Quantitative and Qualitative Research on Efficacy of Non-pharmacological Pain Management

ADVANCED RESEARCH DESIGN
Name
Professor’s Name
Course
Institution
Date
Advanced Research Design
Introduction
Chronic pain remains a serious healthcare challenge regardless of the advancements in pain management over the last decades. Avoiding painful interventions should be the primary avenue of managing chronic pain (Park & Moon, 2010). Traditionally, stakeholders in healthcare have employed both pharmacological and non-pharmacological interventions in managing pain. Still, there is no conclusive data on the best approaches to pain management. As the debate continues, the challenges associated with pain, including neurodevelopmental issues and behavioral challenges, continue to escalate with detrimental consequences both short-term and long-term (Reno, 2021). Non-pharmacological interventions to pain have triggered debates with factions believing that such interventions prove inadequate with limited consistency. The industry is highly dependent on pharmacological pain interventions that are believed to be swift in addressing pain, albeit with notable risks such as addiction (Park & Moon, 2010). Focusing on clinical stability and recovery of the individuals experiencing pain remains the focus of healthcare professionals. In contemporary healthcare, multidisciplinary teams, especially nurses, must develop the ultimate strategies to manage pain among patients (Beckett et al., 2016). In an industry that is fast appreciating the inputs of evidence-based practice, enhancing knowledge in the prospects of pain management remains a necessity. Nurses should have a variety of options if faced with pain management decisions. Still, emphasis must be put on the outcomes of the approaches chosen to manage various aspects of pain. This research focuses on non-pharmacological pain management approaches and their efficacy relative to pharmacological interventions with the PICOT questions’ findings based on quantitative and qualitative research methodologies.
Background
Chronic pain is a serious challenge going by the prevalent data. Chronic pain is commonplace, especially in the US. In 2019, the National Center for Health Statistics (NCHS), in collaboration with the Centers for Disease Control and Prevention (CDC), released data indicating that 50 million Americans are experiencing chronic pain at least once a year. That number translates to approximately 20% of the US population. Pain issues cost the economy severely. It is indicated that individuals with chronic pain miss more workdays (10) compared to those who do not suffer from chronic pain and miss three workdays per year on average. With that number, the total economic impact of chronic pain in terms of lost wages amounts to $80 billion annually (Reno, 2021). The economic impacts of chronic pain extend to lost productivity that is valued at $300 billion annually. Amidst such financial losses, chronic pain also comes as a serious challenge to the patients. Patients with chronic pain stay at risk of developing further complications, including dysfunctions in their physical and mental states. It has been indicated in the literature that patients with chronic pain are more likely to develop psychological disorders than those without chronic pain challenges. Considering the impacts of chronic pain on patients and the economy, efforts must be implemented to change the trends (Reno, 2021). Newer and more insightful pain management strategies must be explored to deliver better patient outcomes. Superficially, pharmacological approaches, non-pharmacological approaches, or a combination of both could be used to address the challenges.
Literature Review
Pain management in literature has been a factor of either pharmacological or non-pharmacological interventions. Healthcare professionals, presently, must refer to evidence and recommend the most appropriate pain management strategies for their patients. Often, factors such as the cause of pain, severity of pain, and mental or physical conditions of the patients are assessed before conclusive recommendations are reached. Each intervention can be assessed individually, with the outcomes geared towards answering the research questions.
