https://www.um.edu.mt/library/oar/handle/123456789/107044 2026-06-15T07:35:31Z https://www.um.edu.mt/library/oar/handle/123456789/110208 Title: Chronic pain management : pain management programme versus invasive procedures Abstract: Overview of the topic: The Pain Management Programme (PMP) consists of a multidisciplinary approach to assess and improve the patient’s quality of life, despite the pain present and work towards the relief of pain (Gauntlett-Gilbert & Brook, 2018). The ability of the PMP is to build up coping strategies to help people control and reduce their pain. The pain management programme is compared to typical orthopaedic invasive procedures that are thought to aid in chronic pain relief. Research question: Is the pain management programme an effective primary approach to chronic pain when compared to invasive procedures? PICO elements: The population (P) adults with orthopaedic chronic pain representing an age of 18years or older. The intervention (I) consisting of a multidisciplinary approach to assess and improve the patient’s quality of life working towards the relief of pain. The comparison (C) intervention was invasive/ interventional procedures. The expected outcome (O) improved pain relief with regards to the chronic pain management programme. Methods: The key elements of the PICO question were used as key terms to generate various alternative search terms. The adopted terms were combined using Boolean Operators to expand the search and narrowed down through the use of limiters by utilising inclusion and exclusion criteria. The joint terms were searched in three primary databases; PubMed, Hydi and EBSCO. The PRISMA 2020 checklist was the main framework used to screen articles. The Critical Appraisal Skills Programme (CASP) tools were used to critically appraise the literature. Any ethical matters were taken into consideration. Results: A total of five key studies were identified, one systematic review and four randomised controlled trials. Results showed no statistically significant improvements of patients undergoing surgical interventions compared to non-surgical therapy. A significant improvement in secondary outcomes with regards to the PMP involving work status and pain medication use, was observed. Implications and recommendations: It is recommended to provide pain management education to all chronic pain patients. The integration of the PMP into routine clinical work will require the training of medical staff and their awareness of its importance. Additional financial resources and personnel will have to be allocated to improve on the PMP currently available. Description: B.Sc. (Hons)(Melit.) 2022-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/110205 Title: The relationship between health literacy and self-management in persons living with type 2 diabetes mellitus : a cross-sectional survey study Abstract: Background Few studies have explored the relationship between health literacy and diabetes self-management in Europe. Individuals living with type 2 diabetes mellitus have a distinct self-management when compared to other classifications of diabetes. Moreover, each country may have different forms of support. Personal health literacy focuses on the individual rather than the organisation. The “Integrated Model of Healthy Literacy” was used as a theoretical framework in this present study. This addresses health literacy as a dynamic process and identifies health behaviours as influencing factors. Objectives The aim of this study was to explore the relationship between health literacy and diabetes self-management and glycaemic control amongst Maltese adults. Design A cross-sectional research design was used in this study. Methods Convenience sampling was used to recruit 381 participants from Diabetes Clinics in Malta. Data was collected by a questionnaire which included 16 items measuring health literacy from the ‘European Health Literacy Survey Questionnaire’ and 20 items from the ‘Diabetes self-management questionnaire-revised”. Recent laboratory test results for glycated haemoglobin levels were recorded as a measure of blood glucose control. Multiple regression was used to identify the predictors of health literacy. Spearman’s correlation was used to identify the relationships between health literacy and diabetes self-management and HbA1c. Results The results indicated that 47% (n= 179) of the participants had inadequate health literacy, 12.6% (n= 48) had limited health literacy whilst 40.4% (n= 154) had sufficient health literacy. The most significant predictors of health literacy were educational level, household monthly Net income and family history of diabetes. The results demonstrated medium-high diabetes self-management with medication taking being the strongest aspect of self-management. HbA1c values indicated that 27% of individuals had good glycaemic control, 47.5% had medium control and 25.5% had poor glycaemic control. Health literacy was significantly positively related to diabetes self-management and significantly negatively related to HbA1c levels. Conclusions Health literacy was poor amongst this cohort of persons living with type 2 diabetes. The results of this study indicating the importance of health literacy in encouraging self-management and in increasing the likelihood of good diabetes control highlight the importance of diabetes education. Diabetes nurse specialists are particularly placed to promote education and health literacy amongst persons with type 2 diabetes. Other health professionals however also have a role in assessing any areas in relation to diabetes care which need clarification. This should happen at every patient encounter. Description: M.Sc.