Student’s Name:
PICOT QUESTION: In elderly Caucasian adults, what is the effect of symptom management of pain with non-pharmacologic measures of pain control versus pharmacologic measures, in the management of chronic pain within a period of one year?
QUANTITATIVE STUDIES
Author/Title/Year (APA format): Golino, A. J., Leone, R., Gollenberg, A., Christopher, C., Stanger, D., Davis, T. M., … Friesen, M. A. (2019). Impact of an active music therapy intervention on intensive care patients. American Journal of Critical Care, 28(1), 48–55. https://doi.org/10.4037/ajcc2019792.
Problem related to PICOT: Patients in the intensive care unit continue to experience poorly-managed pain.
Purpose: To examine the impact of an active music therapy intervention on physiological parameters and self-reported pain and anxiety levels of patients in the intensive care unit
Sample/Population: 52 adult patients in the intensive care unit.
Data Collection Method: Quantitatively using self-assessment tools.
Major Findings/Conclusions: There was a significant reduction in pain among patients post-intervention.
Contribution to Review of the Literature: Active music therapy is an effective nonpharmacological intervention for managing pain in intensive care units.
Author/Title/Year (APA format): Feeney, C., Bruns, E., LeCompte, G., Forati, A., Chen, T., & Matecki, A. (2017). Acupuncture for pain and nausea in the intensive care unit: a feasibility study in a public safety net hospital. Journal of Alternative and Complementary Medicine, 23(12), 996–1004. https://doi.org/10.1089/acm.2016.0323.
Problem related to PICOT: There is an increasing need to manage pain and nausea symptoms in intensive care unit (ICU) patients.
Purpose: To examine the acceptability and feasibility of acupuncture in relieving symptoms of pain and nausea in patients admitted in the intensive care unit.
Sample/Population: 576 patients hospitalized in the intensive care unit.
Data Collection Method: Quantitatively using a structured questionnaire.
Major Findings/Conclusions: There was immediate decrease in pain after acupuncture. The pain score decreased by 2.36 points.
Contribution to Review of the Literature: Acupuncture is a safe, feasible, and acceptable non-pharmacological pain management intervention in the intensive care unit.
QUALITATIVE STUDIES
Author/Title/Year: Munkombwe, W. M., Petersson, K., & Elgán, C. (2020). Nurses’ experiences of providing nonpharmacological pain management in palliative care: A qualitative study. Journal of Clinical Nursing, 29(9-10), 1643–1652. https://doi.org/10.1111/jocn.15232.
Problem related to PICOT: Nurses’ attitudes regarding non-pharmacological pain management therapies used in palliative care are not adequately understood.
Purpose: To explore nurses’ views and experiences regarding the non-pharmacological pain management interventions used with palliative care patients.
Sample: 15 palliative care nurses.
Data Collection Method: Qualitatively by conducting individual interviews.
Key Findings/Themes: Positive nurse-patient relationships are central to positive outcomes for successful non-pharmacological pain management.
Contribution to Review of the Literature: Nurses should understand their patients and be sensitive to their needs when they are using non-pharmacological interventions to manage pain.
Author/Title/Year: Oberoi, D., Reed, E. N., Piedalue, K. A., Landmann, J., & Carlson, L. E. (2022). Exploring patient experiences and acceptability of group vs. individual acupuncture for Cancer-related pain: a qualitative study. BMC Complementary Medicine and Therapies, 22(1), 155. https://doi.org/10.1186/s12906-022-03600-6.
Problem related to PICOT: Poor pain control in patients experiencing chronic pain.
Purpose: To examine the effects of acupuncture in pain control among cancer patients.
Sample: 11 cancer patients.
Data Collection Method: Qualitatively using semi-structured, open-ended, and in-depth interviews.
Key Findings/Themes: Patients reported positive experiences with acupuncture.
Contribution to Review of the Literature: Acupuncture improves pain symptoms in cancer patients experiencing chronic pain.
MIXED METHODS STUDIES:
Author/Title/Year (APA format): Bao, Z., & Landers, M. (2022). Non-pharmacological interventions for pain management in patients with dementia: A mixed-methods systematic review. Journal of Clinical Nursing, 31(7-8), 1030–1040. https://doi.org/10.1111/jocn.15963.
Problem related to PICOT: Poor pain management in patients with dementia.
Purpose: To assess the effectiveness of non-pharmacological pain management interventions in adult patients with dementia.
