Use Of Non-pharmacological Methods Research Articles

Práticas de enfermeiras na assistência ao parto no Brasil: revisão de literatura

OBJETIVO: Descrever e discutir a produção científica acerca da prática de enfermeiras na assistência ao parto. MÉTODO: Foi realizada uma revisão de literatura integrativa utilizando publicações disponíveis. A busca dos artigos ocorreu nas bases de dados LILACS, BDENF, Portal de periódicos CAPES, Biblioteca Eletrônica Científica Online SCIELO no período de 2014 a 2019, sendo selecionados e analisados 14 estudos. Para pesquisa foi utilizado os descritores “saúde da mulher”, “parto humanizado”, “parto normal”, “enfermeiras obstétricas”, “humanização da assistência” com o operador booleano AND no final de cada descritor. Os critérios de inclusão utilizados foram artigos originais e de revisão, publicados na íntegra, na língua portuguesa em periódicos nacionais. RESULTADOS: Emergiram duas categorias de análise: Prática das enfermeiras acerca das boas práticas da assistência ao parto e nascimento e fatores que interferem no trabalho de parto das parturientes. CONSIDERAÇÕES FINAIS: Verificou-se uma adesão às boas práticas de atenção ao parto e nascimento, como o uso de métodos não farmacológicos no manejo da dor, presença do acompanhante, dentre outros. No entanto, também foi observado que as mulheres são colocadas em um lugar passivo e ficam expostas devido a uma estrutura inadequada e a falta de recursos materiais.

Effect of Voluntary and Forced Training with Royal Jelly Consumption on Learning and Spatial Memory of Rat Model of Alzheimer’s Disease

Background: One of the age-related disorders is Alzheimer’s Disease (AD) that impairs learning and memory. It appears that the use of non-pharmacological methods due to fewer complications can help improve the memory process. Objectives: The present study aimed to review the effect of voluntary and forced training with Royal Jelly (RJ) consumption on learning and spatial memory of rats with AD. Methods: We divided 46 rats with AD into seven groups of eight rats including (1) RJ, (2) voluntary training, (3) forced training, (4) forced training with RJ, (5) voluntary training with RJ, (6) control, and (7) sham. During eight weeks, groups 1, 4, and 5 received RJ 100 mg/kg daily; groups 2 and 5 ran on running wheels for three sessions of 60 min per week and groups 3 and 4 swam for three sessions of 60 min per week. Twenty-four hours after the last training session, learning and spatial memory were measured by the shuttle box and Y maze, respectively. Shapiro-Wilk, one-way ANOVA, and two-way ANOVA test with Bonferroni’s post hoc test were used for data analysis (P ≤ 0.05). Results: Training and RJ had significant effects on the increase of Step-Through Latency (STL) (P ≤ 0.05) and the Percentage of Alteration (PA) (P ≤ 0.05), as well as the decrease of Time spent in Dark Compartment (TDC) (P ≤ 0.05). Training and RJ consumption had a significant interactive effect on the decrease of TDC (P ≤ 0.05). Conclusions: It appears that training simultaneously with RJ consumption has interactive effects on improving memory in rats with AD.

Gastroesophageal reflux disease with cardial manifistations: perspectives of non-pharmacological treatment methods

In this article we present the review of the literature and our own research regarding gastroesophageal reflux disease (GERD) with cardiac manifestations. The methods of treatment of patients with GERD using mineral waters, physio- and balneotherapeutic factors, as well as acupuncture are discussed. The conclusion is drawn about the effectiveness of the use of non-pharmacological methods in mono- and complex therapy of GERD and the need for further research in this direction.

