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Linkiewich D, Dib KC, Forgeron PA, Dick BD, McMurtry CM. Roadmap to the 'Chronic Pain GPS for Adolescents' Intervention: Content and Design Considerations for a Group Peer Support Intervention. Clin J Pain 2024; 40:288-298. [PMID: 38303597 DOI: 10.1097/ajp.0000000000001201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 01/16/2024] [Indexed: 02/03/2024]
Abstract
OBJECTIVES A biopsychosocial approach to understanding and treating pain is crucial; however, there are limited socially targeted interventions for adolescents with chronic pain (ACP). Peer support interventions implemented with other populations are associated with positive outcomes. ACPs perceive peer support to have high potential value. This study explored the preferences of ACP regarding the content and design of a group peer support intervention. METHODS Fourteen ACP (M age : 15.21 y; 9 females; 3 males, 1 nonbinary, and 1 gender questioning) completed a virtual interview and survey. Interviews were analyzed using inductive qualitative content analysis, and surveys were analyzed using descriptive statistics. RESULTS Adolescents described how they want to both talk and do activities together within a fun and casual environment with a facilitator present-ideally, someone with lived experience of chronic pain. Preferences were for a medium-sized group intervention that was in-person, at a consistent time on a weekday after school, and semi-structured. Barriers to attending and engaging in the potential group peer intervention were also discussed. DISCUSSION ACPs desire a facilitated socially focused intervention that provides them with the opportunity to spend time with other ACPs. A group peer support environment where ACPs can provide and receive peer support through sharing their experiences with others who understand them as well as engage in activities was described. The findings from this study provide insights for the development of a group peer support intervention.
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Affiliation(s)
| | | | | | - Bruce D Dick
- Department of Anesthesiology and Pain Medicine, Psychiatry & Pediatrics, University of Alberta, Stollery Children's Hospital, Edmonton, AB, Canada
| | - C Meghan McMurtry
- Department of Psychology, University of Guelph, Guelph
- Department of Anesthesia, McMaster Children's Hospital, McMaster University, Hamilton, Ontario, Canada
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Dillane D, Ramadi A, Nathanail S, Dick BD, Bostick G, Chan K, Douglas C, Goplen G, Green J, Halliday S, Hellec B, Rashiq S, Scharfenberger A, Woolsey G, Beaupre LA, Pedersen ME. Correction: Elective surgery in ankle and foot disorders-best practices for management of pain: a guideline for clinicians. Can J Anaesth 2024; 71:306. [PMID: 38114874 DOI: 10.1007/s12630-023-02679-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 09/19/2023] [Accepted: 09/20/2023] [Indexed: 12/21/2023] Open
Affiliation(s)
- Derek Dillane
- Department of Anesthesia and Pain Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Ailar Ramadi
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Stephanie Nathanail
- Collaborative Orthopaedic REsearch (CORe), University of Alberta, Edmonton, AB, Canada
| | - Bruce D Dick
- Department of Anesthesia and Pain Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Geoff Bostick
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Kitty Chan
- Collaborative Orthopaedic REsearch (CORe), University of Alberta, Edmonton, AB, Canada
| | - Chris Douglas
- Department of Anesthesia and Pain Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Gordon Goplen
- Collaborative Orthopaedic REsearch (CORe), University of Alberta, Edmonton, AB, Canada
| | - James Green
- Department of Anesthesia and Pain Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Susan Halliday
- Department of Anesthesia and Pain Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | | | - Saifee Rashiq
- Department of Anesthesia and Pain Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Angela Scharfenberger
- Collaborative Orthopaedic REsearch (CORe), University of Alberta, Edmonton, AB, Canada
| | - Guy Woolsey
- Collaborative Orthopaedic REsearch (CORe), University of Alberta, Edmonton, AB, Canada
| | - Lauren A Beaupre
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada.
- Collaborative Orthopaedic REsearch (CORe), University of Alberta, Edmonton, AB, Canada.
- Departments of Physical Therapy and Surgery, University of Alberta, 6-110B Clinical Sciences Building, 8440-112 St., Edmonton, AB, Canada.
| | - M Elizabeth Pedersen
- Collaborative Orthopaedic REsearch (CORe), University of Alberta, Edmonton, AB, Canada
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Linkiewich D, Dib KC, Forgeron PA, Dick BD, McMurtry CM. Perceptions of Adolescents With Chronic Pain About Peer Support: Reflexive Thematic Analysis. J Pediatr Psychol 2023; 48:655-663. [PMID: 36860181 DOI: 10.1093/jpepsy/jsad014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 02/13/2023] [Accepted: 02/13/2023] [Indexed: 03/03/2023] Open
Abstract
OBJECTIVE Social challenges are a common experience for adolescents with chronic pain. Group peer support for these adolescents could be a promising intervention; however, no studies have focused exclusively on the peer support needs of this population. The present study addressed this gap in the literature. METHODS Adolescents with chronic pain between 12 and 17 years of age completed a virtual interview and demographics questionnaire. Interviews were analyzed using inductive reflexive thematic analysis. RESULTS Fourteen adolescents (Mage: 15.21 years; 9 females; 3 males, 1 nonbinary, 1 gender questioning) with chronic pain participated. Three themes were generated: "Being Misunderstood," "They Would Understand Me," and "Moving Forward Together in Our Pain Journeys." Adolescents with chronic pain feel misunderstood and under supported by their peers without pain leading to feeling "othered" by having to explain their pain, yet not feeling free to talk about their pain with friends. Adolescents with chronic pain expressed that peer support would provide the forms of social support they are missing amongst their friends without pain as well as companionship and a sense of belonging due to shared knowledge and experiences. CONCLUSIONS Adolescents with chronic pain desire peer support from others like themselves, highlighting the challenges in their everyday friendships as the impetus for this support, as well as their anticipated short- and long-term benefits, including learning from their peers and developing new friendships. Findings indicate that adolescents with chronic pain may benefit from group peer support. Findings will inform the development of a peer support intervention for this population.
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Affiliation(s)
| | | | | | - Bruce D Dick
- Department of Anesthesiology and Pain Medicine, Psychiatry & Pediatrics, University of Alberta, Stollery Children's Hospital, Canada
| | - C Meghan McMurtry
- Department of Psychology, University of Guelph, Canada
- McMaster Children's Hospital and Department of Anaesthesia, McMaster University, Canada
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Gross DP, Rachor GS, Krebs BK, Yamamoto SS, Dick BD, Brown CA, Asmundson GJG, Straube S, Els C, Jackson TD, Brémault-Phillips S, Voaklander D, Stastny J, Berry T. Risk Factors for Developing Concurrent Posttraumatic Stress Injury After Work-Related Musculoskeletal Injury: A Case-Control Study. J Occup Environ Med 2022; 64:e579-e584. [PMID: 35901517 PMCID: PMC9426736 DOI: 10.1097/jom.0000000000002621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study aimed to study risk factors for developing concurrent posttraumatic stress injury (PTSI) among workers experiencing work-related musculoskeletal injury (MSI). METHODS A case-control study was conducted using workers' compensation data on injured workers undergoing rehabilitation programs for concurrent MSI and PTSI (cases) and MSI only (controls). A variety of measures known at the time of the compensable injury were entered into logistic regression models. RESULTS Of the 1948 workers included, 215 had concurrent MSI and PTSI. Concurrent MSI and PTSI were predicted by type of accident (adjusted odds ratio [OR], 25.8), experiencing fracture or dislocation fracture or dislocation (adjusted OR, 3.7), being public safety personnel (adjusted OR, 3.1), and lower level of education (adjusted OR, 1.9). CONCLUSIONS Experiencing a concurrent PTSI diagnosis with MSI after work-related accident and injury appears related to occupation, type of accident, and educational background.
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Dillane D, Ramadi A, Nathanail S, Dick BD, Bostick G, Chan K, Douglas C, Goplen G, Green J, Halliday S, Hellec B, Rashiq S, Scharfenberger A, Woolsey G, Beaupre LA, Pedersen ME. Elective surgery in ankle and foot disorders-best practices for management of pain: a guideline for clinicians. Can J Anaesth 2022; 69:1053-1067. [PMID: 35581524 DOI: 10.1007/s12630-022-02267-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 02/14/2022] [Accepted: 03/06/2022] [Indexed: 01/10/2023] Open
Abstract
PURPOSE Complex elective foot and ankle surgeries are often associated with severe pain pre- and postoperatively. When inadequately managed, chronic postsurgical pain and long-term opioid use can result. As no standards currently exist, we aimed to develop best practice pain management guidelines. METHODS A local steering committee (n = 16) surveyed 116 North American foot and ankle surgeons to understand the "current state" of practice. A multidisciplinary expert panel (n = 35) was then formed consisting of orthopedic surgeons, anesthesiologists, chronic pain physicians, primary care physicians, pharmacists, registered nurses, physiotherapists, and clinical psychologists. Each expert provided up to three pain management recommendations for each of the presurgery, intraoperative, inpatient postoperative, and postdischarge periods. These preliminary recommendations were reduced, refined, and sent to the expert panel and "current state" survey respondents to create a consensus document using a Delphi process conducted from September to December 2020. RESULTS One thousand four hundred and five preliminary statements were summarized into 51 statements. Strong consensus (≥ 80% respondent agreement) was achieved in 53% of statements including the following: postsurgical opioid use risk should be assessed preoperatively; opioid-naïve patients should not start opioids preoperatively unless non-opioid multimodal analgesia fails; and if opioids are prescribed at discharge, patients should receive education regarding importance of tapering opioid use. There was no consensus regarding opioid weaning preoperatively. CONCLUSIONS Using multidisciplinary experts and a Delphi process, strong consensus was achieved in many areas, showing considerable agreement despite limited evidence for standardized pain management in patients undergoing complex elective foot and ankle surgery. No consensus on important issues related to opioid prescribing and cessation highlights the need for research to determine best practice.