Sample: 8 peer-reviewed articles published between January 2009 and February 2020.
Data Collection Method: Mixed-method systematic review of literature.
Key Findings/Themes/Conclusions: Non-pharmacological therapies such as massage and play activity are programs are affective pain management strategies in adult patients with dementia.
Contribution to Review of the Literature: Non-pharmacological interventions can be used to manage pain in adult patients with dementia.
Author/Title/Year (APA format): Kidanemariam, B. Y., Elsholz, T., Simel, L. L., Tesfamariam, E. H., & Andemeskel, Y. M. (2020). Utilization of non-pharmacological methods and the perceived barriers for adult postoperative pain management by the nurses at selected National Hospitals in Asmara, Eritrea. BMC Nursing, 19, 100. https://doi.org/10.1186/s12912-020-00492-0
Problem related to PICOT: Poorly controlled pain poses a significant challenge to post-operative patients.
Purpose: The explore the non-pharmacological pain management methods that are commonly used by nurses to control post-operative pain and perceived barriers to implementation.
Sample: 154 nurses.
Data Collection Method: Quantitatively using Likert-scale questionnaire and qualitatively using interviews
Key Findings/Themes/Conclusions: Non-pharmacological pain management strategies that are commonly used with postoperative patients include; emotional support and creating a comfortable environment.
Contribution to Review of the Literature: Non-pharmacological pain management methods are helpful for postoperative patients.
META-ANALYSIS STUDIES
Author/Title/Year (APA format): Sakamoto, J. T., Ward, H. B., Vissoci, J., & Eucker, S. A. (2018). Are nonpharmacologic pain interventions effective at reducing pain in adult patients visiting the emergency department? A systematic review and meta-analysis. Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine, 10.1111/acem.13411. Advance online publication. https://doi.org/10.1111/acem.13411.
Problem related to PICOT: Rising cases of pain complaint among patients visiting the emergency department despite overreliance on pharmacological interventions.
Purpose: To examine the effectiveness of non-pharmacological interventions in managing pain in the emergency department.
Search selection method: Studies that addressed acupuncture and physical therapies.
Meta-Analysis Model: Random effects model
Consistency/Variation of Studies: Consistency for studies that explored musculoskeletal pain.
Summary of Findings: Non-pharmacological interventions are effective in reducing pain in the emergency department.
Author/Title/Year (APA format): Saragih, I. D., Suarilah, I., Son, N. T., & Lee, B. O. (2022). Efficacy of non-pharmacological interventions to reduce pain in people with dementia: A systematic review and meta-analysis. Journal of Clinical Nursing, https://doi.org/10.1111/jocn.16444.
Problem related to PICOT: Unmanaged pain in patients with dementia.
Purpose: To examine the efficacy of non-pharmacological pain management interventions in decreasing pain in patients with dementia.
Search selection method: non-pharmacological interventions in dementia patients.
Meta-Analysis Model: Random effects model.
Consistency/Variation of Studies: Consistency in the types of studies that explored pain management interventions in patients with dementia.
Summary of Findings: Non-pharmacological interventions are effective in reducing pain in patients with dementia.
CLINICAL PRACTICE GUIDELINES
Author/Title/Year (APA format): The Joint Commission. (2018). Non-pharmacologic and non-opioid solutions for pain management. https://www.jointcommission.org/-/media/tjc/documents/resources/pain-management/qs_nonopioid_pain_mgmt_8_15_18_final1.pdf.
Problem related to PICOT: Pain management medications such as opioids put patients at risk of drug abuse and respiratory depression.
Stakeholders represented: Healthcare organizations, healthcare professionals, policymakers, and the public health department.
Systematic review of literature: Yes
Strength of recommendations used: High-quality
Recommendations have been peer reviewed: Yes
Summary of findings as related to PICOT: Evidence-based non-pharmacological pain management interventions are safe for use with patients. They are categorized as psychological interventions, environmental-based interventions, and physical interventions.
Author/Title/Year (APA format): Qaseem, A., McLean, R. M., O’Gurek, D., Batur, P., Lin, K., Kansagara, D. L., Clinical Guidelines Committee of the American College of Physicians, Commission on Health of the Public and Science of the American Academy of Family Physicians, Cooney, T. G., Forciea, M. A., Crandall, C. J., Fitterman, N., Hicks, L. A., Horwitch, C., Maroto, M., McLean, R. M., Mustafa, R. A., Tufte, J., Vijan, S., & Williams, J. W., Jr (2020). Nonpharmacologic and pharmacologic management of acute pain from non-low back, musculoskeletal injuries in adults: A clinical guideline from the American College of Physicians and American Academy of Family Physicians. Annals of Internal Medicine, 173(9), 739–748. https://doi.org/10.7326/M19-3602.
