NRSG 313 Unit 4 – Individual Project

The need to get the best outcomes from the treatment options has led to an exploration of various treatment strategies. Increasingly over the years, less authentic approaches have been explored with a major focus on improving patient outcomes. The implication is that in recent years, more patients have opted for alternative treatments, which they either use alone or in combination with various conventional treatment approaches (Kemppainen et al.,2019). For example, many alternative approaches are currently being used to manage conditions such as chronic conditions. Therefore, it is key for nurses to understand the types of complementary and alternative medicine options available to patients so that they be in a position to appropriately advise patients and make necessary recommendations for better patient outcomes (Lindquist et al.,2018). Therefore, the purpose of this paper is to select an alternative therapy for a patient with various chronic conditions and perform a literature review of articles that support the therapy.

The Selected Therapy

Various mind-body techniques have gained prominence in recent times due to their usefulness in helping patients manage various conditions. Therefore, the chosen approach for this case study is yoga (Zhu et al.,2020). The patient has various comorbid conditions, which indicates that a single treatment approach may not be sufficient to give him better health. However, yoga as an alternative therapy offers several benefits to a patient such as Yakisoma, a fifty-five-year-old patient of Asian origin. The yoga approach entails the integration of physical exercise with mental focus. During such sessions, patients are taught relaxation, self-care, self-awareness, and good posture.

The Condition the Patient Could Use the Therapy For and What Research Says About the Therapy

Yakisoma has various chronic conditions, including depression, BHP, dyslipidemia, diabetes mellitus, and chronic lower back pain. While the patient may use yoga to help in the treatment and management of these chronic conditions, the condition that could most benefit from the use of yoga is chronic lower back pain. Therefore, the condition of the patient which could be managed using yoga is chronic lower back pain (Neyaz et al.,2019). Chronic lower back pain can be described as a patient that persists for at least three months. The condition has been shown to affect individuals of all ages.

Yoga is an ancient practice that started in India thousands of years ago (Patel, 2020). In its original form, yoga was made of various components such as meditation, relaxation and breathing techniques, and physical posture. Over the years, a biopsychosocial approach has been widely used as a gold standard for the management and treatment of conditions such as chronic pain.

What the Three Studies Are About

The negative impacts of chronic lower back pain have led to efforts from various stakeholders to come up with various strategies for treating and managing the condition. One of the approaches which has gained much attention in recent times is the use of yoga. As such, this section explores three studies that report the effectiveness of yoga in the treatment and management of chronic lower back pain. In one of the recent studies, Patil et al.(2018) conducted a study to determine the impact of yoga in comparison to normal physical exercise on the quality of life among nurses with chronic low back pain. According to this study, chronic low back pain is the most common musculoskeletal disorder among the nursing population, and up to 86% of the nurses end up suffering from some form of back pain in their lifetime. Therefore, this study was majorly about comparing the efficacy of yoga and normal physical exercise in reducing the impact of chronic low back pain.

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Another recent study on yoga was conducted by Colgrove et al. (2019). This study was conducted with the major aim of exploring the feasibility of offering yoga as an intervention for chronic lower back pain among the underserved population. According to these authors, chronic low back pain is the most common cause of chronic pain in the US, and therefore, a lot of money, as high as one hundred billion dollars, is spent every year to help manage it. In addition, individuals usually look for medical intervention, including pharmacological treatments, surgery, and rehabilitation, with the hope of getting better, but they still undergo such chronic pains. As such, this study was about exploring the effectiveness of yoga in controlling such pains.

The third study on the use of yoga for chronic pain was conducted by Anheyer et al.(2022). This was a systematic review with a meta-analysis conducted with the major aim of exploring the use of yoga in treating chronic low back pain. According to these researchers, low back pain is a major concern in the public health domain as it has a prevalence of 75%. In addition, the prevalence has steadily increased, with the last decade seeing an increase of 17% prevalence. The condition is also known to the among the leading causes of disability globally. The authors also indicated that the majority of individuals experiencing chronic low back pain, especially in the US, have opted for alternative treatment and management approaches such as the use of yoga.

How Each of the Studies Was Conducted

As discussed earlier, chronic lower back pain has various negative impacts on individuals’ lives; therefore, studies have been conducted to explore more impactful options for treatment and management. The authors of the studies discussed in the previous section used various methods to conduct the studies. Therefore, this section looks into how each of the studies was conducted. Patil et al.(2018) was a randomized controlled trial conducted among the nursing population. Those who were targeted were individual nurses who had been diagnosed to be having chronic low back pain. The participants were drawn from a tertiary care teaching hospital in India. A total of 88 individuals were recruited to take part in the study, where forty-four were randomly assigned to the yoga group while the remaining half were randomized into the physical exercise group. The researchers followed the randomized controlled single-blind design with individuals in both groups getting a six-weeks intervention.

