Pain management nursing : official journal of the American Society of Pain Management Nurses
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Unrelieved postoperative pain may have a negative impact on the physiological and psychological well-being of patients. Pharmacological methods are currently used to relieve such pain in gynecological patients; however, inadequate pain control is still reported, and the use of nonpharmacological pain-relieving methods is increasingly being advocated, one of which is music therapy. The purpose of this literature review was to identify, summarize, and critically appraise current evidence on music therapy and postoperative pain management among gynecological patients. ⋯ The findings indicated that music therapy, in general, was effective in reducing pain intensity, fatigue, anxiety, and analgesic consumption in gynecological patients during the postoperative period. It is recommended as an adjunct to pharmacological pain-relieving methods in reducing postoperative pain. Future researches on music therapy to identify the most effective application and evaluate its effect by qualitative study are recommended.
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Fibromyalgia (FM) patients were recently found to have more symptom burden from bothersome pelvic pain syndromes that women seeking care for pelvic floor disease at a urogynecology clinic. We sought to further characterize pelvic floor symptoms in a larger sample of FM patients using of validated questionnaires. Female listserv members of the Fibromyalgia Information Foundation completed an online survey of three validated questionnaires: the Pelvic Floor Distress Inventory 20 (PFDI-20), the Pelvic Pain, Urgency and Frequency Questionnaire (PUF), and the Revised Fibromyalgia Impact Questionnaire (FIQR). ⋯ Women with FM report significantly bothersome pelvic floor and urinary symptoms. Fibromyalgia management should include evaluation and treatment of pelvic floor disorders recognizing that pelvic distress and urinary symptoms are associated with more severe FM symptoms. Validated questionnaires, like the ones used in this study, are easily incorporated into clinical practice.
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Observational Study
The Algoplus Score to Assess Acute Postoperative pain in Elderly patients-A Pilot Observational Study.
Standard verbal or analogue scales may not be accurate to assess acute postoperative pain in elderly patients. This study was designed to field test the Algoplus tool, developed specifically for this population and based on observation of patient behavior. Prospective, observational cohort. ⋯ When the NRS score exceeded 3/10, indicating the need for analgesic intervention, the Algoplus score was generally lower than the recommended trigger for analgesia (2/5). These results are promising, but further evidence of a clinical benefit to the use of Algoplus for acute postoperative pain is needed. In future studies, scoring should be adjusted to take into account the time from extubation, the state of sedation, and the patient's gender in order to interpret results.
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Multicenter Study
Applying the RE-AIM Framework to Evaluate Integrative Medicine Group Visits Among Diverse Women with Chronic Pelvic Pain.
The purpose of this study was to evaluate group medical visits using an integrative health approach for underserved women with chronic pelvic pain (CPP). We implemented an integrative medicine program to improve quality of life among women with CPP using Centering, a group-based model that combines healthcare assessment, education, and social support. Patients were from university-affiliated and public hospital-affiliated clinics. ⋯ No improvements were observed for pain catastrophizing. Our pilot program provides preliminary data that an integrative health approach using a group-based model can be adapted and implemented to reach diverse women with CPP to improve physical and psychological well-being. Given these promising findings, rigorous evaluation of implementation and effectiveness of this approach compared with usual care is warranted.
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Randomized Controlled Trial Multicenter Study
Face-to-face Information and Emotional Support from Trained Nurses Reduce Pain During Screening Mammography: Results from a Randomized Controlled Trial.
Pain and discomfort during breast examination can affect a woman's adherence to breast cancer-screening programs. The aim of this study was to determine whether a nursing intervention protocol that provides verbal information and support to women could reduce pain during mammography. A randomized controlled trial of 436 Spanish women aged 50-69 who attended a breast-screening program was performed. ⋯ Consequently, the probability of feeling pain during mammography was lower among women in the experimental group (OR = 0.44; 95% CI: 0.24-0.81). The intervention was more effective among women with the highest anxiety levels (OR = 0.33; 95% CI: 0.11-0.98), who did not expect pain (OR = 0.28; 95% CI: 0.08-0.97), and who did not fear the outcome of the mammography (OR = 0.18; 95% CI: 0.04-0.85). Providing verbal information, as well as supporting the women during the test, is a simple and achievable intervention for nurses and can help to reduce pain during screening mammography.