Pharmacological Pain Management Modalities Across Minnesota: The Non-Opioid Pain Alleviation Information Network Project.

Objective: The Non-Opioid Pain Alleviation Information Network (NOPAINMN) project was designed to identify, consolidate, and map evidence-based non-opioid and non-pharmacological pain management complementary and integrative health (CIH) modalities for chronic pain management across Minnesota into a searchable and informational website (www.nopainmn.org ). Methods: The Academic Consortium for Integrative Medicine & Health's Pain Task Force White Paper identifying evidence-based research of non-pharmacological pain practice (NPPC) was reviewed and referenced. National and state certifying boards and accrediting organizations for NPPC modalities were accessed to identify Minnesota-based NPPC providers' name, business/health-system affiliation, address, contact information, and credentials. The NOPAINMN website displays these data in a consumer-facing website with searchable fields such as NPPC modality type, and location with varying distances. The website was β-tested by practitioners and stakeholders for optimization. Eight main NPPC modalities and their respective subcategories were identified and mapped: Acupuncture; Integrative Medical Care (Functional medicine consultation and Integrative medicine consultation); Massage Therapy; Mind-Body Therapies (Biofeedback, Clinical Hypnosis, Mindfulness-Based Stress Reduction, and Music Therapy); Movement Therapies (Tai Chi, qigong, and Yoga Therapy); Psychology (Cognitive Behavioral Therapy); Rehabilitative Therapies (Physical and Occupational Therapy); and Spinal Manipulation. Results: All information compiled resulted in 17,155 providers/practitioners. Physical Therapy had the greatest number of reported providers (n = 5224), followed by Occupational Therapy (n = 3792), Psychology (n = 3324), Chiropractic (n = 3033), Acupuncture (n = 591), and Massage Therapy (n = 544). The Resource Map included 56 major health systems, 686 facilities, 2651 solo or private group practices, and 14 academic training schools. With web-based cross-referencing, providers and facilities were affiliated and linked with health systems to produce an interconnected mapping system. β-Testing with patients found that the website was reported as relatively easy to use and informative. Conclusion: The website was created to assist individuals, health care providers, insurance carriers, and health care facilities in finding evidence-based information and resources on NPPC to guide, support, and proactively manage and engage chronic pain patients across Minnesota.

Current pediatric pain practice in Nigeria, South Africa, Uganda, and Zambia: A prospective survey of anesthetists.

Children in hospital experience significant pain, either inherent with their pathology, or caused by diagnostic/therapeutic procedures. Little is known about pediatric pain practices in sub-Saharan Africa. This survey aimed to gain insight into current pain management practices among specialist physician anesthetists in four sub-Saharan African countries. A survey was sent to 365 specialist physician anesthetists in Nigeria, South Africa, Uganda and Zambia. Content analysis included descriptive information about the respondents and their work environment. Thematic analysis considered resources available for pediatric pain management, personal and institutional pain practices. One hundred and sixty-six responses were received (response rate 45.5%), with data from 141 analyzed; Nigeria (27), South Africa (52), Uganda (41) and Zambia (21). Most respondents (71.83%) worked at tertiary/national referral hospitals. The majority of respondents (130/141, 91.55%) had received teaching in pediatric pain management. Good availability was reported for simple analgesia, opioids, ketamine, and local anesthetics. Just over half always/often had access to nurses trained in pediatric care, and infusion pumps for continuous drug delivery. Catheters for regional anesthesia techniques and for patient-controlled analgesia were largely unavailable. Two thirds (94/141, 66.67%) did not have an institutional pediatric pain management guideline, but good pharmacological pain management practices were reported, in line with World Health Organization recommendations. Eighty-eight respondents (62.41%) indicated that they felt appropriate pain control in children was always/often achieved in their setting. This survey provides insight into pediatric pain practices in these four countries. Good availability of a variety of analgesics, positive pain prescription practices, and utilization of some non-pharmacological pain management strategies are encouraging, and suggest that achieving good pain control despite limited resources is attainable. Areas for improvement include the development of institutional guidelines, routine utilization of pain assessment tools, and access to regional anesthesia and other advanced pain management techniques.

