Outcome data will be analyzed using intention to treat analysis to account for any subjects that drop out during the course of study. Outcome measures of pain using NRS-11 and jaw ROM using the TheraBite ROM Scale will be assessed at baseline, immediately after the 2-week intervention, and at 2 week, 4 week, 6 week, and 8 week follow up periods. Although NRS-11 pain measures are technically classified as ordinal measures, most studies using NRS-11 as an outcome measure utilize parametric tests and consider the measures as interval or ratio data rather than ordinal measures.27 Therefore, assuming homogenous variance and a normal distribution, a parametric 2-tailed mixed-ANCOVA will be used as the primary statistical analysis. Prior to …show more content…
The ANCOVA will control for initial pretest differences by equating the two groups based on covariate scores and adjusting the posttest scores of pain and ROM appropriately. Once these posttest scores are determined, the adjusted posttest scores will be analyzed to see if there was a difference between groups. A significance level of α = 0.05 will be chosen to minimize the chance of a Type I error.
If a significant difference is found, Tukey’s test will be run as a post hoc test to see at which period in time the significant difference occurred. If data is not found to be normal or the variance is not homogenous, then a nonparametric 2-tailed Friedman’s ANOVA by ranks and a 2-tailed Kruskal-Wallis ANOVA by ranks will be run instead with the same significance level.
Sample size is estimated a priori based on a previous study analyzing the short-term effects of hypnosis on oral function and pain in subjects with TMD.33 Pain is chosen as the priority primary outcome measure in comparison to the other primary outcome measure, jaw ROM, as many TMD patients struggle with chronic pain, which diminishes their quality of life. Therefore, the posttest NRS-11 mean pain scores and standard deviations for the control (X1=3.9 and s1=1.5) and hypnosis group (X2=2.9 and s2=2.4)33 were utilized to first calculate effect size, d (Equation A.1). Because the standard deviations, s, were different between the two groups,
2. One of the important factors that you need to establish is how much pain the person is feeling. This can be difficult as we all have different pain levels. Several methods have been developed to measure pain but the most common one is to ask the person to describe it on a scale 1 to 10, with 1 being the mildest to 10 being the worst pain they have ever felt. It is about individual experience and you need to react to the level at which that person describes their pain as one persons pain thresholds may be different to another.
The ratings for this scale vary from no pain, a zero, to the worst pain one could possibly endure, a ten ('Misha' Backonja & Farrar, 2015). This type of tool used for measuring pain is considered a self-assessment. Meaning, the individual rates his/her pain on the provided scale. All individuals who have received medical treatment, whether for a serious injury or a yearly physical, has been asked, “What would you rate your pain today, on a scale of one to ten?”. This pain assessment tool is considered a fully ordered variable due to the individual having a wide range to rate his/her
Three different measurements were taken before and after the study. They included, pain intensity, disability, and quality of life. Pain was taken using a visual analog scale (VAS) which ranges from 0 to 10; 0 equaling no pain at all and 10 equaling the worst pain ever felt. Disability was taken using the Neck Disability Index (NDI). The NDI consisted of 10 items and were scored using percentages, the higher the percentage the higher the disability. And lastly, quality of life was taken using the Medical Outcome Study Short-Form 36 Health Survey (SF-36). Scores in SF-36 ranged from 0 to 100 and the higher the patients number got, the better quality of life.
