Non-pharmacological Methods Of Pain Management Research Articles

“…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.

THE EFFECT OF DEEP BREATHING AND MASSAGE RELAXATION TECHNIQUES ON REDUCING THE SCALE OF PAIN IN HERNIOTOMY PATIENTS

Herniotomyis a surgery performed to free the hernia sac up to the neck, so that adhesions do not occur and then it is repositioned. The hernia sac is stitched, tied as high as possible and then cut. The patient will always experience pain after surgery on day 1. Deep breathing and massage relaxation techniques are one of the non-pharmacological pain management methods to reduce pain. this research aims todetermine the effect of deep breathing relaxation techniques and massage on reducing the pain scale in herniotomy patients. This research uses a literature review by searching articles on the Google Scholar electronic database. Several articles were found in the Google Scholar search database, but only 8 articles met all the inclusion criteria and were reviewed. Results: pain in post-operative patients often occurs, there are many non-pharmacological techniques to treat pain, one of which is the deep breathing technique. Conclusion: The conclusion of the 8 journals studied is that deep breathing relaxation therapy is very influential in reducing pain intensity in postoperative patients if done correctly and continuously.

Effects of non-pharmacological methods on post-operative procedural pain management in neonates admitted in the neonatal intensive care unit: A systematic review

Background In the post-operative period during the NICU stay, neonates must undergo various painful procedures. Non-pharmacological methods may be beneficial in managing the harmful effects of procedural pain on the development of neonates in their early life.
 Objectives To investigate the effect of non-pharmacological methods on post-operative procedural pain in neonates admitted to neonatal intensive care units.
 Methods A search in electronic databases was done to identify randomized clinical trials published from 2010 to 2020 that encompassed neonates undergoing painful procedures in the NICU and followed PRISMA guidelines. Studies with non-human subjects, neonates with unstable vital signs, non-clinical studies, and incomplete methodology were excluded. PubMed, Cochrane, and Physiotherapy Evidence Database (PEDro) were evaluated respectively using Medical Subject Headings (MeSH) and Health Sciences Descriptors (DeCS).
 Results Two reviewers examined articles independently and found 11 articles that met the study's inclusion criteria, with a total of 955 neonates with non-pharmacological methods of pain management in neonates. Non-pharmacological methods, such as massage therapy, oral sucrose, kangaroo mother care, and facilitated tucking showed significant reduction in pain scores among neonates who underwent painful procedures in NICU. Outcomes showed variability in effectiveness, emphasizing the need for tailored approaches.
 Conclusions The findings indicated that non-pharmacological methods can effectively manage pain in neonates admitted to the NICU. Pain management improves the clinical condition of neonates and promotes parents-neonate bonding, with consequent reduction in length of stay in the hospital.

Nonpharmacological pain management methods used by post-operative patients: A cross-sectional study

Nonpharmacological pain management methods used by post-operative patients: A cross-sectional study

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.

Knowledge, Practices, and Attitudes of Nurses Regarding Non-Pharmacological Pain Management in the Midwifery Ward

Background and Objectives: Pregnant women are frequently worried about labor pain, and it is usually the most important problem for them and their relatives. Non-pharmacological pain relief methods provide several benefits, such as no harmful effects on the fetus or baby, no interruption of labor, and even being pleasurable for the mother and fetus. The aim of this study was to assess the nurse’s knowledge, practice, and attitude toward non-pharmacological pain management methods in the delivery room in Erbil Governorate. Method: The descriptive cross-sectional design was utilized to determine nurses' knowledge, practices, and attitudes about labor pain and non-pharmacological pain management, as well as to monitor nurses' practices in the delivery rooms during labor and delivery. A total of 78 nurses from public and private hospitals in Erbil Governorate participated in the study. Structured questionnaires and an observational checklist were used to collect data and used SPSS version 26 was used to analyze it. Result: Nurse’s knowledge (N=27, 50.0%), (N=9, 37.5%) in public and private hospitals was at a good level, and they had a positive attitude (N=32, 59.3%) in public hospitals and a positive attitude (N=14, 58.3%) in private hospitals. But had a fair practice (N=19, 35.18%) in public hospitals and good practice (N=10, 41.7%) in private hospitals towards labor pain and non-pharmacological pain management. This is due to the lack of time, inadequate staff and the great workload of the staff. Conclusion: This survey showed that the knowledge of most of the nurses was at a good level, but it was weak in items such as (cold therapy, acupuncture and acupressure technique), as well as majority of them do the following practices: relaxation technique, give psychological support and, ensure that women's relatives are there during the entire labor process; and they do not use other types of non-Pharmacological

