101
|
Choi NG, Snow AL, Kunik ME. Pain severity, interference, and prescription analgesic use among depressed, low-income homebound older adults. Aging Ment Health 2016; 20:804-13. [PMID: 25923452 DOI: 10.1080/13607863.2015.1037244] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVES Disabled, homebound individuals tend to suffer both chronic pain and depression; however, low-income, homebound older adults have been underexposed in pain and depression research. We examined the extent of pain frequency, intensity, and interference; the relationship between pain and depressive symptoms; and prescription analgesic use and its association with use of antidepressant and anxiolytic medications among these older adults. METHOD The data came from the baseline assessment of 215 homebound individuals aged 50+ who were referred to a clinical trial of depression treatment. Bivariate and multivariate analyses were used to examine the research questions. RESULTS Almost 87% (n = 186) of the participants reported having had chronic pain in the preceding three months. Of the pain reporters, the mean frequency, intensity, and interference of pain were 8.65 ± 2.05, 7.71 ± 2.10, and 7.80 ± 2.82, respectively, on a 1-10 scale, and 61% were taking a prescription analgesic. Analgesic users and nonusers did not differ in depressive symptoms and in pain frequency and intensity, but analgesic users reported higher pain interference than nonusers (8.22 ± 2.46 vs. 7.14 ± 3.22; t = 2.44, df = 184, p = .016). Pain frequency and interference were significantly associated with depressive symptoms, and pain interference was significantly associated with analgesic use in multivariate analysis. Anxiolytic medication use was also correlated with analgesic use. CONCLUSION The findings underscore the significant pain-related problems in these vulnerable individuals and the need for recognizing and treating both pain and depression more effectively using both pharmacologic and nonpharmacologic interventions.
Collapse
Affiliation(s)
- Namkee G Choi
- a The University of Texas at Austin School of Social Work , Austin , TX , USA
| | - A Lynn Snow
- b Department of Psychology , University of Alabama Center for Mental Health and Aging , Tuscaloosa , AL , USA
| | - Mark E Kunik
- c The Center for Innovations in Quality, Effectiveness and Safety (#CIN 13-413) , Michael E. DeBakey VA Medical Center , Houston , TX , USA.,d Houston VA Health Services Research and Development Center of Excellence , Houston , TX , USA.,e Department of Psychiatry , Baylor College of Medicine , Houston , TX , USA
| |
Collapse
|
102
|
Leov J, Barrett E, Gallagher S, Swain N. A qualitative study of pain experiences in patients requiring hip and knee arthroplasty. J Health Psychol 2016; 22:186-196. [DOI: 10.1177/1359105315597054] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
The aim of this study was to conduct an in-depth investigation of experiences with pain before knee and hip replacement surgery. A total of 20 patients were interviewed, and interpretative phenomenological analysis was used to identify themes. These were as follows: living with pain, pain conceptualised, pain treatments and healthcare system. Pre-surgical pain is very disabling and is viewed as biological. There was an associated loss of independence. Pharmaceutical management is used by all but not entirely effective, psychological therapies are underutilised. Patients were frustrated, angry, and confused about qualifying for surgery. Many areas of care could be improved to help these pre-surgical patients.