Using of non-pharmacological pain methods, and the perceived barriers, among nurses in critical care unit in Palestine

BackgroundPain is alleviated in one of the two common approaches, pharmacological or non-pharmacological intervention. Using non-pharmacological methods may have beneficial effect and priority on decreasing patients’ level of pain and decreasing the side effects of pharmacological methods in ICU patients. This study aimed to assess ICU Palestinian nurses use and barriers of non-pharmacological pain management.MethodsA quantitative descriptive cross-sectional design was used to collect responses from a convenient sample of 215 nurses working in six hospitals in Plaestine. The timeframe for data collection was from August 2022 to December 2022. This study had three instrument packages. The first part is demographic data. The second is a tool that used 4-point Likert scale to examine ICU nursing use of non-pharmacological pain methods and it consisted of 16 items. The third is six items of perceived barriers to use non-pharmacological pain methods. All statistical procedures were analyzed using Statistical Package of Social Science (SPSS) version 28.ResultsMore than two-thirds of the nurses used non-pharmacological pain methods in ICU. 60% of the nurses have high levels of use, 10.2% have very high levels. The two highest perceived barriers to use nonpharmacological method were the lack of time, workload, and patient instability with 83.7% (n = 180), and 77.2% (n = 166), respectively. Demographic variables were not significantly associated with the use of non-pharmacological pain management methods, except age.ConclusionAdopting culturally sensitive non-pharmacological pain methods to decrease ICU patients’ level of pain, may positively reflected on patients’ outcome and on healthcare system. Developing, implementing and continuous monitoring of guidelines regarding using nonpharmacological for nurses and physicians are recommended which will be reflected positively on patients’ outcomes. Great efforts to overcome the barriers of lack of time and workload is impertive to increase the clinical usage of nonpharmacological pain methods.

Non-pharmacologic Pain Management Knowledge and Barriers among Nurses in Erbil Hospitals

Aim of the study: Pain management is a multidisciplinary approach for easing suffering and improving the patients’ quality of life and nurses play a significant role in providing pain assessment and treatment. Non-pharmacological pain management is any intervention intended to improve health or well-being that does not involve the use of any drugs or medicine. This study aimed to assess the nurses’ knowledge and their barriers regard-ing non-pharmacologic pain management. Methods: A descriptive cross-sectional study was carried out at Hawler, Rizgary and Nanakaly teaching hospitals in medical and oncology wards on a non-probability purposive sample of 100 nurses who worked in the above wards. The data was collected from the end of December to the end of February 2020 through self-reports by nurses using a constructive single choice questionnaire. Each correctly answered item was recorded as 1 and the incorrect one as 0. Results: The higher percentages of nurses, including males aged between (30-39) years, institute graduates, and experienced in jobs between (1-10) years. 69% of nurses have a moderate level of non-pharmacologic pain management, and, 47% of nurses have not applied non-pharmacological pain management in hospitals. Only 16% of them applied, and 37% sometimes applied, psychological and physical methods of non-pharmacologic pain management were more applied by 29% and 23% respectively by nurses than other methods. Nurses had many barriers to using non-pharmacological pain management, like nursing workload and lack of protocol for pain management. Conclusion: This study concluded that the majority of nurses have a fair (moderate) level of knowledge about non-pharmacological pain management and applied by only 16 % of nurses. Nurses have many barriers to using non-pharmacological pain management.

Practice of non-pharmacological post-operative pain management and associated factors among nurses working in public referral hospitals of Amhara regional state, Ethiopia, 2019

