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Hernández-Sánchez S, Poveda-Pagán EJ, Toledo-Marhuenda JV, Lozano-Quijada C. Dealing with Chronic Pain: Tips to Teach Undergraduate Health Sciences Students. J Pain Res 2022; 15:3223-3232. [PMID: 36281308 PMCID: PMC9587724 DOI: 10.2147/jpr.s377124] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 09/21/2022] [Indexed: 11/23/2022] Open
Abstract
Chronic pain is a significant and costly problem all over the world that negatively impacts the quality of life of sufferers. There are clear discrepancies between the prevalence of chronic pain in society and the low priority assigned to educating future physicians about the complexities of pain. This condition also occurs in other undergraduate health science students, although research in this area has not been studied as much as in medical schools. Based on the International Association for the Study of Pain (IASP) Pain Curriculum Outline, a systematic search of the available literature, and the authors' own experiences, we highlight some relevant tips to educate health science trainees in the management of patients with chronic pain. These tips highlight current international recommendations for a comprehensive approach to this prevalent problem in society, which should be learnt during the university training of health professionals.
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Affiliation(s)
- Sergio Hernández-Sánchez
- Center for Translational Research in Physiotherapy, Department of Pathology and Surgery, Faculty of Medicine, Miguel Hernandez University, Alicante, Spain
| | - Emilio José Poveda-Pagán
- Center for Translational Research in Physiotherapy, Department of Pathology and Surgery, Faculty of Medicine, Miguel Hernandez University, Alicante, Spain
| | - Jose Vicente Toledo-Marhuenda
- Center for Translational Research in Physiotherapy, Department of Pathology and Surgery, Faculty of Medicine, Miguel Hernandez University, Alicante, Spain,Correspondence: Jose Vicente Toledo-Marhuenda, Center for Translational Research in Physiotherapy, Department of Pathology and Surgery, Faculty of Medicine, Miguel Hernandez University, Alicante, Spain, Tel +34 965919204, Email
| | - Carlos Lozano-Quijada
- Center for Translational Research in Physiotherapy, Department of Pathology and Surgery, Faculty of Medicine, Miguel Hernandez University, Alicante, Spain
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Turner HN, Oliver J, Compton P, Matteliano D, Sowicz TJ, Strobbe S, St Marie B, Wilson M. Pain Management and Risks Associated With Substance Use: Practice Recommendations. Pain Manag Nurs 2021; 23:91-108. [PMID: 34965906 DOI: 10.1016/j.pmn.2021.11.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 11/13/2021] [Indexed: 01/08/2023]
Abstract
Assessing and managing pain while evaluating risks associated with substance use and substance use disorders continues to be a challenge faced by health care clinicians. The American Society for Pain Management Nursing and the International Nurses Society on Addictions uphold the principle that all persons with co-occurring pain and substance use or substance use disorders have the right to be treated with dignity and respect, and receive evidence-based, high quality assessment, and management for both conditions. The American Society for Pain Management Nursing and International Nurses Society on Addictions have updated their 2012 position statement on this topic supporting an integrated, holistic, multidimensional approach, which includes nonopioid and nonpharmacological modalities. Opioid use disorder is used as an exemplar for substance use disorders and clinical recommendations are included with expanded attention to risk assessment and mitigation with interventions targeted to minimize the risk for relapse or escalation of substance use. Opioids should not be excluded for anyone when indicated for pain management. A team-based approach is critical, promotes the active involvement of the person with pain and their support systems, and includes pain and addiction specialists whenever possible. Health care systems should establish policies and procedures that facilitate and support the principles and recommendations put forth in this article.
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Affiliation(s)
| | - June Oliver
- Swedish Hospital, Northshore University Healthsystem, Chicago, IL.
| | | | | | | | | | - Barbara St Marie
- University of Iowa College of Nursing, Washington State University, College of Nursing
| | - Marian Wilson
- Oregon Health & Science University School of Nursing; Washington State University, College of Nursing
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Fox AM, LaCroix JM, Bond AE, Perera KU, Luk JW, Goldston D, Weaver J, Soumoff A, Ghahramanlou-Holloway M. Evaluating Suicide Risk Using the Reasons for Dying-Reasons for Living (RFD-RFL) Index in a Military Psychiatric Inpatient Setting. Psychiatry Res 2021; 295:113576. [PMID: 33307388 DOI: 10.1016/j.psychres.2020.113576] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 11/12/2020] [Indexed: 11/19/2022]
Abstract
The present study aimed to explore reasons for dying (RFD) and reasons for living (RFL) among suicidal inpatients, conceptualize the RFD-RFL index, and examine whether suicide risk indicators were associated with the RFD-RFL index scores. Participants were military personnel (N = 167) psychiatrically hospitalized following a suicide-related crisis who provided baseline data as part of a randomized controlled trial. Family was the most commonly reported RFL (39.7%) and was the top ranked RFL for 65.9% of participants. The most frequently endorsed RFD categories included general descriptors of self (26.9%), general statements about escape (19.7%), and others/relationships (19.1%). Greater RFD-RFL index scores were associated with a greater wish to die relative to wish to live, greater hopelessness, and with a history of lifetime multiple suicide attempts. Endorsing more RFD relative to RFL may indicate heightened suicide risk. Results of this study identify the characteristics of RFD and RFL among a high-risk, military sample, and provide preliminary support for the clinical utility of evaluating the quantities of RFD and RFL. Clinicians are encouraged to explore RFD and RFL when working with suicidal patients. Future research may explore military-specific RFD and evaluate the validity of the proposed RFD-RFL index.