Collapse
|
103
|
Karp JF, DiNapoli EA, Wetherell J, Bolon C, Rodriguez E, Shega J, Weiner DK. Deconstructing Chronic Low Back Pain in the Older Adult—Step by Step Evidence and Expert-Based Recommendations for Evaluation and Treatment: Part IX: Anxiety. PAIN MEDICINE 2016; 17:1423-35. [DOI: 10.1093/pm/pnw135] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
|
104
|
Barrett M, Chu A, Chen J, Lam KY, Portenoy R, Dhingra L. Quality of Life in Community-Dwelling Chinese American Patients with Cancer Pain. J Immigr Minor Health 2016; 19:1442-1448. [PMID: 26993113 DOI: 10.1007/s10903-016-0392-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Although pain can be a powerful influence on health-related quality of life (HRQL) in cancer populations, culturally-based beliefs and behaviors may directly impact HQRL or modify the association between pain and HQRL. Studies of well-defined ethnic groups may clarify these relationships and inform culturally competent clinical practices intended to reduce illness burden. We evaluated HRQL in 121 non-English-speaking Chinese immigrants with cancer pain using the Functional Assessment of Cancer Therapy-General (FACT-G) scale. Overall, 91.2 % were born in China and 86.0 % were Cantonese-speaking; 50.8 % had no formal education (mean age = 63.2 years; 68.6 % women). Although the mean FACT-G score did not differ from U.S. population norms, most subscale scores for Chinese immigrants were lower and the score for social/family well-being was higher (all p < 0.05). Higher educational level, caregiver presence, lower psychological distress, lower pain intensity and interference, and lower symptom distress were associated with better HRQL (all p < 0.05). These findings confirm the importance of diverse influences on HQRL in ethnic Chinese cancer patients with chronic pain and suggest that this group may be distinguished from the majority population by the extent to which social/family well-being is preserved. Future studies in the growing population of Chinese Americans with cancer are needed to evaluate various aspects of social/family well-being and determine whether they modify the association between pain and HRQL.
Collapse
Affiliation(s)
| | - Alice Chu
- MJHS Institute for Innovation in Palliative Care, 39 Broadway, 3rd Floor, New York, NY, 10006, USA
| | - Jack Chen
- MJHS Institute for Innovation in Palliative Care, 39 Broadway, 3rd Floor, New York, NY, 10006, USA
| | - Kin Yui Lam
- Community Oncology, Beth Israel Medical Center, New York, NY, USA
| | - Russell Portenoy
- MJHS Institute for Innovation in Palliative Care, 39 Broadway, 3rd Floor, New York, NY, 10006, USA.,Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Lara Dhingra
- MJHS Institute for Innovation in Palliative Care, 39 Broadway, 3rd Floor, New York, NY, 10006, USA.
| |
Collapse
|
105
|
Pope JE, Deer TR, Bruel BM, Falowski S. Clinical Uses of Intrathecal Therapy and Its Placement in the Pain Care Algorithm. Pain Pract 2016; 16:1092-1106. [PMID: 26914961 DOI: 10.1111/papr.12438] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 11/17/2015] [Accepted: 12/02/2015] [Indexed: 11/29/2022]
Abstract
Intrathecal drug delivery is an effective treatment option for patients with severe chronic pain who have not obtained adequate analgesia from more conservative therapies (eg, physical therapy, systemic opioids, nonsteroidal anti-inflammatory drugs, antidepressants, and anticonvulsants). This review focuses on, but is not limited to, the 2 agents currently approved by the U.S. Food and Drug Administration for intrathecal analgesia: preservative-free morphine and ziconotide (a nonopioid, selective N-type calcium channel blocker). We describe the appropriate use of intrathecal therapy in the management of severe chronic pain, based on current best practices. Topics addressed here include patient selection, trialing, dosing and titration, adverse event profiles, long-term management, intrathecal therapy for cancer-related pain, and the placement of intrathecal therapy in the pain care algorithm. In appropriately selected patients with chronic pain, intrathecal therapy can provide substantial pain relief with improved functioning and quality of life. Successful long-term management requires ongoing patient monitoring for changes in efficacy and the occurrence of adverse events, with subsequent changes in intrathecal dosing and titration, the addition of adjuvant intrathecal agents, and the use of concomitant oral medications to address side effects, as needed. Based on an infrequent but clinically concerning risk of overdose, granuloma, and other opioid-induced complications, nonopioid therapy with ziconotide may be preferred as a first-line intrathecal therapy in patients without a history of psychosis or allergy.
