2014 myresearch SCIENCE Internship Program

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3 2014 myresearch SCIENCE Internship Program

4 Maya Gaines-Smith Science Internship Program

5 Does Mobilization of Patients With a Cancer Diagnosis Decrease Pain? Maya Gaines-Smith Marianne Douglas, MS CCC/SLP Scott Tremmel PT

6 Introduction Cancer This word alone can bring multiple emotions to your mind. Cancer can come with both physical and psychological burdens. As healthcare providers it is our job to minimize these burdens to the best of our ability.

7 Background In America alone, over 14,483,830 people are living with cancer as of January 1st, At Marymount Hospital there were approximately 1,000 inpatient cancer cases in 2013.

8 Background Chronic pain: Pain lasting longer than 6 months 7. Effects: disrupt sleep, shorter tempers, shorter memory, lack of concentration and affects healing process.

9 Background Why are cancer pain scores relevant? According to Anesthesia & Analgesia Journal, patients that had pain scores 7 out of 10 took a longer time to recover 3. 30%-50% of cancer patients experience chronic pain when undergoing treatment 2. 70%-90% in advanced stages experience chronic pain 2.

10 Background Physical and occupational therapy aim to address physiological deficits that patients present with. PT & OT focus on pain management through: Strengthening Mobility Repositioning Guided Relaxation 5.

11 Hypothesis Pain perception decreases in inpatient cancer patients who are mobilized by physical or occupational therapy as measured by the Wong- Baker pain scale.

12 Abstract The purpose of this study was to assess if pain perception decreases in cancer inpatients who are mobilized by PT/OT. This is compared to the use of traditional techniques, which made up the control group. Pain was measured using the Wong-Baker pain scale.

13 Methodology Pain scores were recorded from each treatment session of 180 cancer patients with PT/OT. Nursing pain scores were used to create the control group, consisting of 92 patients with cancer. Patients with a initial 0/10 Wong-Baker score were omitted from the final data.

14 Data Key: 1= First Session Score 2= Final Session Score

15 Data

16 Results Control Group Wong-Baker Averages: Pre: Post: PT/ OT Patient Wong-Baker Averages: Pre: Post: Control Wong-Baker Range: PT/OT Wong-Baker Range:

17 Results PT/OT Pain Management Techniques Documented Positioning Strengthening Mobility and Walking Traditional Techniques Documented Medication Rest Repositioning Relaxation Techniques

18 Conclusions PT/OT/RN facilitated the greatest decrease in pain scores utilizing a combination of alternative and traditional pain management techniques. PT/OT are brought in to get patients mobilized, and consequently lowered their pain scores.

19 Recommendations Culture of mobility in the hospital would be beneficial to patient recovery and pain management. Staying active prevents strength and functional mobility loss during the stay of patients. All patients should be encouraged to move, even if they don t require PT/OT.

20 References 1. "Cancer Prevalence: How Many People Have Cancer?" Cancer Prevalence: How Many People Have Cancer? American Cancer Society, Inc., n.d. Web. 07 July "Cancer-Pain.org: Understanding: What Is Cancer Pain?" Cancer-Pain.org: Understanding: What Is Cancer Pain? ACOR, Inc., 26 July Web. 07 July Pavlin, D. Janet, C. Chen, D. A. Penaloza, Nayak L. Polissar, and F. Peter Buckley. "Pain as a Factor Complicating Recovery and Discharge After Ambulatory Surgery." Anesthesia & Analgesia 95.3 (2002): Web. 4. "Chronic Pain." Coping with the Emotional Impact of Pain. University of Oxford, n.d. Web. 07 July Fisch, Michael J. "CHAPTER 04 - Application of Pain Management Principles in Specific Cancer Care Settings." Cancer Pain Management. New York: McGraw-Hill Companies,, The Professional Book Group, X. Print 6. my36degrees.com (cancer ribbon picture) 7. "Chronic Pain Management." Webmd. Ed. Melinda Ratini. WebMD, LLC, 4 Apr Web. 16 July 2014.

21 Special Thanks Office of Civic Education Initiatives Bryan Pflaum, MFA, Director Nedra Starling, MA, MPH, ABD/DrPH, Manager, Public Access and Clinic-Based Programming Mentor and Co-Mentor Marianne Douglas, MS CCC/SLP Scott Tremmel PT Rehabilitation Department

22 Copyright 2014 Cleveland Clinic Foundation

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