A STUDY TO ASSESS THE EFFECTIVENESS OF FOOT REFLEXOLOGY ON REDUCING PAIN AMONG POST CAESAREAN MOTHER IN SMI HOSPITAL, DEHRADUN

Reflexology is unique and simple method becoming increasingly popular as part of the alternative health care movement. It is one of the non-pharmacological methods of pain management. The research approach used for this study was quantitative research approach. A pre-experimental design was used for the study. By using purposive sampling technique 40 samples was selected. Findings of the study, majority of women mild pain 20 (50%), 15(38%) had moderate pain and 5(12%) had severe pain in pretest level of scores.

Non-Pharmacological Pain Management Practice and Associated Factors Among Nurses Working at Comprehensive Specialized Hospitals.

Non-pharmacological pain management practices are very important for the successful treatment of pain. It has an impact on the patient's quality of life and the family's financial situation owing to missed workdays, direct medical expenses, and incapacity from pain. Therefore, this study is intended to assess non-pharmacological pain management practice and associated factors among nurses working at comprehensive specialized hospitals in northwest, Ethiopia. Institution-based cross-sectional study design was employed from May 30 to June 30, 2022. A stratified random sampling technique was used to select 322 study participants. A binary logistic regression model was used to identify factors associated with non-pharmacological pain management practice. Variables with a P-value less than .25 in the bi-variable analysis were entered into the multivariable logistic regression analysis and a P-value of less than .05 was considered as having a statistically significant association. A total of 322 nurses participated, with a response rate of 98.8%. It was found that 48.1% (95% CI: 42.65, 53.62) of nurses had good practice in non-pharmacological pain management. Pain assessment tool availability (AOR = 1.68 [95% CI: 1.02, 2.75]) (P = .04), good pain assessment practice (AOR = 1.74 [95% CI: 1.03, 2.84]) (P = .03), favorable attitude (AOR = 1.71 [95% CI: 1.03, 2.95]) (P = .03), and age (26-35) (AOR = 4.46 [95% CI: 1.24, 16.18]) (P = .02) were factors significantly related to non-pharmacological pain management practice. According to this work, the prevalence of non-pharmacological pain management practices was found to be low. Good pain assessment practices, availability of pain assessment tools, favorable attitude, and age (26-35) years were significant factors of non-pharmacological pain management practice. Hospitals are better give training on non-pharmacological pain management methods for nurses as they are important to treat pain holistically, increase patient satisfaction, and are cost-effective.

Evidence-Based Nursing Practices for the Prevention of Newborn Procedural Pain in Neonatal Intensive Therapy-An Exploratory Study.