Collapse
Affiliation(s)
- Jason E Pope
- Summit Pain Alliance, Santa Rosa, California, U.S.A
| | - Timothy R Deer
- Center for Pain Relief, Charleston, West Virginia, U.S.A
| | - Brian M Bruel
- University of Texas, M.D. Anderson Cancer Center, Houston, Texas, U.S.A
| | - Steven Falowski
- St. Luke's Neurosurgical Associates, St. Luke's University Health Network, Bethlehem, Pennsylvania, U.S.A
| |
Collapse
|
106
|
Wong HJ, Anitescu M. The Role of Health Locus of Control in Evaluating Depression and Other Comorbidities in Patients with Chronic Pain Conditions, A Cross-Sectional Study. Pain Pract 2016; 17:52-61. [PMID: 26895696 DOI: 10.1111/papr.12410] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Revised: 08/26/2015] [Accepted: 09/05/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Chronic pain is significantly influenced by behavioral, cognitive, and emotional factors. Few studies have investigated the health locus of control (HLC)-one's belief regarding where control over one's health lies-as it relates to patients with chronic pain. The purpose of this prospective, cross-sectional study was to examine the relationship between depression and health/pain locus of control (HLC) in adult patients with persistent pain. MATERIAL AND METHODS A series of questionnaires was administered to chronic pain patients, and these questionnaires were scored and analyzed. Patients were categorized into 3 groups based on health locus of control (internal, chance, powerful-others), which were examined with respect to their depression scores using analysis of variance. RESULTS A total of 131 patients completed the study: 33% belonged to the internal group, 39% in the chance group, and 28% in the powerful-others group. The 3 groups had depression scores of 40 (SD = 8), 47 (SD = 10), and 42 (SD = 8), respectively. We found significant difference in depressions scores between the chance group and the internal group (P < 0.005) with the chance group having higher depression scores compared to the internal group. CONCLUSIONS The study shows that patients with an internal locus of control are less depressed compared to patients with fatalistic views on their health/pain in the chance group. The chance dimension of the Multidimensional Health Locus of Control scale was found to be a potential predictor of psychiatric comorbidities such as depression in the chronic pain patient population.
Collapse
Affiliation(s)
- Harry J Wong
- Pritzker School of Medicine, The University of Chicago, Chicago, Illinois, U.S.A
| | - Magdalena Anitescu
- Department of Anesthesia and Critical Care, University of Chicago Medicine, Chicago, Illinois, U.S.A
| |
Collapse
|
107
|
Abstract
The complex, bidirectional correlation between chronic low back pain (CLBP) and generalized anxiety disorder (GAD), common ailments in primary care, can increase the risk of inadequate treatment. This article will review the relationship between CLBP and GAD and provide optimal management strategies for NPs caring for individuals with this dyad.
Collapse
|
108
|
|
109
|
Healey EL, Jinks C, Tan VA, Chew-Graham CA, Lawton SA, Nicholls E, Finney AG, Porcheret M, Cooper V, Lewis M, Dziedzic KS, Wathall S, Mallen CD. Improving the care of people with long-term conditions in primary care: protocol for the ENHANCE pilot trial. JOURNAL OF COMORBIDITY 2015; 5:135-149. [PMID: 29090162 PMCID: PMC5636040 DOI: 10.15256/joc.2015.5.60] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 11/25/2015] [Indexed: 02/01/2023]
Abstract
BACKGROUND Long-term conditions (LTCs) are important determinants of quality of life and healthcare expenditure worldwide. Whilst multimorbidity is increasingly the norm in primary care, clinical guidelines and the delivery of care remain focused on single diseases, resulting in poorer clinical outcomes. Osteoarthritis, and anxiety and/or depression frequently co-occur with other LTCs, yet are seldom prioritized by the patient or clinician, resulting in higher levels of disability, poorer prognosis, and increased healthcare costs. OBJECTIVE To examine the feasibility and acceptability of an integrated approach to LTC management, tackling the under-diagnosis and under-management of osteoarthritis-related pain and anxiety and/or depression in older adults with other LTCs in primary care. DESIGN The ENHANCE study is a pilot stepped-wedge cluster randomized controlled trial to test the feasibility and acceptability of a nurse-led ENAHNCE LTC review consultation for identifying, assessing, and managing joint pain, and anxiety and/or depression in patients attending LTC reviews. Specific objectives (process evaluation and research outcomes) will be achieved through a theoretically informed mixed-methods approach using participant self-reported questionnaires, a medical record review, an ENHANCE EMIS template, qualitative interviews, and audio recordings of the ENHANCE LTC review. DISCUSSION Success of the pilot trial will be measured against the level of the primary care team engagement, assessment of training delivery, and degree of patient recruitment and retention. Patient satisfaction and treatment fidelity will also be explored. ISRCTN registry number: 12154418.