Evaluation of the Effect of Massage by the Mother on the Pain of Term Infants after Care Measures

Introduction: Hospitalized infants undergo a lot of painful procedures during care and treatment, and the use of non-pharmacological methods to reduce the effects of pain helps the infants to relax and stay healthy. Therefore, this study aimed to determine the effect of massage by the mother on the pain of term infants after care measures. Materials and methods: This quasi-experimental study was performed on 80 infants in the neonatal ward. Neonates were selected by random sampling and randomly divided into two groups. In both groups, the pain score was measured in the first time of the invasive procedure and then in the experimental group after 5 days of massage and the control group without massage, again in the next time of the invasive procedure, the pain score was measured before, during and after the intervention. Findings obtained from the NIPS questionnaire were analyzed using SPSS statistical software. Results: The difference between the pain scores before the intervention was not significant in the control and experimental groups, but after five days of massage, the pain score in the experimental group was significantly lower than the control group. The results show that pain in children increases during and after the procedure, but the amount of pain decreases with massage by mothers. Conclusion: Clinical and therapeutic measures in the intensive care unit cause neonatal pain and massage is one of the cost-free and simple solutions to reduce pain in infants. According to the findings of our study on the positive effect of massage by the mother on neonatal pain, it is recommended that nurses use it as an effective intervention in reducing the pain of infants.

Practices During Preparturition and Normal Delivery Care in a Maternity Hospital in Southern Brazil

This study aimed to evaluate the practices of hospital care during pré parturition and normal delivery in a maternity hospital in Southern Brazil. A cross-sectional and quantitative study performed with 82 postpartum women. Results were evaluated for the total number of postpartum women and in two groups according to hospital delivery time (≤ 8 and > 8 hours). Chi-square and Fisher Exact tests were used. with a significance level of 5%. Percentages of useful practices were: oral diet (23.2%), freedom of position and movement (90.2%), non-pharmacological methods to alleviate pain (64.6%), companion in prepartum (62.1%) and parturition (42.5%) and partogram (62.2%). Harmful practices: enema (3.7%), trichotomy (3.7%), lithotomy position (92.7%) and Kristeller maneuver (20.7%). Practices used inappropriately: amniotomy (4.9%), oxytocin (41.5%), analgesia (1.2%) and episiotomy (36.6%). The hospital labor time above 8 hours was associated with offering oral diet (p < 0.001), use of non-pharmacological methods for pain relief (p < 0.01), oxytocin infusion (p = 0.01) and episiotomy (p < 0.01). The delivery care with minimum intervention compatible with the recommendations is still a challenge.

Doğum Salonunda Çalışan Ebe ve Hemşirelerin Doğum Ağrısının Yönetiminde Kullanılan Nonfarmakolojik Yöntemleri Bilme ve Kullanma Durumları

Doğum Salonunda Çalışan Ebe ve Hemşirelerin Doğum Ağrısının Yönetiminde Kullanılan Nonfarmakolojik Yöntemleri Bilme ve Kullanma Durumları

El alivio del dolor en el parto. Empoderamiento y vulnerabilidad de las mujeres en la toma de decisiones. Estudio cualitativo.

Introduction In Spain the use of epidurals for pain relief during childbirth is widespread. Currently, we can observe a progressive change in attitude towards a less interventionist care and the use of non-pharmacological methods to reduce pain, unless the woman has left instructions otherwise. Aims To explore the decision-making process concerning pain relief methods in childbirth in order to detect the elements of vulnerability that are present in said process and examine the demands directed towards healthcare professionals. Methodology This study has applied a qualitative methodology with a phenomenological theoretical-methodological approach. The technique used to obtain information was the semistructured individual interview. The study was carried out in Catalonia. The participants were 17 adult women with low-risk pregnancies. Results Three categories have been identified after the analysis: (a) Completion of the birth plan: an approach to the decision; (b) The rationale of the decision: resources and barriers; and (c) The approach to pain in childbirth: elements of vulnerability. Conclusions Women do not always make firm decisions when completing the birth plan; The decisions expressed may be statements of intent. At the time of delivery, the perceived pain can be experienced as a threat that makes them feel vulnerable. The role of midwives and other healthcare professionals is to help work out this sense of vulnerability.

The Effects of a Dysmenorrhea Support Program on University Students Who Had Primary Dysmenorrhea: A Randomized Controlled Study.