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Affiliation(s)
- Derek Dillane
- Department of Anesthesia and Pain Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Ailar Ramadi
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Stephanie Nathanail
- Collaborative Orthopaedic REsearch (CORe), University of Alberta, Edmonton, AB, Canada
| | - Bruce D Dick
- Department of Anesthesia and Pain Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Geoff Bostick
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Kitty Chan
- Collaborative Orthopaedic REsearch (CORe), University of Alberta, Edmonton, AB, Canada
| | - Chris Douglas
- Department of Anesthesia and Pain Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Gordon Goplen
- Collaborative Orthopaedic REsearch (CORe), University of Alberta, Edmonton, AB, Canada
| | - James Green
- Department of Anesthesia and Pain Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Susan Halliday
- Department of Anesthesia and Pain Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | | | - Saifee Rashiq
- Department of Anesthesia and Pain Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Angela Scharfenberger
- Collaborative Orthopaedic REsearch (CORe), University of Alberta, Edmonton, AB, Canada
| | - Guy Woolsey
- Collaborative Orthopaedic REsearch (CORe), University of Alberta, Edmonton, AB, Canada
| | - Lauren A Beaupre
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada.
- Collaborative Orthopaedic REsearch (CORe), University of Alberta, Edmonton, AB, Canada.
- Departments of Physical Therapy and Surgery, University of Alberta, 6-110B Clinical Sciences Building, 8440-112 St., Edmonton, AB, Canada.
| | - M Elizabeth Pedersen
- Collaborative Orthopaedic REsearch (CORe), University of Alberta, Edmonton, AB, Canada
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Baerg K, Tupper SM, Chu LM, Cooke N, Dick BD, Doré-Bergeron MJ, Findlay S, Ingelmo PM, Lamontagne C, Mesaroli G, Oberlander TF, Poolacherla R, Spencer AO, Stinson J, Finley GA. Canadian surveillance study of complex regional pain syndrome in children. Pain 2022; 163:1060-1069. [PMID: 34799536 PMCID: PMC9100430 DOI: 10.1097/j.pain.0000000000002482] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 08/28/2021] [Accepted: 09/07/2021] [Indexed: 11/25/2022]
Abstract
ABSTRACT This study describes the minimum incidence of pediatric complex regional pain syndrome (CRPS), clinical features, and treatments recommended by pediatricians and pain clinics in Canada. Participants in the Canadian Paediatric Surveillance Program reported new cases of CRPS aged 2 to 18 years monthly and completed a detailed case reporting questionnaire from September 2017 to August 2019. Descriptive analysis was completed, and the annual incidence of CRPS by sex and age groupings was estimated. A total of 198 cases were reported to the Canadian Paediatric Surveillance Program, and 168 (84.8%) met the case definition. The minimum Canadian incidence of CRPS is estimated at 1.14/100,000 (95% confidence interval 0.93-1.35/100,000) children per year. Incidence was highest among girls 12 years and older (3.10, 95% confidence interval 2.76-3.44/100,000). The mean age of CRPS diagnosis was 12.2 years (SD = 2.4), with the mean time from symptom onset to diagnosis of 5.6 months (SD = 9.9) and no known inciting event for 19.6% of cases. Most cases had lower limb involvement (79.8%). Nonsteroidal anti-inflammatory drugs (82.7%) and acetaminophen (66.0%) were prescribed more commonly than antiepileptic drugs (52.3%) and antidepressants (32.0%). Referrals most commonly included physical therapy (83.3%) and multidisciplinary pain clinics (72.6%); a small number of patients withdrew from treatment because of pain exacerbation (5.3%). Pain education was recommended for only 65.6% of cases. Treatment variability highlights the need for empiric data to support treatment of pediatric CRPS and development of treatment consensus guidelines.
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Affiliation(s)
- Krista Baerg
- Department of Pediatrics, University of Saskatchewan, Saskatoon, Canada
- Department of Pediatrics, Saskatchewan Health Authority, Saskatoon, Canada
| | - Susan M. Tupper
- Department of Clinical Excellence, Quality, Safety & Strategy, Saskatchewan Health Authority, Saskatoon, Canada
| | - Luan Manh Chu
- Department of Pediatrics, University of Saskatchewan, Saskatoon, Canada
| | | | - Bruce D. Dick
- Departments of Anesthesiology and Pain Medicine, Psychiatry & Pediatrics, University of Alberta, Edmonton, Canada
- Faculties of Medicine and Dentistry & Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | | | - Sheri Findlay
- Department of Pediatrics, McMaster University, Hamilton, Canada
| | - Pablo M. Ingelmo
- Chronic Pain Service, Montreal Children's Hospital, McGill University Health Center, Montréal, Canada
| | - Christine Lamontagne
- Department of Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, Canada
| | - Giulia Mesaroli
- Department of Rehabilitation, The Hospital for Sick Children, Toronto, Canada
- Department of Physical Therapy, University of Toronto, Toronto, Canada
| | | | - Raju Poolacherla
- Department of Anesthesia and Perioperative Medicine and Department of Pediatrics, Children's Hospital London Health Sciences Centre, London, Canada
| | - Adam Oscar Spencer
- Department of Pediatric Anesthesia, University of Calgary Cumming School of Medicine, Calgary, Canada
| | - Jennifer Stinson
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
| | - G. Allen Finley
- Departments of Anesthesia & Psychology, Dalhousie University, Halifax, Canada
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Moharrami M, Ali S, Dick BD, Moeinvaziri F, Amin M. The relationship between nitrous oxide sedation and psychosocial factors in the pediatric outpatient setting. Paediatr Anaesth 2022; 32:548-555. [PMID: 35020963 DOI: 10.1111/pan.14395] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 12/23/2021] [Accepted: 01/07/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Moderate sedation using nitrous oxide (N2 O) has become common in pediatric dentistry. However, less is known regarding the role of patients' characteristics and psychosocial factors in their cooperative behavior during dental procedures with N2 O. AIMS This study aimed to examine pediatric dental patients' behaviors while undergoing N2 O sedation and to measure the associations between child's cooperative behavior and demographic, physiological responses, and psychosocial factors. METHODS In this within-subject observational study, participants received 40% N2 O/O2 , by nasal hood, for non-surgical dental procedures. The main outcome measure was the extent of cooperative behaviors, as assessed by the Frankl scale at five timepoints, namely T1: pre-administration of N2 O, T2: post-administration of N2 O, T3: dental injection, T4: dental treatment, and T5: post-procedure administration of 100% O2 . Predictors included age, sex, psychosocial factors reported using the Parenting Style and Dimension Questionnaire and Spence Children Anxiety Scale, as well as pulse rate, respiratory rate, and oxygen saturation. The Wilcoxon signed-rank test and generalized estimation equation were used for data analyses. RESULTS In 80 children with a mean age of 7.2 (2.2) years, administration of N2 O was significantly associated with cooperative behaviors (odds ratio [OR]:2.62, confidence interval [CI]: 1.46-4.70, p = .001) when adjusted for other predictors. There was no interaction between any of the predictors and N2 O sedation on behaviors. Except for the authoritative parenting style (OR: 1.96, CI: 1.16-3.31, p = .012), which predicted more cooperative behaviors, other predictors were not associated with behavioral outcomes. CONCLUSION In children sedated with N2 O, behavior was independent of the child's demographic and psychosocial factors. While sedated, demographics, vital signs, and anxiety did not contribute to behavior management. However, screening for parenting style may help predict the child's behavioral response.
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Affiliation(s)
- Mohammad Moharrami
- Faculty of Medicine & Dentistry, School of Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Samina Ali
- Department of Pediatrics, Faculty of Medicine & Dentistry, Women and Children's Health Research Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Bruce D Dick
- Department of Anesthesiology and Pain Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Fardad Moeinvaziri
- Faculty of Medicine & Dentistry, School of Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Maryam Amin
- Faculty of Medicine & Dentistry, School of Dentistry, University of Alberta, Edmonton, Alberta, Canada
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Forgeron PA, Dick BD, Chambers C, Cohen J, Lamontagne C, Finley GA. Are They Still Friends? Friendship Stability of Adolescents With Chronic Pain: 1-Year Follow-Up. Front Pain Res 2022; 2:767236. [PMID: 35295468 PMCID: PMC8915730 DOI: 10.3389/fpain.2021.767236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 12/10/2021] [Indexed: 11/13/2022] Open
Abstract
Most adolescents identify their best friend as their main source of social support. Adolescents with chronic pain (ACP) report the loss of friendships due to pain. Friendships protect against loneliness and depression, yet adolescents with pain experience increased levels of loneliness and depression compared to peers. This longitudinal study examines the friendship stability of dyads that included an adolescent with chronic pain compared to non-pain friendship dyads as well as the factors contributing to a friendship breakup. Eighty-three participants from 61 same-sex friendship dyads across 3 sites participated in a 1-year follow-up survey designed to capture friendship features, indices of social-emotional well-being, pain characteristics, and friendship stability. Chi-square, repeated measures ANOVA, and logistic regression were used to analyze the data. Dyads that included an ACP experienced higher rates of friendship breakup. The shorter length of friendship and having chronic pain predicted a friendship breakup at time 2. ACP continues to experience worse scores on indices of social-emotional well-being that are not predicted with a friendship breakup. Understanding what contributes to positive long-term friendships for those with pain may inform strategies to maintain and improve friendships for those with pain and who experience social challenges.
