RETROSPECTIVE & DAILY PAIN RATINGS IN ADULTS WITH POSTHERPETIC NEURALGIA

Background: Postherpetic neuralgia (PHN), which may occur after shingles, is a severe, life altering condition that afflicts approximately 20-30% of individuals who have shingles. While an acute episode of shingles typically lasts 3-4 weeks, PHN can last for months or even years. The primary cause of morbidity in PHN is pain, which is known to be one of the most intractable neuropathic pain disorders. Meditation has been reported as having a positive impact on quality of life in chronic pain, but its use has not been specifically studied in PHN.

Purpose: This study compared pain ratings of community-dwelling older adults with postherpetic neuralgia (PHN) who added meditation to their daily routine with pain ratings of a comparison group who followed their daily routine without the meditation component.

Methods: This randomized pilot study used a repeated measures experimental design to examine the effects of meditation in community dwelling older adults with PHN. Retrospective data were collected at entry to the study (Time 1), two weeks later (Time 2), and then six weeks later (Time 3). Between Time 1 and Time 2 all participants followed usual care only, and recorded their levels of pain in a daily log. Between Time 2 and Time 3 the treatment group added meditation to their usual care, and all participants (treatment and comparative groups) continued recording level of pain in a daily log, for a total of 8 weeks of daily pain ratings for all study participants.

Sample: The 27 study participants were between 55 and 90 years of age, with a mean of 72 years. Fifteen participants were female, and 12 were male. Fourteen participants were White, 11 were Hispanic, and 2 were American Indian. At entry to the study, 18 participants reported moderate or greater pain seven days per week due to PHN.

Results: Analysis of the retrospective data included repeated measures ANOVA for the three time periods. Although no statistically significant differences were found for time or interaction effects, trends indicating a favorable response to mindfulness meditation over time were identified in the majority of the outcome variables. Comparison of retrospective data with daily ratings of pain will be reported on our poster.

Implications: Meditation is a self-management tool that may enable persons with PHN to minimize visits to health care providers for pain control. Multiple medications are often required for managing the pain in PHN, and meditation may provide an adjuvant to pharmacotherapy for pain control. Meditation is easily taught, and can be incorporated into a nurse’s plan of care for older adults with PHN.

Findings from this pilot study will provide data for a larger proposal comparing usual care alone with usual care plus meditation in older adults with a variety of chronic pain conditions. Future studies will include a sample size that is powered to detect significant differences at α=.05.