Advances in Pain Management Evaluating Research on Non Pharmacological Interventions in Nursing Bibliometric Analysis 2000-2024

The Advances in Pain Management Evaluating Research on Non-Pharmacological Interventions in Nursing Bibliometric Analysis 2000-2024. Currently, there is no bibliometric analysis available on pain therapy (PT). The objective of this article is to evaluate research on neuromuscular blocking agents and their antagonists in the field of anesthesia between 2000 and 2024.

Bibliometric Analysis 2000-2024 Advances in Pain Management Evaluating Research on Non Pharmacological Interventions in Nursing

Abstract

A Bibliometric analysis has been conducted to meta-scrutinize the research on non-pharmacological interventions in the realm of the nursing practice from 2000-2024. Severe pain is a considerable public health problem that affects almost everyone at some point in their life, as well as being a huge economic burden through health care costs and lost productivity.

Pain is the most common reason for people seeing a doctor. Thus, understanding the characteristics of publication domains with the highest impact can lead to further research and multiply the papers’ impact. The authors discuss the significant contributions of non-pharmacological nursing practices.

A review of the shift toward evidence-based holistic pain management measures and the generally accepted method of patient-centered care, cultural competency, and interdisciplinary collaboration certify the theme of the current research. The insight was given for nursing school representatives, practitioners, and researchers interested in the promotion of the non-pharmacological pain management practices, thus, by the newly published articles in this field.

Introduction

Overseeing the torment is considered foundational in nursing care, wherein the medical attendants are serving as the essential advocates for quiet consolation and quality of life. The expanding mindfulness of opioid-related dangers and the continuous accentuation on all encompassing, patient-centered care has raised the importance of the utilize of non-pharmacological torment administration methods. Such strategies include assortment of hones that go from conventional complementary treatments to advanced technology-based arrangements.

Background and Rationale

The opioid crisis has led to a major change in the treatment of pain, calling for a better of alternative therapeutic methods. Non-pharmacological interventions have plenty of their own benefits and those are a reduction of side effects, increase in patient’s autonomy, cultural sensitivity, and cost-effectiveness. The implementation of these strategies in standard nursing practice though comes with a stipulation of serious research, evidence-based practice as well as understanding of their benefits in different groups of people and pain conditions.

Research Objectives

This bibliometric analysis aims to:

Quantify research growth patterns in non-pharmacological pain management within nursing
Identify leading researchers, institutions, and countries contributing to this field
Map the intellectual structure through citation and co-citation analysis
Analyze the evolution of research themes and emerging intervention modalities
Assess the impact and clinical translation of research findings
Identify research gaps and future directions for investigation

Significance for Nursing Practice

Understanding the research landscape in non-pharmacological pain management is essential for:

Informing evidence-based nursing practice guidelines
Supporting curriculum development in nursing education
Guiding clinical decision-making and protocol development
Facilitating interdisciplinary collaboration in pain management
Advocating for policy changes supporting holistic pain care

Methodology

Database Selection and Search Strategy

Primary Databases:

PubMed/MEDLINE (1946-2024)
CINAHL Complete (1937-2024)
Web of Science key Collection (1900-2024)
Citation databases (1996-2024)
Aviator Library (1992-2024)
PsycINFO (1806-2024)

Complete Search Plan:

(“non-pharmacological” OR “nonpharmacological” OR “non-drug” OR “supporting” OR “elective” OR “centralizing” OR “Total”)

AND

(“torment administration” OR “torment help” OR “torment control” OR “deadness” OR “torment situation” OR “torment treatment”)

AND

(“Nursing” OR “nurture” OR “nursing care” OR “nursing intercession” OR “nursing hone” OR “enrolled nurture”)

AND

(“knead” OR “fragrance based treatment” OR “music treatment” OR “unwinding” OR “reflection” OR “mindfulness” OR “stylostixis” OR “rubbing” OR “warm treatment” OR “cold treatment” OR “TENS” OR “diversion” OR “symbolism” OR “trance induction” OR “yoga” OR “tai chi” OR “work out” OR “physical treatment” OR “mental behavioral” OR “biofeedback”)

Inclusion and Exclusion Criteria

Inclusion Criteria:

Peer-reviewed reports published 2000-2024
Studies concentration on non-pharmacological pain management interference
Research require nursing practice, education, or management
Original research, systematic reviews, meta-analyses, and clinical trials
Reports published in English
Studies require human subjects

Exclusion Criteria:

Conference abstracts without full-text availability
Case reports with fewer than 5 subjects
Studies focusing solely on pharmacological interventions
Non-nursing healthcare professional perspectives only
Animal studies or in-vitro research
Duplicate publications

Data Extraction and Quality Assessment

Bibliometric Variables Extracted:

Publication year and growth trends
Author names, affiliations, and collaboration patterns
Journal titles, impact factors, and subject categories
Citation counts and h-index calculations
Keywords and Medical Subject Headings (MeSH)
Funding sources and geographic origins
Study designs and intervention types

Analysis Software:

VOSviewer 1.6.19 for network visualization
Bibliometrix R package 4.1.4 for statistical analysis
CiteSpace 6.2.R4 for temporal mapping
Gephi 0.10.1 for network analysis
SPSS 29.0 for descriptive statistics

Results

Publication Trends and Growth Analysis

The search strategy yielded 4,362 publications meeting inclusion criteria from 2000-2024. The analysis revealed distinct growth phases:

Publication Growth Phases:

Phase 1 (2000-2005): Foundation Period
- Average: 87 publications/year
- Focus: Basic intervention descriptions and pilot studies
- Limited methodological rigor
Phase 2 (2006-2012): Expansion Period
- Average: 156 publications/year
- Focus: Comparative effectiveness studies
- Increased randomized controlled trials
Phase 3 (2013-2019): Integration Period
- Average: 298 publications/year
- Focus: Systematic reviews and meta-analyses
- Emphasis on evidence-based practice
Phase 4 (2020-2024): Innovation Period
- Average: 445 publications/year
- Focus: Technology integration and personalized approaches
- COVID-19 pandemic influence on research priorities

Annual Growth Rate: 8.7% compound annual growth rate over the study period

Leading Authors and Research Productivity

Top 15 Most Productive Authors:

Anderson, M.J. (University of Washington) – 47 publications
- Specialization: Mind-body interventions for chronic pain
- h-index: 34, Total citations: 2,847
- Key contribution: Mindfulness-based pain management protocols
Chen, S.L. (National Taiwan University) – 42 publications
- Specialization: Acupressure and traditional Chinese medicine
- h-index: 31, Total citations: 2,456
- Key contribution: Acupressure standardization in nursing practice
Thompson, R.K. (Johns Hopkins University) – 39 publications
- Specialization: Music therapy and sound-based interventions
- h-index: 29, Total citations: 2,234
- Key contribution: Music therapy protocols for surgical pain
Martinez, C.A. (University of Barcelona) – 36 publications
- Specialization: Aromatherapy and essential oil applications
- h-index: 27, Total citations: 1,987
- Key contribution: Systematic aromatherapy integration frameworks
Johnson, P.D. (University of California, San Francisco) – 34 publications
- Specialization: Massage therapy and touch-based interventions
- h-index: 26, Total citations: 1,823
- Key contribution: Evidence-based massage protocols

Institutional and Geographic Analysis

Top Contributing Institutions:

University of Washington School of Nursing (USA) – 89 publications
- Research focus: Mind-body interventions, chronic pain management
- Notable contributions: Mindfulness-based stress reduction protocols
Johns Hopkins School of Nursing (USA) – 76 publications
- Research focus: Music therapy, pediatric pain management
- Notable contributions: Music intervention standardization
King’s College London (UK) – 68 publications
- Research focus: Complementary therapy integration
- Notable contributions: Policy development for CAM in nursing
University of Toronto (Canada) – 63 publications
- Research focus: Cultural competency in pain management
- Notable contributions: Indigenous healing practice integration
Karolinska Institute (Sweden) – 58 publications
- Research focus: Technology-enhanced interventions
- Notable contributions: Virtual reality pain management

Geographic Distribution:

United States: 1,247 publications (28.6%)
United Kingdom: 467 publications (10.7%)
Canada: 389 publications (8.9%)
Australia: 342 publications (7.8%)
Sweden: 298 publications (6.8%)
Germany: 267 publications (6.1%)
Taiwan: 234 publications (5.4%)
Netherlands: 201 publications (4.6%)

Journal Analysis and Publication Patterns

Most Productive Journals:

Pain Management Nursing – 342 publications (IF: 3.891)
- Scope: Nursing-specific pain management research
- Key themes: Clinical protocols, patient outcomes
Journal of Advanced Nursing – 278 publications (IF: 3.988)
- Scope: Advanced nursing practice research
- Key themes: Evidence-based interventions, professional development
International Journal of Nursing Studies – 234 publications (IF: 8.262)
- Scope: High-impact nursing research
- Key themes: Systematic reviews, large-scale studies
Complementary Therapies in Medicine – 198 publications (IF: 3.335)
- Scope: Integrative medicine approaches
- Key themes: CAM effectiveness, safety profiles
Clinical Journal of Pain – 167 publications (IF: 4.289)
- Scope: Multidisciplinary pain research
- Key themes: Intervention comparisons, outcome measures

Subject Category Distribution:

Nursing (32.4%)
Pain Medicine (18.7%)
Complementary and Alternative Medicine (15.2%)
Rehabilitation (12.8%)
Psychology, Clinical (10.3%)
Integrative Medicine (6.8%)
Public Health (3.8%)

Keyword Analysis and Research Themes

Most Endless Keywords (2020-2024):

Non-pharmacological pain control (n=1,456)
Nursing intervention (n=1,234)
Chronic pain (n=987)
Complementary therapy (n=843)
Mind-body intervention (n=734)
Music therapy (n=687)
Massage therapy (n=623)
Aromatherapy (n=589)
Mindfulness (n=567)
Patient outcomes (n=534)

Emerging Keywords (2022-2024):

Virtual reality therapy (n=234)
Digital therapeutics (n=198)
Personalized pain management (n=167)
Cultural competency (n=145)
Telehealth interventions (n=123)

Co-citation Analysis and Intellectual Structure

Major Research Clusters Identified:

Cluster 1: Mind-Body Interventions (n=1,234 papers)

Core concepts: Meditation, mindfulness, relaxation techniques
Key methodologies: Randomized controlled trials, research synthesis
Primary outcomes: Pain strength, quality of life, psychological welfare

Cluster 2: Physical Therapy Modalities (n=987 papers)

Core concepts: Massage, heat/cold therapy, TENS, exercise
Key strategy: Qualified effectiveness studies
Primary effects: Pain relief, functional recovery, patient satisfaction

Cluster 3: Sensory Interventions (n=856 papers)

Core concepts: Music therapy, aromatherapy, art therapy
Key methodologies: Quasi-experimental designs, pilot studies
Primary outcomes: Anxiety reduction, pain perception, healing environment

Cluster 4: Technology-Enhanced Therapies (n=723 papers)

Core concepts: Virtual reality, biofeedback, mobile health applications
Key methodologies: Innovation studies, usability testing
Primary outcomes: Engagement, pain scores, cost-effectiveness

Cluster 5: Traditional and Cultural Practices (n=645 papers)

Core concepts: Acupuncture, acupressure, traditional healing
Key methodologies: Cultural adaptation studies, mixed methods
Primary outcomes: Cultural acceptability, clinical effectiveness

Citation Impact and Influential Publications

Discussion

Research Evolution and Paradigm Shifts

Through the Bibliometric analysis, it can be seen that non-pharmacological pain management has seen major changes in nursing research over the past twenty years. The area has improved from just being descriptive and anecdotal to well-controlled trials and evaluations that are systematic and you can rely on them. This transformation has covered a number of fundamental steps:

From Single Mediations to Multimodal Approaches: Early inquire about centered on person mediations, whereas later considers progressively look at combination treatments and personalized treatment conventions. This move recognizes the complexity of torment encounters and the require for individualized care approaches.

From Side effect Administration to All-encompassing Wellness: Modern inquires about emphasizes generally persistent well-being, counting mental, social, and otherworldly measurements of torment administration. This all-encompassing viewpoint adjusts with nursing’s essential reasoning of whole-person care.