BackgroundPostoperative pain is a combined effect of several unpleasant sensory, emotional and mental experiences. Patient’s previous experiences, nature and duration of surgery, site and size of the incision and the extent of surgical trauma are some of the factors affecting the degree of post-operative pain. ObjectivesTo assess practice of non-pharmacological post-operative pain management and associated factors among nurses working in public referral hospitals of Amhara regional state, Ethiopia. MethodInstitutional based cross-sectional study was conducted among nurses working in public referral hospitals of Amhara regional state, Ethiopia from March to April 2019. Census method was employed to select study participants. Data were entered into Epi info version 7.2.0.1 and exported to SPSS window version 20 for analysis. Binary and multivariable logistic regression was used to see the association between dependent and independent variables. The odds ratio with a 95 % confidence interval was computed. P-value < 0.05 was used to declare association. ResultsThree hundred nurses working in post-operative units of selected referral hospitals of Amhara regional state were involved in the study. The respondents’ ages (Mean ± SD.) were (29.8 ± 7.3) years and their experience (Mean ± SD) post-operative unit was (3.8 ± 3.3) years. Majority (59.7 %) of the respondents were females. This study revealed that about 50.2 % of nurses were not applied non-pharmacological post-operative pain management techniques for their patients. Nurse’s educational status, attendance of training, attitude of nurses, willingness of patients, experience in nursing, marital status and working unit were associated with practice of non-pharmacological post-operative pain management with p-value of < 0.05. ConclusionIn this study, nearly half of nurses didn’t apply non-pharmacologic pain management techniques for patients when they had pain. In-service training and educational development are recommended for nurses about non-pharmacologic pain management.

Non-Pharmacological Pain Management in Labor: A Systematic Review

Childbirth is a remarkable, life-changing process and is frequently regarded as an excruciating, physically and emotionally demanding experience that women endure. Labor pain management poses a significant challenge for obstetricians and expectant mothers. Although pharmacological pain management is the gold standard, it still imposes risks on the mother and baby. Recently, non-pharmacological pain management (NPPM) has emerged as a safe, effective option. Six databases were searched for articles published up to 2023 using specific related keywords and defined inclusion and exclusion criteria. The extraction and gathering of data was made so as to be categorized into physical, psychological, and complementary NPPM techniques. In light of the enormous development and diversity of NPPM techniques, the present review aims to examine contemporary NPPM knowledge and application, discussing efficacy, advantages, limitations, and potential adverse effects, with a specific focus on women’s individual requirements, to strengthen obstetricians’ knowledge in guiding decision-making for women in childbirth.

Virtual reality hypnosis diminishes experimental cold pain and alters autonomic responses.

Immersive virtual reality (VR) is a promising tool to reduce pain in clinical setting. Digital scripts displayed by VR disposals can be enriched by several analgesic interventions, which are widely used to reduce pain. One of these techniques is hypnosis induced through the VR script (VRH) which is facilitated by immersive environment and particularly efficient even for low hypnotizable patients. The aim of this study is to assess the efficacy of a VRH script on experimentally induced cold pain perception (intensity and unpleasantness) and physiological expression. 41 healthy volunteers had been recruited in this within-subjects study. They received 9 stimulations of 20 s (3 non-nociceptive cold; 3 low nociceptive cold and 3 highly nociceptive cold) during a VRH session of 20 min (VRH condition) or without VRH (noVRH condition). Physiological monitoring during the cold pain stimulation protocol consisted of recording heart rate, heart rate variability and respiratory frequency. Maximum cold pain intensity perception, measured through the visual analog scale (VAS) on 10, was of 3.66 ± 1.84 (VAS score/10) in noVRH condition and 2.46 ± 1.54 in VRH (Wilcoxon, p < 0.0001). Considering pain unpleasantness perception, 3.68 ± 2.06 in noVRH and 2.21 ± 1.63 in VRH (Wilcoxon, p < 0.0001). Hypnotizability negatively correlated with the decrease in VAS intensity from noVRH to VRH (Spearman r = -0.45; p = 0.0038). In our sample, we found that 31/41 volunteers (75.6%) displayed a reduction of more than 10% of their VAS pain intensity and unpleasantness scores. Trait anxiety was the best predictor of the VRH responders, as well as heart rate variability. In addition, respiratory rate was diminished under VRH in every subgroup. VRH is an effective tool to reduced pain intensity and unpleasantness in a vast majority of healthy subjects. We further indicate in this study that heart rate variability parameter RMSSD (root mean square of successive differences) is a good predictor of this effect, as well as anxiety as a personality trait (but not state anxiety). Further studies are expected to determine more precisely to whom it will be the most useful to offer tailored, non-pharmacological pain management solutions to patients.