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Affiliation(s)
- Amber M Fox
- Uniformed Services University of the Health Sciences, Suicide Care, Prevention, and Research (CPR) Initiative, Department of Medical and Clinical Psychology (MPS), 4301 Jones Bridge Road, Bethesda, MD 20814, USA.
| | - Jessica M LaCroix
- Uniformed Services University of the Health Sciences, Suicide Care, Prevention, and Research (CPR) Initiative, Department of Medical and Clinical Psychology (MPS), 4301 Jones Bridge Road, Bethesda, MD 20814, USA
| | - Allison E Bond
- Uniformed Services University of the Health Sciences, Suicide Care, Prevention, and Research (CPR) Initiative, Department of Medical and Clinical Psychology (MPS), 4301 Jones Bridge Road, Bethesda, MD 20814, USA
| | - Kanchana U Perera
- Uniformed Services University of the Health Sciences, Suicide Care, Prevention, and Research (CPR) Initiative, Department of Medical and Clinical Psychology (MPS), 4301 Jones Bridge Road, Bethesda, MD 20814, USA
| | - Jeremy W Luk
- Uniformed Services University of the Health Sciences, Suicide Care, Prevention, and Research (CPR) Initiative, Department of Medical and Clinical Psychology (MPS), 4301 Jones Bridge Road, Bethesda, MD 20814, USA
| | - David Goldston
- Duke University, School of Medicine, Box 3527 Med Ctr, Durham, NC 27710, USA
| | - Jennifer Weaver
- Fort Belvoir Community Hospital, 9300 DeWitt Loop, Fort Belvoir, VA 22060, USA
| | - Alyssa Soumoff
- Walter Reed National Military Medical Center, 8901 Rockville Pike, Bethesda, MD 20889, USA
| | - Marjan Ghahramanlou-Holloway
- Uniformed Services University of the Health Sciences, Suicide Care, Prevention, and Research (CPR) Initiative, Department of Medical and Clinical Psychology (MPS), 4301 Jones Bridge Road, Bethesda, MD 20814, USA.
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Eckardt P, Bailey D, DeVon HA, Dougherty C, Ginex P, Krause-Parello CA, Pickler RH, Richmond TS, Rivera E, Roye CF, Redeker N. Opioid use disorder research and the Council for the Advancement of Nursing Science priority areas. Nurs Outlook 2020; 68:406-416. [PMID: 32279897 DOI: 10.1016/j.outlook.2020.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 02/03/2020] [Accepted: 02/21/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Chronic diseases, such as opioid use disorder (OUD) require a multifaceted scientific approach to address their evolving complexity. The Council for the Advancement of Nursing Science's (Council) four nursing science priority areas (precision health; global health, determinants of health, and big data/data analytics) were established to provide a framework to address current complex health problems. PURPOSE To examine OUD research through the nursing science priority areas and evaluate the appropriateness of the priority areas as a framework for research on complex health conditions. METHOD OUD was used as an exemplar to explore the relevance of the nursing science priorities for future research. FINDINGS Research in the four priority areas is advancing knowledge in OUD identification, prevention, and treatment. Intersection of OUD research population focus and methodological approach was identified among the priority areas. DISCUSSION The Council priorities provide a relevant framework for nurse scientists to address complex health problems like OUD.
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Affiliation(s)
| | | | - Holli A DeVon
- University of California Los Angeles School of Nursing, Los Angeles, CA
| | - Cynthia Dougherty
- Dept of Biobehavioral Nursing and Health Informatics, University of Washington School of Nursing, Seattle, WA
| | | | | | - Rita H Pickler
- The Ohio State University College of Nursing, Columbus, OH
| | | | - Eleanor Rivera
- New Courtland Center for Transitions and Health, University of Pennsylvania School of Nursing, Colonial Penn Center, Philadelphia, PA
| | - Carol F Roye
- Pace University, College of Health Professions, Pleasantville, NY
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Brown LA, Lynch KG, Cheatle M. Pain catastrophizing as a predictor of suicidal ideation in chronic pain patients with an opiate prescription. Psychiatry Res 2020; 286:112893. [PMID: 32146246 PMCID: PMC7442673 DOI: 10.1016/j.psychres.2020.112893] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 02/19/2020] [Accepted: 02/20/2020] [Indexed: 11/28/2022]
Abstract
Chronic pain and opioid use are associated with increased risk for suicidal ideation and behaviors (SIB) in cross-sectional studies, particularly among individuals who catastrophize about their pain. This study examined the longitudinal association between two styles of pain coping, catastrophizing and hoping/praying, as predictors of subsequent SIB, as well as possible mediators of this association among patients with chronic pain receiving long-term opioid therapy. Participants (n = 496) were adults with chronic nonmalignant pain on long-term opioid therapy who did not develop an opioid use disorder. Participants were assessed for pain coping, suicidal ideation, depression, social support and pain interference at baseline, and were reassessed for SI, depression, and pain interference at 6- and 12-month follow-ups. Catastrophizing was a significant predictor of increased subsequent SIB, whereas hoping/praying did not protect against future SIB. The relationship between catastrophizing and future SIB was mediated by depression, but not social support or pain interference. In conclusion, catastrophizing was an important predictor of subsequent SIB due to its effect on increasing depression among patients with chronic nonmalignant pain receiving long-term opioid therapy. Future research should explore the extent to which targeting catastrophizing reduces subsequent depression and suicide risk.
