• Title/Summary/Keyword: Nonpharmacological methods

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Nonpharmacological Treatment of Insomnia (불면증의 비약물학적 치료)

  • Yoon, In-Young
    • Sleep Medicine and Psychophysiology
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    • v.7 no.1
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    • pp.5-9
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    • 2000
  • Several nonpharmacological treatment methods of insomnia and their effects were reviewed. A long-term use of most hypnotics may produce tolerance, dependence, cognitive and psychomotor impairments at daytime, shallow sleep, and rebound insomnia on drug withdrawal. To reduce hypnotic abuse, nonpharmacological strategies have been developed to correct disordered behavioral and cognitive factors. These treatments aim at modifying maladaptive sleep habits, lowering physiological and cognitive arousal levels, and correcting dysfuctional beliefs and attitudes about sleep. These non-pharmacological or cognitive behavior treatments include stimulus control, sleep restriction, relaxation training, sleep hygiene education, cognitive therapy, and light therapy. Among them the stimulus control therapy has been demonstrated most effective as a single treatment or in combination with other treatments. Through nonpharmacological treatments, sleep latency was most significantly reduced and wake time after sleep onset was also reduced. About 50% of insomniacs reported clinical improvements in terms of nearly normalized sleep latency, awakening time, sleep efficiency, and reduction of hypnotic use. Compared to the hypnotic therapy, nonpharmacological treatments are more cost-effective and more readily accepted by patients, and their effects last longer.

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Effectiveness of various nonpharmacological analgesic methods in newborns

  • Kumar, Pancham;Sharma, Rakesh;Rathour, Sukhdev;Karol, Sunidhi;Karol, Mohit
    • Clinical and Experimental Pediatrics
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    • v.63 no.1
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    • pp.25-29
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    • 2020
  • Background: Pain during the developmental period may adversely affect developing neuronal pathways and result in adverse neurodevelopmental, cognitive, and behavioral effects in later life. Immunizations, e.g., hepatitis B vaccine (HBV), administered at birth are painful experiences to which neonates are universally subjected. Purpose: Here we aimed to study and compare the effectiveness of various nonpharmacological pain management methods in newborns to enable the development of safe and effective analgesic methods for newborns. Methods: This prospective study was conducted at a tertiary care hospital in the Himalayan region. Three hundred term healthy neonates were divided into 6 groups of 50 each. Groups 1-5 were intervention groups, patients of which received a nonpharmacological intervention (breastfeeding, nonnutritive sucking, rocking, 25% sucrose, or distilled water) before the intramuscular HBV, while patients in group 6 received no intervention. The pain response in each group after the HBV injection was assessed and compared using cry duration and Douleur Aigue Nveau-ne (DAN) score, a behavioral acute pain rating scale for newborns. Results: Cry duration was decreased in all intervention groups, significantly so in the sucrose (19.90 seconds), breastfeeding (31.57 seconds), and nonnutritive sucking (36.93 seconds) groups compared with controls (52.86 seconds). DAN scores decreased significantly (P<0.05) at one or more points i.e. 30, 60, or 120 seconds in the breastfeeding and 25% sucrose intervention groups compared with controls. Conclusion: Oral sucrose and nonnutritive sucking are simple yet underutilized nonpharmacological interventions that effectively reduce pain in newborns.

Effects of nonpharmacological interventions on the psychological health of high-risk pregnant women: a systematic review and meta-analysis

  • Yoo, Hyeji;Ahn, Sukhee
    • Women's Health Nursing
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    • v.27 no.3
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    • pp.180-195
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    • 2021
  • Purpose: This study aimed to summarize the current evidence on the effects of nonpharmacological interventions on psychological health outcomes for women with high-risk pregnancies due to conditions such as preeclampsia, gestational diabetes, or preterm labor. Methods: The following databases were searched from January 2000 to December 2020: PubMed, Ovid Embase, CINAHL, Web of Science, DBpia, RISS, and KISS. Two investigators independently reviewed and selected articles according to the inclusion/exclusion criteria. RoB 2 and the ROBINS-I checklist were used to evaluate study quality. Results: Twenty-nine studies with a combined total of 1,806 pregnant women were included in the systematic review and meta-analysis. Psychological health improvements were found in women with preeclampsia (Hedges' g=-0.67; 95% confidence interval [CI], -0.91 to -0.44), gestational diabetes (Hedges' g=-0.38; 95% CI, -0.54 to -0.12), and preterm labor (Hedges' g=-0.73; 95% CI, -1.00 to -0.46). The funnel plot was slightly asymmetrical, but the fail-safe N value and the trim-and-fill method showed no publication bias. Conclusion: Nonpharmacological interventions for women with high-risk pregnancies due to conditions such as preeclampsia, gestational diabetes, and preterm labor can improve psychological parameters such as anxiety, stress, and depression. Nurses can play a pivotal role in the nursing management of pregnant women with high-risk conditions and apply various types of nonpharmacological interventions to meet their needs in uncertain and anxious times during pregnancy.

