Critique Paper On Mind-Body Exercises Or Nurses With Chronic Low Back Pain: An Evidence- Based Review

Abstract

The abstract defined the short summary of the study in a sequential manner in less than 205 words. This study is relevant to my future study on the importance of education on back prevention as it related to prevalence of the back-pain incidence. While the article is quite informative, it is not clear how the multimodal techniques were determined to be more effective than conventional treatment. A brief summation of the prevalence and implications of chronic low back pain (CLBP) for nurses were provided. Data collection based on articles reviewed were current, published during 2015, and provided a conclusion emphasizing the importance of further investigation on use of yoga and tai chi for nurses with chronic low back pain. Introduction with Problem The purpose of this assignment is to provide a critique review of the literature study on Mind Body Exercises for Nurses with Chronic Low Back Pain. According to this study, nursing staff continue to suffer from chronic low back pain (CLBP) due to heavy workloads and various schedules. CLBP is a major concern in healthcare industry resulting in loss of quality of life, lost work days, increased worker’s compensation claims, and potential chronic health problem. It is estimated that the prevalence of back pain for nurses is 50% to 80% of the workforce. Pain perception is affected by past experiences with pain, emotional health, job satisfaction, education, financial status, and well-being. Modifiable factors of this sector include long work hours, high physical demands and demanding schedules, while non-modifiable factors include an aging workforce. Reviewing this article strategically reveals the following findings. Use of Multi-modal treatment modalities which include mind-body exercises based on evidence-based studies was recommended for nurses suffering from chronic low back pain. In this article the research hypothesis involves the relationship of multimodal aspect of complementary and integrative exercises and its potential to impact the physiological and psychological factors of chronic low back pain. The study compares it to conventional unimodal treatment modalities. While the research hypothesis is provided, the research problem is not clearly identified. The key terms and concepts, however, are clearly identified and understandable to the reader.

The title encompasses what the study is all about and clearly stated that it is an evidence-based review which is relevant to the nursing population and occurrence of chronic back pain. Authors Pinky Budhrani- Shani, Donna L. Berry, Patricia Arcari, Helene Langevin and Peter M. Wayne. Pinky Budharani-Shani Mitttleman Family Fund Integrative Nursing Fellowship funded Pinky Budhrani while Dr. Peter Wayne was given a grant from National Complementary and Integrative Health of the National Institute of Health. In reviewing research, an investigator should scrutinize who funded the study to make sure that there is no foundation for bias. In this study Dr. Wayne has association with the Yoga and Tai Chi foundation making it controversial as this study push for further investigation on its relevance.

Conceptual Framework/Methodology

The conceptual or theoretical framework in this study is not clearly defined but methodology discussed is based on systematic review of literatures published prior to and during the year of 2015. These literature studies were identified through PubMed, Medline, and science direct resources which is limited to English language only. The reference lists included 118 relevant articles with focus on prevalence, burden, and risk factors of low back pain within the last 10 years. Studies include treatment modalities involving mind and body exercises. Unfortunately, the relevance of yoga and tai chi was not found in some of the studies but insinuated that it is beneficial. Based on the literature search and other studies taken from National Health Interview Survey, it was discussed that 8, 196 nurses who suffered from low back pain, disclosed the benefits of mind-body exercises. Identifying the articles to be included and excluded in the article, was based on searching the main key words through electronic search of the topic of interest. This is a review of articles so sample size was not specified and no human subjects were directly involved in the study as it is a literature review of the available research. There is no specific tool used but subtopics were created such as the effects of mind-body exercise on low back pain and its impact on risk factors, importance of strength, flexibility, posture and body awareness.

Literature Review

Based on the literature review several studies identified that modifiable factors can impact the way nurses perceived their pain and how they seek treatment. Occupational factors, psychological factors, physical factors, psychosocial and lifestyle can directly affect prevalence of back pain among nurses. According to Bhudrani-Shani et al (2016) these occupational related factors can be attributed also to poor nurse staffing, longer shifts, repetitive motion of lifting and handling patients, and working weekends. Some of the psychosocial factors can be influenced by cultural, social health beliefs, job dissatisfaction and lack of social support. CCLBP on nurses is a known complex health problem among nurses. One must consider the multifactorial variables in relation to development of back pain. While this study utilized several literatures, out of 118 references cited, 45 articles are over 10 years and majority of the articles are also over 5 years. This is probably the reason why there are no relevant studies related to the significance of yoga and tai chi. Results Data from systematic review of and literature in this study revealed that nurses are in danger of having the highest rate of back pain prevalence which is 40-90% worldwide and 52% in United States. According to this study 38% of nurses reported work related back pain injuries resulting in lost days and 20% were forced to change their jobs due to disability. There is enough evidence relating to the difficulty of treating back pain with conventional modality. Lifestyle factors and other modifiable variables play an important role in treating back pain among nurses. Multiple factors and multimodal therapy consideration are significant when considering back pain treatment which includes mind-body exercises. In addition to these, systematic review which included 83 randomized trials concluded that both exercise and behavioral treatment were efficient in pain intensity reduction. Yoga and tai chi were two identified popular mind-body exercise that showed potential in preventing low back pain which foster improvement in physical and emotional balance. This is a good study, however, it does not clearly describe how the data were analyzed and it did not completely describe the statistical analysis of the results. According to Terry (2018) a good study has good analysis and description of how a researcher designs a tool for analyzing the data of study.

Implication and Conclusion

The study described the limitations and future research directions. Limitations of the study included is the extensive nature of the research question, key words limitations to include English studies only, and poor identification of literature studies on yoga and tai chi. Based on study findings it is recommended that sensitivity to nurses’ schedules be considered. Promotion of healthcare can be done in a healthcare setting for easy accessibility. Most of all it is suggested in this study that educational initiatives on back prevention and other preventative strategies such as ergonomics, weight lifting skills, and stress reduction. Lastly, according to this study exposing nurses to holistic mind-body exercises can potentially address CLBP issue. The study did address the relevance of the topic but did not clearly answer the research questions due to its identified limitation. The implication is very relevant to my future study on back pain prevention and education.