Problem related to PICOT: Acute pain from non-low back pain and musculoskeletal injuries are contributing to poor quality of life in adults in outpatient settings.
Stakeholders represented: Clinicians and patient populations with non-low back pain and musculoskeletal injuries.
Systematic review of literature: Yes
Strength of recommendations used: High-quality.
Recommendations have been peer reviewed: Yes.
Summary of findings as related to PICOT: specific acupressure and transcutaneous electrical nerve stimulation are effective in reducing pain and improving physical function in patients with non-low back pain and musculoskeletal injuries.
References
Bao, Z., & Landers, M. (2022). Non-pharmacological interventions for pain management in patients with dementia: A mixed-methods systematic review. Journal of Clinical Nursing, 31(7-8), 1030–1040. https://doi.org/10.1111/jocn.15963.
Feeney, C., Bruns, E., LeCompte, G., Forati, A., Chen, T., & Matecki, A. (2017). Acupuncture for pain and nausea in the intensive care unit: a feasibility study in a public safety net hospital. Journal of Alternative and Complementary Medicine, 23(12), 996–1004. https://doi.org/10.1089/acm.2016.0323.
Golino, A. J., Leone, R., Gollenberg, A., Christopher, C., Stanger, D., Davis, T. M., … Friesen, M. A. (2019). Impact of an active music therapy intervention on intensive care patients. American Journal of Critical Care, 28(1), 48–55. https://doi.org/10.4037/ajcc2019792.
Kidanemariam, B. Y., Elsholz, T., Simel, L. L., Tesfamariam, E. H., & Andemeskel, Y. M. (2020). Utilization of non-pharmacological methods and the perceived barriers for adult postoperative pain management by the nurses at selected National Hospitals in Asmara, Eritrea. BMC Nursing, 19, 100. https://doi.org/10.1186/s12912-020-00492-0
Munkombwe, W. M., Petersson, K., & Elgán, C. (2020). Nurses’ experiences of providing nonpharmacological pain management in palliative care: A qualitative study. Journal of Clinical Nursing, 29(9-10), 1643–1652. https://doi.org/10.1111/jocn.15232.
Oberoi, D., Reed, E. N., Piedalue, K. A., Landmann, J., & Carlson, L. E. (2022). Exploring patient experiences and acceptability of group vs. individual acupuncture for Cancer-related pain: a qualitative study. BMC Complementary Medicine and Therapies, 22(1), 155. https://doi.org/10.1186/s12906-022-03600-6
Sakamoto, J. T., Ward, H. B., Vissoci, J., & Eucker, S. A. (2018). Are nonpharmacologic pain interventions effective at reducing pain in adult patients visiting the emergency department? A systematic review and meta-analysis. Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine, 10.1111/acem.13411. Advance online publication. https://doi.org/10.1111/acem.13411.
Saragih, I. D., Suarilah, I., Son, N. T., & Lee, B. O. (2022). Efficacy of non-pharmacological interventions to reduce pain in people with dementia: A systematic review and meta-analysis. Journal of Clinical Nursing, https://doi.org/10.1111/jocn.16444.
The Joint Commission. (2018). Non-pharmacologic and non-opioid solutions for pain management. https://www.jointcommission.org/-/media/tjc/documents/resources/pain-management/qs_nonopioid_pain_mgmt_8_15_18_final1.pdf.
Qaseem, A., McLean, R. M., O’Gurek, D., Batur, P., Lin, K., Kansagara, D. L., Clinical Guidelines Committee of the American College of Physicians, Commission on Health of the Public and Science of the American Academy of Family Physicians, Cooney, T. G., Forciea, M. A., Crandall, C. J., Fitterman, N., Hicks, L. A., Horwitch, C., Maroto, M., McLean, R. M., Mustafa, R. A., Tufte, J., Vijan, S., & Williams, J. W., Jr (2020). Nonpharmacologic and pharmacologic management of acute pain from non-low back, musculoskeletal injuries in adults: A clinical guideline from the American College of Physicians and American Academy of Family Physicians. Annals of Internal Medicine, 173(9), 739–748. https://doi.org/10.7326/M19-3602.