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WEEK 3 replies

Claudia Avila

11/13/24, 11:03 AM

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Nursing EBP

November 13, 2024

Literature Review

In my literature review on multimodal pain management for elderly hospice patients with cancer, Hinther et al. (2021) highlighted significant reductions in opioid consumption. They improved early postoperative outcomes for head and neck cancer patients using multimodal analgesia (MMA), emphasizing its role in minimizing dependency risks and promoting recovery. Similarly, Dong et al. (2021) found that MMA reduced pain scores and complication rates in gynecological cancer patients, demonstrating faster mobilization and shorter hospital stays. Brooks et al. (2023) observed that while elderly patients using multimodal protocols for arthroplasty consumed more total opioids, they reported improved pain and mobility outcomes. These findings underscore the potential for tailored multimodal strategies, integrating pharmacological and non-pharmacological therapies, to enhance patient comfort and overall well-being.

Likewise, Shehu et al. (2022) emphasized the importance of personalized interventions, indicating benefits for physical function in older cancer patients despite slight declines in specific measures, which reflects the need for flexible approaches. Fernández-Gualda et al. (2023) further demonstrated the positive impact of pain neuroscience education as part of multimodal programs, showing reduced pain catastrophizing and improved physical function.

I consider that these studies highlight a trend towards integrating diverse therapeutic approaches to manage complex pain and improve quality of life. Nevertheless, they also expose gaps, such as variations in response based on patient characteristics and the need for individualized care plans. However, from an optimistic perspective, these authors support my way, which helps my project by validating the need for a comprehensive, patient-centered multimodal approach tailored to hospice cancer patients to reduce pain and enhance the quality of life.

Search and Select High-Quality Research

To identify high-quality, evidence-based practices, I utilized systematic searches in databases such as PubMed, CINAHL, and NCBI, NIH, focusing on peer-reviewed studies, meta-analyses, and clinical trials relevant to pain management in cancer patients. I applied inclusion criteria such as studies involving elderly populations, hospice care, and multimodal approaches, ensuring relevance and rigor (Titler, 2024). One effective strategy involved employing Boolean operators and specific keywords like “multimodal pain management,” “hospice cancer patients,” and “elderly care.” For instance, using this strategy led me to Dong et al. (2021) and Brooks et al. (2023), which provided critical insights into pain management’s efficacy.

Peer’s Capstone

I recommend utilizing well-established databases like PubMed and CINAHL; for me, they were vital in my search to access high-quality evidence relevant to healthcare topics. These databases contain peer-reviewed studies and systematic reviews that ensure robust and current data. Additionally, employ critical appraisal tools like the Critical Appraisal Skills Programme (CASP) checklists at or consult to evaluate a study’s methodology, sample size, and outcomes, ensuring that the selected evidence is both valid and relevant to clinical practice (Titler, 2024).

References

Brooks, E., Freter, S. H., Bowles, S. K., & Amirault, D. (2017). Multimodal Pain Management in Older Elective Arthroplasty Patients. Geriatric orthopaedic surgery & rehabilitation, 8(3), 151–154. C

Dong, W., An, B., Wang, Y., Cui, X., & Gan, J. (2021). Effect of multimodal analgesia on gynecological cancer patients after radical resection. American journal of translational research, 13(4), 2686–2693.

Fernández-Gualda, M. Á., Ariza-Vega, P., Lozano-Lozano, M., Cantarero-Villanueva, I., Martín-Martín, L., Castro-Martín, E., Arroyo-Morales, M., Tovar-Martín, I., Lopez-Garzon, M., Postigo-Martin, P., González-Santos, Á., Artacho-Cordón, F., Ortiz-Comino, L., Galiano-Castillo, N., & Fernández-Lao, C. (2023). Persistent pain management in an oncology population through pain neuroscience education, a multimodal program: PaiNEd randomized clinical trial protocol. PloS one, 18(8), e0290096. G

Hinther, A., Nakoneshny, S. C., Chandarana, S. P., Matthews, T. W., Hart, R., Schrag, C., Matthews, J., McKenzie, C. D., Fick, G. H., & Dort, J. C. (2021). Efficacy of Multimodal Analgesia for Postoperative Pain Management in Head and Neck Cancer Patients. Cancers, 13(6), 1266. I

Shehu, E., Roggendorf, S., Golla, A., Koenig, A., Stangl, G. I., Diestelhorst, A., Medenwald, D., Vordermark, D., Steckelberg, A., & Schmidt, H. (2022). Development and Evaluation of a Multimodal Supportive Intervention for Promoting Physical Function in Older Patients with Cancer. Cancers, 14(11), 2599. S

Titler, M. G. (2024).
The evidence for evidence-based practice implementation. In R. G. Hughes (Ed.),
Patient safety and quality: An evidence-based handbook for nurses (Chap. 7). Agency for Healthcare Research and Quality (US). Available from

 

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