The effect of standard care, ibuprofen, and music on pain relief and patient satisfaction in adults with musculoskeletal trauma.
OBJECTIVE
The purposes of this study were to determine the most effective nursing intervention to decrease pain for patients with minor musculoskeletal trauma and moderate pain at triage and to examine patient satisfaction.


METHODS
Patients were assigned to 1 of 3 intervention groups: (1) standard care (ice, elevation, and immobilization); (2) standard care and ibuprofen; or (3) standard care and music distraction. Patients were monitored for pain ratings for 60 minutes. Patients who sustained minor musculoskeletal trauma within the past 24 hours and presented with pain ratings of 4 or greater were included. Two patient satisfaction questions were asked upon discharge from the emergency department.


RESULTS
Seventy-seven patients met the inclusion criteria. No differences in pain ratings between groups were demonstrated. A statistically significant reduction in pain for all patients occurred at 30 minutes (F = 16.18, P <.01) and was maintained at 60 minutes. However, 70% of patients continued to report pain ratings of 4 or greater (on a scale of 1 to 10) at 60 minutes. The reduction in pain was not found to be clinically significant.Eighty-four percent of patients stated that they were more satisfied with their overall care in the emergency department because of the immediate attention to pain relief they received at triage. No differences in satisfaction existed between treatment groups, although patients who reported higher pain ratings expressed statistically significant lower satisfaction with pain management scores (F = 9.375, P =.003).


CONCLUSIONS
None of the therapies-standard care (ice, elevation, immobilization), standard care with ibuprofen, or standard care with music distraction-provided clinically significant pain relief to patients who had minor musculoskeletal trauma (ie, sprains and fractures) and moderate pain at triage. Interestingly, satisfaction scores were sometimes positive, even when pain was not relieved.
Northwestern Memorial Hospital, Chicago, IL 60607, USA. ptanabe@nmh.org
P
P
Tanabe
R
R
Thomas
J
J
Paice
M
M
Spiller
R
R
Marcantonio
D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D015400:Clinical Nursing Research; D003131:Combined Modality Therapy; D017679:Cryotherapy / Q000379:methods / Q000451:nursing; D016529:Emergency Nursing / Q000379:methods* / Q000592:standards; D004638:Emergency Treatment / Q000379:methods* / Q000451:nursing / Q000523:psychology* / Q000592:standards; D006801:Humans; D007052:Ibuprofen / Q000627:therapeutic use*; D009141:Musculoskeletal System / Q000293:injuries*; D009147:Music Therapy / Q000592:standards*; D010146:Pain / Q000209:etiology* / Q000523:psychology; D059408:Pain Management; D010147:Pain Measurement; D017060:Patient Satisfaction; D012146:Rest; D013165:Splints; D013997:Time Factors
D000894:Anti-Inflammatory Agents, Non-Steroidal; D007052:Ibuprofen