Abstract
Purpose
Patients with chronic pain and/or spasticity who have an intrathecal targeted drug
delivery (TDD) pump require frequent needle access procedures to refill the pump's
medication reservoir. Some patients find the access procedure painful and/or anxiety
provoking. The purpose of this study was to determine if a nursing intervention of
providing a distraction with a music relaxation video during the pump access procedure
would reduce patients’ pain and state anxiety.
Design/Methods
In this longitudinal, pre-test post-test, quasi-experimental design, patients watched
a 13-minute calming music video while the nurse performed the needle access procedure.
Data collection instruments included a combination of researcher-developed questionnaires,
the Defense & Veterans Pain Rating Scale (DVPRS), and the State Trait Anxiety Inventory
(STAI). Pain and anxiety were measured pre- and post-pump refill procedures at baseline
with no intervention (T1) and at two subsequent pump refills with the music video
intervention (T2 and T3).
Results
The sample consisted of 31 adults with chronic pain (n = 28) or spasticity (n = 3).
All participants had an implanted pump for at least six months. Specialty trained
nurses refilled the participants’ pump in their home. The findings support the use
of a music video as an effective intervention for reducing participants’ perception
of pain and anxiety during the pump refill procedure. Neither pre-test pain nor pre-test
anxiety scores differed across time. Post-test mean pain scores decreased consistently
across time (T1 = 5.55, T2 = 4.42, T3 = 4.23; P = .002). Post-test anxiety scores showed a significant decrease (P <.05) between T1 (M = 37.87) and T2 (M = 30.94) which was not sustained at T3 (M = 35.68,
P = .284). Overall, the majority of participants indicated liking the music video intervention.
They also expressed interest in using the intervention for future refill procedures
or other stressful situations.
Conclusions
The music video was effective in producing a sustained reduction over time of participants’
pain during the pump refill procedures; it was most effective in initially reducing
participants’ state anxiety at the initial intervention visit; however, it did not
demonstrate a progressively sustained effect. Participants’ opinions about the music
video experience were positive.
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Article info
Publication history
Published online: June 10, 2021
Accepted:
May 3,
2021
Received in revised form:
March 5,
2021
Received:
April 27,
2020
Identification
Copyright
© 2021 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.