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Affiliation(s)
- Paula A. Forgeron
- Faculty of Health Sciences, School of Nursing, University of Ottawa, Ottawa, ON, Canada
- Department of Anesthesia, Dalhousie University, Halifax, NS, Canada
- Children's Hospital of Eastern Ontario's Research Institute, Ottawa, ON, Canada
- *Correspondence: Paula A. Forgeron
| | - Bruce D. Dick
- Department of Anesthesiology and Pain Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Christine Chambers
- Pediatrics and Neuroscience, Dalhousie University, Halifax, NS, Canada
- Psychology, Dalhousie University, Halifax, NS, Canada
| | - Janice Cohen
- Behavioural Neurosciences and Consultation Liaison Team, Mental Health, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
- School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Christine Lamontagne
- Children's Hospital of Eastern Ontario's Research Institute, Ottawa, ON, Canada
- Department of Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, ON, Canada
- Department of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Gordon Allen Finley
- Department of Anesthesia, Dalhousie University, Halifax, NS, Canada
- Psychology, Dalhousie University, Halifax, NS, Canada
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Gross DP, Rachor GS, Yamamoto SS, Dick BD, Brown C, Senthilselvan A, Straube S, Els C, Jackson T, Brémault-Phillips S, Voaklander D, Stastny J, Berry T. Characteristics and Prognostic Factors for Return to Work in Public Safety Personnel with Work-Related Posttraumatic Stress Injury Undergoing Rehabilitation. J Occup Rehabil 2021; 31:768-784. [PMID: 33751310 DOI: 10.1007/s10926-021-09963-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/13/2021] [Indexed: 06/12/2023]
Abstract
Public safety personnel (PSP) are at risk of developing posttraumatic stress injury (PTSI) due to exposure to traumatic experiences and accidents. Rehabilitation programs are available, but their success varies. We studied: (1) characteristics of PSP undergoing PTSI rehabilitation in comparison to non-PSP workers; and (2) predictive value of various factors for return to work. Methods A population-based cohort study was conducted using data on injured workers undergoing PTSI rehabilitation. Of the 488 workers included, 131 were PSP. Outcome measures were: (1) return to pre-accident work at rehabilitation discharge; (2) days receiving wage replacement benefits in the year following rehabilitation. Results PSP were mainly employed (90.8%), male (59.5%), paramedics/ambulance workers (58.0%); a minority (43.5%) returned to pre-accident work after rehabilitation. Compared to non-PSP workers, PSP were more likely to initially be diagnosed with psychological injuries (94.7% versus 59.4%, p < 0.001) rather than musculoskeletal injuries. Return to pre-accident work was predicted by shorter injury duration, having a primary mental health diagnosis, working at time of admission, and not having symptoms requiring treatment in a complex rehabilitation program. PSPs were slower to experience full recovery in the year after rehabilitation. Factors predicting fewer benefit days included not having a secondary psychological injury, being employed, and working at time of admission. Conclusions Most PSP did not return to work in full after PTSI rehabilitation. Outcomes are likely to improve by starting treatment earlier and maintaining connections with the workplace.
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Affiliation(s)
- Douglas P Gross
- Department of Physical Therapy, University of Alberta, 2-50 Corbett Hall, Edmonton, Alberta, T6G 2G4, Canada.
| | - Geoffrey S Rachor
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | | | - Bruce D Dick
- Department of Anesthesiology & Pain Medicine, University of Alberta, Edmonton, Canada
| | - Cary Brown
- Department of Occupational Therapy, University of Alberta, Edmonton, Canada
| | | | - Sebastian Straube
- Division of Preventive Medicine, Department of Medicine, University of Alberta, Edmonton, Canada
| | - Charl Els
- Department of Psychiatry, University of Alberta, Edmonton, Canada
| | - Tanya Jackson
- Division of Preventive Medicine, Department of Medicine, University of Alberta, Edmonton, Canada
| | | | - Don Voaklander
- School of Public Health, University of Alberta, Edmonton, Canada
| | - Jarett Stastny
- Workers' Compensation Board of Alberta, Edmonton, Canada
| | - Theodore Berry
- Workers' Compensation Board of Alberta, Edmonton, Canada
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10
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Lee S, Dick BD, Jordan A, McMurtry CM. Psychological Interventions for Parents of Youth With Chronic Pain: A Scoping Review. Clin J Pain 2021; 37:825-844. [PMID: 34475341 DOI: 10.1097/ajp.0000000000000977] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 08/19/2021] [Indexed: 01/23/2023]
Abstract
OBJECTIVE Parents are integral to their youth's chronic pain experiences, and intervening with parents may improve parent and youth functioning. Existing systematic reviews are not specific to pain or do not systematically report critical aspects to facilitate implementation of parent interventions in diverse settings. Thus, this scoping review aimed to map published parent interventions for pediatric chronic pain to summarize the participant and intervention characteristics, treatment components, methods, outcomes, feasibility, and acceptability, as well as identify gaps for future research. METHODS Four databases were searched (PubMed, PsycINFO, CINAHL, and Google Scholar). Studies of any design reporting psychological interventions including parents of youth (0 to 18 y) with chronic pain were included. Data on study characteristics, treatment components, effectiveness, and feasibility/acceptability were extracted. RESULTS Fifty-four studies met inclusion criteria from 9312 unique titles. The majority were nonrandomized cognitive-behavioral therapy interventions delivered individually. The degree of parent participation ranged from 17% to 100%; the average enrollment rate was 68%. Reported parent and youth outcomes were variable; 26% of studies did not include any parent-related outcomes. DISCUSSION Parent interventions may be a helpful and feasible way to support parents and youth with chronic pain. There is variability across study characteristics, treatment content/aims, parent participation, and parent/youth outcomes.
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Affiliation(s)
- Soeun Lee
- Department of Psychology, University of Guelph, Guelph
| | - Bruce D Dick
- Department of Anesthesiology and Pain Medicine, Psychiatry & Pediatrics, University of Alberta
- Pediatric Chronic Pain Clinic, Stollery Children's Hospital, Edmonton, AB, Canada
| | - Abbie Jordan
- Department of Psychology and Bath Centre for Pain Research, University of Bath, Bath, UK
| | - C Meghan McMurtry
- Department of Psychology, University of Guelph, Guelph
- Pediatric Chronic Pain Program, McMaster Children's Hospital, Hamilton
- Children's Health Research Institute and Department of Pediatrics, Schulich School of Medicine and Dentistry, London, ON
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11
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Forgeron PA, Chambers C, Dick BD, Cohen J, Finley GA, Lamontagne C. Dyadic analysis of adolescent friendships behaviours during pain: Comparison of those with chronic pain versus those without chronic pain. Eur J Pain 2021; 26:428-444. [PMID: 34614279 DOI: 10.1002/ejp.1869] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 09/10/2021] [Accepted: 09/22/2021] [Indexed: 11/11/2022]
Abstract
BACKGROUND Social context has been found to influence pain intensity and tolerance. The aims of this study were to determine the impact of one type of social context on the painful experiences of adolescents with and without chronic pain by examining interactions within and across friendship dyads during experimental pain. METHODS Each adolescent in 61 same-sex friendship dyads (30 dyads with a chronic pain member) across three sites participated in the cold pressor task and acted as the observer during their friend's participation. They also completed a battery of measures to capture friendship features and pain outcomes. Pain intensity was measured using an 11-point numeric scale. Pain tolerance was measured by the length of time in the cold pressor device. Videotapes of their interactions were coded for verbal and non-verbal behaviours. A series of Actor Partner Independence Modelling, Hierarchical Multiple Regression and Multivariate Analysis of Covariance was used to analyse the data. RESULTS Friendship features were not associated with pain intensity or tolerance. Both members of dyads with a chronic pain member used fewer non-attending behaviours when they were observing their friend resulting in participants in those dyads having lower pain tolerance. Moreover, within dyads, one's friend's behaviours when experiencing pain influenced pain tolerance but only for those dyads with a chronic pain member. CONCLUSIONS Strategies aimed at improving social interactions for adolescents with chronic pain while they are experiencing pain are discussed. Research is needed to understand how different peer relationships influence pain tolerance in adolescents with chronic pain. SIGNIFICANCE OF THE RESEARCH During pain, patterns of interactions differ within and between adolescent friendship dyads when one has chronic pain (CP) versus controls. Dyads with a CP member use fewer non-attending behaviours despite non-attending behaviours rated as more helpful. Pain intensity was solely related to the participant's behaviour. Amongst dyads with a CP member, pain tolerance was also influenced by their friend's behaviours. Friends of adolescents with pain engage in more unhelpful behaviours perhaps decreasing the ability of CP adolescents to engage in social activities.