Effectiveness of maternal-targeted training on nonpharmacologic pain management on heel stick sampling: A randomized controlled trial

BackgroundHeel stick sampling, which is a common procedure in newborns, causes acute pain, and parents are aware of this. AimThe current study aimed to investigate the effectiveness of maternal-targeted training on newborn pain management, addressing the use of nonpharmacological methods and anxiety. MethodsThe study is 2-arm, parallel-group randomized controlled trial. A total of 64 mothers were included in this study. Mothers were randomly allocated to each group; intervention (n:32) and control (n=:32). Training on nonpharmacological pain management in newborns was given to the mothers in the intervention group. Data were collected with an Introductory Information Form, Nonpharmacological Pain Management Use Checklist, and State-Trait Anxiety Inventory. ResultsNonpharmacological methods were used for the procedures in the control group and the intervention group, with an absolute difference of 68.8% between groups. The difference was statistically significant (p < 0.001) and had a large effect (d = −79.222; 95% CI, −9.365 to 670.143. There was no significant difference between the groups in terms of anxiety score (p = 0.558). ConclusionDemonstrates the clinical relevance and feasibility of training targeting maternal on neonatal pain management during the heel stick sampling procedure.Practice Implications: When non-pharmacological methods in pain management of newborns were recommended by the nurse, maternal involvement in pain management increased significantly, suggesting that nurses have a key role in ensuring parental involvement.Clinical Trial Registration: NCT05173662.

Empowering Pediatric Nurses in Non-Pharmacological Pain Management through Supportive-Educative Nursing Interventions at Islamic Hospital Jakarta Cempaka Putih

ABSTRAK Manajemen nyeri non-farmakologis pada anak merupakan komponen penting dalam perawatan pediatrik yang membutuhkan pengetahuan, sikap, dan keterampilan perawat yang kompeten. Namun, perawat anak sering menghadapi kendala dalam memahami metode-manajemen nyeri non-farmakologis. Oleh karena itu, Kegiatan Pengabdian kepada Masyarakat (PkM) ini bertujuan untuk mengevaluasi efektivitas program Supportive-Educative Nursing Interventions dalam meningkatkan perilaku perawat anak dalam menerapkan manajemen nyeri non-farmakologis. Kegiatan PkM melibatkan 15 perawat anak di Rumah Sakit Islam Jakarta Cempaka Putih dan terdiri dari lima sesi, termasuk brainstorming, edukasi kesehatan, pemutaran video, praktik kompres dingin, dan sesi diskusi. Analisis data menggunakan metode analisis kuantitatif dan kualitatif sederhana. Hasil PkM menunjukkan peningkatan signifikan dalam pengetahuan, sikap, dan keterampilan perawat anak dalam manajemen nyeri non-farmakologis pada anak. Temuan ini menegaskan pentingnya pendekatan pendidikan dan pelatihan dalam meningkatkan kualitas perawatan anak di lingkungan rumah sakit. Kata Kunci: Manajemen Nyeri Non-Farmakologis, Perawat Anak, Supportive-Educative Nursing Interventions ABSTRACT Non-pharmacological pain management in children is a crucial component of pediatric care that requires competent nurses to possess knowledge, attitude, and skills. However, pediatric nurses often face challenges due to inadequate understanding of non-pharmacological pain management methods. Therefore, this Community Service Activity (CSA) aims to evaluate the effectiveness of the Supportive-Educative Nursing Interventions program in improving the behavior of pediatric nurses in implementing non-pharmacological pain management. The CSA involved 15 pediatric nurses at Jakarta Cempaka Putih Islamic Hospital and consisted of five sessions, including brainstorming, health education, video presentations, cold compress practice, and discussion sessions. Data analysis was conducted using simple quantitative and qualitative methods. The results of the CSA showed a significant increase in the knowledge, attitude, and skills of pediatric nurses in non-pharmacological pain management in children. These findings emphasize the crucial role of educational and training approaches in enhancing the quality of pediatric care in a hospital setting. Keywords: Non-pharmacological pain management; Pediatric nurses; Supportive-educative nursing interventions

Prevalence of Pharmacologic and Nonpharmacologic Pain Management Therapies Among Adults With Chronic Pain-United States, 2020.

Prevalence of Pharmacologic and Nonpharmacologic Pain Management Therapies Among Adults With Chronic Pain-United States, 2020.

