Effectiveness of nursing intervention for adult patients experiencing chronic pain: a systematic review

Question / Objectives The major objective of this review is to determine the best available evidence regarding the effectiveness of nursing interventions for adult patients experiencing chronic pain Criteria used for considering studies for this review Type of participants • Patients with chronic pain. • Patients undergoing treatment outside the hospital (Primary Care and/or Outpatients Units). • Adults (i.e. 18 years of age and older). Types of interventions / phenomena of interest This review will consider studies that assess the effectiveness of the nursing intervention for chronic pain listed below. A nursing intervention is defined as: "Any treatment, based upon clinical judgment and knowledge, that a nurse performs to enhance client outcomes. Nursing interventions include all interventions performed by nurses, both direct and indirect care, targeted at individuals, families and communities, whether treatments are initiated by nurses, doctors or other professionals. This review will consider studies that evaluate the effectiveness of non-pharmacological nursing interventions. These include the following: • Nurses´ active listening interventions (individual or group-based) regarding chronic pain sufferers’ fears, anxieties and expectations • Education, training and health awareness interventions (individual or groupbased) regarding patients’ ability to manage their self-care: - Lifestyle factors: nutritional, physical and postural exercises, etc. - Massages - Cold-heat therapy, e.g. ice packs - Teaching relaxation techniques - Social activities during free time, relationships, etc. • Nurses’ training of family interventions: - Improving knowledge and/or modifying attitudes concerning the disease and resulting pain. - For caregivers to manage patient’s chronic pain better Type of outcomes The positive or negative outcomes to be considered for adult patients are as follows: • quality of life • satisfaction with nursing interventions • increasing (or otherwise) independence in daily activities • compliance or non-compliance with medical treatment • pain threshold • medication for chronic pain • improvement in and/or maintenance (or otherwise) of social relationships and free-time activities • level of anxiety and symptoms of depression • return to work and/or reduction in sick leave days • health care requests • when patients decide not to follow nursing interventions