A Systematic Review of Nonpharmacological Interventions on Activities of Daily Living in Dementia (치매 환자의 일상생활 수행능력 향상을 위한 비약물 중재에 관한 체계적 고찰)

  • Koo, Seul-Gi;Park, Hae-Yean;Park, Ji-Hyuk
    • 한국노년학
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    • v.37 no.2
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    • pp.445-459
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    • 2017
  • The purpose of this study is to provide a systematic review of the nonpharmacological interventions of ADL improvement for dementia published in foreign journals for the past 10 years, and to provide general information on nonpharmacological interventions and effective intervention methods to dementia expert in clinical practice. We searched published studies in the Medline Complete, PubMed Central, and Scopus databases from January 2007 to November 2016. The main keywords used "Dementia AND (ADL OR Activities of daily living) AND Nonpharmacological interventions" and total of 9 studies were selected for analysis from 974 searched articles. The level of evidence were belonged to 3 each studies in I~III level. The mostly provided nonpharmacological interventions were exercise, the study field was variety of areas including rehabilitation(occupational therapy, physical therapy), nursing, and psychology. The Barthel Index(BI) was most frequently used assessment tools to evaluate basic activities of daily living, Cognition was most dependent variables measured with the ADL. Through this study, we provided evidence for the understanding of nonpharmacological interventions of ADL improvement for dementia. In the future, based on this study, helpful intervention needed for ADL training.

Biofeedback Treatment for Tension-Type Headache and Migraine (긴장성두통과 편두통의 바이오피드백 치료)

  • Park, Joo-Eon;Lee, Kye-Seong;Shin, Sang-Eun
    • Korean Journal of Psychosomatic Medicine
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    • v.14 no.1
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    • pp.25-32
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    • 2006
  • Objectives : Headache is a clinical symptom that more than 90% of all individuals experience during their life time. This article provides a current concept of tension-type and migraine headaches and summarizes the effects of biofeedback treatment and/or relaxation techniques. Methods : The following terms were used for Pubmed/Medline search : biofeedback, relaxation, physiological, behavioral, nonpharmacological, headache, tension-type headache, and migraine. A review of references from relevant literature was also conducted to collect reports not identified in the Pubmed/Medline search. Interviews with experts on biofeedback were also included in this review. Results : Headache is a psychophysiological symptom that can be treated by some behavioral interventions including biofeedback and relaxation. Literatures on biofeedback and/or relaxation have consistently reported significant therapeutic effects on headaches. Important factors that we have to consider, when we apply to headache patients with biofeedback and relaxation techniques, were also presented. Conclusion : The available evidence suggests that biofeedback and relaxation techniques are effective treatments for the patients with headaches and can be provided to the patients as monotherapy or combination therapy with medication.

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Randomized Controlled Trials of Miniscalpel Acupuncture for Lumbar Spinal Stenosis Cited in the China National Knowledge Infrastructure Database

  • Yoon, Sang Hoon;Kim, Yoon Sik;Kwon, Min Goo;Kwon, Chan Young
    • Journal of Acupuncture Research
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    • v.34 no.3
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    • pp.59-69
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    • 2017
  • Objectives : This study analyzed the current status of randomized controlled trials (RCTs) of miniscalpel acupuncture for lumbar spinal stenosis (LSS) in China. Methods : A literature search was performed using the China National Knowledge Infrastructure (CNKI) database. All studies up to June 7th, 2017 were searched. The quality of included RCTs was assessed with the Jadad scale. Results : Five RCTs were finally included in this review. The overall quality of the RCTs was assessed as low. All articles evaluated miniscalpel acupuncture as monotherapy or in combination with filiform needle therapy, drug injection therapy, Tuina treatment, thermal coagulation therapy, or spinal decompression. Miniscalpel acupuncture as monotherapy or adjunctive therapy showed greater therapeutic effect and fewer adverse effects. Conclusion : Miniscalpel acupuncture is a safe and effective nonpharmacological treatment for LSS. However, high-quality studies with consistent treatment protocols are needed to confirm these findings.

Acupuncture clinical trial study for treatment of Nocturnal Enuresis (야뇨의 침술 치료 임상시험에 대한 최근 경향)

  • Chang, Gyu-Tae
    • The Journal of Pediatrics of Korean Medicine
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    • v.17 no.2
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    • pp.213-224
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    • 2003
  • Background and Objectives: Nocturnal enuresis is a common problem that can be troubling for children and their families. Treatment options include nonpharmacologic and pharmacologic measures. Various nonpharmacologic treatments have been shown to have a positive effect on bed-wetting in small studies but have not been extensively evaluated (generally weak strength of evidence). This study was undertaken to determine if there is any evidence for the clinical efficacy of acupuncture for treatment of nocturnal enuresis. Methods : Author conducted a computerized literature search in following database: Medline(via Pubmed), NDSL. There were no restrictions on the language of publication. The data were extracted in a standardized, predefined manner and assessed critically. Results : 4 article was selected. Acupuncture is composed of general acupuncture, electro, laser. Acupuncture treatment of the children had significantly more dry night than before treatment Conclusion : Alternative, nonpharmacological approach using acupuncture works in children with monosymptomatic nocturnal enuresis.

