Effects of Nurse-Led Pain Management Interventions for Patients with Total Knee/Hip Replacement

Background: A literature review was conducted to assess nurse-led nonpharmacologic pain management interventions intended for total knee/hip replacement patients. Design: This was a systematic review and meta-analysis. Data Sources: The PubMed, Embase, CINAHL, and Cochrane Library databases were searched to identify relevant studies. Review Methods: The systematic review was conducted based on the Cochrane Handbook for Systematic Reviews of Interventions and all Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) reporting guidelines. Two reviewers independently selected the studies and appraised their quality. Thereafter, the effects of all described nurse-led nonpharmacologic pain management interventions were estimated regarding pain, anxiety, and satisfaction through a meta-analysis. Results: In total, 219 relevant studies were found through a search. Finally, 23 studies were selected for review, with 17 included in the meta-analysis. Nurse-led nonpharmacologic pain management was effective for pain relief (effect size, −0.22; 95% confidence interval [CI], −0.42 to −0.02), and educational interventions were especially effective (effect size, −0.36; 95% CI, −0.69 to −0.03). Although interventions reduced anxiety and improved satisfaction, these results were not statistically significant based on the analysis. Conclusion: Our findings support that nurse-led nonpharmacologic pain management interventions could help reduce pain in patients with total knee/hip replacement by supplementing pharmacologic pain management. Implications for Nursing: Nurse-led nonpharmacologic pain interventions should be considered to reduce patient pain with total knee/hip replacement.