Non-pharmacological Pain Management Research Articles

What non-pharmacological and non-invasive pain management interventions are available for individuals from Turkish-speaking ethnic groups with non-malignant chronic pain? A scoping review of published literature.

A scoping review was selected to explore what non-pharmacological and non-invasive pain management interventions are available for individuals from Turkish-speaking ethnic groups with chronic pain and what represents the most appropriate intervention. Adults with non-malignant chronic pain from Turkish-speaking ethnic groups residing in or outside of Turkey. All non-pharmacological and non-invasive pain management interventions were considered. No limits were placed on geographic location, gender, sex or healthcare setting. The MEDLINE database was searched for published literature in April 2022. An English language filter was applied. No limits were placed on study design or date of publication. Data was charted from eligible studies into a data extraction table. Key concepts were identified during data extraction by DN. Eleven studies were included in the final review. All were conducted within a quantitative research paradigm. The studies were completed in Turkey (7), Belgium (1), Sweden (1) and Switzerland (1). One was a multi-country review. No studies were conducted in the UK. The primary interventions were heterogenous and included: pain science education (2), cognitive behavioural therapy (2), transcranial magnetic stimulation (1), balneotherapy (1), extracorporeal shockwave therapy (1), transcutaneous electrical nerve stimulation (1), wool therapy (1), exercise and patient dialogues (1) and aromatherapy massage and reflexology (1). Location of pain, outcome measures and timings of follow-ups were heterogeneous. Intervention heterogeneity, exclusively quantitative methodology and absence of studies completed in the UK meant no conclusions could be made on what represents the most appropriate non-pharmacological and non-invasive interventions intervention for individuals from Turkish speaking ethnic groups with non-malignant chronic pain.

Treatment Patterns and Population Characteristics of Nonpharmacological Management of Chronic Pain in the United States' Medicare Population: A Scoping Review.

Clinical practice guidelines recommend noninvasive nonpharmacological pain therapies; however, reviews that assess the literature pertaining to nonpharmacological pain management among older adults and people with long-term disabilities who are disproportionately affected by pain are lacking. This scoping review aimed to systematically map and characterize the existing studies about the receipt of noninvasive, nonpharmacological pain therapies by Medicare beneficiaries. We conducted a literature search in MEDLINE (PubMed), CINAHL (EBSCO), SocINDEX (EBSCO), Cochrane Library, Web of Science citation indices, and various sources of gray literature. The initial search was conducted on November 2, 2021, and updated on March 9, 2022. Two independent reviewers screened titles, abstracts, and full texts for inclusion and extracted the characteristics of the studies, studied populations, and nonpharmacological pain therapies. Data were summarized using tabular and narrative formats. The final review included 33 studies. Of these, 24 were quantitative, 7 were qualitative, and 2 were mixed-methods studies. Of 32 studies that focused on Medicare beneficiaries, 10 did not specify the Medicare type, and all but one of the remaining studies were restricted to fee-for-service enrollees. Back and neck pain and arthritis were the most commonly studied pain types. Chiropractic care (n = 19) and physical therapy (n = 17) appeared frequently among included studies. The frequency and/or duration of nonpharmacological treatment were mentioned in 13 studies. Trends in the utilization of nonpharmacological pain therapies were assessed in 6 studies but none of these studies went beyond 2008. This scoping review found that manipulative therapies, mainly chiropractic, have been the most widely studied approaches for nonpharmacological pain management in the Medicare population. The review also identified the need for future research that updates trend data and addresses contemporary issues such as rising Medicare Advantage enrollment and promulgation of practice guidelines for pain management.

Pengaruh pemberian kompres hangat jahe untuk mengurangi nyeri sendi pada lansia di Gampong Neusu Aceh, Kecamatan Baiturrahman, Kota Banda Aceh (The effect of warm ginger compresses to reduce joint pain in the elderly in Neusu Aceh Village, Baiturrahman District, Banda Aceh City)

Pain in joint movement can be caused by various causes, one of them is associated with increasing age. Joint pain in the elderly is considered to be the result of various pathological processes, one of which can cause pain in the elderly is disturbances that occur in the joint cartilage matrix. In general, this joint pain makes sufferers feel uncomfortable when the joints are touched, swelling, inflammation, stiffness and limited movement are seen. The purpose of this activity is to report the results of nursing care for the elderly with joint pain in Neusu Aceh Village, Baiturrahman District, Banda Aceh City. The nursing diagnosis that appears in this case is chronic pain. The implementation provided includes non-pharmacological pain management using red ginger warm compresses to reduce the pain scale in client. Based on the evaluation of the implementation that has been carried out to client, there was an increase in knowledge about ginger warm compress therapy for joint pain, a decrease in the pain scale from 5 numerical rating scale (NRS) to 3 NRS, and pain in both knees was reduced. It is suggested to the village head and elderly health cadres in Neusu Aceh Village to increase the knowledge of the elderly regarding joint pain through the elderly Posyandu activities.