In order to establish a treatment, plan it is important to set goals for this patient. In general goals for RA include early recognition and diagnosis, referral to a rheumatologist, and tight control and low disease activity (Cohen & Cannella, 2017). There are also scales that need to be completed by the NP and patient to determine how the treatment is working for a patient. When setting goals, it is important to determine a successful way to evaluate this patients' pain. In the older population it is common for pain to be under treated and part of the cause of this is because the assessment for pain is not matching the patients' needs. Once a successful evaluation has been chosen for this pain it would be important to use this same
Hypnosis can be defined as a form of highly focused concentration with relative suspension perplexed awareness used to lessen pain experience. (King.B, 2001) It can also be used alongside analgesics such as morphine. (Bamford.C, 2006) This paper will be discussing the effectiveness of its use to manage pain and related areas based on the benefits and limitations highlighted by various methodologies. These methodologies include decade long observations of case studies, testing on amputees and cancer patients whilst comparing use of pharmacological medicines to use of hypnosis itself. Some of the advantages of hypnosis include how it increases self efficacy by actively allowing patient to control pain symptoms, (Williamson.A, 2004)
The Pain Assessment Survey was developed to assess whether registered nurses are using evidence-based standards to assess and manage pain for special populations. Descriptive statistics were used in this study. The sample group surveyed included registered nurses currently enrolled in an on-line Baccalaureate program. A quasi-non-experimental study was utilized to allow the collection of a large amount of data at one time, while allowing the researches to compare and contrast the use of evidence based practice standards when preventing medication errors. This study contained both dependent and independent variables. The independent variable present is the use of evidence-based practice standards in the assessment of pain in special populations. The dependent variable is the management of pain in special populations of different cultures and chronic pain syndromes. The researchers concluded that out of the 50 participants of the survey, the majority use the verbal pain scale. The researchers concluded that registered nurses are using evidence-based standards of practice when assessing pain in special populations such as those with different cultural backgrounds and those with chronic pain
The t score that represents the greatest relative difference between pretest and 3 months is t = 4.14. The results of the analyses indicate that this is a statistically significant result, with p < .05.
The strength of this recommendation is inconclusive. As practitioners, we should have minimum restraint in following this recommendation and should be on the lookout for new evidence in addition to strongly listening to patient preference. This recommendation is based upon three RCT’s. Two of these studies were of high strength and one was of moderate strength with regard to quality. All three of these studies had moderate applicability. In these studies, pain improvement was not consistently statistical significant (MD = .81, 95% CI -1.76, .14; MD = 2.26, p<.001; MD = -.82, 95% CI -1.247, -.39), and neither was function (MD = 3, 95% CI -1.05, 7.05; MD = 6.54, p=.001). In addition, the authors concluded the clinical significance of these findings were
Validity: Overall the study is valid but limited as the study examined individual patients as a single case making the ability to generalize limited. The foremost dilemma with the study is the challenge in determining the difference in scores that correspond directly to a clinically important modification. The ability of the VAS to detect significant changes relies heavily on an established baseline as a standard to compare future data. Throughout the duration of the study, patients were asked frequently to complete the VAS and RMQ, this may possibly lead to learning effects which may impact the results of the pain and functional status
when pain scores were greater than 5 on a 0-10 pain scale scoring system. In addition to
Joint Pain: A Prospective Cohort Study in the General Population. The Journal of Pain Official
One-way analysis of variance (ANOVA) by a Tukey’s post hoc test was performed to compare the various treatments. All pictures were processed using PS CS6 software. P<0.05 was treat as significant in all tests.
| Based on explicit knowledge and this can be easy and fast to capture and analyse.Results can be generalised to larger populationsCan be repeated – therefore good test re-test reliability and validityStatistical analyses and interpretation are
The Shapiro-Wilk statistical test is used to assess the normal distribution of the pain intensity before conducting subsequent statistical tests. Data analysis is performed using mixed models with two-sided, with a type I error set as .05. Concerning the primary objective, the comparison between randomized groups will be performed using ANOVA with a baseline score as a covariate. The correlation between baseline and follow-up scores is also calculated (Vickers, 2001). In the secondary analysis, chi-square is carried out to express the frequencies of adverse effects and response rate. Also, A paired student test is suggested to evaluate the pain reduction within the two groups. Sensitivity analysis will be proposed to assess the robustness of the data based on the pattern-mixture and selection
Assess the location, characteristics, onset, duration, frequency and severity of pain to collect the baseline information for compare the effective of the treatment