Answer To: write assessment essay XXXXXXXXXXwords use the subheading to address the assessment objectives. 1....
Sahiba answered on Jul 15 2022
Article: Improving the patient’s experience of a bone marrow biopsy - an RCT
(1) Problem and Research Question
Problem: In modern health care, cancer pain or postoperative pain. Brown and Fanurik (1996) say procedural discomfort. Craig (1993) says anxiety, anticipation, and emotional distress are the worst effects of pain. It is troublesome for bone marrow biopsies. Any unpleasant intervention should cause the patient little suffering and worry. In many haematology centres, local anaesthesia (LA) alone for this treatment. Since many patients find bone marrow biopsy unpleasant and disturbing, pain medication may be inadequate (Johnson et al., 2008).
Research Question: The nurse may perform or support the process of bone marrow biopsy. Thus, how nursing can assess and relieve procedure discomfort? How may Nurses detect pain more sensitively and accurately than other health professionals? With a wide range of pain sensation and analgesic responses, by whom?
Potentially necessary nursing intervention is N2O/O2, which, if used effectively, could minimise patient procedural discomfort. How? Does it offer benefits over other strong analgesics, such as sedation with awareness and a stellar safety record? Can nurses instruct and supervise the need for patient monitoring with less than conscious sedation and N2O/O2 self-administration? Can N2O/short O2's half-life, which means patients spend less time in the clinic, affect cost-effectiveness? Do low medical expenses and the lack of anaesthetist insurance help with cost-effectiveness?
(2) Critical appraisal
In this double-blind, randomised, controlled trial, N2O/O2 did not often reduce bone marrow biopsy discomfort. Men who received N2O/O2 experienced mild pain compared to those who received the placebo. For women, there was no difference, though. It might have resulted from the various responses that men and women who had previously had biopsies had.
Given N2O/O2 efficacy results in other painful procedures, it is surprising that there was no overall effect in bone marrow biopsy. The scientists concluded that this may have happened since the women did not react, and those who had never had a biopsy only felt slightly uncomfortable. Men utilised more gas than women, regardless of the volume, which explains why the N2O/O2 group reported more analgesia. It may have an impact on future therapy and research. If more extensive studies confirm that men use analgesics more frequently, it would be interesting to investigate the possible causes of this increased use.
N2O/O2 will be used by women in the same ways as men in the future, thanks to research and medicinal applications. In the inhalation method utilised in the study by Fich et al. (1997), however, patients in the current trial received specific breathing instructions. Also, multiply the depth or duration of inhalations by their number. A finding of more inhalations, if verified in more careful research, would suggest that the variance in consumption among genders was a matter of frequency rather than style, even though the study couldn't address these latter elements. It may only take giving women participants explicit instructions to increase the number of times they inhale for them to get an excellent therapeutic response and allow for further research.
Perneger (1998) claims that we failed to consider various test results. The higher efficacy in men could be a type I error from numerous testing. Without a doubt, doing so would have resulted in an insignificant outcome—however, such an interpretation for two reasons. First, given the stark disparity between male and female scores, we postulated that the women's modest responses were to blame for the group's overall lack of response. Men's answers match the research on how people react to N2O/O2 in procedural pain. The N2O/O2 and placebo groups' mean pain score difference was second-largest. Despite these limitations, replication research may be beneficial.
Curnow et al. 2003 found that previous biopsies increased pain perception regardless of gas dosage. The patients in the recent study presumably had unfavourable expectations about their painful experiences, which enhanced their pain experience even if reports of pain intensity from biopsy varied. Many pain experience models consider this anticipated function in pain modulation. According to the fear-avoidance theory of pain proposed by Lethem et al. in 1983, if experts predict pain based on recent unfavourable occurrences, they would experience more pain during subsequent painful episodes. This discovery may help determine the patients' pain thresholds and select the most effective medications.
(3) CASP checklist and appraisal summary
Bone marrow biopsies are necessary for several haematological disorders. People report experiencing discomfort throughout therapy, despite the LA. N2O/O2 is an excellent substitute for LA to manage pain during invasive diagnostic procedures like sigmoidoscopy. RCT, double-blind, randomly assigned N2O/O2 or oxygen in addition to LA to 48 patients who needed a bone marrow biopsy. N2O/O2 significantly reduced pain for males but not for women, according to participant ratings and comments on the experiment. Independent of gas, previous biopsies made all patients more uncomfortable. Neither group saw significant side effects. More research on the safe, efficient, and simple-to-use analgesic N2O/O2 for painful diagnostic (and other) procedures.
(4) Application - outcome & methodological rigour
Due to these advantages for both nurses and patients, N2O/O2 may be recommended for routine use as a...