EVALUATING THE EFFICIENCY OF NON-PHARMACOLOGICAL PAIN MANAGEMENT TECHNIQUES DURING LABOR AND DELIVERY

Labor and delivery is a natural procedure that causes women significant pain and discomfort. Many women choose pharmacological pain management techniques, yet there is growing interest in non-pharmacological pain management techniques, viewed as safer and more natural than pharmacological methods. This study aimed to assess the efficacy of non-pharmacological pain management techniques during labor and delivery. In a randomized controlled trial, we randomly assigned 246 expectant women to either a non-pharmacological intervention or a control group. During labor and delivery, the non-pharmacological intervention group received a combination of relaxation techniques, including massaging and physical therapy, aromatherapy, TENS, and mixed interventions. The control group received standard care devoid of non-pharmaceutical interventions. Pain levels were measured using a visual analog scale at 30-minute intervals. Additionally, the length of labor, delivery mode, and birth outcomes were recorded using the APGAR score system. The demographic characteristics of patients in both groups were comparable and non-significant in variations (p&gt;0.05). Forty participants utilized each non-pharmacologic technique. Comparing VAS pain scale scores at 30-minute intervals, the distribution of pain intensity levels was comparable between the groups. The larger fraction of neonates in the non-pharmacological group had higher APGAR scores, indicating no need for immediate medical attention. Based on a reasonable comparison of the effectiveness of various interventions for managing labor pain and distress, it was found that 9 (22.5%) of 40 patients who received massaging therapy reported low efficacy in managing labor pain, 13 (32.5%) reported moderate efficacy, and 28 (70%) reported high efficacy. In the aromatherapy of 40 patients, 16 reported low efficacy, 21 reported moderate efficacy, and 13 reported high efficacy in managing labor pain. Ten patients (25%) reported low efficacy, 12 patients (30%) reported moderate efficacy, and 28 patients (70%) reported high efficacy in managing labor pain through TENS. It provided cost-effective and safe alternatives to pharmaceutical interventions during labor and delivery. When properly implemented, these techniques reduced pain intensity comparable to commercial medicines while significantly improving the birthing experience and potentially contributing to better maternal and neonatal outcomes.

Provider perspectives on pain management practices and needs in pediatric dentistry

BackgroundDental pain is common yet understudied and often undertreated in youth. To improve pain management in pediatric dentistry, it is necessary to understand practices and perceptions among providers. The authors assessed pediatric dentists’ use of and attitudes toward evidence-based pain management (EBPM) strategies. MethodsThe authors used a 27-item online survey to assess attitudes about EBPM, pain management and assessment practices, tools for disseminating knowledge about EBPM, and opinions regarding priority areas for improving pain management. Descriptive statistics were used to summarize findings; open-ended items were analyzed thematically. ResultsParticipants (N = 625) were pediatric dentists (89.2%) and pediatric dentistry residents (10.8%). Most respondents agreed that pain management is an important aspect of clinical care and thought that improvements in pain management practices are needed. Providers reported spending the most time facilitating pain management during the procedure (compared with before or after), and 73.2% said they feel this is an adequate amount of time. Distraction, tell-show-do techniques, and supportive language were the most used nonpharmacologic pain management strategies, and providers’ observational approaches were used most frequently for pain assessment. Top priority areas for improving pain management were reported as developing tools for caregivers and provider resources on nonpharmacologic pain management (ie, continuing education courses). ConclusionsProviders reported high use of EBPM strategies, low use of validated pain assessment tools, and a particular interest for professional development opportunities and patient resources focused on nonpharmacologic pain management. Practical ImplicationsFindings from this survey can inform dissemination and implementation of science efforts to improve pain management in pediatric dentistry.