Non-pharmacological Pain Management Interventions
Non-pharmacological pain management interventions are among the sought-after interventions in pain management presently bearing their protracted outcomes. A non-pharmacological or non-pharmaceutical intervention is a type of health intervention that is not based on medication use (Reno, 2021). The interventions can be employed to enhance an individual’s relaxation, dietary habits, and sleep improvement. In pain management, non-pharmacological interventions can include sensory or physical interventions, psychological interventions, or others. In some cases, practitioners can employ a combination of non-pharmacological interventions as deemed fit for a patient. The individual non-pharmacological interventions can be employed as discussed below from different pieces of literature:
Physical/Sensory Interventions
Physical or sensory interventions constitute a range of techniques that are aimed at relaxing or activating various body organs. Physical interventions primarily help release the strain that some individuals can feel to trigger pain. Practitioners can employ different physical intervention mechanisms to manage pain for their patients (Reno, 2021). Primary among the strategies is massage. Massage is the process of kneading or rubbing parts of the body, especially muscles and joints, to relieve pain and decrease tension (Park & Moon, 2010). Pain can complicate the patient’s condition by elevating stress, reducing one’s ability to execute daily activities, and altering an individual’s posture. Massage has been found appropriate in addressing some of the above challenges as it interrupts an individual’s cycle of distress. Massage enhances lymphatic circulation as well as blood circulation. Massage can also have an analgesic activity on the area being targeted and reduce inflammation and edema. Furthermore, it can manually release muscle spasms while boosting endogenous endorphin release and providing competing sensory stimuli that override pain signals (Maciel et al., 2019).
There remain debates on the exact mechanisms of pain management through massages. However, the process of kneading and rubbing soft tissues of the body can lead to the relaxation of tense muscles, increase blood flow in the underlying tissues, and relieve pain by an extension (Park & Moon, 2010). There have been scientific suggestions that massage can enhance dopamine levels that increase relaxation in individuals. Proper utilization of massage can also trigger improved posture, strengthen the body’s immune system, and lower blood pressure. Among patients undergoing chronic pain, massage is highly effective in enhancing a patient’s mood while also improving his/her quality of life. With the above positive impacts linked to the use of massages, individuals undergoing chronic pain linked to heightened blood pressure, distress, or altered posture can be subjected to massage.
The second physical/sensory intervention that practitioners can employ as a pain management tool is positioning. Positioning is a physical intervention involving proper body alignment to reduce anxiety and stress (Park & Moon, 2010). Proper positioning helps in eliminating further complications, prevents developing bed ulcers, reduces the risk of developing more physical injuries. Combined, the above outcomes reduce pain among patients. Positioning is normally a common cause of pain among the elderly and children who cannot coordinate a part of their bodies. Such individuals must be monitored with the practitioners ensuring that they are positioned correctly. In chronic pain management, efficient positioning improves blood circulation and reduces pain by extension.
The hot and cold technique is another approach to pain management that practitioners can explore without emphasizing pharmaceutical inputs (Maciel et al., 2019). Hot and cold is an easy-to-use and inexpensive therapy that can deliver effective pain management outcomes with minimum side effects if employed appropriately. Cold therapy constitutes an application of a cool substance or device to any part of the body. The device can be placed on the region with more pain. Studies indicate that active warming and cold treatment have delivered positive outcomes in cases of rectal trauma, colitis, appendicitis, cholelithiasis, urolithiasis, cystitis, and mild trauma. Cold treatment can suppress the inflammatory process, decrease edema, and decrease the pain threshold. Depending on the patient, a cold compress can be used between 15 and 30-minute periods and up to 3 times per day (Reno, 2021). Hot and cold therapy is among the most traditional and popular non-pharmacological mechanisms in treating pain. Some of the pains targeted by the technique include arthritis, back pain, extremities pain, joint pain, and muscle pain. There have been indications that cold and hot therapies are more efficient in pain management than other over-the-counter options such as Ibuprofen and Paracetamol. That is because heat efficiently stimulates thermoreceptors in the skin and deeper tissues. That can help in pain management as it closes the gating system in the spinal cord. Heat also reduces striated muscle spasms by inhibiting muscle spindle excitability and reducing tension in muscle trigger points.
