Investigating the Impact of Nature Music and Acupressure on the Pain Intensity of Conscious Patients Hospitalized in ICU
Abstract
Background: Despite advances in pain management, the incidence of postoperative pain remains a concern. In addition, analgesics have many side effects. Therefore, non-pharmacological interventions aimed at reducing the dosage of analgesics seem necessary, whether as a complementary or independent medication. In this regard, the present study was conducted with the aim of investigating the impact of music and acupressure on the pain intensity in the conscious patients hospitalized in intensive care units (ICU).
Methods: The present quasi-experimental study was conducted on conscious patients undergoing laparotomy surgery who were hospitalized in the surgical ICU of hospitals affiliated with Shahid Beheshti University in 2023. We randomly assigned 90 patients to one of three groups: nature music, acupressure, or combined. The data collection tools consisted of patients' demographic information form and the visual pain assessment scale, which was measured once before the intervention and over five time points after it. For participants in the nature music group, sounds of rivers, birds, and waterfalls were played using an MP3 player device and headphones for 20 minutes on one occasion. For the participants in the acupressure group, pressure was applied to L14 or Hogo for 10 seconds of pressure, followed by 2 seconds of rest, for a duration of 20 minutes, so that the patient could feel heat, numbness, and heaviness. We simultaneously performed nature music and acupressure for the participants in the combined group. SPSS version 19 was used for data analysis.
Results: Three groups of participants were homogeneous, with no statistically significant differences in terms of demographic characteristics (P value < 0.05). There was no statistically significant difference in the pain intensity of the patients among the three groups before the intervention. However, there was a significant difference among the three groups at 30 minutes, 60 minutes, 2 hours, 3 hours, and 4 hours after the intervention, and the combined and concurrent use of music therapy and acupressure proved to be more effective in reducing the pain intensity.
Conclusion: The results indicated the effectiveness of both nature music and acupressure when used alone or in combination. Their combined and concurrent implementation is more effective. Therefore, we recommend that nurses adopt combined care programs for pain management in ICU patients.
[2] Capdevila M, Ramin S, Capdevila X. Regional anesthesia and analgesia after surgery in ICU. Curr Opin Crit Care. 2017; 23(5):430-9.
[3] Moreno AP, Alvarez AA, Conde SM, Flecha MP, Ureña MG. The intensive care unit in the postoperative period of major abdominal surgery. Med Intensiva (Engl Ed). 2019; 43(9):569-77.
[4] Rasulehvandi R, Kazeminia M, Jafari F, Rahmati M, Mohamad Gholizadeh A, Khashmin MM. Pain Relief Management in the Intensive Care Unit (ICU): A systematic review. J Mil Med. 2022; 24(5):1291-309.
[5] Nazari R, Sharifnia H, Mousazadeh N, Hasani A. Validation of the Persian version of critical care pain observation tool. J Crit Care Nurs. 2021; 14(3):51-9.
[6] Siffleet J, Young J, Nikoletti S, Shaw T. Patients’ self‐report of procedural pain in the intensive care unit. J Clin Nurs. 2007; 16(11):2142-8.
[7] Kotfis K, Zegan-Barańska M, Szydłowski Ł, Żukowski M, Ely E. Methods of pain assessment in adult intensive care unit patients—Polish version of the CPOT (Critical Care Pain Observation Tool) and BPS (Behavioral Pain Scale). Anaesthesiol Intensive Ther. 2017; 49(1):66-72.
[8] Mędrzycka-Dąbrowska W, Dąbrowski S, Gutysz-Wojnicka A, Basiński A, Kwiecień-Jaguś K. Nurses' knowledge and barriers regarding pain management. J Perianesthesia Nurs. 2018; 33(5):715-26.
[9] Joshi GP, Beck DE, Emerson Jr RH, Halaszynski TM, Jahr JS, Lipman AG, et al. Article commentary: defining new directions for more effective management of surgical pain in the United States: highlights of the inaugural surgical pain Congress™. Am Surg. 2014; 80(3):219-28.
[10] Puntillo KA, Max A, Timsit JF, Vignoud L, Chanques G, Robleda G, et al. Determinants of procedural pain intensity in the intensive care unit. The Europain® study. Am J Respir Crit Care Med. 2014; 189(1):39-47.
[11] Harvin JA, Kao LS. Pain management in the surgical ICU patient. Curr Opin Crit Care. 2020; 26(6):628-33.
[12] White PF, Kehlet H. Improving postoperative pain management: what are the unresolved issues? J Am Soc Anesthesiol. 2010; 112(1):220-5.
