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Bikmoradi A, Abdolmaleki S, Tapak L. The Effect of Telephone Consultation and Follow-up on Pain Reduction in Multiple Sclerotic Patients: a Randomized Clinical Trial. Avicenna J Nurs Midwifery Care 2020; 28 (1) :11-19
URL: http://nmj.umsha.ac.ir/article-1-1962-en.html
1- Health Economics and Management Department, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran , bikmoradi@umsha.ac.ir
2- Medical Surgical Department, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran
3- Biostatistics Department, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
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✅ Telephone counseling together with telephone follow-up reduces pain in patients with multiple sclerosis and improves patient health. Therefore, counseling with telephone follow up is recommended in reducing pain intensity of patients.
Extended Abstract:   (885 Views)
Introduction

More than 2.3 million people worldwide have multiple sclerosis (MS). The disease is the leading cause of death, disability and increased medical costs [1]. The prevalence of 61 out of every 100,000 population in Iran indicates an increase in the prevalence of this disease in the country [2].
Although the role of genetic and environmental factors (virus, cigarettes, stress, and nutrition) in the development of MS has been confirmed to some extent, its cause is still unknown.
Common symptoms of MS include a wide range of anesthesia (paraesthesia), weakness, visual disturbances, diplopia, imbalance, gait disorders, dizziness, spasm, ataxia, nystagmus, neuropathic pain, emergency urgency, urinary retention disorders, sexual dysfunction, and cognitive and disability including heat tolerance [11].
In these patients, pain is a common symptom associated with age, sex, duration of illness, and symptoms such as physical, sensory-motor, and cognitive impairment, including sleep disturbance, fatigue, depression, disability, poor quality of life, absenteeism, and impaired sleep [12]. About 50 to 60 percent of MS patients can tolerate the pain. Only about 12% of them experience severe pain and seek medical treatment [14, 13].
Multiple sclerosis pain is often chronic and occurs in the form of muscle spasms and migraine headaches associated with active inflammatory processes, and common painkillers, nonsteroidal anti-inflammatory drugs, narcotic painkillers (such as morphine), and anticonvulsants for tricuspid regurgitation and anticonvulsants [17].
Since chronic diseases such as MS affect all economic, financial, social and emotional aspects of the individual, family and society, medical treatment and control of the course of the disease alone is not enough. Psychologists are able to help them increase their ability to perform daily activities and reduce their social, psychological and economic problems [19].
One way to track distance is through information technology [21]. Peck points out that remote care reduces the costs and facilitates access to care and leads to improved communication and presentation. Also, it eliminates barriers regarding time and distance [22].
The aim of this study was to determine the effect of counseling and telephone follow-up on reducing the severity of pain in MS patients.
 

 

Materials and Methods

A randomized clinical trial was conducted on 70 MS patients attending the multiple sclerosis Clinic at Sina (Farshchian) Hospital, Hamadan, Iran. A two-month intervention was administered, with phone calls organized as follows: Week 1) two calls revolving around medication schedule Week 2) two calls about a diet plan, Week 3) two calls about the exercise schedule، Week 4) two calls about the role of stress in MS; and Weeks 5 to 8) four weekly reminder calls to ensure patient compliance with the contents delivered within the first 4 weeks. Pain assessment scale was completed before and after the intervention.
The collected data were analyzed by SPSS 16 (SPSS Inc., Chicago, IL., USA), descriptive statistics (mean and standard deviation) and inferential statistics (paired t-test, independent t-test, Chi-square, regression analysis and Fisher test) at a confidence level of 0.95.
Also, this research was approved by the ethics code of IR.UMSHA.REC.1396.183 in the ethics committee of Hamadan University of Medical Sciences.


 

Results

The mean of pain severity in the experimental group before and after the consultation with telephone follow up was statistically significant (P=0/001). The mean of pain severity in the experimental group after the intervention was reduced to 4.32 with a standard deviation of 0.17. However, the mean and standard deviation of pain in the experimental group also showed a downward trend. The comparison of the mean pain severity in the two groups after the intervention showed a significant difference (P<0.001). The results are illustrated in Tables 1 and 2.
 