Background: Due to the progress in neonatology, in particular, in the past three decades, the mortality rate among patients of intensive care units has decreased. However, this is connected not only with newborns needing to stay longer in the unit, but also with the exposure of newborns to many painful procedures and stresses. Lack of or insufficient pain prevention has a negative impact on the sensory or locomotor development of newborns. Despite the presence of guidelines based on scientific evidence, the use of pharmacological and non-pharmacological pain-management methods in newborns is still insufficient. Aim: The aim of the study was to: identify the knowledge nurses/midwives have of recommended non-pharmacological and/or pharmacological methods, in particular, in relation to medical intervention procedures; assess the interventions for pain relief applied by midwives/nurses most often in their clinical practice; examine the role of age, general work experience, education level and years of work of medical professionals on a neonatal ward, as well as the referral level of a unit, versus the application of pharmacological and non-pharmacological methods. Methods: A descriptive and quantitative study conducted in 2019 among Polish nurses/midwives working at neonatal intensive care units. Results: The analysis of the material reflected the deficit of knowledge and the insufficient daily use of recommended pain-relief measures among the respondents. Conclusions: The interpretation of data indicates that despite the clear and easily available recommendations of scientific societies concerning the mode of conduct in particular medical procedures, medical personnel do not apply those recommendations in their everyday practice. It is necessary to plan and implement education strategies for nurses/midwives on standard pain-management interventions during painful medical procedures.

Efficacy of Su Jok Seed Therapy in Migraine: A Randomized Placebo-Controlled Study

Introduction: Migraine is an important health problem that negatively affects individuals’ activities of daily living. The decrease in the quality of life because of migraine increases the need for the development of new pharmacological and nonpharmacological treatment methods for pain management. Limited studies have reported the application of a traditional therapy, such as Su Jok seed therapy, to prevent or minimize migraine. This study aimed to examine the effect of Su Jok seed therapy on the severity, duration, and frequency of headaches in patients with migraine. Methods: The study was conducted between September 2020 and February 2021 with 47 students diagnosed with migraine. Of these, 24 patients were included in the intervention group and 23 in the placebo control group. Data were collected using a patient information form developed by the researchers, a migraine diary, the Numeric Pain Rating Scale (NPRS), and the Headache Impact Test-6 (HIT-6) questionnaire. Each patient in the intervention and placebo groups received eight sessions of Su Jok seed therapy, twice a week for 4 weeks. Data were evaluated at the 30th, 60th, and 120th min of the therapy using NPRS, before the therapy (pretest), after the therapy (posttest), and 4 weeks after the therapy (follow-up) using a migraine diary and the HIT-6 questionnaire. Results: Descriptive statistics (mean, standard deviation/standard error, and percentages) were used for data analysis. Student’s t, Mann-Whitney U, repeated-measures analysis of variance, Bonferroni, Friedman, Dunn-Bonferroni, and χ² tests were used in this study. Significance was set at p < 0.05. After the administration of Su Jok seed therapy, the difference in mean NPRS scores between the groups was significant (p < 0.05) from the 60th min of the administration. Furthermore, a significant decrease was observed in the severity, duration, and frequency of headaches; the HIT-6 questionnaire scores; and the amount of painkillers consumed by the patients in the intervention group after the therapy and in the follow-up period compared with the pretest data. Additionally, the level of satisfaction of the patients in the intervention group was significantly higher after the therapy than that of those in the placebo group. Conclusion: Su Jok seed therapy reduced the severity, duration, and frequency of migraines, which in turn reduced the amount of painkillers consumed and the HIT-6 scores of patients with migraines.

Efficacy of non-pharmacological interventions to reduce pain in people with dementia: A systematic review and meta-analysis.

