Introduction
Among diseases causing chronic pain, migraine is known quite well among general audiences, yet the awareness about its identification and treatment remains quite low. Nonetheless, the phenomenon has been studied meticulously by multiple researchers exploring different ways of reducing the painful experiences and alleviating them (Voicu et al., 2019). For instance, Skarstein, Lagerløv, Kvarme, and Helseth (2016) suggest that meditation could be used to introduce patients to the opportunity of self-regulating migraine. In turn, the study by Andersson, Persson, and Kjellgren (2017) represents the other side of the spectrum of solutions to managing pain, suggesting psychoactive medications as the last resort. The inclusion of these studies into the literature review has helped to create the basis for evaluating the effects of caffeine on the medications taken by adolescents with migraine, which this paper studies (Lee, Choi, Choi, & Chung, 2016). Although both articles had several weaknesses that reduced their applicability of their results slightly, the overall effective management of limitations helped the authors to make the research outcomes meaningful and helpful.
Critical Appraisal
Study Background
Studying pain management and alleviation is central to modern healthcare. Both Andersson et al. (2017) and Skarstein et al. (2016) focus on the problem of pain alleviation in chronic patients. Andersson et al. (2017) elaborates on the application of psychoactive substances and the associated threats, whereas Skarstein et al. (2016) consider the effects of analgesics on the quality of young people’s lives. Thus, the purpose of Skarstein et al.’s (2016) paper is to evaluate whether analgesics have any tangible side effects on the well-being of adolescents with migraine, namely, meditation. In turn, Andersson et al. (2017) explore the benefits of self-treatment involving the use of over-the-counter medicine and the detrimental effects that psychoactive drugs produces on the target population.
Consequently, the objective that the paper by Andersson et al. (2017) pursues can be summarized as defining the negative outcomes of self-treatment and the threats that they imply for the health of patients with migraine. Addressing the problem of pain management on a broader sense, Skarstein et al. (2016) considers the application of analgesics as the method of alleviating severe chronic pain, in general, yet the research pursues a similar goal of proving the negative effects of the said medicine on patients. Thus, the corresponding research questions that each study asks are “How over-the-counter analgesic reduces adolescents’ quality of life?” and “What themes are associated with the use of psychoactive substances for managing migraine?” Both articles have very high significance for the development of nursing since they evaluate the opportunities for alleviating pain and suggest new ways of improving patients’ health status.
Method of Study
Both articles under analysis use the qualitative research method to answer the questions that they ask. However, each of the articles manages to create a unique way of researching the topic. The data collection method and the resulting choice of the analysis framework are the main points of difference between the articles. Specifically, Skarstein et al. (2016) use in-depth interviews as the method of extracting data, which reduces the sample size significantly. Arguably, interview results may be interpreted subjectively, which makes it a less credible method of data collection (Voicu et al., 2017). However, the integration of interviews into the research also helps to obtain additional information that will allow examining the emergent themes closer and identify the effects of analgesic on patients with migraine.
Likewise, the approach that Andersson et al. (2017) incorporate into their research to obtain and analyze data is very elaborate and accurate. The authors adopt a literature review to obtain information and utilize the thematic analysis as the basis for the assessment of the discourse. The use of a literature review as the main data collection technique helps to encompass the latest information concerning the effects that psychoactive substances have on the management of pain. What makes the described strategy different from the approach utilized by Skarstein et al. (2016) is the absence of research participants.
However, the specified amount of data is very difficult to encompass and process, which is the main limitation of the chosen method. Thus, the application of thematic analysis is particularly useful and thoughtful in this case. Namely, the inclusion of thematic analysis into the research as the main analysis tool helps to distill key themes, thus determining underlying factors affecting the alleviation of pain in the selected demographic (Andersson et al., 2017). Therefore, the methods used by Andersson et al. (2017) can be considered legitimate and appropriate for the questions that their paper posse and the results that they seek to obtain. The themes such as despair, high reliance on the forum support, search for alternative treatment, dosage, and effects were identified.
Results of Study
Both studies provide vital information for managing the needs of young patients with migraine. Andersson et al.’s (2017) research proves that, while very few explicitly negative results were reported after prescribing illicit drugs, adolescents with migraine showed higher levels of desperation when seeking the ways of obtaining the specified substances compared to those that relied on the prescribed medication. In turn, the study by Skarstein et al. (2016) showed the prevalence of the decision to use over-the-counter substances in patients with migraine. Moreover, the author discovered that the described choice was often the result of maternal influence (Skarstein et al., 2016). Overall, the research points to the low quality of life in young people with migraine who resort to using over-the-counter analgesic as the method of alleviating their pain.
