Presenter Information

Ashley ThomasFollow

Start Date

22-3-2019 10:00 AM

End Date

22-3-2019 11:30 AM

Abstract

Availability and Nursing Implementation of Measurement Tools in the Co-Occurrence of Depression and Chronic Pain: An Integrative Literature Review

Ashley Thomas

Faculty Sponsor: Barbara Harris

Background: There is high correlation between chronic pain and depression. They are seen throughout the literature to interact and feedback symptoms upon each other. However, there is not a comprehensive screening tool that assess both symptoms and not a clear indication of nursing responsibility in assessment of the co-occurrence.

Objectives: The purpose of this literature review is to create a comprehensive review of current research concerning the availability of screening tools that measure the co-occurrence of chronic pain and depression and how nurses implement the results of those screening tests.

Method: An integrative literature review was completed on twelve research studies. They were found using the databases: PsychInfo, Cumuative Index to Nursing and Allied Health Literature (CINAHL) complete, and Pubmed. The search terms used were: screening, intervention or treatment, co-occurrence or comorbidity alongside the phrase chronic pain AND depression and clinical setting OR clinical, nursing role, or nursing alongside the further specification AND chronic pain AND depression. Inclusion and exclusion criteria were applied.

Results: There were no comprehensive screening tools tested on any population that assessed both chronic pain and depression in one tool. The most common methodology found across the studies was to screening for depression in chronic pain populations and to screen using separate tools. All the tools that were tested were verified through various statistical data to be reliable screening options. Some notable screening tools for depression screening were the Zung Self-Rating Depression Scale (Zung), the Patient Health Questionnaire (PHQ) and PHQ-9, and the Beck Depression Inventory. Some notable chronic pain measurement tools were the Numerical Rating Scale (NRS), the Visual Analog Scale (VAS), the Pain Disability Index (PDI), the Profile of Chronic Pain: Screen (PCP:S) and the Profile of Chronic Pain: Extended Assessment (PCP:EA). Some tools that did not directly measure chronic pain and depression but rather focused on critical factors affected by the pain-depression dyad like quality of life and control belief were the Multidimensional Health Locus of Control (MHLC) and Quality of Life Scale (QOLS). To answer the second research question of nursing implementation of screening tool results, empathy, education, promotion of self-efficacy, assessment, and focus on strengthening and stretching exercises; evoke the mind-body approach including: yoga, medication, hypnosis, and progressive relaxation; mindfulness and cognitive behavioral therapy were encouraged

Conclusion: Although there are many reliable screening tools in the clinical setting there needs to be a comprehensive model that focused on the consequences of pain and depression on the mind, body, spirit, and interactions. The role of nurses is assessing changes in pain and depression need to be expanded as well to improve patient outcomes. The theory of unpleasant symptoms is a good reference for a new comprehensive model of screening because it focuses on physiological, psychological and situation factors that influence symptoms and performance. The notable screening tools reviewed were synthesized according to the theory to highlight good line of questioning.

Keywords: chronic pain, depression, screening tools, nursing role, co-occurrence, theory of unpleasant symptoms

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Mar 22nd, 10:00 AM Mar 22nd, 11:30 AM

Availability and Nursing Implementation of Measurement Tools in the Co-Occurrence of Depression and Chronic Pain: An Integrative Literature Review

Availability and Nursing Implementation of Measurement Tools in the Co-Occurrence of Depression and Chronic Pain: An Integrative Literature Review

Ashley Thomas

Faculty Sponsor: Barbara Harris

Background: There is high correlation between chronic pain and depression. They are seen throughout the literature to interact and feedback symptoms upon each other. However, there is not a comprehensive screening tool that assess both symptoms and not a clear indication of nursing responsibility in assessment of the co-occurrence.

Objectives: The purpose of this literature review is to create a comprehensive review of current research concerning the availability of screening tools that measure the co-occurrence of chronic pain and depression and how nurses implement the results of those screening tests.

Method: An integrative literature review was completed on twelve research studies. They were found using the databases: PsychInfo, Cumuative Index to Nursing and Allied Health Literature (CINAHL) complete, and Pubmed. The search terms used were: screening, intervention or treatment, co-occurrence or comorbidity alongside the phrase chronic pain AND depression and clinical setting OR clinical, nursing role, or nursing alongside the further specification AND chronic pain AND depression. Inclusion and exclusion criteria were applied.

Results: There were no comprehensive screening tools tested on any population that assessed both chronic pain and depression in one tool. The most common methodology found across the studies was to screening for depression in chronic pain populations and to screen using separate tools. All the tools that were tested were verified through various statistical data to be reliable screening options. Some notable screening tools for depression screening were the Zung Self-Rating Depression Scale (Zung), the Patient Health Questionnaire (PHQ) and PHQ-9, and the Beck Depression Inventory. Some notable chronic pain measurement tools were the Numerical Rating Scale (NRS), the Visual Analog Scale (VAS), the Pain Disability Index (PDI), the Profile of Chronic Pain: Screen (PCP:S) and the Profile of Chronic Pain: Extended Assessment (PCP:EA). Some tools that did not directly measure chronic pain and depression but rather focused on critical factors affected by the pain-depression dyad like quality of life and control belief were the Multidimensional Health Locus of Control (MHLC) and Quality of Life Scale (QOLS). To answer the second research question of nursing implementation of screening tool results, empathy, education, promotion of self-efficacy, assessment, and focus on strengthening and stretching exercises; evoke the mind-body approach including: yoga, medication, hypnosis, and progressive relaxation; mindfulness and cognitive behavioral therapy were encouraged

Conclusion: Although there are many reliable screening tools in the clinical setting there needs to be a comprehensive model that focused on the consequences of pain and depression on the mind, body, spirit, and interactions. The role of nurses is assessing changes in pain and depression need to be expanded as well to improve patient outcomes. The theory of unpleasant symptoms is a good reference for a new comprehensive model of screening because it focuses on physiological, psychological and situation factors that influence symptoms and performance. The notable screening tools reviewed were synthesized according to the theory to highlight good line of questioning.

Keywords: chronic pain, depression, screening tools, nursing role, co-occurrence, theory of unpleasant symptoms

 

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