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Amber DG, Lore D, Elien VDG, Jan S, Michel M, An DG, Mira M. From breast cancer diagnosis to survivorship: Analyzing perioperative biopsychosocial phenotypes and their relationship to pain on long term. THE JOURNAL OF PAIN 2024; 26:104709. [PMID: 39419367 DOI: 10.1016/j.jpain.2024.104709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 09/30/2024] [Accepted: 10/13/2024] [Indexed: 10/19/2024]
Abstract
Persistent breast cancer treatment-related pain affects up to 40% of patients, decreasing their quality of life (QoL). While current research typically utilizes correlation and regression analysis to identify biopsychosocial phenotypes contributing to this pain, this study employs cluster analysis to identify qualitatively different phenotypes based on somatosensory and psychosocial characteristics both before and one week post-breast cancer surgery. Further, it investigates how these phenotypes are related to pain intensity one year post-surgery and examines the evolution of phenotype membership from pre- to post-surgery. Somatosensory and psychosocial functioning was evaluated pre- and post-surgery in 184 women undergoing unilateral breast cancer surgery. Eight different quantitative sensory testing (QST) methods including mechanical detection and pain thresholds, pressure pain thresholds, thermal detection and pain thresholds, and conditioned pain modulation were performed at the surgical area (trunk, arm, major pectoral muscle) and a distant location (quadriceps muscle). Psychosocial functioning was assessed using the Central Sensitization Inventory, Pain Catastrophizing Scale, Depression Anxiety Stress Scale-21, and the McGill Quality of Life Questionnaire. Pain intensity was evaluated one year post-breast cancer surgery using the Visual Analogue Scale. Latent class analysis identified five distinct phenotypes before and post-surgery, characterized by differences in mechanical and pain thresholds alongside psychosocial factors. Moreover, higher psychosocial distress and lower QoL correlated with elevated pain intensity one year post-surgery. These findings underscore the importance of addressing breast cancer patients' mental health perioperatively. Therefore, future research should explore whether psychological interventions perioperatively can reduce long-term pain intensity. PERSPECTIVE: This secondary analysis, utilizing cluster analysis, reveals five distinct phenotype based on somatosensory and psychosocial characteristics both before and post-breast cancer surgery. Higher psychosocial distress and lower quality of life correlated with elevated pain intensity one year post-surgery, emphasizing the need to address patients' mental health perioperatively. TRIAL REGISTRATION: clinicaltrials.gov (NCT03351075).
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Affiliation(s)
- De Groote Amber
- MOVANT, Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium; Pain in Motion International Research Group, Belgium
| | - Dams Lore
- MOVANT, Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium; Pain in Motion International Research Group, Belgium; University Hospital Leuven, Department of Physical and Rehabilitation Medicine, Leuven, Belgium
| | - Van der Gucht Elien
- University Hospital Leuven, Department of Physical and Rehabilitation Medicine, Leuven, Belgium
| | - Schepers Jan
- Department of Methodology and Statistics, Maastricht University, Maastricht, the Netherlands
| | - Mertens Michel
- MOVANT, Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium; Pain in Motion International Research Group, Belgium; Research School CAPHRI, Department of Rehabilitation Medicine, Maastricht University, the Netherlands
| | - De Groef An
- MOVANT, Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium; Pain in Motion International Research Group, Belgium; KU Leuven - University of Leuven, Department of Rehabilitation Sciences, Leuven, Belgium
| | - Meeus Mira
- MOVANT, Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium; Pain in Motion International Research Group, Belgium.