This study aims to determine the results of a cognitive-behavioral approach in a dysmenorrhea support program that covers the symptoms, acquaintance, and attitudes toward menstruation of university students who had primary dysmenorrhea. This randomized controlled, prospective, experimental study was carried out in a nursing school using a pretest-posttest design. A total of 682 female nursing students and 584 volunteers from the 2017-2018 academic year participated in a study of the prevalence of primary dysmenorrhea (94.0%). Study subjects were first-year female nursing students who scored severe on a visual analog scale for primary dysmenorrhea. As a result of the analysis, 80 female nursing students were assigned to study and control groups. A total of 60 students, 29 in the study group and 31 in the control group, completed the study. The study group participated in a 6-session cognitive-behavioral approach in a dysmenorrhea support program. No intervention was administered to the control group. The control group and the study group were followed by using data collection forms during three menstrual cycles. The Participant Introductory Form (PIF), Dysmenorrhea Follow-up Form (DFF), Dysmenorrhea Information Form (DIF), Functional and Emotional Dysmenorrhea Scale (FEDS), Visual Analog Scale (VAS), and Menstrual Attitude Questionnaire (MAQ) were used to measure outcomes. In the case of primary dysmenorrhea, the use of nonpharmacological methods was higher in the study group than in the control group. In the third cycle, although the rate of analgesics use was 20.7% in the study group, it was 50% in the control group. Primary dysmenorrhea symptoms, pain levels, and analgesic use decreased. No change was observed in the attitude toward menstruation. A cost-effective, reliable, cognitive-behavioral approach-based dysmenorrhea support program can be used to relieve symptoms, decrease the use of analgesics, and increase knowledge about primary dysmenorrhea.

Determining the Use of Nonpharmacologic Methods by Surgical Nurses for Postoperative Pain Management and the Influencing Professional Factors: A Multicenter Study

PurposeThe purpose of this study was to determine the use of nonpharmacologic methods by surgical nurses for postoperative pain management and to identify the influencing professional factors. DesignA regional survey model. MethodsThe sample of the study consisted of 443 surgical nurses working in regions of Turkey. The data were collected using a personal information form and questionnaire. FindingsHot-cold application (53.3%), exercise (50.8%), positioning (68.8%), movement restriction (35.7%), resting (55.5%), and distraction (42.2%) were among the methods usually used by nurses. The nurses who were working in the Black Sea region chose the nursing profession willingly, received the training on pain management, and used nonpharmacologic methods at higher rates (P < .030, P < .004, P < .033, and P < .000, respectively). ConclusionsGender, geographic region of work, choosing the profession willingly, and receiving training on pain management affected the nurses’ rate of using nonpharmacologic methods.

Uso dos métodos não farmacológicos durante o trabalho de parto: estudo observacional transversal

Esta pesquisa teve como objetivo descrever a frequência do uso dos métodos não farmacológicos de alivio da dor e suas características. Realizou-se um estudo quantitativo, transversal e descritivo no Alojamento Conjunto do Hospital de Clínicas de Uberlândia, entre janeiro a junho de 2017, com 82 puérperas. Das mulheres pesquisadas 92,7% foram informadas sobre os métodos, sendo os mais utilizados: exercícios respiratórios em 93,9%, banho de chuveiro por 82,9% e a deambulação em 81,7%; 93,3% tiveram a presença de um acompanhante, sendo que 81,7% participaram ativamente dos exercícios. Concluiu-se que nesta instituição a maioria das parturientes foram orientadas e utilizaram algum dos métodos não farmacológicos de alivio da dor.

Children’s views on postsurgical pain in recovery units in Norway: A qualitative study