Collapse
Affiliation(s)
- Emma L Healey
- Research Institute for Primary Care & Health Sciences, Keele University, Keele, Staffordshire, UK
| | - Clare Jinks
- Research Institute for Primary Care & Health Sciences, Keele University, Keele, Staffordshire, UK
| | - Valerie A Tan
- Research Institute for Primary Care & Health Sciences, Keele University, Keele, Staffordshire, UK
| | | | - Sarah A Lawton
- Research Institute for Primary Care & Health Sciences, Keele University, Keele, Staffordshire, UK
| | - Elaine Nicholls
- Research Institute for Primary Care & Health Sciences, Keele University, Keele, Staffordshire, UK
| | | | - Mark Porcheret
- Research Institute for Primary Care & Health Sciences, Keele University, Keele, Staffordshire, UK
| | - Vince Cooper
- Research Institute for Primary Care & Health Sciences, Keele University, Keele, Staffordshire, UK
| | - Martyn Lewis
- Research Institute for Primary Care & Health Sciences, Keele University, Keele, Staffordshire, UK
| | - Krysia S Dziedzic
- Research Institute for Primary Care & Health Sciences, Keele University, Keele, Staffordshire, UK
| | - Simon Wathall
- Research Institute for Primary Care & Health Sciences, Keele University, Keele, Staffordshire, UK
| | - Christian D Mallen
- Research Institute for Primary Care & Health Sciences, Keele University, Keele, Staffordshire, UK
| |
Collapse
|
110
|
Knoerl R, Lavoie Smith EM, Weisberg J. Chronic Pain and Cognitive Behavioral Therapy. West J Nurs Res 2015; 38:596-628. [DOI: 10.1177/0193945915615869] [Citation(s) in RCA: 85] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Cognitive behavioral therapy (CBT) is often used to treat chronic pain; however, more information is needed about what are the most efficacious dose and delivery methods. The aims of this review were to determine (a) which CBT doses, delivery methods, strategies, and follow-up periods have been explored in recent intervention studies of individuals with chronic pain and (b) whether the outcomes described in the selected studies were consistent with recommendations by the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials. The CINAHL, EMBASE, PubMed, PsycInfo, and SCOPUS databases were searched for randomized controlled trials published from 2009 to 2015 testing CBT for adults with chronic pain. Thirty-five studies were included in this review. Results revealed that CBT reduced pain intensity in 43% of trials, the efficacy of online and in-person formats were comparable, and military veterans and individuals with cancer-related chronic pain were understudied.
Collapse
Affiliation(s)
- Robert Knoerl
- University of Michigan School of Nursing, Ann Arbor, USA
| | | | | |
Collapse
|
111
|
Gender differences in the impact of mental disorders and chronic physical conditions on health-related quality of life among non-demented primary care elderly patients. Qual Life Res 2015; 25:1461-74. [DOI: 10.1007/s11136-015-1182-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2015] [Indexed: 12/21/2022]
|
112
|
Tok OY, Tok L, Atay IM, Argun TC, Demirci N, Gunes A. Toxic keratopathy associated with abuse of topical anesthetics and amniotic membrane transplantation for treatment. Int J Ophthalmol 2015; 8:938-44. [PMID: 26558205 DOI: 10.3980/j.issn.2222-3959.2015.05.15] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Accepted: 05/11/2015] [Indexed: 11/02/2022] Open
Abstract
AIM To evaluate the clinical findings of toxic keratopathy associated with abuse of topical anesthetics and the treatment efficacy of amniotic membrane transplantation (AMT). METHODS Fifteen eyes of 10 patients with abuse of topical anesthetics were included in this study. The data collected included patients' demographic information, initial best corrected visual acuity (BCVA), clinical findings, time to AMT, duration of epithelization, additional treatments, posttreatment BCVA, and the results of psychiatric examination. RESULTS All patients were male, with the mean age of 37.9±5.4y. The patients had received 0.5% proparacaine hydrochloride due to pain resulting from foreign bodies, such as welding flash burns and car battery explosions, for a mean of 18.2±12.4d. The mean initial BCVA of the patients was 0.069±0.100. All patients had persistent epithelial defects, stromal infiltration, ring ulcer, and corneal edema. Initially, medical treatment was attempted in all cases. Because of severe pain, persistent epithelial defects and progressing stromal thinning did not improve with medical treatment, thus, the patients underwent AMT. The mean posttreatment BCVA of the patients was 0.33±0.27. All of them, except for two patients, showed improved visual acuity. One patient underwent evisceration for corneal melting and endophthalmitis in another center, and one patient underwent evisceration for severe pain of unknown origin. All 5 patients who consented to a psychiatric examination had depression, had personality disorder, and used tobacco. CONCLUSION AMT appears to be an effective method for pain relief, rapid epithelial and stromal healing; however, visual prognosis is still poor despite medical and surgical interventions.