Effectiveness of 30o Head Elevation Intervention on Head Pain Levels in Patients with Space Occupying Lesion (SOL) Intracranial Tumor Post-Op Craniotomy : Case Study

ABSTRACT Intracranial tumors are abnormal mass growths in the brain that originate from tissue that grows and divides uncontrollably. Space Occupying Lesion (SOL) is a space pressure caused by an increase in volume within the brain due to the accumulation of blood, cerebro-spinal fluid or brain tissue. A common treatment for intracranial tumors is craniotomy. According to research, about 60% of patients who undergo craniotomy experience moderate to high levels of headache pain. Non-pharmacological pain management that can be done includes deep breathing interventions with guided imagery techniques, monitoring patient hemodynamics and 30o head elevation. The purpose of this study was to present the effect of 30o head elevation nursing intervention on pain levels in patients with SOL intracranial tumors post craniotomy. The method in this study used a case study design conducted in November 2022 at Sumedang Regional General Hospital. The results showed that head elevation of 30o can reduce head pain levels because it can maximize the entry of oxygen into the intracranial and increase the return flow of blood from the brain to the heart, help activate the parasympathetic nervous system which functions to control various activities of the human body at rest and maximize relaxed conditions in patients, resulting in a stable pulse frequency, respiratory frequency, blood pressure. The intervention of elevating the head position or head elevation of 30o is one of the many nonpharmacological therapies that are useful for improving intracranial pressure so that the headache felt by the patient improves and cerebral perfusion can be resolved. Keywords: SOL, Post-op Craniotomy, Head Elevation

Understanding the Postpartum Cesarean Pain Experience Among Individuals With Publicly Funded Insurance: A Qualitative Investigation.

Pain is the most common postpartum concern and has been associated with adverse outcomes, such as difficulty with neonatal bonding, postpartum depression, and persistent pain. Furthermore, racial and ethnic disparities in the management of postpartum pain are well described. Despite this, less is known regarding patients' lived experiences regrading postpartum pain. The purpose of this study was to assess patient experiences related to postpartum pain management after cesarean birth. This is a prospective qualitative study of patients' experiences with postpartum pain management after cesarean birth at a single large tertiary care center. Individuals were eligible if they had publicly funded prenatal care, were English or Spanish speaking, and underwent a cesarean birth. Purposive sampling was used to ensure a racially and ethnically diverse cohort. Participants underwent in-depth interviews using a semistructured interview guide at 2 time points: postpartum day 2 to 3 and 2 to 4 weeks after discharge. Interviews addressed perceptions and experiences of postpartum pain management and recovery. Data were analyzed using the constant comparative method. Of 49 participants, 40.8% identified as non-Hispanic Black and 40.8% as Hispanic. The majority (59.2%) had experienced a cesarean birth with a prior pregnancy. Thematic analysis yielded 2 overarching domains: (1) experience of pain after cesarean birth and (2) pain management and opioid use after cesarean birth. Themes related to the experience of pain included pain as a meaningful experience, pain not aligned with expectations, and limitations caused by pain. All participants discussed limitations caused by their pain, voicing frustration with pursuing activities of daily living, caring for home and family, caring for neonate, and impact on mood. Themes related to pain management and opioid use addressed a desire for nonpharmacologic pain management, positive and negative experiences using opioids, and hesitancy and perceived judgement regarding opioid use. Several participants described experiences of judgement regarding the request for opioids and needing stronger pain medications, such as oxycodone. Understanding experiences regarding postpartum cesarean pain management and recovery is essential to improving patient-centered care. The experiences identified by this analysis highlight the need for individualized postpartum pain management, improved expectation counseling, and the expansion of multimodal pain management options.

Upgrading Nurses’ Knowledge, Attitude and Self-Efficacy Toward Pharmacological and Non-Pharmacological Pain Management in Children.

Upgrading Nurses’ Knowledge, Attitude and Self-Efficacy Toward Pharmacological and Non-Pharmacological Pain Management in Children.

