1
|
Jiménez-Sánchez C, la Cruz NBD, Lafuente-Ureta R, Francín-Gallego M, Calvo S, Fortún-Rabadán R, Pérez-Palomares S. Physical therapy interventions for people experiencing homelessness to improve pain and self-perceived health status. BMC Public Health 2024; 24:993. [PMID: 38594673 PMCID: PMC11003153 DOI: 10.1186/s12889-024-18453-6] [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: 12/18/2023] [Accepted: 03/26/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND Homeless shelters have emerged as components of the social services network, playing an important role in providing health care to the homeless population. The aim of this study was to evaluate an individualized physical therapy intervention for people experiencing homelessness and to determine the relationship between self-perceived variables. METHODS Pre and post study, setting at the "Santa y Real Hermandad de Nuestra Señora del Refugio y Piedad" homeless shelter in Zaragoza, Spain. Participants were people experiencing homelessness with musculoskeletal disorders who attended a physical therapy service at shelter facilities. A physical therapy program was implemented including health education, exercise and manual therapy, electrotherapy, thermotherapy and bandaging. Demographic variables (age and gender), nationality, employment situation, educational level, pain location, number of painful areas, feeling of loneliness (3-Item Loneliness Scale; values from 3 to 9), pain intensity (Numerical Pain Rating Scale [NPRS]; from 0 to 10) and self-perceived health (Clinical Global Impression [CGI]; from 1 to 7). RESULTS Sixty-four homeless people (age of 46.4 ± 10.9 years) participated in the study. Musculoskeletal pain was reported by 98.4% of subjects, with moderate pain intensities (6.1), and 48.4% presenting with pain at multiple sites. Perceptions of loneliness were low (3.7 ± 2.5) and self-perceived health status was moderately ill (3.5 ± 1.7). Positive significant correlations were identified between pain intensity and self-perceived health. The average number of sessions was 1.5 (± 0.8), with manual therapy (35.6%) followed by health education (23.5%) being the most frequently used techniques. Both pain and self-perceived health improved after treatment, even following a brief intervention. CONCLUSIONS This study demonstrates the potentially negative impact of untreated pain on the self-perceived health of homeless individuals with musculoskeletal disorders that should be targeted for consideration. The findings suggest that a paradigm shift in pain management, including a physical therapy service in shelters, is needed to address the rehabilitation demands of these individuals in a real-life context. This study was approved by the Aragon Ethics Committee (PI19/438) and performed according to the Transparent Reporting of Evaluations with Nonrandomized Designs (TREND) statement.
Collapse
Affiliation(s)
- Carolina Jiménez-Sánchez
- Department of Physical Therapy, Faculty of Health Sciences, Universidad San Jorge, Villanueva de Gállego, Zaragoza, Spain
- IIS Aragón, Zaragoza, Spain
| | - Natalia Brandín-de la Cruz
- Department of Physical Therapy, Faculty of Health Sciences, Universidad San Jorge, Villanueva de Gállego, Zaragoza, Spain
- IIS Aragón, Zaragoza, Spain
| | - Raquel Lafuente-Ureta
- Department of Physical Therapy, Faculty of Health Sciences, Universidad San Jorge, Villanueva de Gállego, Zaragoza, Spain
| | - Marina Francín-Gallego
- Department of Physical Therapy, Faculty of Health Sciences, Universidad San Jorge, Villanueva de Gállego, Zaragoza, Spain
| | - Sandra Calvo
- IIS Aragón, Zaragoza, Spain.
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain.