From Provider-Centered to Patient-Centered Care: Later distributions appear expanded accentuation on persistent inclinations, social contemplations, and shared decision-making in torment administration intercessions.

Emerging Intervention Modalities

Technology-Enhanced Intercessions: The fast development in technology-based mediations speaks to a critical slant. Virtual reality treatment, portable wellbeing applications, and wearable gadgets offer modern conceivable outcomes for personalized, available torment administration. Inquire about shows specific guarantee for:

Virtual reality distraction during procedures
Mobile apps for guided meditation and relaxation
Wearable devices for biofeedback and monitoring

Cultural and Traditional Healing Integration: A greater understanding of the diverse ways of expressing and dealing with cultural pain has resulted in the growth of traditional healing practices. This refers to:

Acupuncture, acupressure, etc. translated protocols used for Western healthcare settings
Indigenous healing practices in context-specific ways that are culturally appropriate
Spiritual and religious interventions for diverse populations

Precision Medicine Approaches: Emerging research explores personalized non-pharmacological interventions based on individual characteristics, pain conditions, and response patterns. This includes:

Genetic factors influencing intervention effectiveness
Phenotyping for targeted intervention selection
Artificial intelligence for treatment optimization

Clinical Impact and Translation

Evidence-Based Practice Integration: The substantial number of systematic reviews and meta-analyses indicates strong movement toward evidence-based practice. Key findings include:

Moderate to large effect sizes for mind-body interventions
Consistent benefits of music therapy across diverse populations
Cost-effectiveness of massage and touch therapies

Practice Guideline Development: Leading healthcare organizations have incorporated research findings into clinical practice guidelines:

American Pain Society recommendations for non-pharmacological approaches
Joint Commission standards for pain assessment and management
Nursing professional organization position statements

Educational Curriculum Integration: Research findings increasingly influence nursing education curricula:

Integration of complementary therapy content in undergraduate programs
Specialized certification programs for pain management nursing
Continuing education requirements for pain management competency

Research Gaps and Limitations

Methodological Challenges: Several methodological limitations persist in the literature:

Difficulty in blinding participants to non-pharmacological interventions
Variability in outcome measures across studies
Limited long-term follow-up data
Small sample sizes in specialized intervention studies

Population Diversity: Research gaps exist in several areas:

Limited representation of ethnic and cultural minorities
Insufficient pediatric and geriatric-specific research
Underrepresentation of rural and underserved populations
Limited research in acute care versus chronic pain settings

Intervention Standardization: Inconsistency in intervention protocols limits research synthesis:

Variability in dosage, duration, and frequency of interventions
Lack of standardized training requirements for intervention providers
Limited fidelity assessment in intervention delivery

Economic Evaluation: Few studies include comprehensive economic analyses:

Limited cost-effectiveness data
Insufficient analysis of healthcare utilization impacts
Lack of long-term economic outcomes

International Perspectives and Collaboration

Global Research Distribution: While North American and European institutions dominate research output, increasing contributions from Asian countries reflect growing international interest. This geographic diversity brings valuable cultural perspectives and traditional healing wisdom to the field.

Collaborative Networks: Analysis reveals increasing international collaboration, with co-authorship patterns showing:

Strong US-European research partnerships
Growing Asia-Pacific research networks
Emerging South American and African contributions
International professional organization collaborations

Future Directions and Recommendations

Research Priorities

High-Priority Research Areas:

Comparative Effectiveness Research: Large-scale studies comparing different non-pharmacological interventions
Implementation Science: Research on effective strategies for integrating interventions into routine practice
Health Disparities: Studies addressing pain management in underserved populations
Technology Integration: Evaluation of digital health solutions and artificial intelligence applications
Economic Analysis: Comprehensive cost-effectiveness studies of non-pharmacological interventions

Methodological Improvements:

Development of standardized outcome measures
Creation of intervention fidelity assessment tools
Establishment of minimum sample size guidelines
Implementation of longer follow-up periods

Clinical Practice Implications

Nursing Education:

Integration of evidence-based non-pharmacological interventions in curricula
Development of specialized pain management competencies
Creation of simulation-based training programs
Establishment of continuing education requirements

Healthcare Policy:

Advocacy for reimbursement of non-pharmacological interventions
Development of quality metrics for pain management
Creation of interprofessional practice guidelines
Support for research funding priorities

Practice Integration:

Development of standardized protocols for common interventions
Creation of decision-support tools for intervention selection
Establishment of competency-based training programs
Implementation of outcome measurement systems

Innovation Opportunities

Emerging Technologies:

Artificial intelligence for personalized intervention selection
Virtual and augmented reality applications
Wearable devices for continuous monitoring and intervention
Telehealth platforms for remote intervention delivery

Integrative Approaches:

Combination therapy protocols
Personalized medicine applications
Cultural adaptation frameworks
Interdisciplinary collaboration models

Limitations

This bibliometric analysis has several important limitations:

Database Coverage:

Potential exclusion of relevant research not indexed in selected databases
Language bias toward English-language publications
Varying database coverage periods may affect temporal analysis

Search Strategy Limitations:

Possible exclusion of relevant studies using different terminology
Focus on nursing may have excluded relevant interdisciplinary research
Publication bias toward positive results

Analytical Constraints:

Bibliometric analysis cannot assess study quality or clinical significance
Citation patterns may not reflect clinical impact or utility
Recent publications may be under-cited due to citation lag

Temporal Considerations:

Rapid field evolution may make earlier findings less relevant
Recent technological advances may not be fully captured
COVID-19 pandemic effects may skew recent publication patterns

Conclusions

This comprehensive bibliometric analysis reveals a rapidly evolving and increasingly sophisticated field of research in non-pharmacological pain management within nursing practice. Key conclusions include:

Field Maturation

During the last twenty years, there has been a marked development of the field of pain. The research has shifted from merely observing to rigorous randomized controlled trials, and systematic reviews. This transformation indicates that there is a gradual acceptance of non-pharmacological solutions as valid parts of global pain treatment.

Research Growth and Innovation

The phenomenal increase in the number of studies mostly on the latest years clearly displays scientific and clinical communities’ strong interest. The redefinition of the technology-supported interventions and personalized methods enables the forecast of a new wave of innovative and transformative progress in the field.

Clinical Translation Success

Your observation of multiple systematic reviews, meta-analyses, and practice guidelines has indicated the achievement of a translation of research findings into clinical practice. Medical and healthcare organizations are more and more acknowledging the non-pharmacological interventions for their services, and so they are incorporating it into standard care protocols.

Global Perspective and Cultural Integration

By strengthening the ties of the various multinational teams and cultural variety of research methods, the field has improved its understanding about the phenomenon of pain management among different people and healthcare institutions. The merging of customary healing procedures with the Western medicine grounded on science and statistics is a major leap forward.

Future Potential

The distinguished investigate holes and developing advances recommend considerable openings for proceeded progression. Need zones incorporate usage science, wellbeing incongruities inquire about, innovation integration, and financial assessment?

Implications for Nursing Practice

Non-pharmacological torment administration intercessions have advanced from elective choices to basic components of comprehensive nursing care. The strong prove base bolsters their integration into schedule hone, nursing instruction, and healthcare arrangement.

The discoveries of this Bibliometric examination give a guide for analysts, teachers, and professionals looking for to progress non-pharmacological torment administration in nursing. As the field proceeds to advance, continuous checking of investigate patterns and developing proves will be fundamental to guarantee that clinical hone remains current and evidence-based.

The extreme objective of this investigate endeavor is to progress persistent results, decrease dependence on pharmacological intercessions with noteworthy side impacts, and give medical attendants with compelling devices for overseeing one of healthcare’s most essential challenges: the alleviation of human enduring through the easing of torment.

Keywords: Bibliometric analysis, non-pharmacological pain management, nursing interventions, complementary therapy, mind-body interventions, evidence-based practice, pain relief, holistic care

Funding: This Bibliometric analysis was supported by grants from the National Institute of Nursing Research and the American Organization for Nursing Leadership.

Conflicts of Interest: The authors declare no conflicts of interest related to this research.

Data Availability Statement: Detailed Bibliometric datasets and analysis files are available through the corresponding author upon reasonable request. All data sources are publicly available academic databases.

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