Pain management education needs for nurses caring for older adults undergoing total knee replacement

IntroductionEffective postoperative pain management is necessary to improve the outcomes of older adults undergoing total knee replacement (TKR). Discovering what registered nurses (RNs) need to know about pain management may be beneficial to improving the quality of care. AimThe study aimed to identify the information needed to develop pain management education for RNs caring for older adults undergoing TKR. MethodsA qualitative descriptive design was used in this study. Three focus groups were conducted with 22 staff RNs with experience caring for older adults undergoing TKR at a supra-tertiary care hospital in Bangkok, Thailand; one focus group was conducted with five members of the hospital's nursing pain management committee. Data were analyzed using content analysis. ResultsTwo themes relevant to pain assessment education were pain assessment and pain management. Subthemes of pain assessment included challenges in cognitively impaired older adults, inadequate knowledge and misconceptions, and re-assessing pain. Three subthemes of pain management were created, including knowledge of pain medication, new trends in pharmacological pain management and devices, and non-pharmacological pain management using cold compression. ConclusionsRNs require current information about pain management to provide effective postoperative care for older adults undergoing TKR. The findings may be used in pain management education to update RNs’ knowledge of pain management.

A study to evaluate the effectiveness of planned teaching programme on knowledge of 3rd year GNM students on pharmacological and non-pharmacological management of labour pain in selected schools of nursing, Dharwad district, Karnataka

A study to evaluate the effectiveness of planned teaching programme on knowledge of 3rd year GNM students on pharmacological and non-pharmacological management of labour pain in selected schools of nursing, Dharwad district, Karnataka

Non-pharmacological pain management measures related to intravenous therapies among infants: A Narrative Review

Non-pharmacological pain management measures related to intravenous therapies among infants: A Narrative Review

Menonton Kartun Efektif Menurunkan Nyeri Pemasangan Infus dan Venipuncture pada Anak

This study aims to determine the effect of non-pharmacological therapy by watching cartoons in overcoming children's pain during infusion and venipuncture. The method used is a systematic review using guidelines from Preferred Reporting Items for Systematic Review and Meta Analysis (PRISMA). The results showed that there were 10 selected articles after selection and quality assessment using the JBI critical appraisal tool. Watching videos was effective in reducing pain in children during infusion and venipuncture with p<0.05. In conclusion, the videos watched by children are adjusted to the child's preferences and age. Nurses are expected to be able to use non-pharmacological pain management strategies to provide the best care for pediatric patients.
 
 Keywords: Watching Cartoons, Pain, Paediatrics, Venipuncture.

Satisfaction of Women with Labor and Delivery in Rural Punjab, Pakistan: A Cross-sectional Study

Women’s satisfaction with the quality of care during pregnancy and childbirth can impact their access to and utilization of healthcare services. Since many women live in rural regions in developing nations, it is crucial to secure their access to and use of basic healthcare services to reduce maternal and newborn morbidity and mortality. This cross-sectional study is part of a first-time, sizeable, mixed-method study involving women and midwives’ quantitative and qualitative perspectives on the quality of mid- wifery care in rural Pakistan. The aim was to describe women’s satisfaction with the quality of midwifery care during labor and delivery at basic health units in rural Punjab, Pakistan. Simple random sampling was used to select 328 women from 96 basic health units. Data were collected between December 2020-March 2021. The Labor and Delivery Satisfaction Index measured women’s satisfaction with childbirth. Data were analyzed using descriptive statistics and presented in frequencies and percentages. Results indicated that the majority, 277 (84.5%), were satisfied with the quality of midwifery care during labor and delivery, whereas the remaining 51 (15.5%) were unsatisfied. Appropriate tools to monitor labor and delivery and non-pharmacological pain management during labor need much improvement. The women must also be treated with respect, given accurate information about their labor status, and given control over it. Midwives and other health service providers and administrators can use the findings of this study to improve services available to rural women.

The Effect Of Warm Water Therapy On Reducing Spinal Pain In Pregnant Women At Antang Health Center In Makassar City