Acupuncture is the other non-pharmacological approach commonly used in pain management. It is suggested that acupuncture has been employed for around 5,000 years to manage pain (Maciel et al., 2019). This technique works by putting a needle in a specific body part, which stimulates the nerve. It is used as an old art of empiric body healing. Each needle will trigger none or minimal discomfort. However, it will induce a minor injury at the insertion site, which will activate the body and immune system to improve circulation, wound healing, pain modulation, and analgesia. The location and number of the acupuncture used by the Chinese have changed over time. It is indicated that there are two types of acupuncture presently: acupuncture employed as an anesthetic procedure and acupuncture used for the treatment of many diseases (Beckett et al., 2016). Acupuncture can be employed to address many conditions menstrual cramps, strokes, morning sickness, migraines, insomnia, hypertension, neck or shoulder pains, anxiety and depression, and allergies. The benefits of acupuncture can go beyond conditions to go as far as helping with relaxation. The other common physical interventions employed in pain management presently include transcutaneous electrical nerve stimulation and progressive muscle relaxation. The choice of the technique should depend on the needs of the patient or the presented symptoms.
Psychological Interventions
There is also a range of psychological approaches that practitioners can employ to aid in pain management or relief. Primary among such approaches is cognitive-behavioral therapy (CBT) (Sakakibara et al., 2018). CBT works by incorporating the biopsychosocial (BPS) model into pain therapy, which focuses on cognitive and maladaptive behavioral responses to pain and social and environmental aspects that may alter pain reactions. The approach has proven efficient in addressing pain, psychiatric illnesses, and physical disorders. Cognitive-behavioral therapy helps an individual to develop coping skills such as behavioral pacing, dogmatic assertive communication, recalling and scheduling pleasurable events, structured relaxation exercises, and behavioral activation that improve psychological functioning. CBT for pain can also be employed to repress maladaptive thoughts about pain and pain catastrophizing through the formal application of cognitive restructuring (Smith, 2021).
Mindfulness-based stress reduction is the second psychological intervention that practitioners can employ in addressing pain management. Mindfulness-based stress reduction aims to disconnect the evaluative and emotional elements from the sensory elements of pain (Sakakibara et al., 2018). Since the signal of pain cannot be distinguished, the detachment can alter an individual’s response to pain. Different ideas and beliefs about pain can be perceived using mindfulness-based stress reduction techniques such as meditation and awareness. In essence, the technique revitalizes the perception of pain as an unattached event and not a sign of an underlying matter that demands maladaptive reactions. The other psychological techniques that professionals can employ to address pain management include acceptance and commitment therapy, biofeedback, and guided imagery. The choice of the technique should always depend on the needs of the patients. The psychological approaches have proven effective in addressing pain in cases where patients do not intend engagement in any physical approaches to pain management.
Others
There are other approaches that professionals can implement to alleviate pain among patients. Primary among such factors is religion. In the Middle Ages and some religions, pain was considered religious. Individuals experience pain because it is the will of the Supreme Being. In Christianity, for instance, pain, disease, and suffering are perceived as the outcomes of individual sins. Spiritual and religious lives are important in individual lives. The beliefs can influence individual perceptions of prospects such as pain, death, feelings about life, attitudes, and lifestyle. In a person’s life, spiritual beliefs often place a great significance at the time of illness than at any other time. Both spirituality and religion help individuals to accept their illnesses. The concepts also help in explaining illnesses to other individuals. The other approach that practitioners employ is music therapy. Since ancient times, music has been used to reduce pain, limit suffering, and enhance well-being. Randomized studies have elevated music as an ideal therapy tool for patients undergoing sigmoidoscopy and colonoscopy. Music has also been shown to reduce women’s perceptions and responses to pain during labor. Employing non-pharmacological approaches to pain could revitalize the understanding of pain management in healthcare (Smith, 2021).
Pharmacological Approaches
Pharmacological approaches to pain management constitute the use of medicines to address pain. The application of pharmacological approaches depends heavily on the symptoms that the patient showcases. To treat mild to moderate pain, non-opioid analgesics are usually used first (Maciel et al., 2019). If this is insufficient and there is a risk of sleep deprivation, an antidepressant with analgesic properties should be a...