Table 1. Frequency distribution of patients referring tp Multiple Sclerosis Clinic Farshchian Sina Hospital Hamadan; Two groups of test and control according to demographic and disease characteristics
 

P-value Control Test Variable
% N % N
 
P=0.029
20
31.4
48.6
7
11
17
22.9
45.8
34.3
8
13
12
20-30
40-31
50-41
Age (year)
P=0.337 60
40
21
14
48.6
51.4
17
18
Female
Male
 
Sex
P=0.999 25.7
74.3
9
26
25.7
74.3
9
26
Single
Married
 
Marital status
P=0.028 45.7
14.6
11.4
28.6
16
5
4
10
42.9
34.3
14.3
8.5
15
12
5
3
Housewife
Employee
Student
Freelancer
 
Occupation
P=0.01 28.6
37.1
34.3
10
13
12
25.7
40
34.3
9
14
12
Illiterate
High-school diploma
College Degree
 
Education
P=0.378 54.3
31.4
14.3
19
11
5
40
34.3
25.7
14
12
9
Progressive-  Secondary
Recurrent -Healing
Progressive-Primary
Type of multiple sclerosis
P=0.422 17.2
45.7
37.1
6
16
13
45.7
40
14.3
16
14
5
1 to 4 years
4 to 8 years
8 to 12 years
The duration of the disease
P=0.573 34.3
28.6
25.8
11.4
12
10
9
4
30.4
20
37.1
11.5
11
7
13
4
Gelofen Acetaminophen
Naproxen Baclofen
Pain-killer
P=0.189 34.3
51.4
5.7
8.6
12
18
2
3
31.4
40
22.9
5.8
11
14
8
2
 
None
Once
Twice
Three times
Recurrences
P=0.324 28.6
31.4
40
10
11
14
45.7
25.7
28.6
16
9
10
Sensory
Motor
Vision
The first symptom


Table 2. Comparison of mean pain, rejuvenation, clinic, sclerosis, Farshchian Sina Hospital, Hamadan, in two groups: free and control before and after the intervention.

Groups Before intervention After intervention Paired t-test
M SD M SD
Test 5.86 0.34 4.32 0.17 P=0.001
Control 4.39 0.44 5.21 0.46 P=0.571
Independent t-test P=0.037
t=-2.122 df=0.34
*P<0.001
t=-3.81, df=68
 

Conclusion

Telephone counseling together with telephone follow-up reduces pain in patients with MS and improves patient health. Therefore, counseling with telephone follows up is recommended in reducing pain intensity of patients.

 

Acknowledgments

This article is taken from the Master's thesis in Nursing with the number 2017052734161N1 approved by the Research Council of Hamadan University of Medical Sciences and Health Services with the code of ethics IR.UMSHA.REC.1396.183. The authors thank the Research Vice Chancellor of Hamadan University of Medical Sciences, faculty members of the Hamadan Nursing Department, the staff of the Multiple Sclerosis Clinic of Farshchian (Sina) Hospital in Hamadan and the patients of Multiple Sclerosis for their cooperation and support.

 

Conflicts of Interest

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

 

Type of Study: Original Research | Subject: Nursing
Received: 2018/11/27 | Accepted: 2019/04/27 | Published: 2020/01/3