Collapse
Affiliation(s)
- Ozlem Yalcin Tok
- Department of Ophthalmology, Süleyman Demirel University Research and Education Hospital, TR-32260 Çünür-Isparta, Turkey
| | - Levent Tok
- Department of Ophthalmology, Süleyman Demirel University Research and Education Hospital, TR-32260 Çünür-Isparta, Turkey
| | - Inci Meltem Atay
- Department of Psychiatry, Süleyman Demirel University Research and Education Hospital, TR-32260 Çünür-Isparta, Turkey
| | - Tugba Cakmak Argun
- Department of Ophthalmology, Süleyman Demirel University Research and Education Hospital, TR-32260 Çünür-Isparta, Turkey
| | - Nazire Demirci
- Department of Ophthalmology, Süleyman Demirel University Research and Education Hospital, TR-32260 Çünür-Isparta, Turkey
| | - Alime Gunes
- Department of Ophthalmology, Süleyman Demirel University Research and Education Hospital, TR-32260 Çünür-Isparta, Turkey
| |
Collapse
|
113
|
Arvidsdotter T, Marklund B, Kylén S, Taft C, Ekman I. Understanding persons with psychological distress in primary health care. Scand J Caring Sci 2015; 30:687-694. [PMID: 26463897 DOI: 10.1111/scs.12289] [Citation(s) in RCA: 101] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2015] [Accepted: 08/13/2015] [Indexed: 11/30/2022]
Abstract
The purpose of this study was to gain more knowledge and a deeper understanding of experiences of persons living with psychological distress who seek help in primary care. Psychological distress is a state of emotional suffering associated with stressors and demands that are difficult to cope with in daily life. The lack of effective care for and difficulty in identifying psychological distress is frustrating for patients and health professionals alike. The aim was therefore to gain more knowledge about the experience of living with psychological distress. Twelve persons (nine women and three men) aged 23-51 years were interviewed. Analyses were based on a phenomenological hermeneutic method and indicated that psychological distress may be seen as an imbalance (incongruence) between the self and the ideal self, which slowly breaks down a person's self-esteem. This imbalance was described in three dimensions: Struggling to cope with everyday life, Feeling inferior to others and Losing one's grip on life. It seems to be associated with a gradual depletion of existential capacities and lead to dissatisfaction, suffering, poor self-esteem and lack of control. As psychological distress may be a forerunner to mental, physical and emotional exhaustion, there is a need to initiate preventive or early interventions to avoid mental, physical and emotional chaos in such patients. Patients' with psychological distress need to be involved in a person-centred salutogenic dialogue with health professionals to become aware of and strengthen their own capacities to regain health and well-being.
