Introduction
Pain during chemotherapy in elderly patients with cancer is one of the most important health issues people with the given problem and health workers face today. Traditional pharmacological therapy can help to alleviate pain and assist individuals in their recovery and coping. However, there are many side effects resulting in patients’ claims about this method. For this reason, there is an attempt to use alternative methods of pain management.
The pivotal aim of the given study is to determine the effectiveness of combining unconventional methods such as acupuncture with pharmacological ones. Regarding the given purpose, the implementation of acupuncture combined with medications can be considered an independent variable as it is controlled by the researcher and affects patients’ states. At the same time, participants’ level of comfort and outcomes can be considered dependent variables that should be researched.
To improve the understanding of the investigation, the following concepts should be defined.
Pancreatic cancer – a type of cancer in which cancerous cells from the tissues of the pancreas (Adams, 2016).
Acupuncture – a form of treatment that presupposes inserting thin needles through the skin at specific points of the body to achieve a particular effect (Weidong & Rosenthal, 2013)
Thus, regarding the formulated purpose, the following PICOT question is introduced:
In patients from 60 to 80 years old suffering from pancreatic cancer, does the use of alternative methods of pain management like acupuncture together with pain medication, compared with medication for pain management only reduce pain intensity improving patient comfort during chemotherapy over six months?
Theoretical Framework
The paper utilizes the theoretical framework created by Kolcaba’s Theory of Comfort. It presupposes that the concept of comfort regarding patients’ health is critical and it is fundamental to assess, measure, and evaluate it (Kolcaba’s Theory of Comfort, n.d.). At the same time, not only individuals’ recovery should be promoted, but also their relief and improved feeling (Kolcaba’s Theory of Comfort, n.d.).
This theory correlates with the assumptions provided in the paper as the use of alternative ways of treatment can be considered an effective approach in situations when traditional methods turn out to be ineffective or result in the emergence of multiple side effects without any relief. The idea becomes topical today regarding the growing number of claims about the negative impact of opiates on the state of individuals’ health and their ability to alleviate pain for long periods of time and improve the quality of life (Adams, 2016). The given framework emphasizes such concepts as alternative methods of pain alleviation and management, and combined treatment to achieve better results.
The given notions should be given special attention regarding the project and evaluated to ensure a comprehensive understanding of all advantages and disadvantages of the concept. At the same time, the topicality of these concepts for the modern healthcare sector and the growing number of patients with various types of cancer precondition the choice of the given framework for the investigation and its utilization. It is critical to find safe and effective interventions that can help patients to manage pain during chemotherapy sessions and improve the quality of their lives.
Review of the Literature
The relevant research literature is also focused on the investigation of opportunities for the alternative methods of treatment used to alleviate pain in cancer patients. For instance, Trang, Al-Hasani, Salvemini, Salter, Gutstein, and Cahill (2015) also admit the existence of numerous problems associated with the prolonged use of opioids by patients with cancer. Their complex states affected by the severe disease become even worse because of the emergence of side effects such as analgesic tolerance (diminished pain-relieving effects), hyperalgesia (increased pain sensitivity), and drug dependence (Trang et al., 2015). It means that there is a need for an alternative approach.
For this reason, today there is a focus on the in-depth investigation of alternative therapies as an appropriate option for cancer patients. Reviewing the overall effectiveness of different kinds of unconventional approaches, Singh and Chaturavedi (2015) outline their ability to assist patients in the improvement of the quality of their lives by affecting the physical, psychosocial, social, and spiritual dimensions of individuals.
For this reason, the given approach can become a promising practice that will help to minimize the negative effect of opiates. This idea is supported by Lahoud, Kourie, Antoun, Osta, and & Ghosn (2016) stating that pancreatic cancer is one of the most painful types and every oncologist faces a significant dilemma while trying to select the most appropriate pain management approach.
Under these conditions, the use of acupuncture as a possible supplementary treatment can become an effective measure. Weidong and Rosenthal (2013) present the relevant evidence proving the effectiveness of the given approach in some cases. At the same time, they represent successful and appropriate protocols that can be used to achieve success and improve the state of a patient. In such a way, there is solid research support to the investigated idea.
Methodology
The purpose of the research and the character of the investigated problem precondition the choice of a particular methodology that can help to collect the needed information and make certain conclusions. The qualitative study approach is selected as there is a focus on patients’ experiences regarding the success of pain management and improvement of the quality of life (Creswell & Creswell, 2018).