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Affiliation(s)
- Paula A Forgeron
- School of Nursing, Faculty of Health Sciences, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada.,Adjunct Appointment Department of Anesthesia, Dalhousie University, Halifax, Canada.,Centre of Pediatric Pain Research, IWK Health Centre, Halifax, Nova Scotia, Canada.,Children's Hospital of Eastern Ontario's Research Institute, Ottawa, Canada
| | - Christine Chambers
- Centre of Pediatric Pain Research, IWK Health Centre, Halifax, Nova Scotia, Canada.,Pediatrics and Psychology and Neuroscience, Dalhousie University, Halifax, Canada
| | - Bruce D Dick
- Department of Anesthesiology and Pain Medicine, Faculty of Medicine and Dentistry, University of Albert, Edmonton, Alberta, Canada
| | - Janice Cohen
- Behavioral Neurosciences and Consolation Liaison Service, Mental Health, Children's Hospital of Eastern Ontario, Ottawa, Canada.,School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, Canada
| | - G Allen Finley
- Anesthesia and Psychology, Dalhousie University, Canada.,Dr. Stewart Wenning Chair in Pediatric Pain, IWK Health Centre, Halifax, Nova Scotia, Canada
| | - Christine Lamontagne
- Children's Hospital of Eastern Ontario's Research Institute, Ottawa, Canada.,Department of Anesthesiology and Pain Medicine, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.,Children's Hospital of Eastern Ontario, Canada
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12
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Polmann H, Réus JC, Massignan C, Serra-Negra JM, Dick BD, Flores-Mir C, Lavigne GJ, De Luca Canto G. Association between sleep bruxism and stress symptoms in adults: A systematic review and meta-analysis. J Oral Rehabil 2021; 48:621-631. [PMID: 33377534 DOI: 10.1111/joor.13142] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 11/30/2020] [Accepted: 12/21/2020] [Indexed: 12/15/2022]
Abstract
To synthesise and critically review the association between sleep bruxism (SB) and stress symptoms in adults. A systematic review was performed. The search was completed using seven primary electronic databases in addition to a grey literature search. Two reviewers blindly selected studies based on pre-defined eligibility criteria. Risk of bias of the included articles was performed using the Joanna Briggs Institute Critical Appraisal Checklist for Analytical Cross-Sectional Studies. RevMan 5.4 was used to perform the meta-analysis. The quality of evidence was evaluated according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE). Ten studies were included for qualitative analysis, of which three were included for quantitative analysis. Three studies were evaluated to have low risk of bias, and seven were assessed with moderate risk of bias. Quality of evidence was classified as very low for all outcomes. Individuals with SB were found to have higher levels of some self-reported stress symptoms as assessed through questionnaires with a mean difference of 4.59 (95% CI 0.26-8.92). Biomarkers like epinephrine, norepinephrine, cortisol, adrenaline, dopamine, noradrenaline and prolidase enzyme levels also showed a positive association with SB. Although some associations were identified between probable SB and self-reported stress symptoms and biomarkers of stress in adults, given that the quality of evidence was found to be very low, caution should be exercised in interpreting these results. These findings suggest that additional and better designed studies are warranted in order to clarify the link between SB and stress.
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Affiliation(s)
- Helena Polmann
- Brazilian Centre for Evidence-Based Research, Federal University of Santa Catarina (UFSC), Florianópolis, Brazil
| | - Jéssica Conti Réus
- Brazilian Centre for Evidence-Based Research, Federal University of Santa Catarina (UFSC), Florianópolis, Brazil
| | - Carla Massignan
- Health Sciences Faculty, University of Brasília (UnB), Brasília, Brazil
| | - Junia Maria Serra-Negra
- Belo Horizonte (UFMG), Federal University of Minas Gerais, Pediatric Dentistry and Orthodontics, Minas Gerais, Brazil
| | - Bruce D Dick
- Faculty of Medicine and Dentistry, Department of Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Carlos Flores-Mir
- Faculty of Medicine and Dentistry, Department of Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Gilles J Lavigne
- Faculty of Dentistry, Surgery Department, Pain, Sleep and Trauma Unit, Hôpital du Sacré-Coeur de Montréal, Université de Montréal, Montréal, QC, Canada
| | - Graziela De Luca Canto
- Brazilian Centre for Evidence-Based Research, Federal University of Santa Catarina (UFSC), Florianópolis, Brazil.,Faculty of Medicine and Dentistry, Department of Dentistry, University of Alberta, Edmonton, AB, Canada
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13
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Polmann H, Réus JC, Maia I, Dick BD, Gozal D, Flores-Mir C, Porporatti AL, De Luca Canto G. Association between sleep disordered breathing and symptoms of attention deficits in adults: a systematic review. Sleep Med 2020; 73:223-230. [DOI: 10.1016/j.sleep.2020.06.031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 06/22/2020] [Accepted: 06/23/2020] [Indexed: 10/23/2022]
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14
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McKillop AB, Carroll LJ, Dick BD, Battié MC. What Motivates Engagement in Work and Other Valued Social Roles Despite Persistent Back Pain? J Occup Rehabil 2020; 30:466-474. [PMID: 32016648 DOI: 10.1007/s10926-020-09875-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Purpose The prognosis of persistent back pain is variable, with some individuals adjusting poorly and others continuing to actively engage in work and other valued social roles. The aim of this study was to better understand why some individuals, despite persistent back pain, continue to actively engage in work and other valued social roles. Methods Individuals with persistent back pain, who were participating in their regular duties as a full-time employee, homemaker, student or any combination of these, were recruited from a multidisciplinary pain centre and orthopedic physical therapy clinics in Alberta, Canada. A qualitative study was conducted using semi-structured interviews of 15 participants and a thematic analysis to analyze the data. Results There were two motivators identified for participating in the work role: (1) participation formed part of the participant's self-schema (a cognitive framework that includes one's beliefs about oneself) and (2) participation made it possible to achieve a valued outcome. Conclusions Further understanding of important motivators for maintaining engagement in work and other valued social roles despite persistent back pain can help inform the development of more successful disability and pain management programs.
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Affiliation(s)
- Ashley B McKillop
- Faculty of Rehabilitation Medicine, University of Alberta, 3-48 Corbett Hall, Edmonton, AB, T6G 2G4, Canada.
| | - Linda J Carroll
- School of Public Health, University of Alberta, 4075 Research Transition Facility, Edmonton, AB, T6G 2E1, Canada
| | - Bruce D Dick
- Faculty of Medicine & Dentistry, Department of Anesthesiology & Pain Medicine, University of Alberta, 2-150 Clinical Sciences, Edmonton, AB, T6G 2G3, Canada
| | - Michele C Battié
- School of Physical Therapy & Western Bone and Joint Institute, Western University, Elborn College Room 1445, London, ON, N6G 1H1, Canada
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15
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Loeffen EAH, Mulder RL, Font-Gonzalez A, Leroy PLJM, Dick BD, Taddio A, Ljungman G, Jibb LA, Tutelman PR, Liossi C, Twycross A, Positano K, Knops RR, Wijnen M, van de Wetering MD, Kremer LCM, Dupuis LL, Campbell F, Tissing WJE. Reducing pain and distress related to needle procedures in children with cancer: A clinical practice guideline. Eur J Cancer 2020; 131:53-67. [PMID: 32302949 DOI: 10.1016/j.ejca.2020.02.039] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 02/13/2020] [Accepted: 02/17/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND Children with cancer often undergo long treatment trajectories involving repeated needle procedures that potentially cause pain and distress. As part of a comprehensive effort to develop clinical practice guidelines (CPGs) to address pain prevention and management in children with cancer, we aimed to provide recommendations on the pharmacological and psychological management of procedure-related pain and distress. METHODS Of the international inter-disciplinary CPG development panel (44 individuals), two working groups including 13 healthcare professionals focused on procedural pain and distress. Grading of Recommendations Assessment, Development and Evaluation methodology was used, including the use of systematic literature reviews to inform recommendations and the use of evidence to decision frameworks. At an in-person meeting in February 2018, the guideline panel discussed these frameworks and formulated recommendations which were then discussed with a patient-parent panel consisting of 4 survivors and 5 parents. RESULTS The systematic reviews led to the inclusion of 48 randomised controlled trials (total number of participants = 2271). Quality of evidence supporting the recommendations ranged from very low to moderate. Strong recommendations were made for the use of topical anesthetics in all needle procedures, for offering deep sedation (DS)/general anesthesia (GA) to all children undergoing lumbar puncture, for the use of DS/ GA in major procedures in children of all ages, for the use of hypnosis in all needle procedures and for the use of active distraction in all needle procedures. CONCLUSION In this CPG, an evidence-based approach to manage procedure-related pain and distress in children with cancer is presented. As children with cancer often undergo repeated needle procedures during treatment, prevention and alleviation of procedure-related pain and distress is of the utmost importance to increase quality of life in these children and their families.
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Affiliation(s)
- Erik A H Loeffen
- University of Groningen, University Medical Center Groningen, Beatrix Children's Hospital, Department of Pediatric Oncology/Hematology, Groningen, the Netherlands.
| | - Renée L Mulder
- Department of Pediatric Oncology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands; Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Anna Font-Gonzalez
- Department of Pediatric Oncology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands; Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Piet L J M Leroy
- Department of Pediatrics, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Bruce D Dick
- Departments of Anesthesiology and Pain Medicine, Psychiatry &Pediatrics, University of Alberta, Edmonton, AB, Canada
| | - Anna Taddio
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada; Department of Pharmacy and Research Institute, The Hospital for Sick Children, Toronto, Canada
| | - Gustaf Ljungman
- Department of Women's and Children's Health, Pediatric Oncology, Uppsala University, Uppsala, Sweden
| | - Lindsay A Jibb
- School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Perri R Tutelman
- Centre for Pediatric Pain Research, IWK Health Centre Halifax, NS, Canada
| | - Christina Liossi
- Pediatric Psychology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Alison Twycross
- School of Health and Social Care, London South Bank University, London, United Kingdom
| | | | - Rutger R Knops
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - Marc Wijnen
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | | | - Leontien C M Kremer
- Department of Pediatric Oncology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands; Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - L Lee Dupuis
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada; Department of Pharmacy and Research Institute, The Hospital for Sick Children, Toronto, Canada
| | - Fiona Campbell
- Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, Toronto, ON, Canada
| | - Wim J E Tissing
- University of Groningen, University Medical Center Groningen, Beatrix Children's Hospital, Department of Pediatric Oncology/Hematology, Groningen, the Netherlands; Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
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16
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Abstract
Purpose: The purpose of this study was to explore the transition experience of young adults with chronic pain in Canada from the pediatric health care setting to the adult health care setting. Materials and Methods: A qualitative descriptive approach using semistructured interviews was used to capture the transition experiences of young people with chronic pain who have recently transferred from the pediatric setting to the adult health care setting. Participants were recruited from west, central, and the east coast of Canada to situate the findings within the context of Canada. Interviews were transcribed and analyzed using qualitative inductive content analysis. Results: Nine participants were interviewed, three from each part of Canada (west, central, and east). Five common categories were determined to describe the transition experience of young adults with chronic pain which include (1) independence (I can do it, maybe?), (2) pain trajectory (stress and pain along for the ride), (3) social support networks (need a shoulder to lean on), (4) parental support (obviously they are there), and (5) collaborative systems (the bridge). Conclusion: Young people with chronic pain experience unique challenges when faced with transitioning to the adult health care setting. Supporting the young person and his or her family in preparation and readiness and collaboration between the pediatric and adult health care settings are essential to ensure a smooth transition and avoid negative transition outcomes. Further research is needed to determine the best ways to prepare young people for transition and the care activities required in both pediatric and adult health care settings to improve pain-related outcomes posttransition.