| | - Rocío Fortún-Rabadán
- Department of Physical Therapy, Faculty of Health Sciences, Universidad San Jorge, Villanueva de Gállego, Zaragoza, Spain
| | - Sara Pérez-Palomares
- IIS Aragón, Zaragoza, Spain
- Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, Zaragoza, Spain
| |
Collapse
|
2
|
Abudawood K, Yoon SL, Garg R, Yao Y, Molokie RE, Wilkie DJ. Quantification of Patient-Reported Pain Locations: Development of an Automated Measurement Method. Comput Inform Nurs 2023; 41:346-355. [PMID: 36067491 PMCID: PMC9981814 DOI: 10.1097/cin.0000000000000875] [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] [Indexed: 11/25/2022]
Abstract
Patient-reported pain locations are critical for comprehensive pain assessment. Our study aim was to introduce an automated process for measuring the location and distribution of pain collected during a routine outpatient clinic visit. In a cross-sectional study, 116 adults with sickle cell disease-associated pain completed PAIN Report It Ⓡ . This computer-based instrument includes a two-dimensional, digital body outline on which patients mark their pain location. Using the ImageJ software, we calculated the percentage of the body surface area marked as painful and summarized data with descriptive statistics and a pain frequency map. The painful body areas most frequently marked were the left leg-front (73%), right leg-front (72%), upper back (72%), and lower back (70%). The frequency of pain marks in each of the 48 body segments ranged from 3 to 79 (mean, 33.2 ± 21.9). The mean percentage of painful body surface area per segment was 10.8% ± 7.5% (ranging from 1.3% to 33.1%). Patient-reported pain locations can be easily analyzed from digital drawings using an algorithm created via the free ImageJ software. This method may enhance comprehensive pain assessment, facilitating research and personalized care over time for patients with various pain conditions.
Collapse
Affiliation(s)
- Khulud Abudawood
- College of Nursing, King Saudi bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Saunjoo L. Yoon
- Department of Biobehavioral Nursing Science,College of Nursing, University of Florida, Gainesville, Florida
| | - Rishabh Garg
- Herbert Wertheim College of Engineering, University of Florida, Gainesville, Florida
| | - Yingwei Yao
- Department of Biobehavioral Nursing Science,College of Nursing, University of Florida, Gainesville, Florida
- Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, Chicago, IL
| | - Robert E. Molokie
- Department of Medicine, College of Medicine, University of Illinois at Chicago and Jesse Brown Veterans Administration Medical Center, Chicago, IL
| | - Diana J. Wilkie
- Department of Biobehavioral Nursing Science,College of Nursing, University of Florida, Gainesville, Florida
- Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, Chicago, IL
| |
Collapse
|
3
|
Telisnor G, Garg R, Glayzer JE, Kobak WH, Kiros GE, Yao Y, Wilkie DJ, Schlaeger JM. Image-based documentation of vulvodynia pain location. Pain Manag 2022; 12:417-424. [PMID: 35060761 PMCID: PMC8981421 DOI: 10.2217/pmt-2021-0110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Aims: Better documentation of vulvar pain is needed. We examined pain locations marked on general body and genital specific outlines among women with vulvodynia. Methods: 62 women (mean age 32.1 ± 9.5 years) with vulvodynia marked their pain on a digital genital specific outline (22 segments) and 59 of those women also marked their pain on a digital general body outline (48 segments). We used ImageJ software to determine body surface area (BSA) for each outline. Results: On the general body outline, 24/48 segments were marked; 22/22 segments were marked on the genital specific outline. There was a moderate correlation (r = 0.43; p = 0.001) between the BSA marked on the general body outline and the BSA marked on the genital area outline. Conclusions: Findings support concurrent validity of the BSA as a measure of pain location using either outline.
Collapse
Affiliation(s)
- Guettchina Telisnor
- Department of Biobehavioral Health Nursing Science, University of Florida College of Nursing, Gainesville, FL 32611, USA
| | - Rishabh Garg
- Department of Biobehavioral Health Nursing Science, University of Florida College of Nursing, Gainesville, FL 32611, USA
| | - Jennifer E Glayzer
- Department of Human Development Nursing Science, University of Illinois Chicago College of Nursing, Chicago, IL 60612, USA
| | - William H Kobak
- Department of Obstetrics & Gynecology, University of Illinois Chicago College of Medicine, Chicago, IL 60612, USA
| | - Gebre-Egziabher Kiros
- College of Pharmacy, Florida Agricultural & Mechanical University, Tallahassee, FL 32307, USA
| | - Yingwei Yao
- Department of Biobehavioral Health Nursing Science, University of Florida College of Nursing, Gainesville, FL 32611, USA
| | - Diana J Wilkie
- Department of Biobehavioral Health Nursing Science, University of Florida College of Nursing, Gainesville, FL 32611, USA
| | - Judith M Schlaeger
- Department of Human Development Nursing Science, University of Illinois Chicago College of Nursing, Chicago, IL 60612, USA,Author for correspondence: Tel.: +1 312 413 4669;
| |
Collapse
|
4
|