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Wu F, Liu J, Zheng L, Chen C, Basnet D, Zhang J, Shen C, Feng X, Sun Y, Du X, Zheng JC, Liu J. Preoperative pain sensitivity and its correlation with postoperative acute and chronic pain: a systematic review and meta-analysis. Br J Anaesth 2024; 133:591-604. [PMID: 38879440 DOI: 10.1016/j.bja.2024.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 04/24/2024] [Accepted: 05/21/2024] [Indexed: 08/12/2024] Open
Abstract
BACKGROUND Preoperative pain sensitivity (PPS) can be associated with postsurgical pain. However, estimates of this association are scarce. Confirming this correlation is essential to identifying patients at high risk for severe postoperative pain and for developing analgesic strategy. This systematic review and meta-analysis summarises PPS and assessed its correlation with postoperative pain. METHODS PubMed, Scopus, Cochrane Library, and PsycINFO were searched up to October 1, 2023, for studies reporting the association between PPS and postsurgical pain. Two authors abstracted estimates of the effect of each method independently. A random-effects model was used to combine data. Subgroup analyses were performed to investigate the effect of pain types and surgical procedures on outcomes. RESULTS A total of 70 prospective observational studies were included. A meta-analysis of 50 studies was performed. Postoperative pain was negatively associated with pressure pain threshold (PPT; r=-0.15, 95% confidence interval [CI] -0.23 to -0.07]) and electrical pain threshold (EPT; r=-0.28, 95% CI -0.42 to -0.14), but positively correlated with temporal summation of pain (TSP; r=0.21, 95% CI 0.12-0.30) and Pain Sensitivity Questionnaire (PSQ; r=0.25, 95% CI 0.13-0.37). Subgroup analysis showed that only TSP was associated with acute and chronic postoperative pain, whereas PPT, EPT, and PSQ were only associated with acute pain. A multilevel (three-level) meta-analysis showed that PSQ was not associated with postoperative pain. CONCLUSIONS Lower PPT and EPT, and higher TSP are associated with acute postoperative pain while only TSP is associated with chronic postoperative pain. Patients with abnormal preoperative pain sensitivity should be identified by clinicians to adopt early interventions for effective analgesia. SYSTEMATIC REVIEW PROTOCOL PROSPERO (CRD42023465727).
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Affiliation(s)
- Fan Wu
- Department of Anaesthesiology, School of Medicine, Tongji Hospital, Tongji University, Shanghai, China
| | - Jiehui Liu
- Department of Anaesthesiology, School of Medicine, Tongji Hospital, Tongji University, Shanghai, China
| | - Liang Zheng
- Research Center for Translation Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Changqi Chen
- Department of Anaesthesiology, School of Medicine, Tongji Hospital, Tongji University, Shanghai, China
| | - Diksha Basnet
- Department of Anaesthesiology, School of Medicine, Tongji Hospital, Tongji University, Shanghai, China
| | - Jingya Zhang
- Department of Anaesthesiology, School of Medicine, Tongji Hospital, Tongji University, Shanghai, China
| | - Chaonan Shen
- Research Center for Translation Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xuanran Feng
- Department of Anaesthesiology, School of Medicine, Tongji Hospital, Tongji University, Shanghai, China
| | - Yiyan Sun
- Department of Anaesthesiology, School of Medicine, Tongji Hospital, Tongji University, Shanghai, China
| | - Xue Du
- Department of Anaesthesiology, School of Medicine, Tongji Hospital, Tongji University, Shanghai, China
| | - Jialin C Zheng
- Center for Translational Neurodegeneration and Regenerative Therapy, Tongji Hospital Affiliated to Tongji University School of Medicine, Shanghai, China; Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital Affiliated to Tongji University School of Medicine, Shanghai, China
| | - Jianhui Liu
- Department of Anaesthesiology, School of Medicine, Tongji Hospital, Tongji University, Shanghai, China.
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Aydin A, Gürsoy A. Nurse-led support impact via a mobile app for breast cancer patients after surgery: a quasi-experimental study (step 2). Support Care Cancer 2024; 32:598. [PMID: 39164444 DOI: 10.1007/s00520-024-08819-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 08/16/2024] [Indexed: 08/22/2024]
Abstract
Breast cancer patients may experience some health issues following surgery. Training patients about self-care plays a vital role in managing these symptoms. Mobile applications are a contemporary and appropriate approach to support patients about the potential symptoms following breast cancer surgery. This quasi-experimental study aimed to assess the impact of nurse-led support mobile application (NL-Mapp) delivered on breast cancer patients after surgery. Ninety participants were recruited, with 45 assigned to the intervention group and 45 to the control group. Subjects in the intervention group received NL-Mapp in addition to routine care, while those in the control group received only routine care over four weeks. The intervention included educational content on the postoperative period of breast cancer. Outcomes were assessed at baseline (M0), before discharge (M1), and one month after surgery (M2). The intervention group patients had significantly improved pain, affected shoulder functions, and anxiety owing to the effects of group, time, and group-time interaction. Body image and sexual adjustment were enhanced based on time and group-time interaction effects. During the follow-up period, experimental group patients experienced an improvement in body image and sexual adjustment, while those in the control group showed a decrease. This suggests that NL-Mapp may play a significant role in training breast cancer patients to manage their symptoms after surgery.