Collapse
Affiliation(s)
- Tina Arvidsdotter
- Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Primary Health Care Research Development and Education Centre, Vänersborg, Sweden
| | - Bertil Marklund
- Primary Health Care Research Development and Education Centre, Vänersborg, Sweden.,Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Sven Kylén
- Primary Health Care Research Development and Education Centre, Vänersborg, Sweden
| | - Charles Taft
- Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Centre for Person Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
| | - Inger Ekman
- Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Centre for Person Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
| |
Collapse
|
114
|
Smedley R, Coulson N, Gavin J, Rodham K, Watts L. Online social support for Complex Regional Pain Syndrome: A content analysis of support exchanges within a newly launched discussion forum. COMPUTERS IN HUMAN BEHAVIOR 2015. [DOI: 10.1016/j.chb.2015.04.040] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
115
|
Physical activity, pain responses to heat stimuli, and conditioned pain modulation in postmenopausal women. Menopause 2015; 22:816-25. [DOI: 10.1097/gme.0000000000000398] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
|
116
|
McDonald DD, Soutar C, Chan MA, Afriyie A. A closer look: Alternative pain management practices by heart failure patients with chronic pain. Heart Lung 2015; 44:395-9. [PMID: 26088386 DOI: 10.1016/j.hrtlng.2015.06.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2014] [Revised: 05/27/2015] [Accepted: 06/01/2015] [Indexed: 01/16/2023]
Abstract
OBJECTIVE To describe alternative non-pharmaceutical non-nutraceutical pain self-management strategies used by people with heart failure (HF) in order to reduce chronic non-cardiac pain. BACKGROUND Little is known about alternative pain self-treatments used by HF patients with chronic pain. METHODS A cross-sectional descriptive design was used with 25 hospitalized HF patients who had chronic pain and used at least one alternative pain treatment. Pain intensity, pain interference with function, and current pain treatments were measured with the Brief Pain Inventory. RESULTS Alternative treatments included walking, stretching, use of heat and cold. Five patients used evidence-based pain treatments for their chronic pain conditions. Patients reported moderate pain intensity and pain interference with activity. CONCLUSIONS Patients with HF and chronic pain use few alternative pain treatments. Screening for chronic pain and referral to Integrative Medicine and/or Palliative care for a pain management consult might reduce the added burden of pain in people with HF.
Collapse
Affiliation(s)
- Deborah Dillon McDonald
- University of Connecticut School of Nursing, 231 Glenbrook Road, Storrs, CT 06269-2026, USA.
| | - Christina Soutar
- Saint Francis Hospital and Medical Center, 114 Woodland Street, Hartford, CT 06105, USA
| | - Maria Agudelo Chan
- Masonicare Partners Home Health and Hospice, 111 Founders Plaza, East Hartford, CT 06108, USA
| | - Angela Afriyie
- Saint Francis Hospital and Medical Center, 114 Woodland Street, Hartford, CT 06105, USA
| |
Collapse
|
117
|
Arvidsdotter T, Marklund B, Taft C, Kylén S. Quality of life, sense of coherence and experiences with three different treatments in patients with psychological distress in primary care: a mixed-methods study. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 15:132. [PMID: 25928131 PMCID: PMC4467206 DOI: 10.1186/s12906-015-0654-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Accepted: 04/17/2015] [Indexed: 12/14/2022]
Abstract
Background Psychological distress is associated with impaired health-related quality of life (HRQL) and poor sense of coherence (SOC). In a previous study, we found that therapeutic acupuncture (TA) and an integrative treatment that combined TA with person-centred approach in a salutogenic dialogue (IT) alleviated anxiety and depression significantly more than conventional treatment (CT) in primary care patients. Here, we report on secondary analyses regarding the HRQL and SOC from that previous pragmatic randomised controlled trial (RCT). Method Quantitative and qualitative design. One hundred twenty patients were referred for psychological distress. Quantitative analyses were performed at baseline and after 8 weeks of treatment using the SF-36 mental component summary (MCS), physical component summary (PCS) and the Sense of Coherence-13 (SOC) questionnaires. Qualitative manifest content analyses were based on open-ended questions—“Have you experienced any changes since the start of the treatment? Will you describe these changes?” Results No baseline differences were found. At 8 weeks, both the IT and TA groups had statistically better scores and greater improvement from baseline on the MCS and SOC than the CT group. The effect sizes were large. No significant differences were found between the IT and TA groups or in relation to the PCS. SOC was highly correlated with the MCS but not with the PCS. Dropout rates were low. The experiences of the intervention resulted in four categories: Being heading back; Status quo; Feeling confirmed; and Feeling abandoned, with 13 related subcategories. Conclusion IT and TA seem to improve sense of coherence and mental health status in primary care patients with psychological distress, whereas CT appears to be less beneficial. IT and TA appear to be well-accepted and may serve as useful adjunct treatment modalities to standard primary care. Our results are consistent with much of the previous research in highlighting a strong relationship between SOC and mental health status. The written qualitative data described feeling confirmed and feeling increased self-efficacy, self-care and faith in the future. Those in the CT group, however, described feeling abandoned, missing treatment and experiencing increased emotional and physical problems. More research is needed. Trial registration ISRCTN trial number NCT01631500.