Lam K, Peolsson A, Soldini E, Löfgren H, Wibault J, Dedering Å, Öberg B, Zsigmond P, Barbero M, Falla D. Larger pain extent is associated with greater pain intensity and disability but not with general health status or psychosocial features in patients with cervical radiculopathy. Medicine (Baltimore) 2021; 100:e23718. [PMID: 33663038 PMCID: PMC7909108 DOI: 10.1097/md.0000000000023718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 11/16/2020] [Indexed: 01/05/2023] Open
Abstract
Pain as a result of cervical radiculopathy (CR) can be widespread, nondermatomal and individually specific, but the association between pain extent and other clinical features has never been explored. The objective of this study is to investigate whether pain extent relates to clinical variables including pain intensity in addition to health indicators including disability, general health, depression, somatic anxiety, coping strategies or self-efficacy.An observational cohort study was conducted. Participants were recruited from 4 hospital spinal centres in Sweden. Pain extent was quantified from the pain drawings of 190 individuals with cervical disc disease, verified with magnetic resonance imaging (MRI) and compatible with clinical findings (examined by a neurosurgeon), that show cervical nerve root compression. Pain extent was evaluated in relation to neck pain, arm pain, and headache intensity. Multiple linear regression analysis were then used to verify whether pain extent was associated with other health indicators including disability, health-related quality of life, depression, somatic anxiety, coping strategies and self-efficacy.Pain extent was directly related to neck, arm and headache pain intensity (all P < .01). Multiple linear regression revealed that pain extent was significantly associated only to the level of perceived disability (P < .01).Increased pain extent in people with CR is associated with higher headache, neck and arm pain intensity, and disability but not measures of general health, depression, somatic anxiety, coping strategies or self-efficacy.
Collapse
Affiliation(s)
- Kwun Lam
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK
| | - Anneli Peolsson
- Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine, Unit of physiotherapy, Linköping University, Linköping, Sweden
| | - Emiliano Soldini
- Research Methodology Competence Centre, Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland
| | - Håkan Löfgren
- Neuro-Orthopedic Center, Ryhov Hospital, Region Jönköping County, Jönköping. Jönköping, Region Jönköping County, and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Johanna Wibault
- Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine, Unit of physiotherapy, Linköping University, Linköping, Sweden
- Department of Activity and Health, and Department of Health, Medicine and Caring Sciencess, Linköping University, Linköping, Sweden
| | - Åsa Dedering
- Allied Health Professionals Function, Function Area Occupational Therapy and Physiotherapy, Karolinska University Hospital, Stockholm
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm
| | - Birgitta Öberg
- Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine, Unit of physiotherapy, Linköping University, Linköping, Sweden
| | - Peter Zsigmond
- Department of Neurosurgery, Linköping University Hospital, Linköping
| | - Marco Barbero
- Rehabilitation Research Laboratory, Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland
| | - Deborah Falla
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK
| |
Collapse
|
5
|
Feasibility, reliability, and validity of the 12-item World Health Organization Disability Assessment Schedule 2.0 in patients attending the pain clinic. J Anesth 2020; 35:81-85. [PMID: 33151411 DOI: 10.1007/s00540-020-02871-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 10/23/2020] [Indexed: 12/12/2022]
Abstract
PURPOSE In the cohort of patients attending pain clinic, the primary goal has been shifting from pain reduction to improving activities of daily living and functional status. The 12-item World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) is one of the useful tools for assessment of functional status across all psychiatric and medical diseases; however, its feasibility, reliability, and validity have not been assessed in these patients. Thus, in this study, we evaluated the feasibility, reliability, and validity of the 12-item WHODAS 2.0 in patients attending the pain clinic at our university hospital. METHODS This is a prospective observational study including the patients aged 50 years or older who were attending the pain clinic at Nara Medical University between April 2019 and May 2019. Patient-related outcomes including functional status and activities of daily living were assessed with the 12-item WHODAS 2.0, EuroQol-5 dimension 5 levels, and the Tokyo Metropolitan Institute of Gerontology Index. RESULTS The response rate was 99.7%. The 12-item WHODAS2.0 had a floor effect but no ceiling effect and its Cronbach's α coefficient was 0.909. The correlation coefficients between the 12-item WHODAS 2.0 score and the EuroQol-5 dimension 5 levels and the Tokyo Metropolitan Institute of Gerontology Index were -0.66 and -0.67, respectively. CONCLUSIONS The 12-item WHODAS 2.0 is a useful measurement tool to assess disability of pain patients with high reliability and validity.
Collapse
|