scholarly journals Inpatient Massage Therapy Versus Music Therapy Versus Usual Care: A Mixed-methods Feasibility Randomized Controlled Trial

2017 ◽  
Vol 6 ◽  
pp. 2164957X1773581 ◽  
Author(s):  
Eric J Roseen ◽  
Oscar Cornelio-Flores ◽  
Chelsey Lemaster ◽  
Maria Hernandez ◽  
Calvin Fong ◽  
...  
Keyword(s):  
Pain Management ◽  
Music Therapy ◽  
Patient Experience ◽  
Controlled Trial ◽  
Massage Therapy ◽  
Safety Net ◽  
Music Therapist ◽  
Urban Safety ◽  
Medical Inpatients ◽  
The Impact

Background Little is known about the feasibility of providing massage or music therapy to medical inpatients at urban safety-net hospitals or the impact these treatments may have on patient experience. Objective To determine the feasibility of providing massage and music therapy to medical inpatients and to assess the impact of these interventions on patient experience. Design Single-center 3-arm feasibility randomized controlled trial. Setting Urban academic safety-net hospital. Patients Adult inpatients on the Family Medicine ward. Interventions Massage therapy consisted of a standardized protocol adapted from a previous perioperative study. Music therapy involved a preference assessment, personalized compact disc, music-facilitated coping, singing/playing music, and/or songwriting. Credentialed therapists provided the interventions. Measurements Patient experience was measured with the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) within 7 days of discharge. We compared the proportion of patients in each study arm reporting “top box” scores for the following a priori HCAHPS domains: pain management, recommendation of hospital, and overall hospital rating. Responses to additional open-ended postdischarge questions were transcribed, coded independently, and analyzed for common themes. Results From July to December 2014, 90 medical inpatients were enrolled; postdischarge data were collected on 68 (76%) medical inpatients. Participants were 70% females, 43% non-Hispanic black, and 23% Hispanic. No differences between groups were observed on HCAHPS. The qualitative analysis found that massage and music therapy were associated with improved overall hospital experience, pain management, and connectedness to the massage or music therapist. Conclusions Providing music and massage therapy in an urban safety-net inpatient setting was feasible. There was no quantitative impact on HCAHPS. Qualitative findings suggest benefits related to an improved hospital experience, pain management, and connectedness to the massage or music therapist.

scholarly journals The Impact of Increased Hydrocodone Regulation on Opioid Prescribing in an Urban Safety-Net Health Care System

2019 ◽  
Vol 32 (3) ◽  
pp. 362-374 ◽  
Author(s):  
Thomas F. Northrup ◽  
Kelley Carroll ◽  
Robert Suchting ◽  
Yolanda R. Villarreal ◽  
Mohammad Zare ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Safety Net ◽  
Opioid Prescribing ◽  
Urban Safety ◽  
The Impact ◽  
Care System

Like a Fish out of Water: Managing Chronic Pain in the Urban Safety Net

2018 ◽  
Vol 59 (4) ◽  
pp. 487-500 ◽  
Author(s):  
Sara Rubin ◽  
Nancy Burke ◽  
Meredith Van Natta ◽  
Irene Yen ◽  
Janet K. Shim
Keyword(s):  
Pain Management ◽  
Care Management ◽  
Safety Net ◽  
Complex Care ◽  
Health Capital ◽  
Point Of Entry ◽  
Social Inequities ◽  
Treatment Disparities ◽  
Urban Safety ◽  
Interdisciplinary Study

The subjective nature of pain has always rendered it a point of entry for power and corresponding stratifying processes within biomedicine. The opioid crisis has further exacerbated these challenges by increasing the stakes of prescribing decisions for providers, which in turn has resulted in greater treatment disparities. Using the theoretical frame of cultural health capital (CHC) to account for these disparities in pain management as they unfold at both the macro- and the microlevel, we present findings from an interdisciplinary study of two complex care management programs in urban safety-net hospitals that serve high-utilizing patients. CHC, which considers the ways in which patient–provider interactions reflect and often reinforce broader social inequities, allows for a consideration of power as it circulates through and beyond the patient–provider encounter. Within the current sociopolitical era of pain management, attention must be paid to the stratifying processes that structure how suffering is addressed.

