Chronic Pain: Nursing Interventions - Evidence Summary

Chronic Pain: Nursing Interventions
31 January 2019
Author
Dieu Huong Nguyen, MBBS, MHHSM, MPH
Question
What is the best available evidence regarding the effectiveness of nursing interventions for adult patients
experiencing chronic pain?
Clinical Bottom Line
Chronic pain, which is the third most common health problem, is defined as constant or recurring
unpleasant sensory and emotional experience, of a term longer than six months.1 Chronic pain can have
a substantial impact on a person’s quality of life, causing disabilities, limitations and loss of independence.
Chronic pain is widespread and contributes to morbidity and mortality in people who experience it. There
are many different and varied causes of chronic pain, with the most common location being the lower
back, and the most common condition being arthritis.1 Chronic pain also has significant economic costs
associated with it. Approaches to pain treatment include psychological, pharmacological, and physical.
Non-pharmacological treatments have been recommended as adjunct treatments for those living with,
and experiencing, chronic pain. Nursing interventions may include physical and psychological therapy.1
• A systematic review was performed to assess the effectiveness of nursing interventions for chronic pain.
Different interventions were identified in the review. These included: sensorial stimulation, music therapy,
cognitive behavioral programs, psycho-education programs, physical exercise programs, magnetic field
therapy and guided imagery. Specifically, the review identified:1 (Level 1)
• The Snoezelen intervention, a sensory stimulation intervention for relaxation and distraction, was found
to significantly reduce pain values in adults with chronic pain, although there were limitations in
methodological study design.
• Music therapy was found to be an effective intervention for the reduction of chronic pain in older patients
with osteoarthritis, a finding that was statistically significant. Another study assessing music therapy for
articular pain found that music was a cheap and safe intervention which resulted in statistically significant
reductions in pain and depression.
• A cognitive behavioral program in a multidisciplinary pain treatment center resulted in a significant
reduction in pain intensity, and improved quality of life and quality of sleep compared to general
practitioner care group and a waiting list control group.
• Another study assessed a psycho-education program, the Chronic Pain Self-Management Program,
which resulted in statistically significant reductions in pain and improvements in self-efficacy.
• A study assessing a physical exercise program did not find improvements in pain for residents of an
aged care home with urinary incontinence and musculoskeletal pain;
1