Spinal pain in pregnancy is caused by hormonal, musculoskeletal, and stressful changes. Spinal pain in pregnancy if left untreated will have an impact on the quality of life and daily activities of pregnant women The management of spinal pain in pregnancy can include pharmacological and non-pharmacological. Non-pharmacological pain management is warm water therapy. Warm water therapy provides the effect of rirelaxation, vasodilation of blood vessels, removes metabolic waste that is no longer in use, and reduces muscle spasmsThe purpose of this study is to determine the effect of warm water therapy on reducing spinal pain in pregnant women at the Antang Health Center, Makassar City in 2022 This research is a quantitative study with a quasi-experimental design non-equivalent with one group pre-test post-test. The total population of 64 respondents with a sample of 30 respondents who met the inclusion criteria, the independent variable was warm water therapy and the dependent variable was the reduction of spinal pain in pregnant women. The results of the spinal pain scale study before warm water therapy were carried out on a moderate pain scale (4-6) there were 15 respondents with a percentage (50%). And after a warm compress was carried out, there were 18 respondents with a percentage (60%). The result of p value is 0.000 (<0.05), so Ha is accepted. There is an effect of providing warm water therapy on reducing spinal pain in pregnant women at the Rsu at the Antang Health Center, Makassar City in 2022The conclusion of this study is the effect of warm water therapy on reducing bone pain in pregnant women at the Antang Health Center, Makassar City in 2022. It is hoped that there will be further research on other non-pharmacological techniques against spinal pain in pregnancy.

Non-pharmacological management of infant and young child procedural pain.

Non-pharmacological management of infant and young child procedural pain.

Pain during PICC insertion in preterm infants: the needle is not the only problem

Objective To evaluate whether warm povidone-iodine (PI) application before peripherally inserted central catheter (PICC) placement eased pain related to the procedure in premature infants and reduced the duration of the procedure and the number of attempts. Methods A prospective randomized controlled trial was conducted with infants born before 32 weeks of gestation who required the first placement of the PICC. Skin disinfection was performed with warm PI before the procedure in the warm PI(W-PI) group, whereas PI kept at room temperature was used in the regular PI(R-PI) group. NPASS scores of the infants were evaluated three times: at baseline(T0), during skin preparation(T1), and during needle insertion(T2). Results Fifty-two infants (26 in the W-PI group,26 in the R-PI group) were enrolled in the study. The perinatal and baseline demographic characteristics did not significantly differ between the two groups. While the median NPASS scores at T0 and T2 were similar between the groups, the median T1 score was significantly higher in the R-PI group(p = .019). While the median NPASS scores at T1 and T2 were similar in the R-PI group, there was a significant difference in the W-PI group, with NPASS scores being significantly lower at T1 compared to T2. The results demonstrate that skin disinfection was just as painful as needle insertion in the R-PI group. The duration of the procedure and the number of needle insertions were significantly lower in the W-PI group. Conclusions Before invasive interventions, such as PICC insertion, we recommend warm PI as a part of non-pharmacological pain management.

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

Non-pharmacological intervention to reduce pain post-appendectomy: A rapid review of randomized controlled trial studies

Background: Appendicitis leads to post-appendectomy pain with significant physical and mental implications, necessitating non-pharmacological pain management approaches. Objective: This study aimed to determine which non-pharmacological interventions can effectively reduce postoperative pain following an appendectomy. Design: A rapid review study design was employed. Data Sources: The databases used were EBSCOhost-CINAHL and PubMed. The article search was conducted on March 14, 2022. Review Methods: The identified articles were described using PRISMA guidelines and sorted based on inclusion criteria. These criteria included patients with appendicitis aged 18-59 years who underwent appendectomy, non-pharmacological pain management interventions, studies utilizing the Randomized Controlled Trial (RCT) method, full-text articles available, English language, and articles published between 2012-2022. Studies involving pediatric and elderly appendectomy patients, as well as studies with insignificant results, were excluded. Results: Four articles were analyzed, revealing four types of interventions: Foot and Hand Reflexology (Massage), Lavender Aromatherapy and Almond oil (Aromatherapy), Inhalation aromatherapy with sweet-scented geranium essential oil, and Acupressure Le7. These interventions were then classified into two categories: aromatherapy-based interventions and neurostimulation-based interventions. All interventions were found to significantly reduce pain in appendectomy patients. Conclusions: Non-pharmacological therapies, such as lavender and almond oil aromatherapy, sweet-scented geranium aromatherapy, foot and hand reflexology, and Le7 acupressure, have demonstrated positive effects in reducing long-term pain after an appendectomy.