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Affiliation(s)
- Lily A Brown
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, United States; University of Pennsylvania, Department of Psychiatry, Perelman School of Medicine, 3535 Market Street, Philadelphia, PA 19104, United States.
| | - Kevin G Lynch
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, United States; Center for Clinical Epidemiology and Biostatistics (CCEB), University of Pennsylvania, Philadelphia, PA, United States; University of Pennsylvania, Department of Psychiatry, Perelman School of Medicine, 3535 Market Street, Philadelphia, PA 19104, United States
| | - Martin Cheatle
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, United States; University of Pennsylvania, Department of Psychiatry, Perelman School of Medicine, 3535 Market Street, Philadelphia, PA 19104, United States
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Konietzny K, Chehadi O, Levenig C, Kellmann M, Kleinert J, Mierswa T, Hasenbring MI. Depression and suicidal ideation in high-performance athletes suffering from low back pain: The role of stress and pain-related thought suppression. Eur J Pain 2019; 23:1196-1208. [PMID: 30821880 DOI: 10.1002/ejp.1387] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 02/21/2019] [Accepted: 02/27/2019] [Indexed: 12/18/2022]
Abstract
BACKGROUND Depression and suicidal ideation are important health problems in athletes suffering from pain. Dysfunctional pain cognitions, that is, pain-related thought suppression (PTS), may play an important role in their aetiology. Thought suppression was shown to increase depressive mood, particularly in highly stressed individuals. This cross-sectional study examines the relationship between PTS and stress on depression and suicidal ideation in athletes with pain. METHODS A total of 159 athletes with non-specific low back pain completed a set of questionnaires to measure PTS, depression and stress. Participants were split into groups with high and low stress, and high and low PTS. Two-way ANOVA calculated main effects for PTS, stress and a PTS*stress interaction, with depressive symptoms as dependent. Subsequently, distribution tests were calculated, investigating if the presence of clinically relevant depression and suicidal ideation is dependent of conditions of high/low PTS and stress. RESULTS A main effect of stress demonstrated higher depression scores in highly stressed athletes. Further, a significant PTS*stress interaction showed elevated depression scores in athletes with high PTS and high stress. Distribution analysis revealed positive associations between PTS, stress and depression, with depression being most frequent among athletes with high PTS and high stress. Suicidal ideation was not significantly associated with PTS and only weakly correlated with stress. CONCLUSIONS Our findings show that PTS is the most common pain response in athletes with pain. The results indicate a higher prevalence of depression and elevated depressive symptoms in athletes experiencing high stress, seemingly more pronounced when highly engaging in PTS. SIGNIFICANCE This study contributes to the understanding of depression in athletes with pain, suggesting stress and pain-related thought suppression to increase symptoms and prevalence of depression. As athletes often experience acute or chronic pain, understanding the impact of pain cognitions on health outcomes is an important step in the optimization of treatments.
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Affiliation(s)
- Kerstin Konietzny
- Department of Medical Psychology and Medical Sociology, Faculty of Medicine, Ruhr University of Bochum, Bochum, Germany
| | - Omar Chehadi
- Department of Medical Psychology and Medical Sociology, Faculty of Medicine, Ruhr University of Bochum, Bochum, Germany
| | - Claudia Levenig
- Department of Medical Psychology and Medical Sociology, Faculty of Medicine, Ruhr University of Bochum, Bochum, Germany
| | - Michael Kellmann
- Unit of Sport Psychology, Faculty of Sport Science, Ruhr University Bochum, Bochum, Germany.,School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
| | - Jens Kleinert
- Institute of Psychology, German Sport University Cologne, Cologne, Germany
| | - Tobias Mierswa
- Unit of Sport Psychology, Faculty of Sport Science, Ruhr University Bochum, Bochum, Germany
| | - Monika Ilona Hasenbring
- Department of Medical Psychology and Medical Sociology, Faculty of Medicine, Ruhr University of Bochum, Bochum, Germany
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Incidence and risk factors of suicide after a prostate cancer diagnosis: a meta-analysis of observational studies. Prostate Cancer Prostatic Dis 2018; 21:499-508. [DOI: 10.1038/s41391-018-0073-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 05/26/2018] [Accepted: 06/19/2018] [Indexed: 11/08/2022]
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