The study conducted by Colgrove et al. (2019) was a quasi-experimental study within-subject wait-listed crossover design. The study was designed to include low-income participants who were offered a chance to get yoga for twelve weeks after six to twelve weeks of no intervention. The study subjects were recruited from the family clinic after fulfilling various inclusion criteria. The inclusion criteria used were a history of at least three months of chronic low back pain, having a pain intensity of at least three on a scale of zero to ten, and a minimum disability. The researchers measured the outcomes taken at baseline before commencing the intervention and post-intervention. This study explored various findings such as flexibility, core strength, disability, and pain and how the use of yoga would influence these outcomes.

The other study conducted by Anheyer et al.(2022) was a systematic review with a meta-analysis of the efficacy of using yoga for pain treatment and management. The researchers conducted the review following the PRISMA guidelines for meta-analysis and systematic reviews, as well as the Cochrane recommendations. The researchers used electronic databases such as Scopus, Cochrane Library, and Medline alongside the Who International Clinical Trials Registry Platform and ClinicalTrials.gov. Various inclusion and exclusion criteria were used to obtain relevant articles, which were then used for review and meta-analysis.

The Results of the Three Studies

The three studies conducted on the use of yoga for chronic low back chronic pain management and treatment reported important findings which can be key to effective treatment and management of the condition. The study by Patil et al.(2018) focused on exploring the impact of yoga and physical exercise on the quality of life of nurses with chronic low back pain. Following a data analysis by independent-sample t-test and paired sample-t-tests, the analysis revealed that following the use of the intervention, a significant improvement was observed. For example, both groups experienced positive improvements in the social, psychological, and physical domains. However, more enhanced improvement was observed among patients who were using yoga. The implication is that the use of yoga led to more significantly reduced pain as compared to the use of physical exercise.

The study accomplished by Colgrove et al. (2019) also revealed significant results in relation to the use of yoga among patients with chronic low back pain. This study majorly explored the use of yoga among underserved populations experiencing chronic lower back pain. A total of eight participants completed the designed intervention. Upon the use of the intervention, substantial improvements in the pain score were observed. The researchers compared pain scores measured before the intervention and after the intervention. The researchers also noted substantial improvements in the Oswestry Disability Questionnaire Scores and core muscle strength after the application of yoga. Therefore, this study supported the use of yoga in the management and treatment of chronic lower back pain.

In a systematic review and meta-analysis, Anheyer et al.(2022) also found significant results which can be key in the treatment and management of chronic lower back pain. For example, an analysis of the randomized controlled trials revealed that the use of yoga as compared to passive control led to a significant improvement in pain intensity, implying that yoga was associated with better pain-related outcomes. The use of yoga was also connected to better physical function as compared to passive control, which entailed usual care.

Explanation to the Nurse Practitioner How She Can the Study for the Patient Case

The reviewed articles can be used effectively by the nurse practitioner to improve the patient’s condition. Even though other approaches can be used in managing the remaining chronic conditions, the NP can use yoga to help manage the pain. For example, the research done by Colgrove et al. (2019) outlined twelve sessions of yoga which can be applicable to this patient’s case. The NP can, therefore, use the twelve sessions to help the patient manage the pain better and have a better quality of health and outcomes. In addition, the patient already fits the inclusion criteria; a history of at least three months of chronic low back pain, having a pain intensity of at least three on a scale of zero to ten. Therefore, the patient used the intervention successfully to help with the chronic lower back pain.

Conclusion

The patient, in this case study, has various conditions all occurring at the same time, hence needing appropriate treatment and management. While pharmacological approaches can be key and effective, the patient has indicated that he prefers alternative approaches. As such, yoga as an alternative approach has been proposed to help in the management of chronic lower back pain for better outcomes.

NRSG 313 Unit 4 – Individual Project References

Anheyer, D., Haller, H., Lauche, R., Dobos, G., & Cramer, H. (2022). Yoga for treating low back pain: a systematic review and meta-analysis. Pain, 163(4), e504-e517. http://dx.doi.org/10.1097/j.pain.0000000000002416

Colgrove, Y. M., Gravino-Dunn, N. S., Dinyer, S. C., Sis, E. A., Heier, A. C., & Sharma, N. K. (2019). Physical and physiological effects of yoga for an underserved population with chronic low back pain. International Journal of Yoga, 12(3), 252. https://doi.org/10.4103%2Fijoy.IJOY_78_18

Kemppainen, L. M., Kemppainen, T. T., Reippainen, J. A., Salmenniemi, S. T., & Vuolanto, P. H. (2018). Use of complementary and alternative medicine in Europe: Health-related and sociodemographic determinants. Scandinavian Journal of Public Health, 46(4), 448-455.

Lindquist, R., Tracy, M. F., & Snyder, M. (Eds.). (2018). Complementary and alternative therapies in nursing. Springer Publishing Company.

