NSD203: Inquiry into Clinical Practice - Free Samples to Students

1. Explain the key concepts and principles of the research process and outline the importance of evidence-based practice approaches for the provision of safe and quality health care and for the global health research agenda.

2. Apply key literacy and critical thinking skills to locate, seek, interpret, analyse, synthesise and integrate evidence into practice.
3. Apply knowledge of quantitative and qualitative approaches to explain their role in research of contemporary, global health care issues.

Answer:

Introduction:

It has been found that most of the people consider pain as a normal consequence of aging process, thus, pain is often undertreated or disregarded in case of older people. Such incidents of avoiding acute pain leads to the incident of occurring chronic pain. It has been reported that near about 80% older people suffer from chronic pain and depend on prolong care facilities (Ellis, Wells & Ong, 2017). There are many pharmacological approaches to manage pain in the older people, however, in the recent years the non-pharmacological approaches such as physical therapy, complementary therapy like massage, and cognitive behavioural therapy are found to be effective in order to manage chronic pain (Becker et al, 2017). The assignment has focused to identify the whether the non-pharmacological interventions are effective in pain management or not. The following paper will summarise the findings of two relevant study that has contributed to the understanding of the effectiveness of non-pharmacological treatment of pain.

Key findings:

Ellis, Wells & Ong, (2017) have conducted a study to evaluate the effectiveness of non-pharmacological pain management program in five residential aged care facilities (RACF). The program has included four session of physiotherapy per week. The participants include 62% women and 38% men with an average age of 83 years. The level of pain after the session has been recorded by using a 5 points scale. The main target was to check the changes in PRN medication intake and changes in the ratings of pain. As a result a significant reduction in the number of PRN medication has been found after the end of the treatment. The rating of pain has indicated potential decrease in the pain rate. The pain rate has decreased from 2.4 in the pre-session to 1.1 in the post-session. Massage and physical exercise has been identified as the most effective method in order to reduce the pain in the older people in residential care facilities. The researchers have indicated that non-pharmacological pain management program through physical therapy is effective with the combination of pharmacological treatment, however, it is important to train the staffs of the residential care facilities regarding the care setting, pain assessment and management in order to facilitate the effect of non-pharmacological interventions (Ellis, Wells & Ong, 2017, p. 1-11).

In a qualitative proposed by Becker et al, (2017), effective barriers and facilitators of non-pharmacological interventions have been identified. It is important to understand the factors that contribute to facilitate or restrict the use of non-pharmacological interventions. It would help to understand the effectiveness of non-pharmacological interventions in order to help the older people in residential care to manage their pain in an effective manner. The study has focused to identify the barriers and facilitators of non-pharmacological pain treatment modalities (NPM). The study has recruited 8 groups to list the barriers and facilitators by the users of NPM.  The participants include total 26 patients with an average of 55 years. !4 nurses and 12 PCPs were also included. It has been indicated by the study that, wider array for NPM is available. Facility wide treatment philosophy and enhance the patient knowledge regarding risks and benefits are the most effective facilitators of NPM. On the other hand, transportation issue, high cost, scepticism of the patient and inability to promote NPM after opioid therapy are the common barriers of NPM. However, it has been found that the barriers could be modified to reduce the effect and program could be improved to help the patient with acute pain (Becker et al, 2017, p. 41).

Conclusion:

From the above discussion it can be concluded that, pain is considered as the normal consequence of aging, thus, most of the people ignore it and the pain remain untreated. In such condition acute pain leads to chronic situation. It is important to use proper interventions in order to manage chronic pain in an effective manner. In the recent days many residential aged care have been found to be use non-pharmacological interventions for managing pain in older people. Study has indicated that effective physical therapy and massage could be helpful in order to manage pain in older people. It has been found that with proper physical therapy in combination with pharmacological treatment could reduce the intake of medication and the pain rating. Research has been introduced to identify the barriers and facilitators of non-pharmacological interventions in order to evaluate the effectiveness of non-pharmacological interventions. Increase in facilitators would help to develop the program of non-pharmacological treatment and help the older people to reduce pain effectively. Potential facilitators and barriers have been found, however, the identified barrier could be modified. Thus, it can be said that, with effective non-pharmacological interventions pain management of older people could be facilitated in a residential settings.

References:

Becker, W. C., Dorflinger, L., Edmond, S. N., Islam, L., Heapy, A. A., & Fraenkel, L. (2017). Barriers and facilitators to use of non-pharmacological treatments in chronic pain. BMC Family Practice, 18, 41. https://doi.org/10.1186/s12875-017-0608-2

Ellis, J. M., Wells, Y., & Ong, J. S. M. (2017). Non-Pharmacological Approaches to Pain Management in Residential Aged Care: a Pre-Post-Test Study. Clinical gerontologist, 1-11. DOI: 10.1080/07317115.2017.1399189

nhmrc.gov.au (2018). Resources for guideline developers | National Health and Medical Research Council. Retrieved from https://www.nhmrc.gov.au/guidelines-publications/information-guideline-developers/resources-guideline-developers.