Effectiveness of nursing intervention for adult patients experiencing chronic pain: a systematic review.
OBJECTIVE
To determine the best available evidence regarding the effectiveness of nursing interventions for adult patients experiencing chronic pain.
Randomized Controlled Trials (RCT) and Quasi-Randomized Controlled Trials.


METHODS
Participants were adults, aged at least 18 years, suffering from chronic pain (lasting for longer than six months). Pain of oncological origin and patients admitted in a hospital, were excluded.
Non pharmacological nursing interventions for chronic pain.


METHODS
The primary outcome measure was chronic pain, and secondary outcome measures were: disability, depression, dependence and health related quality of life.


METHODS
All studies, published and unpublished, in English and Spanish, carried out between January 1997 and December 2007 were retrieved..


METHODS
The methodological quality of included articles was assessed by two independent reviewers using appropriate critical appraisal tools from the Joanna Briggs Institute.


METHODS
Data were independently extracted by two reviewers, using the standardised data extraction tool from the Joanna Briggs Institute.A meta-analysis was not possible as the trials were heterogeneous in their interventions, characteristics of the populations, intervention duration measurement instruments and outcomes measures.


RESULTS
1,666 references were identified that fit the aim of the review. 92 articles were retrieved, of which 13 were chosen to be critically appraised for their methodological quality. In the end, eight controlled trials were included.The main results were:Other outcome measures showed an improvement in the quality of life (sensorial stimulation and guided imagery), in depression, disability and empowerment (music therapy) and physical functioning (program of psycho-education).The main limitations of this review were: excluding studies were the professional performing the interventions were not detailed or the intervention was not carried out by a nurse and that the search strategy was limited up to 2007.


CONCLUSIONS
Listening to music, a cognitive-behavioural treatment programme, magnetic therapy, sensorial stimulation, a psychoeducation programme and guided imagery are nursing interventions that helps to reduce the chronic pain in adults and may be used as contributory to the pharmacological treatment. Short exercises for increasing endurance does not reduce pain.


CONCLUSIONS
For future reviews we do not recommend the inclusion of different interventions for the reduction of chronic pain, due to the great number and variability of intervention, but the development of a SR on specific interventions.
1. Centro Tecnológico de Información y Documentación Sanitaria. Murcia. España. 2. Equipo de Atención Primaria "Profesor Jesús Marin". Murcia. España. 3. Hospital Reina Sofía. Murcia. España 4. Complejo Hospitalario Universitarios Insular Materno Infantil. Canarias. España 5. Dirección General de Programas Asistenciales. Canarias. España 6. Escuela Universitaria de Enfermería " Ntra. Sra. Candelaria". Canarias. España. 7. Hospital Universitario de Canarias. Canarias. España. 8. Equipo de Atención Primaria "Laguna San Benito ". Canarias. España. 9. Spanish Collaborating Centre of the Joanna Briggs Institute for Evidence Based Healthcare.
M D
MD
Castillo-Bueno
J P
JP
Moreno-Pina
M V
MV
Martínez-Puente
M M
MM
Artiles-Suárez
M C
MC
Company-Sancho
M C
MC
García-Andrés
I
I
Sánchez-Villar
R
R
Hernández-Pérez