Effect of Multimodal Integrative Interventions on Pain-Related Outcomes among Critically Ill Patients

Abstract

Context: Pain, a persistent problem in critically ill patients, adversely affects outcomes. Despite recommendations, no evidence-based non-pharmacological approaches for pain treatment in critically ill patients have been found.

Aim: To evaluate the effect of multimodal integrative interventions on pain-related outcomes among critically ill patients.

Methods: A quasi-experimental design (pre / post-test) was utilized to fulfill the aim of this study. A convenience sample of sixty adult critically ill patients was recruited from the intensive care unit at Benha University Hospital affiliated to Benha University at Qualyubia Governorate, Egypt. Three tools were used to conduct this study as follows: Critically ill patients' assessment record; The Critical-Care Pain Observation Tool (CCPOT); The Groningen Sleep Quality Scale.

Results: The results show decreased frequency of pain occurrence in the post intervention periods (75%) immediately post to 50% after 48 hours of intervention compared with pre-intervention (100%). The results show a highly statistically significant differences at p ≤0.001 between pre and post of intervention periods regarding the intensity of the pain mean score among studied patients. It also shows statistically significant differences with p-value ≤0.05 regarding all items of sleep quality immediately after and after 48 hours of intervention compared to pre-intervention, except related to having a deep sleep last night, and feel like a slept poorly last night with a p-value ≥0.05. There was a highly positive statistically significant correlation at p-value ≤ 0.001 between pain intensity and other secondary outcomes, including quality of sleep, blood pressure, heart rate and respiratory rate.

Conclusion: Multimodal integrative interventions effectively decrease pain and improve pain-related outcomes among critically ill patients. Appropriate pain assessment must be partnered with an adequate, multimodal, evidence-based management strategy that incorporates both pharmacologic and non-pharmacologic modalities of pain control.