Effects of a non-pharmacological pain management program on older people with cancer in an internal medicine ward of a university hospital

Abstract

This study employed a quasi-experimental research with a two-group pre-posttest design. The objective was to investigate the effects of a non-pharmacological pain management program for older people with cancer. The sample group consisted of 38 older people diagnosed with cancer admitted at the female medical ward 4C, Srinagarind Hospital, divided into a control group (n=19) and an experimental group (n=19). The experimental group received the developed program, while the control group received standard care of the study setting.
Research instruments included three categories: 1) instruments for screening sample into the study, including the depression screening tool, the Thai Mini-Mental State Examination (TMSE), and the innovative pain assessment form for older people (developed by the researchers); 2) instruments for conducting the study, which was a non-pharmacological pain management program for older people developed by the researcher; and 3) instruments for data collection, comprising a demographic data questionnaire, the Brief Pain Inventory Thai version (BPI-T), the innovative pain assessment form for older people, and a non-pharmacological pain management record form. The instruments were verified by five experts. Validity test revealed that content validity index (CVI) of the innovative pain assessment form for older people, the non-pharmacological pain management program for older people, the demographic data questionnaire, and the non-pharmacological pain management record form were 0.83, 0.83, 1.0 และ 1.0, respectively. Reliability test of the BPI-T obtained the cronbach's alpha coefficient of 0.86. Demographic data between groups were analyzed using Chi square test, Fisher’s Exact test and independent t test. Data distribution was tested using Shapiro wilk test and revealed normal distribution for continuous data. Comparisons of pain scores before and after the experiment within the groups were analyzed using Paired t test statistics. The differences in pain scores before the experiment, pain scores after the experiment, as well as the mean difference in pain scores before and after the experiment were compared between the groups using the independent t test.
The results demonstrated that: After the experiment, the mean pain scores in the experimental group (=1.561.30) were significantly lower than before the experiment (=4.441.63) (p<.001); the mean pain scores in the control group (=1.961.63) were significantly lower than before the experiment (=4.371.97) (p<.001); the mean pain difference score in the experimental group (=2.88.80) was significantly higher than in the control group (=2.40.61) (p=.024). This study indicated that the developed pain management program can reduce pain more than the original standard of care. Therefore, the developed pain management program should be considered for implementation in older people with cancer and other patients with similar contexts.