References
1. Hayes S, Kennedy C, Galvin R, Finlayson M, McGuigan C, Walsh CD, et al. Interventions for Preventing Falls in People with Multiple Sclerosis. 2017. [DOI:10.1002/14651858.CD012475] [PMCID]
2. Mazdeh M, Khazaei M, HASHEMI FN, Ghiasian M. Frequency of Multiple Sclerosis (MS) Among Relatives of MS Patients in Hamadan Society, Iran. Avicenna Journal of Neuro Psych Physiology. 2016;3(1). [DOI:10.17795/ajnpp-38613]
3. Rumah KR, Vartanian TK, Fischetti VA. Oral Multiple Sclerosis Drugs Inhibit the in Vitro Growth of Epsilon Toxin Producing Gut Bacterium, Clostridium Perfringens. Frontiers in cellular and infection microbiology. 2017 Jan 25;7:11. [DOI:10.3389/fcimb.2017.00011] [PMID] [PMCID]
4. Farma BS. Introduction to Multiple Sclerosis 1, Translation Company Bayer Farma Shrink Office. Tehran: Jalal Publication. 2010;1389.
5. Kamm CP, Uitdehaag BM, Polman CH. Multiple Sclerosis: Current Knowledge And Future Outlook. European neurology. 2014;72(3-4):132-41. [DOI:10.1159/000360528] [PMID]
6. Fricska-Nagy Z. New Data in the Epidemiology of Multiple Sclerosis in Hungary (Doctoral dissertation, szte).
7. Thompson AJ, Toosy AT, Ciccarelli O. Pharmacological Management of Symptoms in Multiple Sclerosis: Current Approaches and Future Directions. The Lancet Neurology. 2010 Dec 1;9(12):1182-99. [DOI:10.1016/S1474-4422(10)70249-0]
8. Jelinek GA, Hassed CS. Managing Multiple Sclerosis in Primary Care: Are We Forgetting Something?. Quality in Primary Care. 2009;17(1):55-61.
9. Wilsdon T, Barron A, Mitchell-Heggs A, Ginoza S. Access to Medicines for Multiple Sclerosis: Challenges and Opportunities. Report prepared for Biogen Idec. London. 2014 Feb.
10. Metz I, Weigand SD, Popescu BF, Frischer JM, Parisi JE, Guo Y, Lassmann H, Brück W, Lucchinetti CF. Pathologic Heterogeneity Persists in Early Active Multiple Sclerosis Lesions. Annals of neurology. 2014 May;75(5):728-38. [DOI:10.1002/ana.24163] [PMID] [PMCID]
11. Milo R, Miller A. Revised Diagnostic Criteria of Multiple Sclerosis. Autoimmunity reviews. 2014 Apr 1;13(4-5):518-24. [DOI:10.1016/j.autrev.2014.01.012] [PMID]
12. Heitmann H, Biberacher V, Tiemann L, Buck D, Loleit V, Selter RC, Knier B, Tölle TR, Mühlau M, Berthele A, Hemmer B. Prevalence of Neuropathic Pain in Early Multiple Sclerosis. Multiple Sclerosis Journal. 2016 Aug;22(9):1224-30.Day MA, 13. [DOI:10.1177/1352458515613643] [PMID]
13. Ehde DM, Ward LC, Hartoonian N, Alschuler KN, Turner AP, Kraft GH, Jensen MP. An Empirical Investigation of a Biopsychosocial Model of Pain in Multiple Sclerosis. The Clinical journal of pain. 2016 Feb 1;32(2):155-63. [DOI:10.1097/AJP.0000000000000240] [PMID]
14. Fritz NE, Roy S, Keller J, Prince J, Calabresi PA, Zackowski KM. Pain, Cognition and Quality of Life Associate with Structural Measures of Brain Volume Loss in Multiple Sclerosis. NeuroRehabilitation. 2016 Jan 1;39(4):535-44. [DOI:10.3233/NRE-161384] [PMID] [PMCID]
15. Brunner LS. Brunner & Suddarth's Textbook of Medical-Surgical Nursing. Lippincott Williams & Wilkins; 2010.
16. Martinelli Boneschi F, Colombo B, Annovazzi P, Martinelli V, Bernasconi L, Solaro C, Comi G. Lifetime and Actual Prevalence of Pain and Headache in Multiple Sclerosis. Multiple Sclerosis Journal. 2008 May;14(4):514-21. [DOI:10.1177/1352458507085551] [PMID]
17. Khan N, Smith MT. Multiple Sclerosis-Induced Neuropathic Pain: Pharmacological Management and Pathophysiological Insights from Rodent EAE Models. Inflammopharmacology. 2014 Feb 1;22(1):1-22. [DOI:10.1007/s10787-013-0195-3] [PMID] [PMCID]