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Affiliation(s)
- Aydanur Aydin
- Nursing Department, Faculty of Health Sciences, Gümüşhane University, University Street, Gümüşhane, Turkey.
| | - Ayla Gürsoy
- Nursing Department, Faculty of Health Sciences, Antalya Bilim University, Antalya, Turkey
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Vittori A, Cascella M, Di Gennaro P, Marchetti G, Francia E, Mascilini I, Tarquini R, Innamorato MA, Petrucci E, Marinangeli F, Coluccia S, Picardo SG. Advanced statistical approaches for predicting pain after pediatric thoracotomy: a cross-sectional study using zero-inflated and Poisson models. JOURNAL OF ANESTHESIA, ANALGESIA AND CRITICAL CARE 2024; 4:53. [PMID: 39103959 PMCID: PMC11299347 DOI: 10.1186/s44158-024-00188-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Accepted: 07/28/2024] [Indexed: 08/07/2024]
Abstract
BACKGROUND Thoracotomy is one of the surgical procedures most burdened by chronic post-operative pain. There is poor evidence regarding the possibility that even in pediatric patients, thoracotomy can be followed by post-operative pain. The primary objective of this analysis is to identify associations with home pain therapy, pain intensity, and possible protective factors acting on chronic pain in this population. METHODS A retrospective cross-sectional study was conducted at Ospedale Pediatrico Bambino Gesù IRCCS. The study included pediatric patients undergoing thoracotomy. For statistical analyses, a logistic model and a zero-inflated strategy were implemented to explore associations and predict factors related to home-based analgesic therapy and pain intensity. RESULTS Gender and age were identified as significant factors in the assignment of home therapy, with males having over seven times the risk compared to females (OR = 7.06, 95% CI = [2.11, 29.7]). At the last measurement, pain intensity was positively associated with age and the number of pain events during the week. CONCLUSIONS The study highlights significant factors influencing post-thoracotomy pain management in pediatric patients. These findings underscore the importance of tailored pain management strategies that consider gender and age to improve post-operative care and outcomes in pediatric thoracotomy patients.
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Affiliation(s)
- Alessandro Vittori
- Department of Anesthesia and Critical Care, ARCO ROMA, Ospedale Pediatrico Bambino Gesù IRCCS, 00165, Rome, Italy
| | - Marco Cascella
- Department of Medicine, Surgery, and Dentistry, Unit of Anesthesiology, Intensive Care Medicine, and Pain Medicine, University of Salerno, Baronissi, 84081, Salerno, Italy.
| | - Piergiacomo Di Gennaro
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori-IRCCS, Fondazione Pascale, 80100, Naples, Italy
| | | | - Elisa Francia
- Department of Anesthesia and Critical Care, ARCO ROMA, Ospedale Pediatrico Bambino Gesù IRCCS, 00165, Rome, Italy
| | - Ilaria Mascilini
- Department of Anesthesia and Critical Care, ARCO ROMA, Ospedale Pediatrico Bambino Gesù IRCCS, 00165, Rome, Italy
| | - Riccardo Tarquini
- Department of Anesthesia and Critical Care, ARCO ROMA, Ospedale Pediatrico Bambino Gesù IRCCS, 00165, Rome, Italy
| | - Massimo Antonio Innamorato
- Pain Unit, Department of Neuroscience, Santa Maria Delle Croci Hospital, AUSL Romagna, 48121, Ravenna, Italy
| | - Emiliano Petrucci
- Department of Anesthesia and Intensive Care Unit, San Salvatore Academic Hospital of L'Aquila, 67100, L'Aquila, Coppito, Italy
| | - Franco Marinangeli
- Department of Anesthesiology, Intensive Care and Pain Treatment, University of L'Aquila, 67100, L'Aquila, Coppito, Italy
| | - Sergio Coluccia
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori-IRCCS, Fondazione Pascale, 80100, Naples, Italy
| | - Sergio Giuseppe Picardo
- Department of Anesthesia and Critical Care, ARCO ROMA, Ospedale Pediatrico Bambino Gesù IRCCS, 00165, Rome, Italy
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Hartup S, Briggs M. Managing chronic pain after breast cancer treatments: are web-based interventions the future? Curr Opin Support Palliat Care 2024; 18:47-54. [PMID: 38170201 DOI: 10.1097/spc.0000000000000691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