To explore children's postsurgical experiences with pain and pain management in the recovery unit. Children's pain is underestimated and undertreated. Untreated pain can cause unnecessary suffering, increased complication risks and may lead to chronic pain. Research exploring children's experiences with postoperative pain and pain management is limited. A qualitative, exploratory study. The study complied with the Consolidated Criteria for Reporting Qualitative Research (COREQ). Children (N=20), 8-16years old, took part in semi-structured interviews about their experiences with pain and postoperative pain management while they were in a recovery unit. Data were collected at two university hospitals in Norway. Content analysis was used to analyse the data. Three themes emerged from the interviews: "children's experiences of what felt unpleasant and painful," "children's experiences with pain management" and "children's recommendations for future pain management". About half of the children reported moderate to severe pain while in the recovery unit and they did not always tell their nurses when they had pain. They also reported experiencing pain in places other than their surgical wounds and stated that nausea and vomiting felt unpleasant and painful. The children indicated that pain medications and the use of nonpharmacological methods helped them cope with their pain and provided several recommendations about how to improve pain management. Paediatric postoperative pain management remains suboptimal. The children in our study provided useful information about their pain experiences, how to improve pain management and explained why they did not tell their nurses when they were in pain. These findings should direct further improvements in paediatric postoperative pain management, such as increased use of pain assessment tools and preparatory information, as well as more appropriate administration of pain medications.

Progress in childbirth care in Brazil: preliminary results of two evaluation studies.

This article aims to describe the preliminary results of two evaluations studies, one about the Stork Network program and the other about the Adequate Birth program, called Stork Network Assessment and Healthy Birth, and to identify possible improvements in comparison to the Birth in Brazil study. Both studies used a cross-sectional design and were conducted in 2017. The Stork Network Assessment study included all 606 public and mixed maternity hospitals from the Stork Network and a total of 10,675 postpartum women. The Healthy Birth study included a convenience sample of 12 private hospitals and 4,798 women. Indicators of labour and childbirth care were: presence of a companion person, care by obstetric nurse, use of partograph, use of non-pharmacological methods, walking during labor, eating, use of peripheral venous catheter, position for delivery, episiotomy, and Kristeller maneuver. The indicators were compared to those verified in Birth in Brazil, a nationwide population-based study in 2011-2012, before the start of the two intervention programs. Comparisons used the chi-square test for independent samples and 95% confidence interval. There was a significant increase in the number of women with access to appropriate technology for labour and childbirth from 2011 to 2017 and a reduction in harmful practices. The private sector also showed a decrease in cesarean rates and an increase in gestational age at birth. The study's results show that properly conducted public policies can change the scenario of care for labor and childbirth, helping to reduce in negative maternal and neonatal outcomes.

Non-pharmacological Approaches to Treatment of Patients over 60 Years as a Way to Improve Pharmacotherapy Safety and Prevent Polypharmacy

Abstract. The demographic aging of the population of the earth observed in recent years is associated, inter alia, with the advent of new effective and safe medicines. However, the availability of highly effective drugs on the market also has a reverse side — the appearance of adverse drug reactions (ADRs), in particular as a result of drug-drug interactions. The use of non-pharmacological methods of treatment and prevention of diseases seems particularly relevant for patients of the older age group, as it allows not only to reduce the drug burden, to reduce the risk of ADRs but also to improve the patient’s state in case of diseases that have no effective pharmacotherapy and pharmacological prophylaxis. The aim of the study was to systematize and analyze data on non-pharmacological treatment methods in order to increase the safety of pharmacotherapy and prevent polypragmasia in elderly patients by informing health care providers about non-drug methods of correcting significant geriatric problems. The approaches to the correction of some major geriatric problems (delirium, sarcopenia, pain syndrome), including cognitive training, physical activity, diet, frequent reorientation of patients, placement of patients in specially equipped rooms («delirium room») were presented. The use of non-pharmacological approaches can significantly improve the safety of drug therapy, reduce the risks of ADRs, improve the patient’s prognosis and quality of life, and also effectively prevent polypharmacy.

\u201cWe know it\u2019s labour pain, so we don\u2019t do anything\u201d: healthcare provider\u2019s knowledge and attitudes regarding the provision of pain relief during labour and after childbirth