Complementary therapies in pain management

2015 ◽  
Author(s):  
Gary Deng ◽  
Barrie R. Cassileth
Keyword(s):  
Pain Management ◽  
Music Therapy ◽  
Complementary Therapies ◽  
Emotional State ◽  
Belief System ◽  
Management Plan ◽  
Opioid Therapy ◽  
Analgesic Effects ◽  
Anxiety Depression ◽  
The Impact

Complementary therapies are modalities that are not traditionally part of Western medical care. Some of these therapies have demonstrated a favourable benefit:risk ratio in recent research and many can be incorporated into a multimodality pain management plan. In general, complementary therapies reduce pain by interfering with the processing of pain signals or lessen the impact of pain on the patient’s emotional state. Mind-body therapies, such as hypnosis, meditation, yoga/qigong, and music therapy, can reduce anxiety, depression, and stress-all common in patients experiencing pain. Acupuncture appears to have direct analgesic effects and reduce nausea and vomiting, which are potential side effects from opioid therapy. Massage therapy may reduce anxiety, and to a lesser degree, depression and pain. Complementary therapies are generally safe when provided by trained practitioners, although certain safety precautions still need to be exercised. The origin of pain, the factors complicating it, burdens and risks to patient, and each patient’s belief system and cultural background should all be considered when selecting from among the complementary modalities for pain.

Abstract 17076: Empowering Telemetry Technicians to Call Code Blue

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Cody McCoy ◽  
Neil Keshvani ◽  
Maryam Warsi ◽  
Eugene Chu ◽  
Anita Hegde
Keyword(s):  
Clinical Status ◽  
Retrospective Chart Review ◽  
Safety Net ◽  
Post Intervention ◽  
Neurologic Outcomes ◽  
Code Blue ◽  
Safety Net Hospital ◽  
Urban Safety ◽  
Life Threatening ◽  
The Impact

Background: Delays in treatment of in-hospital cardiac arrest (IHCA) events are associated with lower survival and poor neurologic outcomes. With centralized telemetry, telemetry technicians need to notify nursing staff of life-threatening arrhythmias immediately for nursing to verify a patient's clinical status and determine whether code blue activation is necessary. Delays in this verification lead to delays in code activation, which can in turn lead to increased morbidity and mortality. Objective: We sought to assess the impact of empowering telemetry technicians to activate code blues on IHCA code survival, survival to discharge, time to cardiopulmonary resuscitation (CPR), and inappropriate code activation. Methods: We implemented a quality improvement protocol September 1, 2016 at Parkland Memorial Hospital, a 900-bed, urban, safety-net hospital, in Dallas, Texas to empower telemetry technicians to call code blue directly for the following life-threatening arrhythmias: ventricular fibrillation, sustained ventricular tachycardia of greater than 30 seconds, asystole, or bradycardia less than 30 beats/minute. We performed a retrospective chart review of all IHCA in patients on centralized telemetry at Parkland for one year prior to the intervention and three years post intervention to look at code survival and survival to discharge. Secondary outcomes were time to CPR and inappropriate code activation. Results: The pre intervention code survival was 12/20 (60.0%) and the post intervention code survival was 46/55 (83.6%) (p=0.03). The pre intervention survival to discharge was 3/20 (15.0%) and the post intervention survival to discharge was 21/55 (38.2%), (p=0.0585). The time to CPR, in seconds, was 180 versus 120 (p=0.58) for pre and post intervention non-PEA codes. There were 0 inappropriate code activations post intervention. Conclusions: Empowering telemetry technicians to activate code blue for general ward patients on centralized telemetry showed a significant improvement in code survival and a trend in survival to discharge. Importantly, there were no inappropriate code activations by telemetry technicians, highlighting the safety of this intervention.