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Affiliation(s)
- Andrea Higginson
- School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Paula Forgeron
- School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
- Department of Anaesthesia, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Denise Harrison
- School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
- Children's Hospital of Eastern Ontario, Ottawa, Canada
| | - G. Allen Finley
- Department of Anesthesia & Psychology, Dalhousie University, Halifax, Nova Scotia, Canada
- Centre for Pediatric Pain Research, IWK Health Centre, Canada
| | - Bruce D. Dick
- Depts. of Anesthesiology and Pain Medicine, Psychiatry & Pediatrics, Faculties of Medicine and Dentistry & Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
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17
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Tamana SK, Ezeugwu V, Chikuma J, Lefebvre DL, Azad MB, Moraes TJ, Subbarao P, Becker AB, Turvey SE, Sears MR, Dick BD, Carson V, Rasmussen C, Pei J, Mandhane PJ. Screen-time is associated with inattention problems in preschoolers: Results from the CHILD birth cohort study. PLoS One 2019; 14:e0213995. [PMID: 30995220 PMCID: PMC6469768 DOI: 10.1371/journal.pone.0213995] [Citation(s) in RCA: 111] [Impact Index Per Article: 22.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 03/05/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Pre-school children spend an average of two-hours daily using screens. We examined associations between screen-time on pre-school behavior using data from the Canadian Healthy Infant Longitudinal Development (CHILD) study. METHODS CHILD participant parents completed the Child Behavior Checklist (CBCL) at five-years of age. Parents reported their child's total screen-time including gaming and mobile devices. Screen-time was categorized using the recommended threshold of two-hours/day for five-years or one-hour/day for three-years. Multiple linear regression examined associations between screen-time and externalizing behavior (e.g. inattention and aggression). Multiple logistic regression identified characteristics of children at risk for clinically significant externalizing problems (CBCL T-score≥65). RESULTS Screen-time was available for over 95% of children (2,322/2,427) with CBCL data. Mean screen-time was 1·4 hours/day (95%CI 1·4, 1·5) at five-years and 1·5 hours/day (95%CI: 1·5, 1·6) at three-years. Compared to children with less than 30-minutes/day screen-time, those watching more than two-hours/day (13·7%) had a 2·2-point increase in externalizing T-score (95%CI: 0·9, 3·5, p≤0·001); a five-fold increased odd for reporting clinically significant externalizing problems (95%CI: 1·0, 25·0, p = 0·05); and were 5·9 times more likely to report clinically significant inattention problems (95%CI: 1·6, 21·5, p = 0·01). Children with a DSM-5 ADHD T-score above the 65 clinical cut-off were considered to have significant ADHD type symptoms (n = 24). Children with more than 2-hours of screen-time/day had a 7·7-fold increased risk of meeting criteria for ADHD (95%CI: 1·6, 38·1, p = 0·01). There was no significant association between screen-time and aggressive behaviors (p>0.05). CONCLUSION Increased screen-time in pre-school is associated with worse inattention problems.
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Affiliation(s)
| | - Victor Ezeugwu
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Joyce Chikuma
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | - Diana L. Lefebvre
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Meghan B. Azad
- Department of Pediatrics & Child Health, Children’s Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Theo J. Moraes
- Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Padmaja Subbarao
- Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Allan B. Becker
- Department of Pediatrics & Child Health, Children’s Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Stuart E. Turvey
- Department of Pediatrics, Child & Family Research Institute, BC Children’s Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - Malcolm R. Sears
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Bruce D. Dick
- Department of Anesthesiology and Pain Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Valerie Carson
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - Carmen Rasmussen
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
| | | | - Jacqueline Pei
- Department of Educational Psychology, University of Alberta, Edmonton, Alberta, Canada
| | - Piush J. Mandhane
- Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
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18
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Polmann H, Domingos FL, Melo G, Stuginski‐Barbosa J, Guerra ENDS, Porporatti AL, Dick BD, Flores‐Mir C, De Luca Canto G. Association between sleep bruxism and anxiety symptoms in adults: A systematic review. J Oral Rehabil 2019; 46:482-491. [DOI: 10.1111/joor.12785] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 01/02/2019] [Accepted: 02/21/2019] [Indexed: 12/29/2022]
Affiliation(s)
- Helena Polmann
- Department of Dentistry, Brazilian Centre for Evidence‐Based Research Federal University of Santa Catarina (UFSC) Florianópolis Brazil
| | - Fabio Luiz Domingos
- Department of Dentistry, Brazilian Centre for Evidence‐Based Research Federal University of Santa Catarina (UFSC) Florianópolis Brazil
| | - Gilberto Melo
- Department of Dentistry, Brazilian Centre for Evidence‐Based Research Federal University of Santa Catarina (UFSC) Florianópolis Brazil
| | | | | | - André Luís Porporatti
- Department of Dentistry, Brazilian Centre for Evidence‐Based Research Federal University of Santa Catarina (UFSC) Florianópolis Brazil
| | - Bruce D. Dick
- Faculty of Medicine and Dentistry University of Alberta Edmonton Alberta Canada
| | - Carlos Flores‐Mir
- Faculty of Medicine and Dentistry University of Alberta Edmonton Alberta Canada
| | - Graziela De Luca Canto
- Department of Dentistry, Brazilian Centre for Evidence‐Based Research Federal University of Santa Catarina (UFSC) Florianópolis Brazil
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19
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Qin P, Dick BD, Leung A, Brown CA. Effectiveness of hand self-shiatsu to improve sleep following sport-related concussion in young athletes: a proof-of-concept study. Journal of Integrative Medicine 2019; 17:24-29. [DOI: 10.1016/j.joim.2018.11.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2018] [Accepted: 10/15/2018] [Indexed: 10/27/2022]
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20
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Fleck-Prediger CM, Ghosh Hajra S, Liu CC, Gray DS, Weaver DF, Gopinath S, Dick BD, D'Arcy RCN. Point-of-care brain injury evaluation of conscious awareness: wide scale deployment of portable HCS EEG evaluation. Neurosci Conscious 2018; 2018:niy011. [PMID: 30488005 PMCID: PMC6251986 DOI: 10.1093/nc/niy011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 09/16/2018] [Accepted: 09/22/2018] [Indexed: 11/14/2022] Open
Abstract
Survivors of severe brain injury may remain in a decreased state of conscious awareness for an extended period of time. Clinical scales are used to describe levels of consciousness but rely on behavioural responses, precipitating misdiagnosis. We have previously utilized event-related potentials (ERPs) to circumvent reliance on behavioural responses. However, practical implementation barriers limit the clinical utility of ERP assessment at point-of-care (POC). To address this challenge, we developed the Halifax Consciousness Scanner (HCS)-a rapid, semi-automated electroencephalography system. The current study evaluated: (i) HCS feasibility in sub-acute, POC settings nationwide; (ii) ERP P300 responses in patients with acquired brain injury versus healthy controls; and (iii) correlations within and between clinical measures and P300 latencies. We assessed 28 patients with severe, chronic impairments from brain injuries and contrasted the results with healthy control data (n = 100). Correlational analyses examined relationships between P300 latencies and the commonly used clinical scales. P300 latencies were significantly delayed in patients compared to healthy controls (P < 0.05). Clinical assessment scores were significantly inter-correlated and correlated significantly with P300 latencies (P < 0.05). In sub-acute and chronic care settings, the HCS provided a physiological measure of neurocognitive processing at POC for patients with severe acquired brain injury, including those with disorders of consciousness.
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Affiliation(s)
- Carolyn M Fleck-Prediger
- Neuroscience and Mental Health Institute, University of Alberta, Canada.,Halvar Jonson Centre for Brain Injury, Canada
| | - Sujoy Ghosh Hajra
- Faculty of Applied Sciences (Engineering Science and Computing Science), Simon Fraser University, Canada.,NeuroTech Lab, Simon Fraser University and Fraser Health Authority, Surrey, BC, Canada
| | - Careesa C Liu
- Faculty of Applied Sciences (Engineering Science and Computing Science), Simon Fraser University, Canada.,NeuroTech Lab, Simon Fraser University and Fraser Health Authority, Surrey, BC, Canada
| | - D Shaun Gray
- Neuroscience and Mental Health Institute, University of Alberta, Canada.,Halvar Jonson Centre for Brain Injury, Canada.,Division of Physical Medicine and Rehabilitation, University of Alberta, Canada
| | - Donald F Weaver
- Krembil Research Institute, UHN, University of Toronto, Canada
| | - Shishir Gopinath
- NeuroTech Lab, Simon Fraser University and Fraser Health Authority, Surrey, BC, Canada
| | - Bruce D Dick
- Neuroscience and Mental Health Institute, University of Alberta, Canada.,Departments of Anesthesiology and Pain Medicine, Psychiatry & Pediatrics, University of Alberta, Canada
| | - Ryan C N D'Arcy
- Faculty of Applied Sciences (Engineering Science and Computing Science), Simon Fraser University, Canada.,NeuroTech Lab, Simon Fraser University and Fraser Health Authority, Surrey, BC, Canada
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21
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McWilliams LA, Kowal J, Verrier MJ, Dick BD. Do Pain-Related Support Preferences Moderate Relationships Between Chronic Pain Patients' Reports of Support Received and Psychosocial Functioning? Pain Med 2018; 18:2331-2339. [PMID: 28122940 DOI: 10.1093/pm/pnw346] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objective The operant theory of chronic pain and related research suggest pain-related solicitous support promotes disability. The current study investigated the hypotheses that solicitous support is positively associated with both disability and relationship satisfaction and that these relationships are moderated by the level of desire for this type of support. Methods Patients with chronic pain (N = 147) and in a relationship were recruited from a multidisciplinary pain treatment center. They provided self-reports of the amount of three types of pain-related support wanted and received (i.e., solicitous, encouragement, and suppression), disability, and relationship satisfaction. Results A hierarchical regression analysis indicated that solicitous support received was not significantly associated with disability. However, a moderation effect was found regarding encouragement. Encouragement received was negatively associated with disability, and this relationship was strongest at lower levels of interest in encouragement. Solicitous support received had a large positive association with relationship satisfaction. Conclusions The findings suggest the influence of pain-related support is more complex than suggested by the operant conditioning model of chronic pain, which emphasizes the possible detrimental impact of solicitous support. Further research is warranted regarding the potential relationship enhancing effects of solicitous support and the influence of encouragement on disability experienced by those with chronic pain.