The results mentioned above have major implications for the nursing practice and the existing nursing standards. First, the use of medication for addressing the needs of adolescents with migraine may finally be reconsidered due to multiple negative effects that it produces. In addition, alternative solutions, including self-regulation of pain and the introduction of pain management techniques that give patients greater agency may finally be developed (Wham, Rowe, Ali, & Rutherford-Markwick, 2017). Finally, the use of over-the-counter medication as the solution to migraine issues will be stopped since it proves to have vastly adverse effects on patients’ well-being. Since adolescents were chosen as the target category of patients for the research, the results of the study become especially significant, as they will help to improve the quality of care for a vulnerable group.
Ethical Considerations
Similarly to quantitative studies, qualitative research also requires addressing possible ethical concerns related to participants’ consent and working with underage participants. Therefore, the fact that Skarstein et al. (2016) emphasize the use of informed consent as a critical part of their data collection model proves that their studies comply with the existing ethical requirements fully. Given the fact that Skarstein et al. (2016) targeted underage students as research participants, obtaining the consent was particularly complicated. The authors managed to address this issue by obtaining consent from school principals: “Principals of ten schools gave written consent to inform and recruit adolescents at their schools” (Skarstein et al., 2016, p. 2). In turn, Andersson et al. (2017) explain quite explicitly in their research that their paper did not need the support of data obtained from research participants, hence none was recruited. Namely, the authors state the following: “No direct interaction or attempted contacts were initiated” (Andersson et al., 2017, p. 9). Therefore, the two ethical issues at hand, namely. Informed consent and the use of underage participants in research were managed adequately.
Conclusion
Despite having minor issues in their methodology and lacking statistical representation in their results, both article sunder analysis have managed to produce important conclusions about the strategies used presently for managing chronic pain, in general, and migraine, in particular. Therefore, the papers under analysis can be used as supporting evidence in the study of migraine and the effects that caffeine produces on the efficacy of medications, specifically, analgesic ones, on adolescents suffering from migraine. The papers by Skarstein et al. (2016) and Andersson et al. (2017) are characterized by high credibility rates and can be used to establish the connection between the use of migraine-related medications and the development of migraine. Although causality is quite difficult to establish in qualitative research, the connection between the variables in the articles under analysis is proven quite clearly, which increases their credibility. Overall, the articles by Skarstein et al. (2016) and Andersson et al. (2017) can be deemed as vital additions to the analysis of migraine as a health issue.
References
Andersson, M., Persson, M., & Kjellgren, A. (2017). Psychoactive substances as a last resort – A qualitative study of self-treatment of migraine and cluster headaches. Harm Reduction Journal, 14(1), 1-10. Web.
Lee, M. J., Choi, H. A., Choi, H., & Chung, C. (2016). Caffeine discontinuation improves acute migraine treatment: A prospective clinic-based study. The Journal of Headache and Pain, 17(1), 1-6. Web.
Skarstein, S., Lagerløv, P., Kvarme, L. G., & Helseth, S. (2016). High use of over-the-counter analgesic; possible warnings of reduced quality of life in adolescents – A qualitative study. BMC Nursing, 15(1), 1-11. Web.
Voicu, V. A., Mircioiu, C., Plesa, C., Jinga, M., Balaban, V., Sandulovici, R.,… Mircioiu, I. (2019). Effect of a new synergistic combination of low doses of acetylsalicylic acid, caffeine, acetaminophen, and chlorpheniramine in acute low back pain. Frontiers in Pharmacology, 10. Web.
Voicu, V. A., Mircioiu, I., Sandulovici, R., Mircioiu, C., Plesa, C., Velescu, B. S., & Anuta, V. (2017). Chlorpheniramine potentiates the analgesic effect in migraine of usual caffeine, acetaminophen, and acetylsalicylic acid combination. Frontiers in Pharmacology, 8(758), 1-11. Web.
Wham, C., Rowe, K., Ali, A., & Rutherford-Markwick, K. (2017). Influences of caffeine consumption among adult New Zealanders: A qualitative study. Journal of Caffeine Research, 7(4), 142-150.