[13] Seo Y, Lee H-J, Ha EJ, Ha TS. 2021 KSCCM clinical practice guidelines for pain, agitation, delirium, immobility, and sleep disturbance in the intensive care unit. Acute Crit Care. 2022; 37(1):1-25.
[14] Gelinas C, Arbour C, Michaud C, Robar L, Côté J. Patients' and ICU nurses' perspectives of non‐pharmacological interventions for pain management. Nurs Crit Care. 2013; 18(6):307-18.
[15] Khalil NS. Critical care nurses' use of non-pharmacological pain management methods in Egypt. Appl Nurs Res. 2018; 44:33-8.
[16] Korkut S, Ülker T, Çidem A, Şahin S. The effect of progressive muscle relaxation and nature sounds on blood pressure measurement skills, anxiety levels, and vital signs in nursing students. Perspect Psychiatr Care. 2021; 57(4):1782-90.
[17] Bauer M. Auricular point acupressure: A complementary medicine treatment for pain management. Pain Manag Nurs. 2024; 25(2):e152-e3.
[18] Abbasi Tadi S, Saberi M, Akbari H. Effect of acupressure at shenmen acupoint on the sleep quality of nurses in emergency departments and intensive care units. Complement Med J. 2021; 10(4):380-95.
[19] Hamlacı Y, Yazici S. The effect of acupressure applied to point LI4 on perceived labor pains. Holist Nurs Pract. 2017; 31(3):167-76.
[20] Yeh ML, Chang YC, Huang YY, Lee TY. A randomized controlled trial of auricular acupressure in heart rate variability and quality of life for hypertension. Complement Ther Med. 2015;23(2):200-9.
[21] Rahgoi A, Mohammadzadeh Zarankesh S, Kasaeizadeghan SS, Naghibeiranvand M. Effect of classical music on physiological characteristics and observational and behavioral measures of pain in unconscious patients admitted to intensive care units. Complement Med J. 2021; 10(4):368-79.
[22] Lin CL, Hwang SL, Jiang P, Hsiung NH. Effect of music therapy on pain after orthopedic surgery—a systematic review and meta‐analysis. Pain Pract. 2020; 20(4):422-36.
[23] Khatooni N, Kolahi M. Nature music and human. Popular Sci. 2020; 10(2):115-40.
[24] Kia Z, Allahbakhshian M, Ilkhani M, Nasiri M, Allahbakhshian A. Nurses’ use of non-pharmacological pain management methods in intensive care units: A descriptive cross-sectional study. Complement Ther Med. 2021; 58:102705.
[25] Begum MR, Hossain MA. Validity and reliability of visual analogue scale (VAS) for pain measurement. J Med Case Rep Rev. 2019; 2(11).
[26] Richard-Lalonde M, Gélinas C, Boitor M, Gosselin E, Feeley N, Cossette S, et al. The effect of music on pain in the adult intensive care unit: a systematic review of randomized controlled trials. J Pain Symptom Manag. 2020; 59(6):1304-19.e6.
[27] Mosavi M, Bahramnejhad F, Ghorbani B. Using verbal music or nature sound music to control pain and anxiety of patients at the end of life. In: Nuom S, editor. The first national conference of art and health. Neishabour: Neishabour University of Medical Sciences; 2017.
[28] Safdari A, Khazaei S, Biglarkhani M, Mousavibahar SH, Borzou SR. Effect of acupressure on pain intensity and physiological indices in patients undergoing extracorporeal shock wave lithotripsy: a randomized double-blind sham-controlled clinical trial. BMC Complement Med Ther. 2024; 24(1):55.
[29] Shady RHA, Seada AIA, Mostafa MF. Effectiveness of acupressure in the reduction of pain and anxiety among patients with open thoracotomy. Am J Nurs Res. 2020; 8(2):182-91.
[30] Daihimfar F, Babamohamadi H, Ghorbani R. A comparison of the effects of acupressure and music on venipuncture pain intensity in children: a randomized controlled clinical trial. Pain Res Manag. 2024; 2024(1):2504732.
[31] Bauer BA, Cutshall SA, Anderson PG, Prinsen SK, Wentworth LJ, Olney TJ, et al. Effect of the combination of music and nature sounds on pain and anxiety in cardiac surgical patients: a randomized study. Altern Ther Health Med. 2011; 17(4).
[32] Wan Q, Wen F-Y. Effects of acupressure and music therapy on reducing labor pain. Int J Clin Exp Med. 2018; 11(2):898-903.
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nature music acupressure pain patient intensive care unit |
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