(Melit.) 2022-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/110197 Title: The incident rate of diabetic retinopathy : controlled diabetes mellitus versus uncontrolled condition Abstract: Background Information: Diabetes mellitus is the leading cause of diabetic retinopathy, putting every patient diagnosed with diabetes mellitus at risk of developing Diabetic retinopathy. Therefore Diabetic retinopathy is considered to be a major chronic micro-vascular complication. The onset and progression of DR is slow and gradual, advancing from mild non-proliferative DR (NPDR), to moderate NPDR. By good glycemic control, diabetics may decrease the prevalence of developing DR. Therefore adequate glucose control measures are required. Research Question: Is the Incident Rate (IR) of Diabetic Retinopathy less in individuals with controlled diabetes mellitus as opposed to those with uncontrolled diabetes mellitus? PICO Elements: The population studied compromised of adults suffering from Diabetes. The intervention being reviewed is glycemic control. The comparison is between uncontrolled and controlled blood glucose levels, and the expected outcome is a reduction in the IR of DR in patients having a controlled blood glucose level. Method: A systematic literature search was conducted to retrieve relevant literature from various databases using keywords, synonyms, boolean operators, and limiters. Eligibility criteria compromised of peer-reviewed literature in English from 2008 onwards, having full text, including all PICO elements, and study design. Medical health professionals who expertise in this field were contacted to broaden the knowledge on the subject and possibly retrieve any unpublished studies on the subject. The PRISMA checklist enabled the identification of relevant articles. The 6 key studies chosen, 5 cross-sectional studies and 1 cohort study, were critically appraised using a Critical Appraisal Skills Programme (CASP) tool as a guideline. This process was then illustrated using a PRISMA flow diagram. Results: The chosen literature provided consistent results and identified that glucose control does reduce the IR o DR. However, various methodological limitations were identified. Implications and Recommendations: Recommendations for further research include sustaining the development for more local research, and having larger sample sizes when conducting a study. Implementation of local staff training to raise awareness should also be implemented. Description: B.Sc. (Hons)(Melit.) 2022-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/110177 Title: The effect of music therapy on pain in preterm infants undergoing invasive procedures Abstract: Background: Prematurity is the leading cause of death in children worldwide (World Health Organization, 2018). Even when children manage to survive this vulnerable stage, they can still suffer from several adverse effects associated with their time spent in the neonatal intensive care unit (NICU) experiencing uncontrolled pain (Williams & Lascelles, 2020). Music therapy (MT) is a non-pharmacological pain management technique that can potentially help alleviate and manage pain during invasive procedures. Research question: Does music therapy have an effect on pain in preterm infants undergoing invasive procedures? PICO Elements: The population is preterm infants undergoing invasive procedures, the intervention is music therapy, and the comparison is no music therapy. The outcome is pain management. Method: A systematic search was undertaken to locate studies using various electronic databases. The PICO framework was used as a foundation from which synonyms could be developed. These were then merged with search tools and limiters to generate a search strategy. The PRISMA framework was used to select the key studies and five RCTs where chosen. The chosen articles where then critically appraised using the CASP tool for RCTs. Ethical aspects where considered. Inclusion Criteria: The studies eligible for inclusion had to have a population of infants, male or female born before 37 weeks of gestation undergoing invasive procedures. Pain was to be measure by validated acute procedural pain assessment tools and physiological parameters. Furthermore, the eligible studies had to be written in English, published after 2017 and studying not more than four intervention groups. Results: The results of the five RCTs collectively were inconclusive. Whilst three of the studies showed an effect of music therapy (MT) on pain, the other two studies showed no statistically significant results. Implications and Recommendations: The need for further research with stronger methods and younger and sicker populations of infants was identified. Furthermore, the need for pain assessment and monitoring was identified and the importance of implementing pain assessment tools within the NICU. The necessity for educating nurses on pain in preterm infants was emphasised. Description: B.Sc. (Hons)(Melit.) 2022-01-01T00:00:00Z