Patel, B. Z. (2020). Yoga as a present and future in India. International Journal of Health, Physical Education & Computer Science in Sports, 37(1), 72.

Neyaz, O., Sumila, L., Nanda, S., & Wadhwa, S. (2019). Effectiveness of hatha yoga versus conventional therapeutic exercises for chronic nonspecific low-back pain. The Journal of Alternative and Complementary Medicine, 25(9), 938–945. https://doi.org/10.1089/acm.2019.0140

Patil, N. J., Nagaratna, R., Tekur, P., Manohar, P. V., Bhargav, H., & Patil, D. (2018). A randomized trial comparing effect of yoga and exercises on quality of life among nursing population with chronic low back pain. International Journal of Yoga, 11(3), 208.

Zhu, F., Zhang, M., Wang, D., Hong, Q., Zeng, C., & Chen, W. (2020). Yoga compared to non-exercise or physical therapy exercise on pain, disability, and quality of life for patients with chronic low back pain: A systematic review and meta-analysis of randomized controlled trials. PloS One, 15(9), e0238544. https://doi.org/10.1371/journal.pone.0238544

Assignment Details

Assignment Description

Introduction

More and more patients want options for alternative treatments that can be used alone or in conjunction with conventional treatments. Patients with chronic conditions will often seek out some form of complementary and alternative medicine (CAM). It is important that nurses have an understanding of the types of CAM so that they can make recommendations and safely advise their patients.

Case Study

Mr. Yakisoma is a 55-year-old Asian male with numerous chronic illnesses, including the following:

Chronic lower back pain
Diabetes mellitus
Hypertension
Dyslipidemia
BHP
Depression
He takes the following prescription medications for his conditions:

Tramadol: 100 mg Q 4â€“5 hrs.
Lisinopril: 40 mg DQ
Hydrochlorothiazide (HCTZ): 25 mg QD
Metformin: XR 2 G day
Sitagliptin: 100 mg DQ
Simvastatin: 40 mg HS
Sertraline: 50 mg QD
ASA EC: 81 mg QD
Other important information about Mr. Yakisoma is as follows:

His vital signs in the clinic today are as follows:
145/90
P-75
R-20
O2 Sat 98% on RA
He rates his lower back pain an 8/10, saying â€œIt always hurts; I canâ€t even play with my grandkids.â€
He reports that he does not sleep well at night.
He says, “I cannot exercise because my back hurts too much.â€
His diabetes is not well-controlled.
His A1C is currently at 8.0.
His cholesterol is not controlled, with the following lipid values:
Total cholesterol: 235 mg/dl
LDL: 110 mg/dl
HDL: 30 mg/dl
Trig: 450 mg/dl
He reports that he is often depressed about how many illnesses he has and how many medications he has to take, and says, â€œI just want to enjoy my life again, decrease my pain, and be active.â€
You are working with a nurse practitioner in a busy primary care clinic. The nurse practitioner has only 20 minutes to spend with Mr. Yakisoma. She knows that you are studying complementary and alternative medicine (CAM) and asks you to give some recommendations for CAM that would be safe and therapeutic for this patient. Mr. Yakisoma has a strong interest in alternative treatments. He says, â€œI donâ€t want to take all of those prescription medications, and they are bad for you!â€

Mr. Yakisoma, the case study patient, has multiple chronic diseases, including pain. Your first task is to identify 1 mindâ€“body technique (e.g., yoga, meditation, hypnotherapy, guided imagery, dreamwork, intuition, music therapy, biofeedback, or animal-assistive therapy) that could be applied to this patient’s case. Conduct a literature review, and use evidence-based research to support or refute the recommended CAM treatment. You should utilize at least 3 research articles to support your assertions about the type of mindâ€“body technique that you choose.

You should review each of the 3 research articles and present the following in a document of 4â€“6 pages, excluding title page and reference page:

State the therapy you selected.
State what condition the case study patient could use this for.
Report what the research has to say on this therapy.
Report what each of the 3 studies was about.
State how each of the 3 studies was conducted.
What were the results of each of the 3 studies?
Explain to the nurse practitioner how she can use this study for this patient’s case.
Ensure that your document includes the following:

The target audience is the nurse practitioner, so higher level thought should be included in this document.
The introduction should include a list of your objectives.
You should select 1 mind-body techniques to investigate and present in this document.
You should outline recommendations for the use of 1 mind-body technique for the case study patient based upon his chronic conditions.
There should also be a conclusion section that reviews the key points.
In-text citations should be used.
There should be a reference page in proper APA format.
Submit a paper of 4â€“6 pages, excluding the title and reference pages, following the APA Expectations document for the College of Nursing.

Please click on this APA Style for CTU Students link for help with APA formatting. Use the CTU Writing Style Guide (templates provided)â€”not the Introductory Writing Style Guide.

NRSG 313 Unit 4 – Individual Project Rubric

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