BackgroundMost women experience pain during labour and after childbirth. There are various options, both pharmacological and non-pharmacological, available to help women cope with and relieve pain during labour and after childbirth. In low resource settings, women often do not have access to effective pain relief. Healthcare providers have a duty of care to support women and improve quality of care. We investigated the knowledge and attitudes of healthcare providers regarding the provision of pain relief options in a hospital in Moshi, Tanzania.MethodsSemi-structured key informant interviews (n = 24) and two focus group discussions (n = 10) were conducted with healthcare providers (n = 34) in Tanzania. Transcribed interviews were coded and codes grouped into categories. Thematic framework analysis was undertaken to identify emerging themes.ResultsMost healthcare providers are aware of various approaches to pain management including both pharmacological and non-pharmacological options. Enabling factors included a desire to help, the common use of non-pharmacological methods during labour and the availability of pharmacological pain relief for women who have had a Caesarean section. Challenges included shortage of staff, lack of equipment, no access to nitrous oxide or epidural medication, and fears regarding the effect of opiates on the woman and/or baby. Half of all healthcare providers consider labour pain as ‘natural’ and necessary for birth and therefore do not routinely provide pharmacological pain relief. Suggested solutions to increase evidence-based pain management included: creating an enabling environment, providing education, improving the use of available methods (both pharmacological and non-pharmacological), emphasising the use of context-specific protocols and future research to understand how best to provide care that meets women’s needs.ConclusionsMany healthcare providers do not routinely offer pharmacological pain relief during labour and after childbirth, despite availability of some resources. Most healthcare providers are open to helping women and improving quality of pain management using an approach that respects women’s culture and beliefs. Women are increasingly accessing care during labour and there is now a window of opportunity to adapt and amend available maternity care packages to include comprehensive provision for pain relief (both pharmacological and non-pharmacological) as an integral component of quality of care.

Non-pharmacological methods of relieving delivery pain

The control of labor pain and the prevention of suffering are the main problems of doctors and midwives in the care of a woman giving birth. The aim of the study was to review the literature on the use and use of non-pharmacological methods to relieve pain in labor. Numerous non-pharmacological methods of pain relief can be initiated during labor. Midwives must be ready to provide comprehensive childbirth education that introduces women to various pain management options. Promoting comfort and satisfaction to women are among the most important tasks of care providers, who should value the physiological birth and the appropriate use of technology, prioritizing humane care providers who should value the physiological birth and the appropriate use of technology, prioritizing humane

Effectiveness of Oral Sucrose Sucking for Procedural Pain Management in Preterm and Term Neonates

Aim: The aim of the study is to assess the effectiveness of oral sucrose sucking prior to minor invasive procedures in pain reduction among term and preterm neonates. Materials and Methods: The research design was true experimental posttest only control group design with convenient sampling technique. The total study sample consisted of 60 term and preterm neonates for minor invasive procedure in NICU of CAIMS hospital were selected (30 experimental, 30 control group). Unpaired t-test was used to test the statistical significance and Fisher exact test was used to test the relationship between the demographic variables and pain scores. The tool used to assess the pain score was Lawrence’s neonatal pain scale (NIPS). Results: With available recent research evidences the results were compared in the nursing practice on safe administration of sucrose sucking prior to minor invasive (heel lance/venepuncture) procedure in term and preterm neonates. There is significant difference in the control and experimental group of neonates in pain reduction with t-test value of 7.73197 and the P value of <0.05. Conclusion: Use of nonpharmacological methods (sucrose sucking) is usually practical and easily implemented in daily care and can provide neonatal nurses with a range of methods for preventing procedural pain and protecting neonates.

Effects of postoperative pain management educational interventions on the outcomes of parents and their children who underwent an inpatient elective surgery: A randomized controlled trial.

To examine the effects of a postoperative pain management educational intervention on the outcomes of parents and their children who underwent inpatient elective surgery. Equipping parents with knowledge and skills to manage their children's postoperative pains is essential. Very limited studies have examined the effects of educational interventions on parents' knowledge, attitudes and use of pharmacological and non-pharmacological pain relief methods. Three-group pre- and post-test randomized controlled trial. Parent-child pairs (N=152) were recruited from September 2013-January 2015 and randomly assigned to either the control group or one of the two intervention groups. Valid and reliable instruments and diary entries were used to collect data at the baseline, 6, 12 and 24hr and 2weeks after the surgery. IBM SPSS 23.0 was used to analyse the data. Parents reported moderate levels of knowledge, attitudes, pain relief methods used and children's postoperative pain. Except for parents' knowledge, types and frequencies of non-pharmacological methods used, there were no statistically significant differences among the three groups in parents' attitudes on pain management and pain medication, their uses of pain relief strategies (questionnaire data), satisfaction with postoperative pain management and children's worst postoperative pain in 2weeks after surgery. Education seemed effective in improving parents' knowledge and use of non-pharmacological methods, but not attitudes, satisfaction with pain management and children's postoperative pain. Future studies are needed to develop modern digitalized ways for educating and supporting parents to optimize their children's postoperative pain management. This study has been registered with BioMed Central Ltd. (Registration No.: ISRCTN24910957).

