Pain Management Using Sustained Mobile Tens Therapy - Assignment Example

Name : xxxxxx Tutor : xxxxxxx Title : xxxxxxx Institution : xxxxxxx @2009 Table of contents Table of contents 1 PAIN MANAGEMENT USING SUSTAINED MOBILE TENS (SMT) THERAPY 2 Introduction 2 Area of Interest 3 Preface to the Research 4 Search Methodology 4 Results of the last Seven Search Hits 5 TENS Therapy 9 Improvement on TENS device 10 Research Methodology to Justify the Research Question 11 Conclusion 11 Bibliography 13 PAIN MANAGEMENT USING SUSTAINED MOBILE TENS (SMT) THERAPY Introduction It has been duly recognized that the vast decline in the mortality of infants and the improved human lifespan in both the developed and developing countries has been greatly influenced by economic and social factors more than medical research developments. The early identification of common conditions categorized as disease risk factors such as solar exposure, smoking, alcohol and dietary fat has greatly contributed to reduction in the prevalence of diseases and mortality as studies have shown in some countries. The differences in success of the methods employed to reduce deaths as a result of nutritional, circulatory and diseases due to infection has had the impact of making people more exposed to the non-communicable diseases which are chronic and more so the ones that affects the elderly. The community-based studies which were largely carried out COPCORD in tropical Asia and Pacific countries showed that the weight of musculoskeletal conditions in terms of pain, disability from economic perspectives are quite substantial thus WHO has signaled a call for educational activities and increase in research to find out the actual causes and consequences of adhered to chronic disease more so rheumatic diseases WHO, 1984). WHO also proposes the addition fast growth of populations in urban areas and new occupational stresses not forgetting the impact of increasing aging population (WHO, 1984). Area of Interest Osteoarthritis is considered the main cause of pain and disability especially the knee. Different problems of soft tissue rheumatism result in shoulder, neck, back and elbow pains. Reactive and viral arthritis should not be assumed for they are also important. Complications as a result of osteoporosis though not classified as a rheumatic condition has a high magnitude of threat to the aging populations of the world. It is now a fact that some risk factors of many of the conditions have been identified and availability of preventative measures are being generated but still a thorough research is required on the same (Wigley, 1993). Community based education is an essential component of prevention and ultimate treatment and the sponsored publication by ILAR on living with Rheumatism an pain (Hampton, 1992) is available and has been translated into more than ten languages thus fills a very important need. Publications help in provision of attitudes and skills besides giving knowledge. A modern attitude on the potentiality of the control of diseases may help individuals believe that more can be done in the protection against pains and aches that are due to age, physical work or just damp condition (Darmawan et al, 1992c). Semi- literate rural populations who do not have access to television can immensely benefit from public education as long as it is provided with a lot of skill, imagination and corporation of local conditions. Preface to the Research The research considered the following: Over five decades of experience in professional physiotherapy clinical practice. The results of a research of a 3-year study of Pain responses from 2,154 Australians who are users of SMT equipments. Knowledge gathered from over forty years of development, research and mass production of Neuro Muscular Stimulation. Transcutaneous Electrical Nerve Stimulation (TENS) as a method of pain management and Electrical Cell Stimulation of bone and soft tissues healing by means of physical therapies (Lundeberg, T. and Ottoson, D. 1998). The culmination of the research of TENS leading to the innovation of a highly portable Sustained Micro pulse (SMT) device (Lundeberg, T. and Ottoson, D. 1998). Search Methodology Using Medline database a thorough narrowing of the research question to obtain the question above was done as shown in the table below; Search Database Key Words Search Hits Medline Pain Management 50 results found Medline Pain Management And Primary Clinics 9 results found Medline What are some of the pain management methods? 7 Results found Results of the last Seven Search Hits The following is a brief detail of the seven search hits found at the Medline database by searching using the key word “What are some of the pain management methods?” 1. “Who guidelines hand hygiene” the article talks about why clean care for patients is a safer care. It is a release from the WHO and can be obtained from the WHO Press. The methods recommended are hand rub which has a higher antimicrobial efficacy (Medline Data base). Its Rank is 16%.  