To identify the efficacy of non-pharmacological interventions designed to reduce pain in people with dementia. Pain is prevalent among patients with dementia but frequently remains untreated. Although non-pharmacological interventions have been used to reduce pain in people with dementia, the efficacy of these interventions for pain management in people with dementia has not been thoroughly synthesised. Systematic review and meta-analysis. The study was conducted in accordance with PRISMA guidelines and Cochrane criteria for systematic reviews. A comprehensive search was performed using the Academic Search Complete, CINAHL, Cochrane Library, EMBASE, MEDLINE, PubMed, OVID and Web of Science databases, from databases inception to 13 March 2022. The modified Cochrane risk-of-bias tool (ROB-2) was used to evaluate the methodological quality of each included study. Standardised mean differences (SMDs) with 95% confidence intervals (CIs) were synthesised using a random-effects model to assess the efficacy of non-pharmacological interventions for reducing pain in people with dementia (using Stata 16.0). The final analysis assessed 12 studies, including 989 persons with dementia. Non-pharmacological interventions were found to reduce pain in 4-8 weeks after the interventions (SMD: -0.32; 95% CI: -0.62 to -0.02). However, the effects of intervention frequency and patient age remain unknown. Non-pharmacological interventions are effective for reducing pain in people with dementia. Further investigations remain necessary to explore the effectiveness of specific non-pharmacological therapies for pain reduction in people with dementia (e.g. aromatherapy, play activity, singing or robotic care). The findings of this study can guide healthcare practitioners when considering the use of non-pharmacological pain management methods for people with dementia and may improve the implementation of these methods in clinical practice. The study suggests non-pharmacological interventions to reduce pain and underlines the relevance of health provider's viewpoints. The types, duration and length of follow-up of non-pharmacological interventions can be offered based on patient's conditions and the standard of clinical practice.

The barriers to offering non-pharmacological pain management as an initial option for laboring women: A review of the literature.

INTRODUCTIONMany women use pharmacological or non-pharmacological pain management (NPPM) during childbirth, however, evidence shows the usage rates of pharmacological pain management are increasing. The shift towards a biomedical approach to birth care opposes the enduring midwifery philosophy of trusting the woman and her body. Identifying midwives’ beliefs and attitudes towards perceived and actual barriers to offering NPPM as an initial option will provide insight into the factors that affect this.METHODSThis review of the literature sought to understand midwives’ beliefs and attitudes towards the barriers to offering NPPM as an initial option for laboring women. Peer-reviewed journals were searched for primary research that met the inclusion criteria and explored midwives’ beliefs and attitudes towards the barriers to offering NPPM as an initial option for laboring women. Included studies were evaluated for quality according to the Critical Appraisal Skills Programme (CASP) checklists.RESULTSThirteen qualitative studies met the inclusion criteria and four main themes of barriers to midwives offering NPPM emerged: health system-related, health facility-related, health practitioner-related, and health consumer-related barriers.CONCLUSIONSThe review of the literature highlighted there are barriers that prevent or delay the initial utilization of non-pharmacological methods of pain management in labor by midwives. These findings can be used as a platform to inform further research into this topic.

Exploring Non-pharmacological Methods for Pre-operative Pain Management.

The management of pain is an essential aspect of surgical care, and pain levels in post-operative patients vary case by case. Treating postoperative pain is crucial as it leads to better outcomes and reduces risk of long term pain. While post-operative analgesics has been the mainstay of treatment, this mini-review explores an emerging concept which is preoperative pain management, with promising potential. Such interventions include educating patients on the expected pain outcomes and available pain medications. Non-pharmacological methods such as relaxation exercises have also proven to be effective after abdominal surgery, and educating patients on the existence of such methods pre-operatively encourages them to make use of available therapies. A major area of importance is the pre-operative psychological and emotional wellbeing of patients, as it is a strong predictor of pain and pain prognosis. Cognitive Behavioral Therapy can be effectively used to tackle preoperative anxiety and reduce pain levels. Hypnosis is another developing modality for decreasing stress. Lastly, long term pre-operative opioid use has been linked with higher pain scores and longer pain duration. This provides the basis on which pre-operative opioid weaning can lead to favorable post-operative pain outcomes.While many of these methods have not been experimented on recipients of abdominal surgery in specific, it still paves the path for newer pain control strategies that can eventually be adopted for visceral surgery patients. This review points the reader and researchers to new and developing areas that hold the potential to revolutionize current established pain management guidelines.