Preoperative Pain Management Education: An Evidence-Based Practice Project

The purpose of this evidence-based practice project was to evaluate the effectiveness of a preoperative pain management patient education intervention on improving patients' pain management outcomes. The project was conducted in an outpatient general surgery service at a teaching institution for patients undergoing same-day surgery. Intervention patients received one-on-one education on postoperative pain management including how to take medications, managing medication side effects, using nonpharmacologic methods, and reporting inadequate postoperative pain control. Comparison patients received general education from multiple health care providers, and this information may not have been consistent. Intervention patients received education at the first preoperative clinic visit. Patients in the intervention and comparison groups completed the Revised American Pain Society Patient Outcome Questionnaire during their first postoperative clinic visit. Results were analyzed by the Mann-Whitney U test/Wilcoxon rank sum test. A 12-month project (N = 99) showed statistically significant results (P = .020 and P=.001, respectively) in questions about side effects and whether the patient was encouraged to use nonpharmacologic methods to reduce pain. The intervention group reported the effects of pain on mood (P = .067) and use of nonpharmacologic methods (P=.052); however, these results were not statistically significant. More intervention patients than comparison patients reported medication side effects and were encouraged to use nonpharmacologic methods for reducing postoperative pain. Intervention patients also reported the effects of pain on mood and the use of nonpharmacologic methods more frequently than comparison patients. Preoperative pain management education may increase patients' knowledge in key areas of postoperative pain management to prevent negative outcomes.

Parents' Use of Nonpharmacologic Methods to Manage Procedural Pain in Infants

ObjectiveTo describe parents' use of nonpharmacologic methods to manage infant procedural pain in the NICU and determine the demographic factors related to such use. DesignA cross-sectional and descriptive study design. SettingLevel III and Level II NICUs (seven units) of four University Hospitals in Finland. ParticipantsParents (N = 178) whose infants were treated in Finnish NICUs. MethodsParents were asked to respond to a structured questionnaire during their infants' hospitalizations. We analyzed the data using the nonparametric Kruskal–Wallis one-way analysis of variance and Mann–Whitney U test. ResultsMost parents reported that they used physical methods, such as touching, holding, and positioning, nearly always/always (86%, 76%, and 55%, respectively). However, less commonly used strategies included recorded music (2%), breastfeeding (2%), and non-nutritive sucking with oral sucrose (6%). Many characteristics of the infants, such as their gestational ages and their conditions, were significantly related to the implementation of nonpharmacologic methods. ConclusionThere is a clear need to extend parents' use of nonpharmacologic methods to manage their infants' procedural pain in the NICU. Because many methods were not considered as pain-relieving strategies, it is important to increase knowledge about the effectiveness of these interventions among parents and nurses.

Turkish Pediatric Nurses’ Use of Non-Pharmacological Methods for Postoperative Pain Relief in 6 to 12 Year Old Children

Objective: This descriptive study was conducted for the purpose of describing the Turkish pediatric nurses’ use of non-pharmacological methods for relieving 6 to 12-year-old children’s postoperative pain. Method: This research was conducted with 92 pediatric nurses working at 17 university hospitals located in Turkey. Data were collected using a web based questionnaire and had to be completed electronically. Results: It was determined that the majority of the nurses give information about postoperative observation (79.3%), and postoperative pain (76.1%). In addition, it was determined that they have been encouraging children to ask about misconceptions (69.6%). Conclusion: Based on these results, the Turkish pediatric surgical nurses used versatile non-pharmacological methods in children’s postoperative pain relief.