2. “Remedy brochure” this is a brochure which talks about why gentle skin lotions and soaps is the solution to most skin issues. Parametric and non-parametric methods was used to determine the reaction of various skin appliances and there effects to the user (Medline Data base). 3. “Opportunities to improve pressure ulcer prevention and treatment” it talks about the implication of the CMS Inpatient Hospital Care Present (Medline Data base). It s rank is 16%. 4. “Insulscan information” it is a letter for an agreement between Medline Industries, Inc. and the customer of InsulScan product (Medline Data base). 5. “Key vendor program” it’s a notification by Medline to its vendors showing the routing guide and instructions in attempt to enable easier and faster procedure for further processing as the goods move through Medline distribution centers (Medline Data base). 6. “Awc brochure”. It is an elaborate brochure showing today’s pain care from Medline in order to address different patient concerns. Some of them includes; “Pain Debridement of Devitalized Tissue pressure redistribution. TENS therapy and so on (Lundeberg, T. and Ottoson, D. 1998). 7. “Lit 049 – mkt 208048” it is an elaboration of what the DIMES have to do with chronic wound care (Medline Data base). Therefore I took interest in the sixth shot which talks about today’s pain care from Medline in order to address different patient concerns. Then I tried to narrow my research question using the PICO procedure which is an abbreviation for; population or patient problem (P), intervention (I), comparison(C) and outcome (O)”. It is very difficult to learn the right skill for asking a research question but it is very vital for the decision making process that is evidence based. In the development of the question, the process starts with a patient problem or question (Houser, J. and Bokovoy, J. 2006). A well constituted question should have four parts that is generally known as PICO i.e. population or patient problem (P), intervention (I), comparison(C) and outcome (O). The initial step in the development of a good research question is to first identify the patient population or problem (Houser, J. 2008). The patient main complaint or condition is generalized to a larger population. In the identification of P in PICO it is important for a health practitioner to be able to describe a group of people with a similar condition and the vital characteristics of the patient i.e. the main complaint, health or disease status and race, sex, age, current medications (Houser, J. 2008). If by any chance the characteristics can be considered as I then search for evidence. The P phrase can be more detailed if any added information can have an influence on my findings expectations (Houser, J. 2008). Identification of intervention is the second major step in the process of PICO. It is very important to have a clue on what is planned for the patient. This may incorporate diagnostic tests, adjunctive therapy, treatment or recommending to a patient to use a certain product or procedure (Houser, J. 2008). The third phase of a well-built question is comparison. It should be limited and very specific to only one alternative choice for effective facilitation of a computerized search. However, one may only have a look at intervention without looking at the alternatives and at times alternatives may not be feasible (Houser, J. and Bokovoy, J. 2006). The final dimension of PICO question is Outcome. It is concerned with specifying the results of what should be accomplished and it has to be measurable. Outcomes normally consist of ways of eliminating or relieving symptoms that are specific (Houser, J. and Bokovoy, J. 2006). Specific outcomes should yield good results that allow one to find the study that has a focus on the intended outcomes of the search. In the definition of the outcome, phrases such as more effective are not accepted unless it elaborates further on how the intervention can be more effective (Houser, J. and Bokovoy, J. 2006). After effective identification of the components of PICO, it is very crucial in the clarification of the type of questioned to be asked and method of search. The questions should be in line with etiology, prevention, diagnosis and prognosis. Basing the final question on four components of PICO, the question can be: For a patient with body pains, can sustained Mobile TENS (SMT) therapy be a remedy in Rural Australia? Once a patient problem has been identified using PICO procedure then it signals readiness for finding the current material and valid evidence as elaborated below. TENS Therapy TENS therapy was developed in the 1970s and has proved to be an effective remedy in the management of chronic pain that includes pain related to musculoskeletal disorders (MSDs) and arthritis (Lundeberg, T. and Ottoson, D. 1998). Electrical impulses that are mild are normally passed through the skin in order to block the signals of pain before its reception by the brain. The impulses also lead to an induction of the release of Endorphins. It