The following design is suggested. It presupposes the creation of the two groups of patients who have the needed type of cancer. The first one will be provided with the traditional treatment implying the use of opiates or other painkillers to manage pain and improve the quality of life. The second group is suggested a new combined approach including acupuncture and traditional treatments to alleviate unpleasant feelings.
The existence of two groups will help to acquire data about the usual and alternative ways of treatment and compare them to determine effectiveness (Creswell & Creswell, 2018). Nurses should be trained to use acupuncture at the special courses before the study as only certified specialists have the right to do it. Every time a patient receives chemotherapy, he should also be provided with the supplementary alternative treatment to trace alterations in his/her state. After the planned intervention, the patients will report their states and success of measures via the surveys and specific self-assessment grids that will help to outline the efficiency of the method.
The selection of the given approach is preconditioned by the fact that it contributes to the improved data collection and comparison of the utilized interventions. As it has already been stated, the formation of two groups helps to monitor the situation regarding the traditional and alternative treatments. At the same time, self-reports can be considered an effective data collection tool as pain is a subjective feeling and patients should describe it on their own.
There is a specific sampling procedure that is needed to select participants of the study. The non-probability, purposive sampling approach is utilized to achieve the goal. Only individuals aged 60 to 80 years with pancreatic cancer will be included in the groups.
However, there is also a particular exclusion and inclusion criteria. Regarding the fact that there are various types of pancreatic cancer characterized by different levels of pain, only individuals with adenocarcinoma as one of the most common types of exocrine tumors will be included (Adams, 2016). It will help to acquire more credible and relevant results while comparing the effects of treatments. All participants should give informed consent to take part in the study and provide their personal data that will be collected via the specific survey. Standardized consent form suggested by WHO will be offered to participants. The anonymity of data is guaranteed to all participants.
Data Analysis
Data analysis methods should help to evaluate the information provided by the participants and make a credible conclusion. Thus, the level of pain will be analyzed using a 10-point scale that provides a patient with enough flexibility and options to describe his/her current state. All surveys provided by the participants will be assessed to compare the impact traditionally, and alternative approaches have on pain management. That is why data from different groups will be processed separately and then discussed.
To display findings, a set of diagrams can be created. The first one will demonstrate the level of pains after the pharmaceutical approach, the second one describes pain levels after the utilization of acupuncture treatment, and the third combined diagram will possess data from two groups to compare findings and figure out the most effective measure regarding the given sample and its peculiarities. This data method will also help to increase the credibility of findings, their relevance, and their applicability to the modern healthcare sector and the sphere of nursing.
Applicability to Nursing
Altogether, the given research touches upon the problem that is topical for modern nursing. The fact is that every year new patients with cancer emerge. They experience high levels of pain that should be mitigated to improve the quality of their lives and attain appropriate results. In such a way, the enhanced understanding of the use of alternative treatments will help to expand nursing knowledge and assist nurses in becoming more effective while delivering care to this category of patients and trying to improve their states.
The research can also be beneficial to nurse practitioners, clinical nurse specialists, and oncology nurses as they acquire an opportunity to apply the information from the paper to real-life cases. In such a way, the project becomes an important source of knowledge about the current peculiarities of pancreatic cancer and pain management in patients who have it. It could also be utilized by other researchers as the basis for future investigations delving into a similar issue and trying to find the most effective way of pain alleviation in patients during chemotherapy.
References
Adams, S. (2016). The indispensable guide to pancreatic cancer. New York, NY: CreateSpace Independent Publishing Platform.
Creswell, J., & Creswell, D. (2018). Research design: Qualitative, quantitative, and mixed methods approaches (5th ed.). Thousand Oaks, CA: SAGE Publications.
Kolcaba’s Theory of Comfort. (n.d.). Web.
Lahoud, M., Kourie, H., Antoun, J., Osta, L., & Ghosn, M. (2016). Road map for pain management in pancreatic cancer: A review. World Journal of Gastrointestinal Oncology, 8(8), 599-606. Web.
Singh, P., & Chaturavedi, A. (2015). Complementary and alternative medicine in cancer pain management: A systematic review. Indian Journal of Palliative Care, 21(1), 105-115. Web.
Trang, T., Al-Hasani, R., Salvemini, D., Salter, M., Gutstein, H., & Cahill, C. (2015). Pain and poppies: The good, the bad, and the ugly of opioid analgesics. The Journal of Neuroscience, 35(41), 13879-13888. Web.
Weidong, L., & Rosenthal, D. (2013). Acupuncture for cancer pain and related symptoms. Current Pain and Headache Reports, 17(3), 321. Web.
WHO. (n.d.). Informed consent form templates. Web.