Parents' awareness and use of nonpharmacological methods to manage their baby's procedural pain in a surgical neonatal intensive care unit

Parents whose babies had undergone major surgery and were admitted to the surgical neonatal intensive care unit for more than five days, and who could communicate in English were surveyed to explore their use of nonpharmacological methods to manage their baby's procedural pain in the post-operative period. Eighty-one parents, including 48 mothers, completed a 4-part questionnaire. Parents most frequently used physical and comforting touch methods to comfort their babies. Skin-to-skin care, sucrose, breastmilk-scented pads, and breastfeeding were least frequently used. While the majority of parents were aware of most unit practices regarding their baby's pain management, some practices needing greater awareness were identified. These findings highlight the need to promote a range of parent-led nonpharmacological pain management methods. This could be achieved by educating clinicians to collaboratively support and encourage parents' involvement in managing their baby's pain.

Nonpharmacological labor pain management methods and risk of cesarean birth: A retrospective cohort study.

Nonpharmacological labor pain management methods (NPLPMM) are noninvasive, low-cost practices that may play a role in reducing the rates of unnecessary cesarean birth. We aimed to evaluate whether the NPLPMM is associated with the mode of birth. We conducted a retrospective cohort study with clinical records of all women admitted for birth from January 2013 to December 2017. Records of women who had spontaneous labor or received induction or augmentation of labor during hospitalization were eligible for the study. We estimated the risk ratios for cesarean birth in general linear models using the Poisson regression with adjustments for the following variables: age, ethnicity, schooling, parity, gestational age, previous cesarean birth, spontaneous labor before admission, or induction/augmentation of labor. Within the total of 3,391 medical records, 40.1% had the use of a nonpharmacological labor pain management method registered. Cesarean rate among the study population was 44.2%. The use of NPLPMM decreased the risk of cesarean birth by 78% (OR=0.22; 95% CI 0.19-0.26). History of a previous cesarean birth (RR=2.63; 95% CI 2.35-2.64), the lack of use of NPLPMM (RR=2.46; 95% CI 2.22-2.72), and primiparity (RR=2.09; 95% CI 1.86-2.34) were the strongest risk factors for cesarean birth in the cohort. The use of NPLPMM may be an effective strategy to reduce unnecessary cesarean birth. Further studies to identify the efficacy of each method may help health professionals to offer more appropriate methods at different stages of labor.

Evaluation of Analgesics Prescription Pattern and Surgical Patients' Responses in Tertiary Hospitals in Southeast Nigeria

Background: Adequate analgesics help the patients to recover quickly from surgery with less discomfort and pain. It helps the patient breathe well, cough, turn and ambulate early to enable quick recovery. Inadequate prescribed analgesic delays recovery and leads to postoperative complications. Despite documented evidence that adequate pain control helps in the quick recovery of surgical patients, it has been reported that doctors' prescriptions of analgesics for postoperative patients are inadequate for the level of pain experienced by the patients. This informed the establishment of pain medication prescription standards by accrediting agencies in some developed countries. Nigeria has no binding standards, and patients' postoperative pain is managed by what doctors and nurses deem adequate. It has been reported that the patients' pain medication needs in Nigeria are unmet. The study, therefore, seeks to evaluate the postoperative analgesics prescription pattern and patients' responses in three tertiary hospitals in Southeast Nigeria. Objective: The study's main purpose was to evaluate the pattern of postoperative prescription of analgesics and surgical patient response to these drugs in tertiary hospitals in Southeast Nigeria. Method: A descriptive cross-sectional survey research design was used for the study. Study sample was 120 surgical patients selected equally from three randomly selected tertiary hospitals from the five States in Southeast Zone. Questionnaire and checklist were the instruments used for data collection in the study. The instrument's reliability was tested using the split-half technique and was analyzed using Spearman's rank-order correlation coefficient, which yielded a value of 0.85. All the hypotheses were tested at 0.05 level of significance. Results: The results show that drugs commonly prescribed by doctors for pain relief were pentazocine, paracetamol, diclofenac, and tramadol. The prescriptions were done mainly by Surgeons and Resident doctors. There was agreement on the pattern of prescription of analgesics by Surgeons in the southeast Nigerian hospitals. The results also show that there is a significant difference (p&lt;0.05) in the mean patients' responses to the prescribed analgesics but found no significant difference (p&gt;0.05) in pain prescription by doctors in the management of surgical patients in tertiary hospitals in Southeast Nigeria. Patients reported experiencing severe pains (41.7%) on the first, moderate pains (45.8%) on the second day, and mild pain (25%) on the third day after surgery. Conclusion: It was concluded that there is no significant difference in the pattern of the prescribed pain relief drugs and their dosages among surgeons from different tertiary hospitals. The patients' responses showed that the prescription pattern does not lead to good pain control in the first three days post-surgery. Recommendation: It was recommended that doctors review their prescription pattern for surgical patients, particularly within the first 72 hours after surgery when the pain is at its peak. Nurses should apply non-pharmacological pain management methods within this period to improve the comfort of the surgical patients.