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Affiliation(s)
| | - John Kowal
- The Ottawa Hospital Rehabilitation Centre, Ottawa, ON, Canada
| | - Michelle J Verrier
- Department of Anesthesiology and Pain Medicine, University of Alberta, Edmonton, AB, Canada
| | - Bruce D Dick
- Department of Anesthesiology and Pain Medicine, University of Alberta, Edmonton, AB, Canada
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22
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Bostick GP, Dick BD, Wood M, Luckhurst B, Tschofen J, Wideman TW. Pain Assessment Recommendations for Women, Made by Women: A Mixed Methods Study. Pain Med 2018; 19:1147-1155. [PMID: 28549183 DOI: 10.1093/pm/pnx137] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Objective To quantitatively describe women's priorities for pain assessment and qualitatively explain unique features of women's pain experiences. Design Mixed-methods study that included a three-round Delphi study followed by in-depth interviews. Setting Clinical research study. Participants Twenty-three women with chronic pain recruited from three women's pain treatment facilities and one interdisciplinary chronic pain clinic. Methods Phase 1 (Delphi) involved completion of a questionnaire that rated agreement with the importance of 32 commonly used pain assessment measures. Answers were compiled, and controlled feedback was provided after each round. This iterative process continued until acceptable stability was reached. Stability was defined as proportion agreement for each response that reached the a priori cutoff score of 75%. Phase 2 (qualitative) involved one-to-one telephone interviews that followed a semistructured interview guide partially informed from phase 1 findings. A descriptive approach summarized and described participants' perspectives while avoiding abstractions. Textual data were analyzed using content analysis. Results Phase 1 identified 15 pain assessments as important. Some commonly used pain assessment measures such as the numeric pain intensity rating scale did not reach agreement as important. However, no pain assessments reached agreement as unimportant. Ten additional women completed face-to-face interviews, and an overall theme of stigmatization emerged that highlighted the importance of soliciting the pain narrative and why some aspects of psychosocial pain assessment did not reach agreement. Conclusions Priorities identified by women for the assessment of pain were largely consistent with expert recommendations; however, important differences were raised that merit consideration for clinicians to reduce stigma.
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Affiliation(s)
| | - Bruce D Dick
- Anesthesiology and Pain Medicine, Psychiatry and Pediatrics, University of Alberta, Edmonton, Canada
| | - Mary Wood
- Cura Physical Therapies, Edmonton, Canada
| | | | | | - Timothy W Wideman
- School of Occupational and Physical Therapy, McGill University, Montreal, Canada
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Yakunchikov DY, Olechowski CJ, Simmonds MK, Verrier MJ, Rashiq S, McWilliams LA, Sobolev IA, Dick BD. The Effect of Social Observational Learning, Empathy and Catastrophizing in Chronic Pain Patients During Acute Pain Induction. Pain Med 2018; 18:871-878. [PMID: 27561307 DOI: 10.1093/pm/pnw186] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Objective In this study, we were interested in determining whether we could alter a pain response in a chronic pain patient population by exposing participants to different videos prior to inducing acute pain. Design This observational case series study required participants to report their pain level during the cold pressor task after viewing an instruction video. Setting Recruitment and testing took place in a tertiary care multidisciplinary pain center. Subjects Forty adults with chronic pain participated in the study and completed the cold pressor test. Methods Prior to testing, questionnaires measuring pain, empathy, and catastrophic thinking were completed and participants were randomized to view an instructional video where an actress either demonstrated pain behavior or a stoic response during the cold pressor test. Results Participants with higher levels of catastrophizing reported higher pain levels during the cold pressor test. Personal Distress Empathy measures of participants who viewed the pain catastrophizing video were significantly correlated with their final pain reports. Following the cold pressor task, participants' pain reports for their primary chronic pain sites were significantly reduced. Conclusions These results support previous findings that people with chronic pain show the tendency toward increased acute pain experience if levels of catastrophizing and Personal Distress Empathy measures are higher. Participants reported attenuated chronic pain following induced pain, also in line with previous research suggesting a central endogenous inhibitory effect. Our findings shed light on the role of emotional and social components affecting the experience of pain in individuals with chronic pain.
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Affiliation(s)
- Dmitry Y Yakunchikov
- Department of Anesthesiology and Pain Medicine, University of Alberta, Edmonton, Alberta, Canada
| | | | - Mark K Simmonds
- Department of Anesthesiology and Pain Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Michelle J Verrier
- Department of Anesthesiology and Pain Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Saifudin Rashiq
- Department of Anesthesiology and Pain Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Lachlan A McWilliams
- Department of Psychology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Igor A Sobolev
- Department of Anesthesiology and Pain Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Bruce D Dick
- Department of Anesthesiology and Pain Medicine, University of Alberta, Edmonton, Alberta, Canada
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Slomp FJ, Mayan MJ, Lasiuk GC, Dick BD. The determinants of meaning of pain following an acute traumatic injury. Scand J Caring Sci 2017; 32:672-680. [PMID: 28851066 DOI: 10.1111/scs.12493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 05/08/2017] [Indexed: 12/01/2022]
Abstract
RATIONALE AND AIMS Meaning is an integral aspect of life that drives behaviours, actions and emotions. Perception of pain is believed to be affected by the meaning of pain. Our primary aim was to investigate and discuss the determinants of meaning in acute pain following a traumatic injury. METHODOLOGICAL DESIGN Using the Interpretive Description approach, a method of qualitative inquiry, 13 adults hospitalised due to their accidental injuries were recruited. Semi-structured interviews that were digitally recorded were used to collect the data. Ethical approval was received by our local Health Research Ethics Board, and all relevant ethical standards were followed as outlined in the approved ethics proposal. FINDINGS The three primary determinants of meaning during an acute pain event, or the experience of acute pain include permanence of injuries, incongruence of care quality, and personal responses to the injury and care received. Although the permanence of an injury is lasting, we did not find any emotional response to this fact while the participants were hospitalised. The emotion characterising the personal response to the perceived poor quality of hospital care received was anxiety. CONCLUSION Both the technical and personal components of healthcare quality have the potential to increase the perception of pain. Meanings in an acute pain event are primarily related to the determinants of incongruent care and the personal response to that determinant: anxiety.
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Affiliation(s)
- Florence J Slomp
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Maria J Mayan
- Faculty of Extension, University of Alberta, Edmonton, AB, Canada
| | - Gerri C Lasiuk
- College of Nursing Simulation Centre, University of Saskatchewan, Saskatoon, SK, Canada
| | - Bruce D Dick
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.,Departments of Anesthesiology and Pain Medicine, Psychiatry & Pediatrics, University of Alberta, Edmonton, AB, Canada
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Bostick GP, Kamper SJ, Haanstra TM, Dick BD, Stitt LW, Morley-Forster P, Clark AJ, Lynch ME, Gordon A, Nathan H, Smyth C, Ware MA, Toth C, Moulin DE. Pain expectations in neuropathic pain: Is it best to be optimistic? Eur J Pain 2016; 21:605-613. [PMID: 27739623 DOI: 10.1002/ejp.962] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2016] [Indexed: 01/12/2023]
Abstract
BACKGROUND Pain expectancy may be an important variable that has been found to influence the effectiveness of treatments for pain. Much of the literature supports a self-fulfilment perspective where expectations for pain relief predict the actual pain experienced. However, in conditions such as neuropathic pain (NeP) where pain relief is difficult to attain, expectations for pain relief could be unrealistic. The objective of this study was to investigate the relationship between realistic/unrealistic expectations and 6-month, post-treatment outcomes. METHODS We performed a retrospective analysis of a large cohort of patients with NeP (n = 789) attending tertiary care centres to determine the association between unrealistic (both positive and negative) and realistic expectations with outcomes after multidisciplinary treatment. An expectation variable with three categories was calculated: realistic expectations were those whose expected reduction in pain was similar to the observed mean group reduction in pain, while optimistic and pessimistic expectations were those who over- or under-estimated the expected response to treatment, respectively. The association between baseline realistic/unrealistic expectations and 6-month pain-related disability, catastrophizing and psychological distress was assessed. RESULTS Univariable analyses suggested that realistic expectations were associated with lower levels of disability, catastrophizing and psychological distress, compared to unrealistic expectations. However, after adjustment for baseline symptom severity, multivariable analysis revealed that patients with optimistic expectations had lower levels of disability, than those with realistic expectations. Those with pessimistic expectations had higher levels of catastrophizing and psychological distress at follow-up. CONCLUSIONS These findings are largely congruent with the self-fulfilment perspective to expectations. SIGNIFICANCE This study defined realistic pain expectations with patient data. Examining the relationship between expectations between pain and disability in a large cohort of patients with neuropathic pain.
