Non-pharmacological pain relief in childbirth and nursing practice

Non-Pharmacological Pain Relief With Childbirth

Dealing with aging dementia patients can be a challenge in and of itself. However, when healthcare providers need to include regulating pain as well, the challenge becomes even greater. Pain management with cognitively impaired patients is a constant problem within geriatric care in modern healthcare facilities (Zwakhalen et al. 2006). The reduced self capacity to report pain in its true degrees then makes pain management a challenge for physicians and healthcare providers (Husebo et al. 2007). Thus, research aims to explore effective measures for observing and reporting pain management within aging dementia patients.

Horgas et al. (2009) is an in-depth examination of the various factors that can be used to report pain within these specific groups of patients. The journal is from the American Geriatrics Society, and thus is clearly peer-reviewed. It is a thorough examination into how dementia patients report their own pain, as well as how their pain can be observed within actual practice. The data was then coded according to the American Hospital Formulary Service System (Horgas et al. 2009). This clearly shows that the research supports evidence-based practices for it uses real observations from patients actually being in the field today in combination with commonly held patterns from prior research.

The study design is a mixed methods approach to understanding the depth and reliability of pain reporting within dementia patients. Previous research, like that conducted by Zwakhalen et al. (2006) was primarily qualitative, examining only prior research publications and not using actual data recorded from evidence in the field. This research uses a more mixed methods approach to the research, embodying elements of both quantitative and qualitative methods. The research used pain interviews, which represents a more qualitative and abstract approach to the research design. Self-reported pain represents the more qualitative elements of the research design, for it relied on dementia patients themselves to present their pain within interviews and examinations. Results provided by the actual participants were then coded in order to appropriately categorize in order to increase their overall reliability (Horgas et al. 2009). The study implemented quantitative measurement devices by using coding methods to quantify the data into meaningful categories that could then be run through statistical analysis. Patients were asked to map their pain using the McGill Pain Questionnaire (Horgas et al. 2009). The research then compared this potentially unreliable data to more reliable data observed by rational professionals in the field, rather than being reported by dementia patients themselves and also coded more observable pain behaviors into quantifiable categories. Researchers used Noldus Observer software "to analyze digitized videotapes and code pain behaviors," (Horgas et al. 2009 p 129). Bracing, stopping, rubbing, grimacing, and a myriad of other vocal and nonverbal cues of pain and pain severity that was recorded totally independent of patients' own description of pain and pain intensity. The study also used observed pain behaviors after participants would conduct a variety of activities like standing and sitting that followed the Pain Behavior Measure (Horgas et al. 2009). This incorporated statistical analysis of quantifiable variables, showing its quantitative elements. The study design was complex in order to understand a very abstract phenomenon. It included one hundred fifty older adults from 17 different assisted living facilities that qualified based on their condition of dementia and was a "quasi-experimental, correlational study of older adults," (Horgas et al. 2009 p 126). The methodology of data collection and interpretation of the study was used to determine the study design, as well as the statistic devices used to analyze the raw data.