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Pain relief from nonpharmacological interventions in the intensive care unit: A scoping review.

Journal of clinical nursing
May 1, 2020
Reidun K Sandvik et al. (4 authors)
Journal ArticleScoping ReviewHuman Study
Study Details

Study Goal

The researchers aimed to evaluate the effectiveness of nonpharmacological interventions, including massage, for pain management in ICU patients.

Results Summary

The study included massage as one of several nonpharmacological interventions but did not specifically highlight its efficacy; pain reduction was noted for hypnosis, acupuncture, and natural sounds.

Population

ICU patients experiencing pain from tissue damage, diseases, surgery, or medical procedures.

Effective Dosage

Not specified

Duration

Not specified

Interactions

None mentioned

Extracted Claims (3)
InterventionDirectionEndpointPopulationDosageImpactClaim #
hypnosis
decrease
pain intensity
patients admitted to the ICU
-
Reduction in pain intensity was conferred
#1
acupuncture
decrease
pain intensity
patients admitted to the ICU
-
Reduction in pain intensity was conferred
#2
listening to natural sounds
decrease
pain intensity
patients admitted to the ICU
-
Reduction in pain intensity was conferred
#3
Abstract

AIMS AND OBJECTIVES: To describe what is known from the existing literature on nonpharmacological interventions targeting pain in patients admitted to the ICU. BACKGROUND: Patients receiving intensive care nursing are exposed to a wide range of pain provoking tissue damage, diseases, surgery and other medical procedures in addition to the pain caused by nursing care procedures. The present shift to light sedation to improve patient outcomes and comfort underscores the need for effective pain management. Opioids are the mainstay for treating pain in the ICUs, whereas nonpharmacological treatments are understudied and possibly under-used. METHOD: A scoping review was undertaken using five of the six steps in the Arksey and O´Malley framework: (a) identification of the research question, (b) identification of relevant studies, (c) study selection, (d) charting the data and (e) collating, summarising and reporting the results. CINAHL, MEDLINE, PubMed, BMJ Best Practice, British Nursing Index and AMED databases were searched using relevant keywords to capture extensive evidence. Data were analysed using the six-step criteria for scoping reviews suggested by Arksey and O´Malley for data extraction. To ensure quality and transparency, we enclosed the relevant Equator checklist PRISMA. RESULTS: Our search yielded 10,985 articles of which 12 studies were included. Tools for pain assessments were VAS, NRS, ESAS and BPS. Interventions explored were hypnosis, simple massage, distraction, relaxation, spiritual care, harp music, music therapy, listening to natural sounds, passive exercise, acupuncture, ice packs and emotional support. Reduction in pain intensity was conferred for hypnosis, acupuncture and natural sounds. CONCLUSION: The findings support further investigations of acupuncture, hypnosis and listening to natural sounds. RELEVANCE TO CLINICAL PRACTICE: The main finding suggests the use of comprehensive multimodal interventions to investigate the effects of nonpharmacological treatment protocols on pain intensity, pain proportion and the impact on opioid consumption and sedation requirements.

Medical Subject Headings (MeSH)
HumansHypnosisIntensive Care UnitsMassageMusic TherapyNursing Staff, HospitalPain ManagementPatient ComfortPhysical Therapy Modalities
Study Links
Quality Scores
SafetyNot Assessed
Efficacy50/10
Quality75/10
Citation Metrics
Total Citations26
Citations/Year5.2
Relative Citation Ratio2.68
NIH Percentile82.4%
Research Impact Scores
APT Score0.75
Weight Score2.38
Normalized Score0.55
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