Collapse
|
118
|
Scarpignato C, Gatta L. Comparing tapentadol to oxycodone/naloxone combination: building castles in the air. Curr Med Res Opin 2015; 31:335-8. [PMID: 25166457 DOI: 10.1185/03007995.2014.957823] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
119
|
Miró J, Gertz KJ, Carter GT, Jensen MP. Pain Location and Functioning in Persons With Spinal Cord Injury. PM R 2014; 6:690-7. [DOI: 10.1016/j.pmrj.2014.01.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2013] [Revised: 01/05/2014] [Accepted: 01/09/2014] [Indexed: 01/22/2023]
|
120
|
Samsson KS, Larsson MEH. Physiotherapy triage assessment of patients referred for orthopaedic consultation - Long-term follow-up of health-related quality of life, pain-related disability and sick leave. ACTA ACUST UNITED AC 2014; 20:38-45. [PMID: 25088308 DOI: 10.1016/j.math.2014.06.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Revised: 05/09/2014] [Accepted: 06/24/2014] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The literature indicates that physiotherapy triage assessment can be efficient for patients referred for orthopaedic consultation, however long-term follow up of patient reported outcome measures are not available. AIM To report a long-term evaluation of patient-reported health-related quality of life, pain-related disability, and sick leave after a physiotherapy triage assessment of patients referred for orthopaedic consultation compared with standard practice. METHODS Patients referred for orthopaedic consultation (n = 208) were randomised to physiotherapy triage assessment or standard practice. The randomised cohort was analysed on an intention-to-treat (ITT) basis. The patient reported outcome measures EuroQol VAS (self-reported health-state), EuroQol 5D-3L (EQ-5D) and Pain Disability Index (PDI) were assessed at baseline and after 3, 6 and 12 months. EQ VAS was analysed using a repeated measure ANOVA. PDI and EQ-5D were analysed using a marginal logistic regression model. Sick leave was analysed for the 12 months following consultation using a Mann-Whitney U-test. RESULTS The patients rated a significantly better health-state at 3 after physiotherapy triage assessment [mean difference -5.7 (95% CI -11.1; -0.2); p = 0.04]. There were no other statistically significant differences in perceived health-related quality of life or pain related disability between the groups at any of the follow-ups, or sick leave. CONCLUSION This study reports that the long-term follow up of the patient related outcome measures health-related quality of life, pain-related disability and sick leave after physiotherapy triage assessment did not differ from standard practice, indicating the possible benefits of implementation of this model of care.
Collapse
Affiliation(s)
- Karin S Samsson
- Department of Clinical Neuroscience and Rehabilitation, The Sahlgrenska Academy, Gothenburg University, Box 430, 405 30 Gothenburg, Sweden; Närhalsan Tjörn Rehabilitation Clinic, Primary Healthcare, Region Västra Götaland, Syster Ebbas väg 1, 471 94 Kållekärr, Sweden.
