Allison Mei R.

Bialba 4nur1 RLE 4

Background of the Study

Pain is considered as the fifth vital sign and is highly subjective. Treating it entails
expertise of medical professionals because they would need to prescribe the most
appropriate drug to a patient that would target the pain perfectly in order for it to
subside. One approach to pain management that is continually rising in fame is
nonpharmacological interventions or better known now as nondrug interventions.
Methods
Patients/family members (n = 6) with a previous experience of ICU hospitalization
and ICU nurses (n = 32) were recruited. Using a semi-structured discussion guide,
participants were asked to share their perspective about non-pharmacological
interventions that they found useful, relevant and feasible for pain management in the
ICU. Interventions were clustered into five categories: a) cognitive-behavioural, b)
physical, c) emotional support, d) helping with activities of daily living and, e) creating a
comfortable environment.
Results
A total of eight focus groups (FGs) with patients/family members (two FGs) and
ICU nurses (six FGs) were conducted. Overall, 33 nonpharmacological interventions
were discussed. The top four non-pharmacological interventions found to be useful,
relevant and feasible in at least half of the FGs were music therapy and distraction
(cognitive-behavioural category), simple massage (physical category) and family
presence

facilitation (emotional

support category).

Interestingly, patients/family

members and nurses showed different interests towards some interventions. For
instance, patients discussed more about active listening/reality orientation, while nurses
talked mostly about teaching/positioning.
Conclusions

Four non-pharmacological interventions reached consensus in patients and

nurses FGs to be useful, relevant and feasible for pain management in the ICU. Other
interventions seemed to be influenced by personal experience or professional role of
the participants. Finally, while many nonpharmacological interventions can potentially be
useful for pain management in the ICU, they should remain complementary to
pharmacological

treatment

until

additional

empirical

evidence

supports

their

effectiveness for pain relief.

Nursing Implications
Nursing Education
Nursing is a field of various expertise and some of them are being a patient
advocate, teacher or healthcare provider. As nurses we would handle different cases
and one of the most common cases among elderlies is chronic pain. This study would
be a great help in implanting knowledge on nurse educators and students as well
regarding the different ways on how can they help their future clients experiencing
chronic pain to be able to try out nonpharmacological or nondrug interventions and
promote higher quality of living.
Nursing Practice
As nurses, we are not only trained to treat the client on a medical and
pharmacologic basis. We are built to treat the client holistically. This study presented the
nonpharmacological approaches to chronic pain management and through this, nurses
would have added knowledge on how to help their clients be able to maximize and
adapt to the various interventions that would be proven to be effective. It would pave
way in managing independently and interdependently this case. Through this study,
nurses would be able to open their eyes to these interventions and be able to come up
with proposed care together with the health care team in order to deliver care efficiently
and confidently for the welfare of their clients. It was highlighted in the study that nurses
are in the ideal position to empower patients not only in chronic pain management but

also in other disease processes. This serves as a proof that nurses do not only do bed
making or administer medications as ordered but also touch lives.
Nursing Research
The study was conducted for the benefit of healthcare providers, relatives or
family members and patients diagnosed with pain. This study would be a reliable and
great reference for future researchers wholl opt to explore more on the specifics of
nonpharmacological or nondrug pain management and its advantages, disadvantages
and the best way to minimize the negatives. The study tackled on the important role of
the nurse as well. Future investigators might go specific on the different roles of nurses
and its increased effectivity in order to come up with the absolute positive result and this
could be a good baseline data. This research also opened a lot of opportunities for
greater improvement on the promotion of nonpharmacological pain management and
avoidance of disease or pain progression.
Nursing Administration
The study was conducted in a foreign country and the measure of
implementation as well. The nursing administration here in the Philippines or in other
countries could use this study to conduct trainings for future nurses to be able to
develop competency in teaching or empowering clients on use of nonpharmacological
or nondrug pain management. This move could not be done easily but with proper
guidance and strict implementation of the ones in position, all of these could be possible
and would surely be beneficial both to the care providers and the clients.