van Veen Suzan, Drenth Hans, Hobbelen Hans, Finnema Evelyn, Teunissen Saskia, de Graaf Everlien
ZuidOostZorg, Center for Elderly Care, Drachten, The Netherlands.
Research Group Healthy Ageing, Allied Health Care and Nursing, University of Applied Sciences Groningen, Groningen, The Netherlands.
Palliat Care Soc Pract. 2024 Jan 10;18:26323524231222496. doi: 10.1177/26323524231222496. eCollection 2024.
Palliative care patients desire more symptom management interventions that are complementary to their medical treatment. Within the multi-professional team, nurses could help support pain management with non-pharmacological interventions feasible for their practice and adaptable to palliative care patients' needs.
The objective was to identify non-pharmacological interventions feasible in the nursing scope of practice affecting pain in palliative care patients.
A systematic review.
A defined search strategy was used in PubMed, CINAHL, PsycINFO, and Embase. Search results were screened double-blinded. Methodological quality was double-appraised with the Joanna Briggs Institute Critical Appraisal Tools. Data were extracted from selected studies and the findings were summarized. The methodological quality, quantity of studies evaluating the same intervention, and consistency in the findings were synthesized in a best-evidence synthesis to rank evidence as strong, moderate, limited, mixed, or insufficient.
Out of 2385 articles, 22 studies highlighted non-pharmacological interventions in the nursing scope of practice. Interventions using massage therapy and virtual reality demonstrated most evidentiary support for pain management, while art therapy lacked sufficient evidence. Mindful breathing intervention showed no significant reduction in pain. Hypnosis, progressive muscle-relaxation-interactive-guided imagery, cognitive-behavioral audiotapes, wrapped warm footbath, reflexology, and music therapy exhibited promising results in pain reduction, whereas mindfulness-based stress reduction program, aromatherapy, and aroma-massage therapy did not.
Despite not all studies reaching significant changes in pain scores, non-pharmacological interventions can be clinically relevant to palliative care patients. Its use should be discussed for its potential value and nurses to be trained for safe practice. Methodologically rigorous research for non-pharmacological interventions in nursing scope of practice for pain relief in palliative care patients is necessary.
The protocol for this study is registered in the International Prospective Register of Systematic Review (PROSPERO registration number: CRD42020196781).
姑息治疗患者希望获得更多与其医疗治疗互补的症状管理干预措施。在多专业团队中，护士可以通过其实际可行且能适应姑息治疗患者需求的非药物干预措施来帮助支持疼痛管理。
目的是确定在护理实践范围内对姑息治疗患者疼痛有效的非药物干预措施。
系统评价。
在PubMed、CINAHL、PsycINFO和Embase中使用了既定的检索策略。检索结果进行双盲筛选。使用乔安娜·布里格斯研究所的批判性评价工具对方法学质量进行双重评估。从选定的研究中提取数据并总结研究结果。通过最佳证据综合法综合评估方法学质量、评估同一干预措施的研究数量以及研究结果的一致性，将证据等级分为强、中、有限、混合或不足。
在2385篇文章中，有22项研究强调了护理实践范围内的非药物干预措施。使用按摩疗法和虚拟现实的干预措施对疼痛管理显示出最多的证据支持，而艺术疗法缺乏充分证据。正念呼吸干预对疼痛的减轻无显著效果。催眠、渐进性肌肉放松 - 交互式引导意象、认知行为录音带、包裹式温脚浴、反射疗法和音乐疗法在减轻疼痛方面显示出有希望的结果，而基于正念的减压计划、芳香疗法和香薰按摩疗法则没有。
尽管并非所有研究都使疼痛评分有显著变化，但非药物干预措施对姑息治疗患者可能具有临床相关性。应讨论其潜在价值并对护士进行安全实践培训。有必要对姑息治疗患者护理实践范围内用于缓解疼痛的非药物干预措施进行方法学严谨的研究。
本研究方案已在国际前瞻性系统评价注册库（PROSPERO注册号：CRD42020196781）注册。