Effects of the addition of transcutaneous electrical stimulation to non-pharmacological measures in labor pain: study protocol for a randomized controlled trial

BackgroundLabor, although natural and physiological, is a period that can be marked by stress, pain, anxiety, suffering, fear, and anguish for a woman. Thus, non-pharmacological methods that reduce pain during labor are important to allow a better experience without the use of medications. Therefore, the aim of this study is to evaluate the effects of non-pharmacological pain relief methods, added or not to the application of transcutaneous electrical stimulation (TENS), on pain, satisfaction with the childbirth, duration of labor, and newborn conditions.MethodsThis is a randomized controlled clinical trial, with a non-probabilistic convenience sample, composed of women in the first active stage of labor, admitted to a public institution. The parturients will be divided into 3 groups: group 1 (n = 36) composed of parturients who will have continuous support and will be encouraged to walk, adopting different positions with the use of the Swiss ball and receiving back massage for 30 min; group 2 (n = 36) composed of parturients who will also have continuous support and will be encouraged to walk, adopt different positions using the Swiss ball, and will receive the application of TENS for 30 min; and group 3 (n = 36) composed of parturients who will have continuous support and will be encouraged to walk, adopting different positions with the use of the Swiss ball, and will receive placebo TENS application for 30 min. The outcomes evaluated in the study will be pain intensity assessed by the visual analog scale of pain applied before, immediately after, and 30 min and 1 h after the interventions; Experience and Satisfaction with Childbirth Questionnaire (QESP) applied 12 to 24 h after delivery; and data regarding delivery (type of delivery, total duration of labor, and possible obstetric complications) and neonate (weight, height, possible complications, Apgar score in the first and fifth minutes).DiscussionWith this research, it is expected to understand the effects of the intervention through TENS electrostimulation added to other non-pharmacological methods for pain management during labor.Trial registrationBrazilian Registry of Clinical Trials (REBEC) RBR-68kh6j. Registered on March 17, 2020

PENGARUH TEKNIK RELAKSASI GENGGAM JARI TERHADAP PENURUNAN INTENSITAS NYERI PASIEN POST OPERASI FRAKTUR DI RUMAH SAKIT BHAYANGKARA MAKASSAR

Pain after surgery is caused by mechanical stimulation of the wound which causes the body toproduce pain chemical mediators. Pain after fracture surgery will have an impact on the endocrinesystem which will increase the secretion of cortisol, catecholamines, and other stress hormones(Kurniawan, 2015). The finger grip relaxation technique is one of the non-pharmacological painmanagement methods that aims to reduce pain by holding fingers, inhaling, and diverting thepatient's attention to other things such as imagining a very pleasant event for the individual. Thus, itcan tolerate the pain that is felt. This study aims to determine the effect of finger grip relaxationtechniques in reducing the pain intensity of postoperative fracture patients, identifying pain intensitypre / post therapy, and analyzing the effect of finger grip relaxation techniques. The method used isQuasi Experimental with One Group Pre-Post Test Design. The sample size was 18 postoperativefracture patients who were hospitalized at Bhayangkara Hospital Makassar. The t test method with asignificance level of 0.05. The results showed the effect of finger grip relaxation techniques onreducing pain intensity. The results of this test also show that the provision of therapy before andafter with a value of t count 7,000 t table 2.109 with a value of ρ 0.000 α 0.05. It is hoped thatpostoperative fracture patients can apply what has been taught so as to reduce pain. Keywords: Post Operation Fracture, Pain, Finger Grip Relaxation Technique

