Non-pharmacological interventions for relieving pain assessment answers

Subject Name : Nursing

2019

Non-pharmacological interventions for relieving pain

IntroductionEvidence based practice (EBP) has been defined by Schmidt, N. A., amp Brown, J. M. (2017),as the use of current and best evidence judiciously, explicitly and conscientiously for making decisions about the health care of a patient. It implies that the healthcare professional has to integrate his clinical expertise with the external clinical evidences generated through systematic research. More precisely, it is the integration of values of patient, best research evidences and clinical expertise in the process of decision making for improving the healthcare of the patient.The clinical expertise refers to collective form of the education, experience and skills of clinicians. The patients also incorporate his preferences, individuality, values and expectations in the process of evidence based practice. The best evidence from the research is located from the clinical researches which has been conducted previously.Below is the diagrammatic scheme of EBP.

Source- Duke university-Medical Centre Library amp Archives. (n.d.).
As a nurse working, in the PACU (Post-Anesthesia Care Unit) evidence based practice can be used for the management pain of the patient who have undergone operations. There are a number of pharmacological methods for pain relieving but they have been found to be inadequate by many of the post-operative patients. There are many non- pharmacological methods which are used for the pain management such use of music for relieving pain and such methods are strongly advocated. However, as a nurse one has to follow evidence based practice and therefore there is need to find evidence from the research about the benefits of music therapy in pain management and if it can be used as an adjunct with pharmacological methods.
PICOThe first step in the evidence based practice process is to find out the questions related to the cause. PICO table is used for illustrating the relevant questions for the concerned evidence based practice as shown below
P Patient The patients are those who have undergone surgery and are kept in ICU. The patients are treated with pharmacological methods for pain management
I Intervention Pain management with the use of pharmacological methods is considered.
C Comparison Music therapy as a non-pharmacological methods for pain relieving is selected as an alternative treatment for the pain management.
O Outcome Is the use of music helpful for such patients in pain management and patient are satisfied
Search strategiesThe databases which were used for finding out the relevant research are
Database Key words Research evidences
Pubmed music therapy is beneficial in pain management The Effect of Listening toMusicon PostoperativePainin Adult Orthopedic Patients
By Schneider, M. A. (2018).
Elsevier music therapy is beneficial in pain management Nursing music intervention A systematic mapping study
By Cierci, Y., Ksack, O. G., zyrek, P., ampCahideevik, C. (2019).
Nursing music protocol and postoperative pain.
By Poulsen, M. J., ampCoto, J. (2018).
Effect of music on postoperative pain and physiologic parameters of patients after open heart surgery.
By zer, N., zl, Z. K., Arslan, S., ampGnes, N. (2013).
Effects of music therapy on pain, anxiety, and vital signs in patients after thoracic surgery.
By Liu, Y., ampPetrini, M. A. (2015).
Other databases like semantic scholar, science direct, elsevier were used for getting the eresearch work done on this issue. Few researched were selected and they were shortlisted on the basis of the quality of evidence shown by them. The quality of evidence is evaluted from the EBP pyramid given below.

Source- Purdue University Global (n.d.)
The study conducted by zer, N., et al. (2013)showed that the music has proved to be a simple, safe and effective non-pharmacological method for pain management in post-operative patients.In another study furnished by Liu, Y., et al. (2015), the effect of music therapy on the post-operative patients who have undergone a thoracic surgery was evaluated using randomized controlled trials. Their results depicted decrease in post-operative pain statistically when music therapy was used. Schneider, M. A. (2018) conducted a study using a comparative, descriptive and quasi-experimental design. In this study the patient listened to the music and gave scored for their pain before and after listening to music. The study showed as satisfactory results in the patients.
Use of music for pain management in post-operative patients.The chosen research for evidence based practice of pain management using music as a therapy and non-pharmacological intervention for relieving pain in post-operative patient is the study conducted by Cierci, Y. et al (2019).This study was selected because according to EBM pyramid it had the best quality of evidence as it was done using a systematic review of relevant literature on the use of music for pain management in post-operative patients.In this study a systematic mapping method was used for evaluating the studies conducted on music intervention for pain management between a time period of 2013 and 2017. From this it was concluded that music was effective in relieving in pain and anxiety in 34.1 percent and 54 percent respectively from the set of selected studies. It is clear from this study that music has beneficial effects in management of pain in post-operative patients. Music therapy can be used as an adjunct and can potentially reduce pain and opioid use.
Another study which reflected that music is an inexpensive, non-pharmacological and side-effect free method for management of pain in the post-operative patients of open heart surgery was confirmed by Jafari, H., Zeydi, A. E., Khani, S., Esmaeili, R., ampSoleimani, A. (2012).Also from the systematic review done by Economidou, E., et al (2012), it was clearly reflected that the use of music therapy has positive effect on the observed and affective pain in most of the studies reviewed by him. In a systematic review done by Cole, L. C., amp LoBiondo-Wood, G. (2014), it was confirmed that the use of music therapy in controlling pain in hospitalized adults had favorable results. However, it is still not used in hospitals as a complimentary therapy for pain management. There is also a lack of protocol which can be used by nurses for implementation according to Poulsen, M. J., ampCoto, J. (2018).
ConclusionWith the EBP pyramid it was established that the study which should be taken needs to have the best quality of evidence. Therefore, from the above search strategy a study was selected for the EBP of music therapy. It has shown that use of music therapy holds benefits for the post-operative patients. And it can be used as a non-invasive, cheap, non-pharmacological means for addressing the pain in the post-operative patients and additionally no side-effects of music therapy was reported.
ReferencesCierci, Y., Ksack, O. G., zyrek, P., ampCahideevik, C. (2019) Nursing music intervention A systematic mapping study. Complementary Therapies in Clinical Practice, (35), May 2019, 109-120.
Cole, L. C., amp LoBiondo-Wood, G. (2014). Music as an adjuvant therapy in control of pain and symptoms in hospitalized adults a systematic review.Pain Management Nursing,15(1), 406-425.
Duke University-Medical Centre Library amp Archives. (n.d.). What is Evidence-Based Practice (EBP)Retrieved from https//guides.mclibrary.duke.edu/c.phpg158201ampp1036021Economidou, E., Klimi, A., Vivilaki, V. G., ampLykeridou, K. (2012). Does music reduce postoperative pain A review. Health Science Journal, 6(3), 365-377.
Jafari, H., Zeydi, A. E., Khani, S., Esmaeili, R., ampSoleimani, A. (2012). The effects of listening to preferred music on pain intensity after open heart surgery.Iranian journal of nursing and midwifery research,17(1), 1.
Liu, Y., ampPetrini, M. A. (2015). Effects of music therapy on pain, anxiety, and vital signs in patients after thoracic surgery.Complementary therapies in medicine,23(5), 714-718.
zer, N., zl, Z. K., Arslan, S., ampGnes, N. (2013). Effect of music on postoperative pain and physiologic parameters of patients after open heart surgery.Pain Management Nursing,14(1), 20-28.
Poulsen, M. J., ampCoto, J. (2018). Nursing music protocol and postoperative pain.Pain Management Nursing,19(2), 172-176.
Purdue University Global. (n.d.). Evidenced Based Practice Pyramid of Resources. Retrieved from https//library.purdueglobal.edu/c.phpg170325ampp2412211Schneider, M. A. (2018). The effect of listening to music on postoperative pain in adult orthopedic patients. Journal of Holistic Nursing, 36(1), 23-32.
Schmidt, N. A., amp Brown, J. M. (2017). Evidence-based practice for nurses. Jones amp Bartlett Learning.