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Intrauterine contraception insertion pain: nursing interventions to improve patient experience.

Identifieur interne : 000800 ( Main/Exploration ); précédent : 000799; suivant : 000801

Intrauterine contraception insertion pain: nursing interventions to improve patient experience.

Auteurs : Carmel Mccarthy [Royaume-Uni]

Source :

RBID : pubmed:28177530

Descripteurs français

English descriptors

Abstract

AIMS AND OBJECTIVES

To examine factors which contribute to the individual's experience of pain in relation to intrauterine contraception insertion and determine evidence-based nursing strategies to best assess and manage this pain.

BACKGROUND

Nurses are increasingly involved in consultations regarding intrauterine contraception. However, concerns regarding painful or difficult insertion may inhibit uptake and discourage nurses from promoting or inserting intrauterine contraception.

DESIGN

Integrative review.

METHODS

Database searches of CINAHL, PubMed, Wiley Online Library and the Cochrane Collaboration for relevant literature. Eight papers met the inclusion criteria and were analysed using an integrative review process.

RESULTS

Physical causes and pharmacological interventions for insertion pain have been thoroughly investigated. Absence of previous vaginal delivery and anxiety may increase the likelihood of procedural pain. The literature fails to conclusively determine any universally effective prophylactic analgesia. Cervical anaesthesia may be beneficial in some cases and oral analgesia may relieve postprocedural pain. Distraction in the form of conversation, music or television can be effective in reducing anxiety.

CONCLUSIONS

A combination of physical, psychological and environmental factors contribute to the individual's pain experience. Nurses have the potential to make a significant impact on pain outcomes by demonstrating clinical expertise and creating a trustful environment. Giving reliable information, acknowledging the significance of anxiety and providing reassurance and distraction are effective pain reducing strategies. Research into nonpharmacological approaches is warranted, especially those which reduce anxiety.

RELEVANCE TO CLINICAL PRACTICE

Increasing uptake of long-acting reversible contraception is a public health goal. Providing effective pain management strategies to improve patient experience may encourage more nurses to recommend, or enhance their scope of practice to include, intrauterine contraception insertion.


DOI: 10.1111/jocn.13751
PubMed: 28177530


Affiliations:

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<term>Dispositifs intra-utérins (effets indésirables)</term>
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<b>AIMS AND OBJECTIVES</b>
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<p>To examine factors which contribute to the individual's experience of pain in relation to intrauterine contraception insertion and determine evidence-based nursing strategies to best assess and manage this pain.</p>
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<div type="abstract" xml:lang="en">
<p>
<b>BACKGROUND</b>
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<p>Nurses are increasingly involved in consultations regarding intrauterine contraception. However, concerns regarding painful or difficult insertion may inhibit uptake and discourage nurses from promoting or inserting intrauterine contraception.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>DESIGN</b>
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<p>Integrative review.</p>
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<div type="abstract" xml:lang="en">
<p>
<b>METHODS</b>
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<p>Database searches of CINAHL, PubMed, Wiley Online Library and the Cochrane Collaboration for relevant literature. Eight papers met the inclusion criteria and were analysed using an integrative review process.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>RESULTS</b>
</p>
<p>Physical causes and pharmacological interventions for insertion pain have been thoroughly investigated. Absence of previous vaginal delivery and anxiety may increase the likelihood of procedural pain. The literature fails to conclusively determine any universally effective prophylactic analgesia. Cervical anaesthesia may be beneficial in some cases and oral analgesia may relieve postprocedural pain. Distraction in the form of conversation, music or television can be effective in reducing anxiety.</p>
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<p>A combination of physical, psychological and environmental factors contribute to the individual's pain experience. Nurses have the potential to make a significant impact on pain outcomes by demonstrating clinical expertise and creating a trustful environment. Giving reliable information, acknowledging the significance of anxiety and providing reassurance and distraction are effective pain reducing strategies. Research into nonpharmacological approaches is warranted, especially those which reduce anxiety.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>RELEVANCE TO CLINICAL PRACTICE</b>
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<p>Increasing uptake of long-acting reversible contraception is a public health goal. Providing effective pain management strategies to improve patient experience may encourage more nurses to recommend, or enhance their scope of practice to include, intrauterine contraception insertion.</p>
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