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Affiliation(s)
- G P Bostick
- Department of Physical Therapy, University of Alberta, Edmonton, Canada
| | - S J Kamper
- The George Institute for Global Health, University of Sydney, NSW, Australia
| | - T M Haanstra
- Department of Orthopedics, VU University Medical Center, Amsterdam, The Netherlands
| | - B D Dick
- Departments of Anesthesiology and Pain Medicine, Psychiatry and Pediatrics, University of Alberta, Edmonton, Canada
| | - L W Stitt
- LW Stitt Statistical Services, London, ON, Canada
| | - P Morley-Forster
- Department of Anaesthesiology, Pain Management and Peri-operative Medicine, Western University, London, ON, Canada
| | - A J Clark
- Department of Anaesthesia, Dalhousie University, Halifax, NS, Canada
| | - M E Lynch
- Department of Anaesthesia, Dalhousie University, Halifax, NS, Canada.,Departments of Psychiatry and Pharmacology, Dalhousie University, Halifax, NS, Canada
| | - A Gordon
- Department of Medicine, Division of Neurology, University of Toronto, ON, Canada
| | - H Nathan
- Department of Anaesthesiology, University of Ottawa, ON, Canada
| | - C Smyth
- Department of Anaesthesiology, University of Ottawa, ON, Canada
| | - M A Ware
- Departments of Family Medicine and Anaesthesia, McGill University, Montreal, QC, Canada
| | - C Toth
- Fraser Valley Health Authority, Surrey, BC, Canada
| | - D E Moulin
- Departments of Neurological Sciences and Oncology, Western University, London, ON, Canada
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Pachêco-Pereira C, Abreu LG, Dick BD, De Luca Canto G, Paiva SM, Flores-Mir C. Patient satisfaction after orthodontic treatment combined with orthognathic surgery: A systematic review. Angle Orthod 2016; 86:495-508. [PMID: 26313228 PMCID: PMC8601732 DOI: 10.2319/040615-227.1] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 06/01/2015] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To synthesize available evidence about factors associated with patients' satisfaction after orthodontic treatment combined with orthognathic surgery. MATERIALS AND METHODS Studies that evaluated any factor associated with patients' satisfaction after the conclusion of an orthodontic treatment combined with an orthognathic surgery were identified. Orthognathic surgical procedures should have been undertaken after completion of craniofacial growth. Any satisfaction psychometric tool was considered. No language limitation was set. A detailed individual search strategy for each of the following bibliographic databases was crafted: MEDLINE, PubMed, EBM Reviews, Web of Science, EMBASE, LILACS, and Scopus. The references cited in the identified articles were also cross-checked, and a partial gray-literature search was undertaken using Google Scholar. RESULTS Eight articles satisfied the inclusion criteria of this systematic review and accounted for 998 patients. The included studies showed large variation in sample size (range = 44 to 505 patients), age (range = 15 to 72 years old), distinct psychological evaluation tools, and time elapsed between the assessment and the completion of surgery and postorthodontic treatment. Most of the studies (five of eight) were classified as having high risk of bias. CONCLUSION Factors associated with satisfaction were final esthetic outcome, perceived social benefits from the outcome, type of orthognathic surgery, sex, and changes in patient self-concept during treatment. Factors associated with dissatisfaction were treatment length; sensation of functional impairment and/or dysfunction after surgery, and perceived omitted information about surgical risks.
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Affiliation(s)
- Camila Pachêco-Pereira
- Assistant Clinical Professor, School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - Lucas G. Abreu
- PhD student, Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Bruce D. Dick
- Associate Professor, Department of Anesthesiology and Pain Medicine and Department of Psychiatry & Pediatrics, and Chief of Psychology, Multidisciplinary Pain Centre, University of Alberta, Edmonton, Canada
| | - Graziela De Luca Canto
- Associate Professor, Department of Dentistry, Federal University of Santa Catarina, Florianopolis, Brazil, and Adjunct Professor, Department of Dentistry School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - Saul M. Paiva
- Professor, Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Carlos Flores-Mir
- Professor and Division Head of Orthodontics, School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
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Troche SJ, Houlihan ME, Connolly JF, Dick BD, McGrath PJ, Finley GA, Stroink G. The effect of pain on involuntary and voluntary capture of attention. Eur J Pain 2015; 19:350-7. [PMID: 25056109 DOI: 10.1002/ejp.553] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2014] [Indexed: 11/08/2022]
Abstract
BACKGROUND There is converging evidence for the notion that pain affects a broad range of attentional domains. This study investigated the influence of pain on the involuntary capture of attention as indexed by the P3a component in the event-related potential derived from the electroencephalogram. METHODS Participants performed in an auditory oddball task in a pain-free and a pain condition during which they submerged a hand in cold water. Novel, infrequent and unexpected auditory stimuli were presented randomly in a series of frequent standard and infrequent target tones. P3a and P3b amplitudes were observed to novel, unexpected and target-related stimuli, respectively. RESULTS Both electrophysiological components were characterized by reduced amplitudes in the pain compared with the pain-free condition. Hit rate and reaction time to target stimuli did not differ between the two conditions presumably because the experimental task was not difficult enough to exceed attentional capacities under pain conditions. CONCLUSIONS These results indicate that voluntary attention serving the maintenance and control of ongoing information processing (reflected by the P3b amplitude) is impaired by pain. In addition, the involuntary capture of attention and orientation to novel, unexpected information (measured by the P3a) is also impaired by pain. Thus, neurophysiological measures examined in this study support the theoretical positions proposing that pain can reduce attentional processing capacity. These findings have potentially important implications at the theoretical level for our understanding of the interplay of pain and cognition, and at the therapeutic level for the clinical treatment of individuals experiencing ongoing pain.
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Affiliation(s)
- S J Troche
- Department of Psychology, University of Bern, Switzerland; Center for Cognition, Learning, and Memory, University of Bern, Switzerland
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Pachêco-Pereira C, Pereira JR, Dick BD, Perez A, Flores-Mir C. Factors associated with patient and parent satisfaction after orthodontic treatment: A systematic review. Am J Orthod Dentofacial Orthop 2015; 148:652-9. [DOI: 10.1016/j.ajodo.2015.04.039] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Revised: 04/01/2015] [Accepted: 04/01/2015] [Indexed: 10/23/2022]
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De Luca Canto G, Singh V, Conti P, Dick BD, Gozal D, Major PW, Flores-Mir C. Association between sleep bruxism and psychosocial factors in children and adolescents: a systematic review. Clin Pediatr (Phila) 2015; 54:469-78. [PMID: 25385932 DOI: 10.1177/0009922814555976] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To summarize the association between sleep bruxism and psychosocial factors in children and adolescents. DESIGN Individual search strategies for five databases were developed. The references cited in the selected articles were checked and a partial gray literature search was undertaken. Only articles that used the international diagnostic criteria for sleep bruxism as proposed by the American Association of Sleep Medicine were included. Any form of reporting of psychosocial factors was considered. RESULTS Of the 44 retained articles, only 7 studies were finally included for the qualitative/quantitative synthesis. No evidence supportive of an association between sleep bruxism and psychosocial factors in children younger than 5 years emerged. A significant association was present in children between 6 and 11 years old and in adolescents 12 to 17 years old. Risk of bias was low-to-moderate in most of the included studies. CONCLUSION The current available evidence suggests an association between sleep bruxism and psychological factors in children older than 6 years.
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Affiliation(s)
- Graziela De Luca Canto
- Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil University of Alberta, Edmonton, Alberta, Canada
| | | | | | - Bruce D Dick
- University of Alberta, Edmonton, Alberta, Canada
| | | | - Paul W Major
- University of Alberta, Edmonton, Alberta, Canada
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Petter M, McGrath PJ, Chambers CT, Dick BD. The effects of mindful attention and state mindfulness on acute experimental pain among adolescents. J Pediatr Psychol 2014; 39:521-31. [PMID: 24599947 DOI: 10.1093/jpepsy/jsu007] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Attention-based coping strategies for pain are widely used in pediatric populations. The purpose of this study was to test a novel mindful attention manipulation on adolescent's experimental pain responses. Furthermore, the relationship between state mindfulness and experimental pain was examined. METHODS A total of 198 adolescents were randomly assigned to a mindful attention manipulation or control group prior to an experimental pain task. Participants completed measures of state mindfulness immediately prior to the pain task, and situational catastrophizing and pain intensity following the task. RESULTS Overall the manipulation had no effect on pain. Secondary analysis showed that meditation experience moderated the effect of the manipulation. State mindfulness predicted pain outcomes, with reductions in situational catastrophizing mediating this relationship. CONCLUSIONS The mindful attention manipulation was effective among adolescents with a regular meditation practice. State mindfulness was related to ameliorated pain responses, and these effects were mediated by reduced catastrophizing.