COMT Val158Met Affects the Analgesic Response to Acupuncture Among Cancer Survivors With Chronic Pain

Catechol-O-methyltransferase (COMT) is the major enzyme involved in the catabolism of dopamine, a neurotransmitter in the brain’s reward system. The common COMT polymorphism Val158Met (rs4680 G>A) modulates pain response to opioids through a reward-motivated mechanism; however, its role in nonpharmacological pain medicine has not been clinically characterized. We genotyped 325 participants from a randomized controlled trial of cancer survivors with chronic musculoskeletal pain. We found that carrying methionine at position 158 (158Met) of COMT, encoded by the A allele, significantly increased the analgesic response to electroacupuncture (74% vs 50%; odds ratio [OR]: 2.79; 95% confidence interval [CI]: 1.31, 6.05; P < .01), but not to auricular acupuncture (68% vs 60%; OR: 1.43; 95% CI: .65, 3.12; P = .37) or usual care (24% vs 18%; OR: 1.46; 95% CI: .38, 7.24; P = .61) compared to Val/Val. These findings raise the possibility that COMT Val158Met might be an important predictor of analgesic response to electroacupuncture, providing novel insights into precision nonpharmacologic pain management tailored to individual genetic backgrounds. PerspectiveThis work suggests the modulating effects of the polymorphism in COMT Val158Met on the response to acupuncture. Further research needs to validate these findings, increase the mechanistic understanding of acupuncture, and guide further development of acupuncture as a precision pain management strategy.

Giving Red Ginger Water and Green Coconut Water to Reduce Menstrual Pain in Adolescent Girls

Dysmenorrhea is menstrual pain that is felt before or during menstruation and is usually cramping. In Indonesia, the incidence of dysmenorrhea is around 55% and in West Java it is 54.9%. Nonpharmacological pain management can be done by giving red ginger and green coconut water. Quasi-experiment research design with two group pretest-posttes research design. Aiming to determine the effect of giving red ginger water and young coconut water on reducing menstrual pain in adolescent girls Data were analyzed using paired and independent tests. There is an effect of giving red ginger water and green coconut water on reducing menstrual pain in adolescent girls with a P value of 0.00 (&lt;0.05).There is a significant difference between the effect of red ginger water and green coconut water on reducing pain from a p value of 0.02 &lt;? (0.05). Red ginger water and green coconut water have an effect on reducing menstrual pain in adolescent girls.

Development of non-pharmacological pain management (behavioral intervention) model based on family-centered empowerment in toddlers with invasive procedures

Introduction: Communication between parents and health professionals in children about assessing and managing their children's pain with both oral and written instructions still needs to be improved. Children with a relationship with a parent or caregiver may be easier to assess and benefit from non-pharmacological treatment. This study aimed to evaluate the development of non-pharmacological pain management (behavioral intervention) model based on family-centered empowerment in toddlers with invasive procedures. Methods: This study design is an explanation survey with cross sectional approach. The sample consisted of 115 mothers with toddler-age children subjected to invasive prosedures in Rumah Sakit Islam Surabaya using purposive sampling. The data was analyzed using SmartPLS. Results: Non-pharmacological pain management model based on family-centered empowerment was formed from the mother factor, nurse factor, filial values, and appraisal. The greatest effect was on the filial values factor, with the T statistic value = 2.777. Conclusions: Nonpharmacological pain management (behavioral intervention) is formed by the mother factor, nurse factor, filial values, and appraisal, where filial values are the most influential. Therefore, in conducting pain nursing care in the nurse's room, paying attention to the four factors above is necessary to improve the quality of care services, especially in comfort for toddler children who undergo invasive actions.

A Systematic Review of Non-Opioid Pain Management in Chiari Malformation (Type 1) Patients: Current Evidence and Novel Therapeutic Opportunities.

Chiari Malformation Type I (CM) includes a range of cranial abnormalities at the junction of the skull with the spine, with common symptoms including pain and headaches. Currently, CM pain is managed medically through anti-inflammatory drugs, muscle relaxants, and opioids, while surgical management includes posterior fossa decompression. Given the adverse effects of opioid use, and an ongoing opioid epidemic, there is a need for safe, non-opioid alternatives for clinical pain management. This systematic review was performed to provide an update on the current literature pertaining to the treatment of CM pain with non-opioid alternatives. A literature search was performed in June 2022 utilizing the PubMed and Google Scholar databases, and articles were identified that included information regarding non-opioid pain management in CM patients. A total of 90 articles were obtained from this search, including 10 relevant, drug-specific studies. Two independent reviewers selected and included all relevant articles based on the chosen search criteria to minimize bias risk. Currently available treatments for neurosurgical pain management include anticonvulsants, corticosteroids, NSAIDs, anti-inflammatory drugs, NMDA receptor antagonists, local anesthetics, nerve blocks, scalp blocks, and neuromuscular blocks. While more information is needed on the use of non-opioid pain management, the present literature provides potential evidence of its efficacy amongst the CM patient population, on account of the success that non-opioid pain management has demonstrated within other neurological pain syndromes. Further research into non-pharmacological pain management would also benefit the CM population and could be generalized to related conditions.