is a suitable technique for pain management though underutilized as alternative to drug use. TENS therapy has gained recognition by the TGA and has over the decades been prescribed by doctors as a reliable technique of pain management (Adrienne, BL. 1992). Many causes and types of pain can benefit from TENS therapy more so arthritis and pain. This type of therapy is very popular amongst the elderly patients who might suffer side effects as a result of strong medications. Its use is not limited to the elderly but can be used by any individual having pain problems (Eisenberg DM, Kessler RC, Foster C. et al. 1993). Electrical stimulation has been accepted widely and is used in most of the hospitals in the developed world and physiotherapy practices (Adrienne, BL. 1992). The portability of the device is very high for it weighs only about 400 grams (American Physical Therapy Association, 1979). People are freed from the suffering that is caused by side effects as a result of drug use. The usage of TENS has been found to act on the following: Mood – Repeated activation of the messages emanating from the sensory nerves induces a feeling good mood and relieves pains thus helps in relaxation. Movement – It helps in exercising of the skeletal and visceral muscles and activation of autonomic healing functions. Healing – It ensures proper blood flow to the paining parts hence stamina and muscular strength and also increased permeability of the body cells. Improvement on TENS device The recently developed innovation of TENS is the mobile SMT. It uses the latest developments in microchip technology which has resulted in the invention of tiny TENS devices that approximately weighs 25 grams (Kenneth DM. 2006). The tiny size and weight means that they can be comfortably worn under clothing and the application of therapy can be done at any time on demand (Kenneth DM. 2006). This calls for the electrical pulse impulse to be in the magnitude of micro pulse. SMT devices have been sold and used in Australian market for about four years. (Kenneth D. Muirden 2006). Research Methodology to Justify the Research Question Some 2,150 SMT users responded to a Pain Study questionnaire was prepared and distributed to some 2,150 SMT users (Kenneth D. Muirden 2006). The purpose of the questionnaire was to gain greater understanding of: The patients use of the SMT device The achieved benefits due to therapy Changes to the consumption of pain killing drugs Changes to lifestyle, work habits, health, quality of life and well-being Opportunities for innovation of design and improvement of customer service. Conclusion The conclusion is very clear and also compelling as there exists a great potential for the Australian government, health community and businesses in developing a strategy that have positive impact by supporting the use of self-applied mobile SMT therapy. Self-care mobile SMT therapy could be a big potential for self-care to manage chronic arthritis. Since it can be obtained at low costs to every Australian in treating the chronic disorders, it acts as a good alternative remedy to the use of conventional drugs. Such a useful strategy would ensure alleviation of chronic pain to the Australian suffering population which numbers about six million. Over a period of time the cost of medication normally passed to people, eating through the state funds and the Australian industry. The reduction of the cost and burden, which is imposed upon the people, the public purse, and the Australian industry (Kenneth D. Muirden 2006). Bibliography Kaplan, B., Rabinerson, D, et.al. (2007) TENS for lowering of labor pains, International Journal of Gynecology & Obstetrics, Volume 60, Issue 3, Pages 251-255. Eisenberg, DM., Davis, RB., Ettner, SL. et al. (1998) Trends in alternative medicine use in the United States, McGraw hill, USA. Eisenberg, DM., Kessler, RC., Foster, C. et al. (1993) Unconventional medicine in the United States: Prevalence, costs, and patterns of use, England Journal of Medicine. 54, (2): 204-205. Kenneth DM. (2006) A four year study of sufferers of arthritic & musculoskeletal pain managing their conditions using self-managed, Sustained Mobile TENS(SMT ) therapy, found online at < http://painstudy.com.au/4-2-meta-analyses/>. Medline Data base. Retrieved on 15th from, http://www.medline.com/search/default.asp?query=some+of+the+pain+managem ent+methods&newSearch=true Houser, J. and Bokovoy, J. (2006) Clinical research in practice: a guide for the bedside scientist, Jones and Bartlett publishers, Toronto. Houser, J. (2008) Nursing research: reading, using, and creating evidence, Jones and Bartlett publishers, Toronto. American Physical Therapy Association (1979) Transcutaneous electrical nerve stimulation, American Physical Therapy Association, Washington D.C. Adrienne, BL. (1992). Easing labor pain: the complete guide to a more comfortable and rewarding birth, Harvard Common Press, Boston. Lundeberg, T. and Ottoson, D. (1998) Pain treatment by TENS: a practical manual, Springer-Verlag, New York. Read More