NSM5RFN Research Foundations

NSM5RFN Research Foundations
Student ID: (insert your student no. only)
Critical Review – Quantitative Studies
© Law, M., Stewart, D., Letts, L., Pollock, N., Bosch, J., Westmorland, M., (1998), McMaster
University (Adapted)
CITATION
Yarahmadi, S., Mohammadi, N., Ardalan, A., Najafizadeh, H., & Gholami, M. (2018). The
combined effects of cold therapy and music therapy on pain following chest tube removal
among patients with cardiac bypass surgery. Complementary therapies in clinical
practice, 31, 71-75.
Just click the box to mark your
response
Respond to the questions below
STUDY PURPOSE
Was the purpose stated clearly?
 Yes
No
Outline the purpose of the study. How does the study apply
to nursing/midwifery and/or your research question?
Research question: Are combined effect of music therapy
and cold therapy suitable in reducing pain after Chest tube
removal in patients?
The removal of the chest tube is an extremely painful
procedure and can be dangerous for the palliative care
patients. The patient may not be benefitted fully from the
palliative acute care therapies. The purpose of this study is
to assess the effectiveness of the cold and the music therapy
independently on these patients as well as the amalgamation
of both the interventions. Hence it can be said that the study
question was stated clearly.
This study has got several nursing or clinical implications.
LITERATURE
Was relevant background
literature reviewed?
Yes
No
Describe the justification of the need for this study
The need for this study was justified as it has been found that
the although painful sensation during the removal of the chest
tube can be managed by the application of certain analgesics ,
the adverse effects posed by the use of the NSAIDs and other
analgesics cannot be overlooked. One of the crucial reason
behind this study is that very few literatures have actually
shown the relevance of the cold therapy on CTR patients,
although cold therapy has long been considered to be
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NSM5RFN Research Foundations
Student ID: (insert your student no. only)
responsible for the conductance of the nerve stimuli and thus
reducing pain. This paper has gained evidences from literature
by Hassanzadeh et al., (2016). As opposed by Sauls et al.,
(2002), cold therapy has been found to be ineffective in
managing pain. A study by Dehcheshmeh & Rafiei, (2015),
Have found the association between the music therapies in
labour pain.
Furthermore the effectiveness of the music therapy has also
been controversial in the pain reduction in STR. In addition
to this previously no studies have evaluated the
effectiveness of the combined therapy in the pain reduction.
Hence these are the rationale behind the need for this study.
STUDY DESIGN
☐Randomized (RCT)
☐Cohort
☐Single case design
☐Before and after
☐Case-control
☐Cross-sectional
☐Case study
Describe the study design. Was the design appropriate for
the study question? (e.g., for knowledge level about this
issue, outcomes, ethical issues, etc.)
The study design is a randomised control trial and the
population for the study has been selected from the patients
who have had a cardiac surgery at the Shahid Madani
Hospital, Khorram Abad, Iran and then were admitted to the
Cardiac Surgery Intensive Care Unit (CSICU) in 2016.
The study design was appropriate as it was based on a
previously conducted study by Mazloum et al., [2012], who
examined the outcome of the application of the ice packs on
the patients who has underwent chest tube removal.
One of the ethical issue that can be considered regarding
this study is that the population that has been considered
consists of high risk group patients.
Specify any biases that may have been operating and the
direction of their influence on the results.
In order to avoid any bias all the data were gathered by a
nurse who was not a part of the research team. Collection of
the data by the research team members may cause bias.
Nurses who are part of the research team may give rise to
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NSM5RFN Research Foundations
Student ID: (insert your student no. only)
compromised interpretation of the respondent’s data.
Sample
N=45
Wasthe sample described in
detail?
☐Yes
☐No
Was sample size justified?
☐Yes
☐No
☐N/A
Sampling (who; characteristics; how many; how was
sampling done?)If more than one group, was there
similarity between the groups?
The sample was described in details. They were selected
consecutively and was assigned randomly in groups by
using an eight member block technique. Three groups were
considered. Group A (cold therapy), group B (Music
therapy), group C (cold and music therapy) and control
(group D).
The inclusion criteria included patient within the age 18-65
years with a chest tube for more than 120 hours or not less
than 24 hours. People having no past history of blindness or
hearing impairment, people who are capable of responding
to the questions, those having no medical history of mental
disorder or those having no history of narcotics usage, or
drugs and alcohols were included in the study. The
exclusion criteria was included those patients who
demonstrated more pain score as high as 7, or unwillingness
to participate in the study, those feeling discomfort with the
cold therapy or who are under the treatment of sedatives or
narcotics as medications.
45 participants were allotted for each group and after the
loss of the participants due to sudden discontinuation and
lost to follow up finally considered 43 participants were
allocated for the application of the cold therapy. Among the
180 patients, finally 45 patients were allocated for each of
the application of music therapy, both music therapy and
cold therapy and control and 43 -44 participants were
finally analysed for the effectiveness of the treatment.
Group A received the 9 inch ice pack at a temperature of
about -5 degree placed above the chest tube while in contact
with the underlying skin for about 20 minutes. A cloth was
provided in between the patient’s skin and the ice pack.
Group B was provided with music stimulation for about 30
minutes. The music continued following the procedure of
the chest tube removal. The patients were allowed to choose
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