18. Kes VB, Cengić L, Cesarik M, Tomas AJ, Zavoreo I, Matovina LZ, Corić L, Drnasin S, Demarin V. Quality of Life in Patients with Multiple Sclerosis. Acta clin croat. 2013 Mar 1;52(1):107-1.
19. Poser CM. The Diagnosis and Management of Multiple Sclerosis. Acta neurologica scandinavica. 2005 Sep;112(3):199-201. [DOI:10.1111/j.1600-0404.2005.00450.x] [PMID]
20. Schlachta-Fairchild L, Varghese SB, Deickman A, Castelli D. Telehealth and Telenursing are Live: APN Policy and Practice Implications. The journal for nurse practitioners. 2010 Feb 1;6(2):98-106. [DOI:10.1016/j.nurpra.2009.10.019]
21. Kumar S, Snooks H, editors. Telenursing. Springer Science & Business Media; 2011 Jul 9. [DOI:10.1007/978-0-85729-529-3]
22. Peck A. Changing the Face of Standard Nursing Practice Through Telehealth and Telenursing. Nursing administration quarterly. 2005 Oct 1;29(4):339-43. [DOI:10.1097/00006216-200510000-00008] [PMID]
23. Collaborative OC. Chronic Obstructive Pulmonary Disease (COPD) Evidentiary Framework. Ontario health technology assessment series. 2012;12(2):1.
24. Hsu YC, Tsai CH, Kuo YM. Telecare Services for Elderly: Predictive Factors of Continued Use Intention. The open biomedical engineering journal. 2016;10:82. [DOI:10.2174/1874120701610010082] [PMID] [PMCID]
25. Kalankesh LR, Pourasghar F, Nicholson L, Ahmadi S, Hosseini M. Effect of Telehealth Interventions on Hospitalization Indicators: A Systematic Review. Perspectives in health information management. 2016;13(Fall).
26. Akhu-Zaheya LM, Wa'ed YS. The Effect of Short Message System (SMS) Reminder on Adherence to a Healthy Diet, Medication, and Cessation of Smoking Among Adult Patients with Cardiovascular Diseases. International journal of medical informatics. 2017 Feb 1;98:65-75. [DOI:10.1016/j.ijmedinf.2016.12.003] [PMID]
27. Myles PS, Troedel S, Boquest M, Reeves M. The Pain Visual Analog Scale: Is It Linear or Nonlinear?. Anesthesia & Analgesia. 1999 Dec 1;87(6):1517. [DOI:10.1213/00000539-199912000-00038]
28. Loos MJ, Houterman S, Scheltinga MR, Roumen RM. Evaluating Postherniorrhaphy Groin Pain: Visual Analogue or Verbal Rating Scale?. Hernia. 2008 Apr 1;12(2):147-51. [DOI:10.1007/s10029-007-0301-9] [PMID]
29. Mendelson G, Selwood TS. Measurement of Chronic Pain: A Correlation Study of Verbal and Nonverbal Scales. Journal of behavioral assessment. 1981 Dec 1;3(4):263-9. [DOI:10.1007/BF01350830]
30. Vickers ER, Cousins MJ, Woodhouse A. Pain Description and Severity of Chronic Orofacial Pain Conditions. Australian dental journal. 1998 Dec;43(6):403-9. [DOI:10.1111/j.1834-7819.1998.tb00200.x] [PMID]
31. Rezvani Amin M, Siratinayer M, Abadi A, Moradyan T. Correlation Between Visual Analogue Scale and Short Form of McGill Questionnaire in Patients with Chronic Low Back Pain. Qom University of Medical Sciences Journal. 2011 Apr 10;5(1):31-4.
32. Ehde DM, Elzea JL, Verrall AM, Gibbons LE, Smith AE, Amtmann D. Efficacy of a Telephone-Delivered Self-Management Intervention for Persons With Multiple Sclerosis: A Randomized Controlled Trial with a One-Year Follow-Up. Archives of physical medicine and rehabilitation. 2015 Nov 1;96(11):1945-58. [DOI:10.1016/j.apmr.2015.07.015] [PMID]
33. Ikemoto K, Yamagata Y, Ikemoto T, Kawai T, Aono S, Arai YC. Telephone Consultation Partially Based on a Cognitive-Behavioral Approach Decreases Pain and Improves Quality of Life in Patients with Chronic Pain. Anesthesiology and pain medicine. 2015 Dec;5(6). [DOI:10.5812/aapm.32140] [PMID] [PMCID]

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