scholarly journals Guided relaxation-based virtual reality versus distraction-based virtual reality or passive control for postoperative pain management in children and adolescents undergoing Nuss repair of pectus excavatum: protocol for a prospective, randomised, controlled trial (FOREVR Peds trial)

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e040295
Author(s):  
Vanessa A Olbrecht ◽  
Sara E Williams ◽  
Keith T O’Conor ◽  
Chloe O Boehmer ◽  
Gilbert W Marchant ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Pain Management ◽  
Pain Intensity ◽  
Pectus Excavatum ◽  
Passive Control ◽  
Controlled Trial ◽  
Novel Therapy ◽  
The Impact ◽  
Guided Relaxation ◽  
Pain Unpleasantness

IntroductionVirtual reality (VR) offers an innovative method to deliver non-pharmacological pain management. Distraction-based VR (VR-D) using immersive games to redirect attention has shown short-term pain reductions in various settings. To create lasting pain reduction, VR-based strategies must go beyond distraction. Guided relaxation-based VR (VR-GR) integrates pain-relieving mind–body based guided relaxation with VR, a novel therapy delivery mechanism. The primary aim of this study is to assess the impact of daily VR-GR, VR-D and 360 video (passive control) on pain intensity. We will also assess the impact of these interventions on pain unpleasantness, anxiety and opioid and benzodiazepine consumption. The secondary aim of this study will assess the impact of psychological factors (anxiety sensitivity and pain catastrophising) on pain following VR.Methods and analysisThis is a single centre, prospective, randomised, clinical trial. Ninety children/adolescents, aged 8–18 years, presenting for Nuss repair of pectus excavatum will be randomised to 1 of 3 study arms (VR-GR, VR-D and 360 video). Patients will use the Starlight Xperience (Google Daydream) VR suite for 10 min. Patients randomised to VR-GR (n=30) will engage in guided relaxation/mindfulness with the Aurora application. Patients randomised to VR-D (n=30) will play 1 of 3 distraction-based games, and those randomised to the 360 video (n=30) will watch the Aurora application without audio instructions or sound. Primary outcome is pain intensity. Secondary outcomes include pain unpleasantness, anxiety and opioid and benzodiazepine consumption.Ethics and disseminationThis study follows Standard Protocol Items: Recommendations for Interventional Trials guidelines. The protocol was approved by the Cincinnati Children’s Hospital Medical Center’s institutional review board. Patient recruitment began in July 2020. Written informed consent will be obtained for all participants. All information acquired will be disseminated via scientific meetings and published in peer-reviewed journals.Trial registration numberNCT04351776.

scholarly journals Community Music Therapy and Participatory Performance

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Elizabeth Mitchell
Keyword(s):  
Music Therapy ◽  
Mental Health Treatment ◽  
Case Study Research ◽  
Western Society ◽  
Community Music ◽  
Music Therapist ◽  
New Type ◽  
Participatory Performance ◽  
The Impact

This case study research explores the impact of a musical performance event—the Coffee House—held bi-annually at an adolescent mental health treatment facility in Southwestern Ontario, Canada. Any client or staff member is welcomed to perform at this event, which is organized by the facility’s music therapist and framed here as an example of community music therapy. Drawing upon Turino’s (2008) ethnomusicological perspective on performance, I will argue that the Coffee House’s success within this context is due to its participatory ethos, wherein success is primarily defined by the act of participation. Here, performance takes place within an inclusive and supportive atmosphere in which participants can overcome anxiety, engage in the risk-taking of performance, and experience increased self-efficacy and confidence. This ethos also naturally affords a “levelling” of institutional relationship dynamics. Resonant with Aigen’s (2004) vision that “performances as community music therapy can forge a new type of art, one that creates meaning and invites participation” (p. 211), the Coffee House exemplifies the ways in which the values within participatory settings are indeed different and new in comparison to presentational settings that are the norm in Western society.

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