PURPOSE OF THE REVIEW Chronic post-treatment pain in breast cancer affects a high proportion of patients. Symptom burden and financial costs are increasingly impacting patients and healthcare systems because of improved treatments and survival rates. Supporting long-term breast cancer symptoms using novel methodology has been examined, yet few have explored the opportunity to utilise these interventions for prevention. This review aims to explore the need for, range of, and effectiveness of such interventions. RECENT FINDINGS Three papers describe risk factors for chronic pain, with six recent papers describing the use of interventions for acute pain in the surgical setting. The evidence for the effectiveness of these interventions to improve pain management in this setting is limited but tentatively positive. The results have to take into account the variation between systems and limited testing. SUMMARY Multiple types of intervention emerged and appear well accepted by patients. Most assessed short-term impact and did not evaluate for reduction in chronic pain. Such interventions require rigorous effectiveness testing to meet the growing needs of post-treatment pain in breast cancer. A detailed understanding of components of web-based interventions and their individual impact on acute pain and chronic pain is needed within future optimisation trials. Their effectiveness as preventative tools are yet to be decided.
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Affiliation(s)
- Sue Hartup
- St James's University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds
| | - Michelle Briggs
- Pain Research Institute, School of Health Sciences, Faculty of Health and Life Science University of Liverpool
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
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Ma F, Zhu Y, Liu Y. The relationship between psychological distress and the nursing humanistic care demands in postoperative cancer inpatients: a cross-sectional study. BMC Nurs 2024; 23:26. [PMID: 38195547 PMCID: PMC10775573 DOI: 10.1186/s12912-024-01704-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 01/01/2024] [Indexed: 01/11/2024] Open
Abstract
PURPOSE We aimed to investigate cancer patients' experiences of psychological distress after surgery and the factors that influence it, and to analyze the relationship between this and the nursing humanistic care demands. METHODS This study used a convenience sampling method to survey 432 cancer patients undergoing surgical treatment in the specialized cancer hospital in Beijing. The survey used socio-demographic information, the Distress Management Screening Measures, and the Nursing Humanistic Care Demands questionnaire. Questionnaire Star was used to collect data online. SPSS24.0 software was used to test the relationship between psychological distress and nursing humanistic care demands. RESULTS The mean scores for psychological distress and nursing humanistic care demands were 3.95 ± 2.71 and 147.02 ± 19.88, respectively, and showed a moderately positive correlation. The main issues that caused psychological distress in patients were: worry, financial problems, surroundings, nervousness, sleep, and pain. Regression analysis showed that gender, financial burden, personality trait, and need for humanistic care in nursing explained 24.5% of the total variance in the model and were independent predictors of psychological distress. CONCLUSION Cancer inpatients have significant psychological distress after surgery and exhibit high levels of nursing humanistic care demands. This study fills the research gap on humanistic care for psychological distress management, nursing humanistic care demands positively predicted psychological distress. Nursing staff should pay attention to the psychological suffering of patients and develop individualized care measures to alleviate their psychological suffering by accurately identifying their nursing humanistic care demands.
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Affiliation(s)
- Fengyan Ma
- Department of Thoracic Surgery. National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Yajing Zhu
- Department of Thoracic Surgery. National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
| | - Yan Liu
- Department of Thoracic Surgery. National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China.
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Ruiz SG, Blakkolb Munz CL, Hernandez N. Paravertebral Blocks in Tissue Expander Breast Reconstruction: Propensity-Matched Analysis of Opioid Consumption and Patient Outcomes. Plast Reconstr Surg 2024; 153:204e-205e. [PMID: 37467391 DOI: 10.1097/prs.0000000000010929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
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