Pengaruh Benson Terhadap Nyeri Insersi pada Pasien yang Menjalani Hemodialisa di RSUD Kota Tanjungpinang

Insertion pain is pain caused by the action of inserting a needle into the AV fistula as a link between blood vessel circulation and the hemodialysis machine during the hemodialysis process. In Brazil it was found that 70% of patients undergoing hemodialysis experienced mild to moderate pain at the time of AV fistula insertion. The phenomenon found in the hemodialysis unit at Tanjungpinang City Regional Hospital in 2020 was 33 patients experiencing moderate pain. This research was conducted to determine the effect of the Benson relaxation technique on pain during insertion in patients undergoing hemodialysis. The research method is a quasi experimental design, with a pre test – post test design approach without control group. The sample consisted of 30 respondents in the intervention and control groups who were routine hemodialysis patients at the Tanjungpinang City Regional Hospital in 2023. Using a non-probability sampling technique, consecutive sampling. Data were processed using the Wilcoxon signed rank test. Univariate analysis of results before the Benson technique, 73.3% experienced moderate pain and after the Benson technique, 80% did not feel pain in the intervention group. It was concluded that there was an influence of the Benson technique on insertion pain in patients undergoing hemodialysis. It is hoped that the Benson relaxation technique will be applied by nurses as non-pharmacological pain management to reduce AV-fistula insertion pain in hemodialysis patients.

The Impact of Postoperative Patient Aromatherapy on Nurse Self-Efficacy.

A nurse-driven aromatherapy program investigated the effect on nurses' self-efficacy when using an essential oil inhalation protocol to reduce patients' postoperative pain and associated symptoms. After viewing an investigator-developed training module, staff nurses implemented aromatherapy. Results of changes in nurses' report of self-efficacy were evaluated using the Self-Efficacy in Providing Non-Drug therapies (SEND) survey tool. Results support that an integrated approach of adding nonpharmacologic pain management to postoperative pain and nausea care may increase nurse self-efficacy.

Level of implementation of pain management and early mobilization strategies to prevent delirium in geriatric trauma patients: A mixed-methods study

BackgroundPain management and early mobilization strategies are recommended in clinical practice guidelines for the prevention of delirium in older adults. However, available data on the implementation of these strategies in trauma are limited. AimsTo describe the use of pain management and early mobilization strategies in older adults at a level I trauma center, as well as the facilitators and barriers to their implementation. MethodsA convergent mixed methods study was used. Quantitative data were collected from sixty medical records. Qualitative data was collected through a focus group with healthcare providers to explore their perspectives regarding the use of the target practices and on barriers and facilitators to their implementation. Descriptive statistics were calculated, and a thematic analysis using an inductive and deductive interpretative descriptive approach was undertaken. ResultsA question on the presence/absence of pain was the most frequently documented pain assessment method. Pain assessment was poorly documented. Frequencies of non-opioid and opioid administrations were similar, but non-pharmacological strategies were not widely used. The first mobilization was performed quickly and was most commonly to a chair. The focus group discussion confirmed many of the data collected in the medical records. Barriers to implementing the targeted strategies were primarily related to organizational context and facilitation processes. ConclusionsAreas for improvement were identified including pain assessment, the use of non-pharmacological pain management strategies and ambulation as a mobilization strategy. Our findings will serve as a starting point for optimizing and adapting practices for geriatric trauma patients and evaluating their impact.

The Effect of Back Massage on Labor Pain in Phase I Active in Maternity Mothers at PMB Intan In Tangerang District 2022

Background:The most important midwifery care in the delivery process is to apply the principle of "Dear Mother" namely respecting each other's culture, beliefs and desires of the mother and involving the husband and family. Non-pharmacological pain management can be carried out by most health care providers (doctors, nurses and midwives) who may also involve the mother's family, including back massage. Objective: Knowing the effect of back massage on labor pain during the first active phase in labor mothers Method: This research is a type of descriptive research with a quasy experimental research design with pretest posttest one group with the sample of this study namely mothers in the active phase of the first stage of labor who experience labor pain as many as 30 respondents. This sample was taken using a purposive sampling method with a measuring instrument, namely a numerical pain scale, an observation sheet with an ANOVA analysis test. Results: The results of this study show that there are differences in labor pain after back massage. There is a coercive effect between back massage and labor pain with a P value = 0.00 (&lt;0.05), husband's assistance with labor pain with a P value = 0.03 while there is no significant effect between parity and labor pain with a P value = 0.07. Conclusion: There is an effect of back massage on labor pain in the first active phase of the birthing mother. Suggestion: it is hoped that more/frequent back massage techniques are performed to reduce labor pain during the first active phase according to SOP.

