The use of visual stimulation in pain management

published_or_final_versionAnaesthesiologyDoctoralDoctor of Philosoph

The development and psychometric evaluation of the Perception of Play Questionnaire for older adults

The objective was to develop and test the psychometric properties of the Perception of Play Questionnaire among older adults. Item generation, content validation, scale piloting for item validation, and assessment of construct validity were employed to develop the questionnaire. A 17-item Perception of Play Questionnaire was developed. Items described how older adults view play from positive and negative prospective. Satisfactory results were found for content validity. The Cronbach’s alpha was.775. Correlations between perception of play and life satisfaction, happiness, and loneliness were demonstrated with statistical significance (p < 0.05). There were significant difference in multiple linear regression for frailty to Timed Up and Go Test (p < 0.01). The Perception of Play Questionnaire can help to understand how older people view the concept and their acceptance level of play. The data gathered using the questionnaire can aid in planning interventions to improve the health of older people

Effects of posture on heart rate variability in non-frail and prefrail individuals: a cross-sectional study

Abstract Background Frailty is an aging-related syndrome leading to high mortality in older adults. Without effective assessment and prevention of frailty, the incidence of frailty and relevant adverse outcomes will increase by 2050 as worldwide populations age. Although evidence suggested heart rate variability (HRV) is a potential measure of frailty, the role of HRV in frailty assessment remains unclear because of controversial findings. This study examined the effects of posture on HRV parameters in non-frail and prefrail individuals to understand the role of HRV in assessing frailty. Methods Forty-six participants aged ≥ 50 years were recruited between April and August 2022. Frailty was defined using Fried’s criteria. HRV was measured in standing, sitting, and lying postures, respectively, using a Polar Watch, and analyzed using Kubios HRV Standard 3.5.0 (Kubios). The five most commonly used parameters were examined, including standard deviations of all normal-to-normal intervals (SDNN), root mean square of the successive differences (RMSSD), low frequency (LF), high frequency (HF), and LF/HF. Independent t-tests and Mann–Whitney tests were used for inter-group comparisons. Friedman tests were used for intra-group comparisons across postures. Results The non-frail group showed significant differences in HRV parameters across postures (all p  0.05). The differences in the non-frail group included higher RMSSD and HF in the lying posture compared to those in the standing posture (29.54 vs 21.99 p = 0.003, 210.34 vs 96.34 p = 0.001, respectively), and higher LF and LF/HF in the sitting posture compared to those in the lying posture (248.40 vs 136.29 P = 0.024, 1.26 vs 0.77 p = 0.011, respectively). Conclusions The effects of posture on HRV were blunted in the prefrail group, which suggests an impaired cardiac autonomic functioning. Measuring the effects of posture on HRV parameters may contribute to frailty assessment. However, further evidence from larger cohorts and including additional HRV parameters is needed

Effects of a peer-led pain management program for nursing home residents with chronic pain: a pilot study

Objectives To examine the feasibility of a peer-led pain management program among nursing home residents. Design A quasi-experimental design. Setting Two nursing homes. Subjects Fifty nursing home residents. Methods The experimental group (n = 32) was given a 12-week group-based peer-led pain management program. There were two 1-hour sessions per week. Education in pain and demonstrations of nonpharmacological pain management strategies were provided. The research team and 12 trained peers led the sessions. The control group (n = 18) received one 1-hour session of pain management program each week over 12 weeks from the research team only. Outcome measures for the participants were collected at baseline (P1) and at week 12 (P2). Data from peer volunteers were collected prior to training (V1) and at week 12 (V2). T-tests were used to compare the differences in outcome measures collected at two time points. Results There was a significant reduction in pain intensity from 5.8 ± 2.6 (P1) to 3.4 ± 2.5 (P2) for the experimental group (p = 0.003) and from 6.3 ± 3.0 (P1) to 3.1±2.4 (P2) for the control group (p = 0.001). Activities of daily living significantly improved for both the experimental group (p = 0.008) and the control group (p = 0.014). There was an enhancement in happiness level for the experimental group (p < 0.001), while the loneliness level dropped significantly for the experimental group (p < 0.001) and the control group (p = 0.031). The peer volunteers showed a significant increase in self-rated pain management knowledge (2.9 ± 2.6 to 8.1 ± 1.2, p<0.001)andself-efficacyinvolunteering(5.8±2.9 to 8.3 ± 1.5, p = 0.032). Conclusion The peer-led pain management program was feasible and has potential in relieving chronic pain and enhancing the physical and psychological health of nursing home residents

An exploration of the use of visually appealing contexts in a pain management program

Purpose: Pleasant pictures can help to reduce stress, promote positive feelings, and even facilitate recovery from diseases. Visual stimulation is an approach of distraction that can effectively reduce pain thresholds and increase pain tolerances. The number of older adults who suffer from pain has increased due to age-related diseases. Technology is increasingly being applied to the management of acute pain. The pain situation among older people was explored in this study, and a visually appealing pain management program was designed with the participants’ experiences in mind. Methods: This was a descriptive observational study. Participants were recruited from local nursing homes. Results: A total of 165 older adults joined the study. The mean age of the participants was 85.6. More female than male participants experienced pain and the intensity of their pain was significantly greater. The results showed no significant differences in pain interferences between males and females. The participants stated that photographs of family members, homes, and natural scenery made them feel relaxed and happy, and reminded them of past happy times. They preferred to view those visually appealing pictures using digital devices (iPad/iPhone) to seeing hard copy versions. Conclusion: A digital-based pain management program using visually appealing contexts for older adults can be implemented. The patients’ experiences were collected and will be considered when developing a future program