Comparison the effect of Swedish massage and interferential electrical stimulation on labor pain and childbirth experience in primiparous women: a randomized controlled clinical trial.

Since mothers are more inclined toward non-pharmacological labor pain management methods, this study aimed to compare the effect of interferential electrical stimulation (IES) and Swedish massage (SM) on labor pain and childbirth experience (primary outcomes) and childbirth satisfaction, duration of active phase and side effects (secondary outcomes) in primiparous women. This randomized controlled trial was performed on 90 primiparous women. Participants were randomly assigned into three groups through the block randomization method. The SM group received two massage techniques of effleurage and petrissage, on T10-L1 and S2-S4 at cervical dilatation of 4 and 8-10cm. The IES group received electrical stimulation in a similar way to SM group, with a base frequency of 4000Hz and a pulse frequency of 80-120Hz by a physiotherapist. Control group received only routine care. The mean pain was significantly lower in the SM group (adjusted mean difference (AMD) - 0.86; 95% confidence interval (95% CI) - 1.60 to - 0.11) and the IES group (AMD - 0.95; 95% CI - 1.70 to - 0.21) compared to the control group. The mean score of childbirth experience was significantly higher in the SM (MD 5.63; 95% CI 2.15-9.11) and IES (MD 3.66; 95% CI 0.18-7.14) group compared to the control group. The mean childbirth satisfaction in the SM (p = 0.003) and IES (p = 0.046) groups was significantly higher than the control group; and duration of the active phase of labor was significantly lower (p < 0.001) than the control group. No serious side effects were occurred in none of the groups. SM and IES are safe methods that can significantly reduce pain and duration of active phase and improve the experience and satisfaction of childbirth.

The Effect of Breastfeeding, Kangaroo Care, and Facilitated Tucking Positioning in Reducing the Pain During Heel Stick in Neonates

PurposeInvasive intervention can negatively affect prognosis, behavior, environmental adaptation in neonates. Some nonpharmacological pain management methods are used for effective pain treatment. This study investigated the effect of breastfeeding, kangaroo care, and facilitated tucking positioning on heel-stick pain in neonates. DesignA quasi-experimental design was employed. The study was conducted in three family health centers in Kütahya/Turkey. The sample consisted of 140 healthy neonates with the gestational age of 37 weeks or more, birth weight greater than 2500 g, and no sucking problems. The sample was divided into four groups (breastfeeding, kangaroo care, facilitated tucking position, and control). Data were collected using a Baby-Mother Characteristics Questionnaire, a Physiological Parameter Follow-up Form, and the Neonatal Infant Pain Scale. Data were analyzed using chi-square, the one-way analysis of variance (ANOVA), Kruskal–Wallis, Student t-test, and Mann-Whitney U tests. The research adhered to ethical principles. ResultsThe facilitated tucking position group cried less and experienced less pain during heel stick than the other groups (p < 0.05). Breastfeeding, kangaroo care, and facilitating tucking help reduce heel-stick pain but facilitating tucking causes less crying and imposes less pain on neonates than the other methods. ConclusionFacilitated tucking position may be preferred to reduce pain during heel stick. Practice implicationsUsing facilitated tucking positions and breastfeeding methods can assist healthcare professionals as supportive methods in pain management.