title: Patients and ICU nurses' perspectives of non-pharmacological interventions for pain management.
abstract: BACKGROUND
  Pain is a major stressor for critically ill patients. To maximize pain relief, non-pharmacological interventions are an interesting avenue to explore.
  
  
  OBJECTIVE
  The study aim was to describe the perspectives of patients/family members and nurses about the usefulness, relevance and feasibility of non-pharmacological interventions for pain management in the intensive care unit (ICU).
  
  
  METHODS
  A qualitative descriptive design was used.
  
  
  METHODS
  Patients/family members (n = 6) with a previous experience of ICU hospitalization and ICU nurses (n = 32) were recruited. Using a semi-structured discussion guide, participants were asked to share their perspective about non-pharmacological interventions that they found useful, relevant and feasible for pain management in the ICU. Interventions were clustered into five categories: a) cognitive-behavioural, b) physical, c) emotional support, d) helping with activities of daily living and, e) creating a comfortable environment.
  
  
  RESULTS
  A total of eight focus groups (FGs) with patients/family members (two FGs) and ICU nurses (six FGs) were conducted. Overall, 33 non-pharmacological interventions were discussed. The top four non-pharmacological interventions found to be useful, relevant and feasible in at least half of the FGs were music therapy and distraction (cognitive-behavioural category), simple massage (physical category) and family presence facilitation (emotional support category). Interestingly, patients/family members and nurses showed different interests towards some interventions. For instance, patients discussed more about active listening/reality orientation, while nurses talked mostly about teaching/positioning.
  
  
  CONCLUSIONS
  Four non-pharmacological interventions reached consensus in patients and nurses' FGs to be useful, relevant and feasible for pain management in the ICU. Other interventions seemed to be influenced by personal experience or professional role of the participants.
  
  
  CONCLUSIONS
  While more evidence is required to conclude to their effectiveness, ICU nurses can use non-pharmacological interventions complementary to pharmacological treatment of pain as they are low cost and safe.
authors.affiliation: C Gélinas, RN, PhD, Ingram School of Nursing, McGill University, Montreal, Quebec, Canada, Centre for Nursing Research and Lady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada, The Alan Edwards Center for Research on Pain, McGill University, Montreal, Quebec, Canada, Quebec Nursing Intervention Research Network (RRISIQ), Montreal, Quebec, CanadaC Arbour, RN, BSc, PhD (c), Ingram School of Nursing, McGill University, Montreal, Quebec, Canada, Centre for Nursing Research and Lady Davis Institute, Jewish General Hospital, Montreal, Québec, Canada, The Alan Edwards Center for Research on Pain, McGill University, Montreal, Quebec, Canada, Quebec Nursing Intervention Research Network (RRISIQ), Montreal, Quebec, CanadaC Michaud, RN, PhD, School of Nursing, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Quebec, Canada, Quebec Nursing Intervention Research Network (RRISIQ), Montreal, Quebec, CanadaL Robar, BSc, Centre for Nursing Research and Lady Davis Institute, Jewish General Hospital, Montreal, Québec, CanadaJ Côté, RN, PhD, Faculty of Nursing, Université de Montréal, Montréal, Québec, Canada, Quebec Nursing Intervention Research Network (RRISIQ), MOntréal, Québec, Canada.
authors.forename: Céline
authors.initials: C
authors.lastname: Gélinas
authors.forename: Caroline
authors.initials: C
authors.lastname: Arbour
authors.forename: Cécile
authors.initials: C
authors.lastname: Michaud
authors.forename: Lauren
authors.initials: L
authors.lastname: Robar
authors.forename: José
authors.initials: J
authors.lastname: Côté
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D016000:Cluster Analysis; D015928:Cognitive Behavioral Therapy / Q000379:methods; D003422:Critical Care / Q000379:methods*; D005190:Family / Q000523:psychology; D005240:Feasibility Studies; D005260:Female; D017144:Focus Groups; D006801:Humans; D007362:Intensive Care Units; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D024802:Nurse's Role / Q000523:psychology; D009740:Nursing Staff / Q000193:education / Q000523:psychology* / Q000592:standards; D016377:Organ Transplantation; D019982:Organizational Case Studies; D059408:Pain Management / Q000523:psychology*; D010149:Postoperative Pain / Q000451:nursing; D010361:Patients / Q000523:psychology*; D026741:Physical Therapy Modalities; D036301:Qualitative Research; D011792:Quebec; D012944:Social Support
keywords: Intensive care unit; Non-pharmacological interventions; Pain; Pain management