RESUMEN
PURPOSE: Patients with chronic pain and/or spasticity who have an intrathecal targeted drug delivery (TDD) pump require frequent needle access procedures to refill the pump's medication reservoir. Some patients find the access procedure painful and/or anxiety provoking. The purpose of this study was to determine if a nursing intervention of providing a distraction with a music relaxation video during the pump access procedure would reduce patients' pain and state anxiety. DESIGN/METHODS: In this longitudinal, pre-test post-test, quasi-experimental design, patients watched a 13-minute calming music video while the nurse performed the needle access procedure. Data collection instruments included a combination of researcher-developed questionnaires, the Defense & Veterans Pain Rating Scale (DVPRS), and the State Trait Anxiety Inventory (STAI). Pain and anxiety were measured pre- and post-pump refill procedures at baseline with no intervention (T1) and at two subsequent pump refills with the music video intervention (T2 and T3). RESULTS: The sample consisted of 31 adults with chronic pain (n = 28) or spasticity (n = 3). All participants had an implanted pump for at least six months. Specialty trained nurses refilled the participants' pump in their home. The findings support the use of a music video as an effective intervention for reducing participants' perception of pain and anxiety during the pump refill procedure. Neither pre-test pain nor pre-test anxiety scores differed across time. Post-test mean pain scores decreased consistently across time (T1 = 5.55, T2 = 4.42, T3 = 4.23; P = .002). Post-test anxiety scores showed a significant decrease (P <.05) between T1 (M = 37.87) and T2 (M = 30.94) which was not sustained at T3 (M = 35.68, P = .284). Overall, the majority of participants indicated liking the music video intervention. They also expressed interest in using the intervention for future refill procedures or other stressful situations. CONCLUSIONS: The music video was effective in producing a sustained reduction over time of participants' pain during the pump refill procedures; it was most effective in initially reducing participants' state anxiety at the initial intervention visit; however, it did not demonstrate a progressively sustained effect. Participants' opinions about the music video experience were positive.