Non-Pharmacological Pain Management In Patient With Gouty Arthritis: A Narrative Review

Gouty arthritis is a condition characterized by joint inflammation due to the accumulation of monosodium urate crystals in the joint, resulting in severe pain, reduced musculoskeletal ability, and poor QoL. Therefore, this study aims to identify non-pharmacological pain management in gouty arthritis sufferers. This study is a narrative review including three databases such as ScienceDirect, Proquest, Pubmed, and the search engine Google Scholar. It was conducted using keywords such as gouty arthritis, non-pharmacology, and pain management. The article was sorted by cyclical criteria, and assessment was performed using JBI Critical Appraisal tools. The results showed that non-pharmacological interventions such as warm compresses using moringa leaves, lemongrass decoction water, ginger, cinnamon, soursop leaves, and CQBG (compound Qingbi granules) are effective in reducing gouty arthritis pain and have no side effects. Therefore, this study is expected to provide useful information and insights regarding pain management to health workers, nurses, sufferers, and the general public.

Development of a Novel Massage Therapy Outcome Measure for Children and Young Adults Receiving Hematopoietic Cell Transplant.

Children receiving hematopoietic stem cell transplantation (HCT) often experience an unfortunate sequalae of negative effects including pain, deconditioning, and anxiety. Massage therapy (MT) has demonstrated effective non-pharmacological management of fatigue, pain, and anxiety in patients undergoing cancer treatment. Existing studies have been limited by the lack of available MT-specific outcome measures to track responses to interventions. This study aimed to describe the creation of a novel MT-specific outcome measure to be utilized in the pediatric acute-care setting and establish construct validity for this measure to assess clinical effectiveness of MT interventions. An oncology ward at a large pediatric tertiary medical center in the United States. A total of 58 children and young adults undergoing HCT. Retrospective Cohort Study. A panel of massage therapists created a novel outcome measure, OMPREP, for use in MT sessions and performed a literature review to ensure face validity of the tool. This outcome measure was administered to patients and data were collected retrospectively to assess construct validity. A total of 1,333 MT sessions were completed (80.7% completion rate) with the novel OMPREP outcome measure utilized on 100% of visits. Mean engagement (p<.001), response (p<.001), and pain (p<.001) scores were all significantly greater at evaluation and discharge compared to the lowest observed scores post-HCT. The novel MT-specific outcome measure, OMPREP, was feasible and demonstrated construct validity when implemented in a pediatric acute-care setting by massage therapists. This new tool may offer a quantitative measure of MT-interventions and assist in tracking patient outcomes.

Non-pharmaceutical management of chronic pain

Chronic pain is a complex and pervasive condition that challenges both individuals and healthcare systems. In light of concerns about overreliance on pharmacological interventions, non-pharmacological approaches have gained prominence in chronic pain management. This article explores the scientific basis and benefits of diverse non-pharmacological interventions, including physical exercise, manual therapies, cognitive-behavioral therapy (CBT), meditation, acupuncture, and herbal medicine, in alleviating chronic pain. Each intervention's mechanisms of action are elucidated, shedding light on their physiological and psychological effects. Physical exercise has emerged as a cornerstone of non-pharmacological pain management, offering benefits such as pain reduction, enhanced mobility, and improved quality of life. Mechanisms encompass endorphin release, anti-inflammatory effects, and central nervous system modulation. Manual therapies, represented by chiropractic manipulation, osteopathic manipulative treatment , and massage therapy, demonstrate significant pain relief through mechanisms involving joint mobilization, muscle relaxation, and neurophysiological responses. Cognitive-behavioral therapy (CBT) operates through cognitive restructuring, behavioral modification, and pain perception modulation. Meditation practices, such as mindfulness and meditation-based pain relief, cultivate mindfulness and promote emotional regulation, leading to reduced pain perception and improved overall well-being. Acupuncture, a traditional Chinese therapy, involves needling specific points to achieve pain relief through mechanisms like endorphin release, neural pathway modulation, and anti-inflammatory effects. Herbal medicine, with its rich pharmacopeia, contributes to pain management through anti-inflammatory, analgesic, and muscle relaxant properties. Mechanisms encompass modulation of neurotransmitters, prostaglandins, and ion channels. Collectively, these non-pharmacological interventions empower individuals to actively engage in their pain management and improve their quality of life.