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A Systematic Review of the Application Nonpharmacological Cognitive Interventions in Patients With Dementia (치매 환자에게 적용된 비약물적 인지중재방법에 대한 체계적 고찰)

  • Kwak, Ho-Soung;Park, Ji-Hyuk
    • Korean Journal of Occupational Therapy
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    • v.26 no.4
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    • pp.13-26
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    • 2018
  • Objective : The aim of the study was to investigate the application of nonpharmacological cognitive interventions in patients with dementia. Methods : We searched published studies in KISS, PubMed, and Sciencedirect databases from January 2013 to December 2017. The main keywords used were "Dementia" AND "Cognitive stimulation OR Cognitive rehabilitation OR Cognitive training" and a total of ten studies were selected for analysis from 753 searched articles. Results : Seven of the ten selected studies showed significant improvements in cognitive function after intervention, whereas three studies showed no improvement in cognitive function; however, activation of brain waves, improvement in the relationship between care givers and patients, improvement in the quality of life of care givers, and improvements in visual motor skills were shown. Mini-Mental State Examination(MMSE) was used as the assessment tool for identifying the effects of the cognitive function improvement, and in four studies the quality of life of dementia patients was measured as an intervention effect. The main subject of the cognitive intervention is patients with mild to moderate dementia. Conclusion : The results of this study can be used as a basis for the selection of intervention methods, as well as their duration and assessment, according to the characteristics of dementia patients.

Acupuncture Clinical Trial Study for Prevention of Postoperative Nausea and Vomiting in Children (소아의 수술 후 오심 및 구토에 대한 침술치료 임상연구 고찰)

  • Chang, Gyu-Tae;Kim, Jang-Hyun;Choi, Eun-Young
    • The Journal of Pediatrics of Korean Medicine
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    • v.19 no.1
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    • pp.173-183
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    • 2005
  • Background and objective : Postoperative nausea and vomiting(PONV) are frequent complications of general anesthesia in children. High cost and associated side effects of antiemetic drugs, have increased interest in nonpharmacological methods for treatment of PONV. The aim of this study was to report the effect of acupuncture for prevention of PONV in children. Material and Method : Randomized clinical trials retrieved by a search of articles indexed on the Medline and NDSL database. Key words to search were 'PONV', 'POV', 'acupuncture', 'children', 'pediatric'. Results : Eleven articles were selected and six of them showed significant effectiveness of acupuncture in preventing PONV in children. Acupuncture methods were needle acupuncture acupressure, electro-acupuncture, laser acupuncture, acupuncture point injection. The main acupuncture point was P6(Neiguan). Conclusion : The effectiveness of acupuncture for prevention of PONV in children has been shown in some, but not all trials. Further studies are needed.

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Perception of Non-pharmacological Therapy for Pain Control and Pattern of Postoperative Pain in Gynecological Surgery Patients (부인과 수술환자의 통증조절을 위한 비약물성 요법의 인식수준 및 통증변화 양상)

  • Ahn, Suk-Hee;Kim, Mi-Ok
    • Women's Health Nursing
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    • v.10 no.2
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    • pp.128-135
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    • 2004
  • Purpose: Women who undergo gynecological surgery have moderate and severe sensation and distress of pain despite the advent of patient controlled analgesia (PCA). The purposes of this study were to describe perception of non-pharmacological therapy for postoperative pain control and examine changes of pain sensation and distress in women who had gynecological surgery. Method: The sample consisted of 52 women who were having gynecological surgery. Subjects who agreed to participate in the study were asked for their opinion about non-pharmacological approaches for postoperative pain control using a structured study questionnaire. Pain sensation and distress were assessed by VAS in the morning and afternoon for 2 days following the surgery. Result: About 50% of the subjects thought that non-pharmacological methods such as relaxation, music, massage, or meditation would be helpful for their postoperative pain control. If both pharmacological and non-pharmacological therapy were given for pain control, 96% of subjects reported it would be effective. Nurses can apply techniques of relaxation, deep breathing, meditation, and music therapy to surgical patients along with PCA. Expected sensation and distress of pain was high, but pain levels gradually decreased over time. However, subjects experienced moderate levels of pain postoperatively although they used PCA. Conclusion: The effect of a combined method of pharmacological and non-pharmacological approach needs to be tested if postoperative pain is to be decreased more.

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