| | - Maria E H Larsson
- Department of Clinical Neuroscience and Rehabilitation, The Sahlgrenska Academy, Gothenburg University, Box 430, 405 30 Gothenburg, Sweden; Närhalsan Research and Development, Primary Healthcare, Region Västra Götaland, Kungsgatan 12, level 6 411 18 Gothenburg, Sweden
| |
Collapse
|
121
|
Franklin Z, Smith N, Fowler N. Defensive high-anxious individuals with chronic back pain demonstrate different treatment choices and patient persistence. PERSONALITY AND INDIVIDUAL DIFFERENCES 2014. [DOI: 10.1016/j.paid.2014.02.020] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
122
|
Arvidsdotter T, Marklund B, Taft C. Six-month effects of integrative treatment, therapeutic acupuncture and conventional treatment in alleviating psychological distress in primary care patients--follow up from an open, pragmatic randomized controlled trial. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2014; 14:210. [PMID: 24980440 PMCID: PMC4096519 DOI: 10.1186/1472-6882-14-210] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Accepted: 06/20/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND To evaluate and compare 6-month effects of 8 weeks of an integrative treatment (IT), therapeutic acupuncture (TA), and conventional treatment (CT) in reducing symptoms of anxiety, depression and in improving health-related quality of life (HRQL) and sense of coherence (SOC) in psychologically distressed primary care patients. METHODS Patients who had participated in an open, pragmatic randomized controlled trial were followed up six months after treatment. The study sample consisted of 120 adults (40 per treatment arm) aged 20 to 55 years referred from four different primary health care centres in western Sweden for psychological distress. Assessments were made at baseline after eight weeks and after 24 weeks. Anxiety and depression were evaluated with the Hospital Anxiety and Depression scale (HADS), HRQL with the SF-36 Mental Component Summary scores (MCS) and SOC with the Sense of Coherence-13 questionnaire. RESULTS No baseline differences were found between groups on any outcome variable. At 24 weeks, IT and TA had significantly better values than CT on all variables. All three groups showed significant improvements from baseline on all variables, except HAD depression in CT; however, improvements were significantly greater in IT and TA than in CT. IT and TA did not differ on any outcome variable. Effect sizes were large in IT and TA for all variables and small or moderate in CT. Improvements on all variables seen after 8-weeks of IT and TA remained stable at 24 weeks and the CT group improved on HAD anxiety. CONCLUSIONS IT and TA seem to be more beneficial than CT in reducing anxiety, depression, and in improving quality of life and sense of coherence after 24 weeks of follow up in patients with psychological distress. More research is needed to confirm these results. TRIAL REGISTRATION ISRCTN trial number NCT01631500.
Collapse
Affiliation(s)
- Tina Arvidsdotter
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Primary Health Care Research Development and Education Centre, Vänersborg, Sweden
| | - Bertil Marklund
- Department of Primary Health Care, University of Gothenburg, Gothenburg, Sweden
- Primary Health Care Research Development and Education Centre, Vänersborg, Sweden
| | - Charles Taft
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- University of Gothenburg Centre for Person-Centred Care, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| |
Collapse
|
123
|
Zhang S, Jin X, You Z, Wang S, Lim G, Yang J, McCabe M, Li N, Marota J, Chen L, Mao J. Persistent nociception induces anxiety-like behavior in rodents: role of endogenous neuropeptide S. Pain 2014; 155:1504-1515. [PMID: 24793908 DOI: 10.1016/j.pain.2014.04.026] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Revised: 04/17/2014] [Accepted: 04/23/2014] [Indexed: 11/30/2022]
Abstract
Anxiety disorder is a comorbid condition of chronic pain. Analgesics and anxiolytics, subject to addiction and abuse, are currently used to manage pain and anxiety symptoms. However, the cellular mechanism underlying chronic pain and anxiety interaction remains to be elucidated. We report that persistent nociception following peripheral nerve injury induced anxiety-like behavior in rodents. Brain expression and release of neuropeptide S (NPS), a proposed endogenous anxiolytic peptide, was diminished in rodents with coexisting nociceptive and anxiety-like behaviors. Intracerebroventricular administration of exogenous NPS concurrently improved both nociceptive and anxiety-like behaviors. At the cellular level, NPS enhanced intra-amygdaloidal inhibitory transmission by increasing presynaptic gamma-aminobutyric acid (GABA) release from interneurons. These findings indicate that the interaction between nociceptive and anxiety-like behaviors in rodents may be regulated by the altered NPS-mediated intra-amygdaloidal GABAergic inhibition. The data suggest that enhancing the brain NPS function may be a new strategy to manage comorbid pain and anxiety.
Collapse
Affiliation(s)
- Shuzhuo Zhang
- MGH Center for Translational Pain Research, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA Department of Anesthesia and Pain Therapy, Beijing Tiantan Hospital Affiliated to Capital Medical University, Beijing 100050, China
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
124
|
Hoffelt C, Zwack A. Assessment and management of chronic pain in patients with depression and anxiety. Ment Health Clin 2014. [DOI: 10.9740/mhc.n198935] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This article will review the role of the pharmacist in the management of chronic pain in patients with comorbid mood disorders.
Collapse
|