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Affiliation(s)
- Mark Petter
- Department of Psychology and Neuroscience, Centre for Pediatric Pain Research, IWK Health Centre, Department of Pediatrics, Department of Psychiatry, Research and Innovation, IWK Health Centre and Capital District Health Authority, Department of Anesthesia, Pain Management, and Perioperative Medicine, Dalhousie University, and Department of Anesthesiology and Pain Medicine, University of AlbertaDepartment of Psychology and Neuroscience, Centre for Pediatric Pain Research, IWK Health Centre, Department of Pediatrics, Department of Psychiatry, Research and Innovation, IWK Health Centre and Capital District Health Authority, Department of Anesthesia, Pain Management, and Perioperative Medicine, Dalhousie University, and Department of Anesthesiology and Pain Medicine, University of Alberta
| | - Patrick J McGrath
- Department of Psychology and Neuroscience, Centre for Pediatric Pain Research, IWK Health Centre, Department of Pediatrics, Department of Psychiatry, Research and Innovation, IWK Health Centre and Capital District Health Authority, Department of Anesthesia, Pain Management, and Perioperative Medicine, Dalhousie University, and Department of Anesthesiology and Pain Medicine, University of AlbertaDepartment of Psychology and Neuroscience, Centre for Pediatric Pain Research, IWK Health Centre, Department of Pediatrics, Department of Psychiatry, Research and Innovation, IWK Health Centre and Capital District Health Authority, Department of Anesthesia, Pain Management, and Perioperative Medicine, Dalhousie University, and Department of Anesthesiology and Pain Medicine, University of AlbertaDepartment of Psychology and Neuroscience, Centre for Pediatric Pain Research, IWK Health Centre, Department of Pediatrics, Department of Psychiatry, Research and Innovation, IWK Health Centre and Capital District Health Authority, Department of Anesthesia, Pain Management, and Perioperative Medicine, Dalhousie University, and Department of Anesthesiology and Pain Medicine, University of AlbertaDepartment of Psychology and Neuroscience, Centre for Pediatric Pain Research, IWK Health Centre, Department of Pediatrics, Department of Psychiatry, Research and Innovation, IWK Health Centre and Capital District Health Authority, Department of Anesthesia, Pain Management, and Perioperative Medicine, Dalhousie University, and Department of Anesthesiology and Pain Medicine, University of AlbertaDepartment of Psychology and Neuroscience, Centre for Pediatric Pain Research, IWK Health Centre, Department of Pediatrics, Department of Psychiatry, Research and Innovation, IWK Health Centre and Capital District Health Authority, Department of Anesthesia, Pain Management, and Perioperative Medicine, Dalhousie University, and Department of Anesthesiology and Pain Medicine, University of Alberta mark.pett
| | - Christine T Chambers
- Department of Psychology and Neuroscience, Centre for Pediatric Pain Research, IWK Health Centre, Department of Pediatrics, Department of Psychiatry, Research and Innovation, IWK Health Centre and Capital District Health Authority, Department of Anesthesia, Pain Management, and Perioperative Medicine, Dalhousie University, and Department of Anesthesiology and Pain Medicine, University of AlbertaDepartment of Psychology and Neuroscience, Centre for Pediatric Pain Research, IWK Health Centre, Department of Pediatrics, Department of Psychiatry, Research and Innovation, IWK Health Centre and Capital District Health Authority, Department of Anesthesia, Pain Management, and Perioperative Medicine, Dalhousie University, and Department of Anesthesiology and Pain Medicine, University of AlbertaDepartment of Psychology and Neuroscience, Centre for Pediatric Pain Research, IWK Health Centre, Department of Pediatrics, Department of Psychiatry, Research and Innovation, IWK Health Centre and Capital District Health Authority, Department of Anesthesia, Pain Management, and Perioperative Medicine, Dalhousie University, and Department of Anesthesiology and Pain Medicine, University of AlbertaDepartment of Psychology and Neuroscience, Centre for Pediatric Pain Research, IWK Health Centre, Department of Pediatrics, Department of Psychiatry, Research and Innovation, IWK Health Centre and Capital District Health Authority, Department of Anesthesia, Pain Management, and Perioperative Medicine, Dalhousie University, and Department of Anesthesiology and Pain Medicine, University of AlbertaDepartment of Psychology and Neuroscience, Centre for Pediatric Pain Research, IWK Health Centre, Department of Pediatrics, Department of Psychiatry, Research and Innovation, IWK Health Centre and Capital District Health Authority, Department of Anesthesia, Pain Management, and Perioperative Medicine, Dalhousie University, and Department of Anesthesiology and Pain Medicine, University of Alberta
| | - Bruce D Dick
- Department of Psychology and Neuroscience, Centre for Pediatric Pain Research, IWK Health Centre, Department of Pediatrics, Department of Psychiatry, Research and Innovation, IWK Health Centre and Capital District Health Authority, Department of Anesthesia, Pain Management, and Perioperative Medicine, Dalhousie University, and Department of Anesthesiology and Pain Medicine, University of Alberta
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Abstract
PURPOSE This is a selective narrative review of the latest information about the epidemiology, impact, and prevention of chronic post-surgical pain (CPSP), intended primarily for those without a special interest in pain medicine. PRINCIPAL FINDINGS Chronic post-surgical pain is an important problem in terms of personal impact. It has staggering economic implications, exerts powerful negative effects on the quality of life of many of those it afflicts, and places a significant burden on chronic pain treatment services in general. It is well known that surgery at certain body sites is apt to cause CPSP, but emerging evidence shows a strong correlation between CPSP and demographic (young age, obesity, and female sex) and psychological characteristics (anxiety, depression, stress, and catastrophizing). Severe acute pain is a strong risk factor for CPSP, and this adds yet more weight to the argument that acute pain should be controlled effectively. In specific circumstances, CPSP can be reduced by regional anesthetic techniques, infiltration of local anesthetic, or preoperative use of gabapentin. The ability of other known interrupters of afferent nociceptive transmission-commonly used to reduce CPSP when administered at the time of surgery-is currently unproven, as is the hypothesis that the use of remifentanil during surgery worsens CPSP. CONCLUSIONS Reduction of CPSP is a worthy long-term outcome for anesthesia providers to consider as they plan the perioperative care of their patients. More evidence is needed about the effect of currently used analgesics and other perioperative techniques on CPSP.
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Affiliation(s)
- Saifee Rashiq
- Division of Pain Medicine, Department of Anesthesiology & Pain Medicine, University of Alberta, 8-120J Clinical Sciences Building, Edmonton, AB, T6G 2G3, Canada,
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Bailey SJ, McWilliams LA, Dick BD. Expanding the social communication model of pain: Are adult attachment characteristics associated with observers' pain-related evaluations? Rehabil Psychol 2012; 57:27-34. [DOI: 10.1037/a0026237] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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McWilliams LA, Dick BD, Bailey K, Verrier MJ, Kowal J. A psychometric evaluation of the Pain Response Preference Questionnaire in a chronic pain patient sample. Health Psychol 2012; 31:343-351. [PMID: 22268714 DOI: 10.1037/a0027014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The Pain Response Preference Questionnaire (PRPQ) assesses preferences regarding pain-related social support. The initial factor analytic study of the PRPQ conducted with a nonclinical sample identified scales labeled Solicitude, Management, Suppression, and Encouragement. The first aim of the current study was to evaluate whether these scales would be appropriate for use with chronic pain patients. The construct validity of the emerging scales and their relations to pain-related disability were also investigated. METHODS A large sample of chronic pain patients (N = 300) completed the PRPQ along with self-reports of personality constructs, coping styles, pain severity, and disability. RESULTS Factor analysis supported a three-factor solution. Two factors were similar to those obtained in its initial evaluation, and were given the identical labels of Solicitude and Suppression. The remaining factor was labeled Activity Direction and was comprised primarily of items that were part of the earlier Management and Encouragement scales. Internally consistent PRPQ scales based on these factors were created. Correlation analyses involving the personality and coping measures provided support for the construct validity of these PRPQ scales. Supportive of their clinical utility, multiple regression analyses indicated that, after adjusting for pain severity, the PRPQ scales accounted for significant variance in disability ratings. CONCLUSIONS Additional factor analytic research aimed at identifying the most appropriate set of PRPQ scales is warranted. The present findings indicate that the PRPQ scales used in the current study have strong psychometric properties and hold promise as research and clinical tools.
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Affiliation(s)
| | - Bruce D Dick
- Department of Anesthesiology and Pain Medicine, University of Alberta
| | | | | | - John Kowal
- Psychology, The Ottawa Hospital Rehabilitation Centre
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Abstract
OBJECTIVE To explore patients' perceptions of their pain while participating in a weekly yoga program. METHODS A consecutive convenience sample was recruited from a Multidisciplinary Pain Centre. Seven adult patients (six women), agreed to participate in an 8-week Hatha yoga program, including weekly group sessions and at-home practice. Data were gathered from participant observation and in-depth interviews. Interviews explored the experience of practicing yoga and its relationship to the participant's pain experience. An inductive analysis of the interviews explored emergent themes from participants' descriptions of their experience. RESULTS Analyses identified three themes: renewed awareness of the body; transformed relationship with the body in pain; and acceptance. DISCUSSION Participants' data suggested that they reframed what it meant to live with chronic pain. Some participants reported that the sensory aspects of pain did not change but that pain became less bothersome. They were better able to control the degree to which pain interfered with their daily life. Other participants reported less frequent or less intense pain episodes because they could recognize body signals and adjust themselves to alleviate painful sensations. The findings suggest that patients who benefit from yoga may do so in part because yoga enables changes in cognitions and behaviours towards pain.
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Affiliation(s)
- Yvonne Tul
- School of Health and Human Performance, Dalhousie University, Halifax, NS, Canada
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Lardner DR, Dick BD, Crawford S. The effects of parental presence in the postanesthetic care unit on children's postoperative behavior: a prospective, randomized, controlled study. Anesth Analg 2010; 110:1102-8. [PMID: 20103538 DOI: 10.1213/ane.0b013e3181cccba8] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND The effects on children of parental presence in the postanesthesia care unit (PACU) have not been extensively studied. The few published studies are retrospective, nonrandomized, or lack adequate controls. They suggest that parental presence in the PACU decreases crying and negative behavior change postoperatively. We performed this prospective, randomized, controlled study to determine whether the presence of a parent affected crying behaviors in the PACU and behavior change 2 weeks postoperatively. METHODS Randomly selected patients, aged 2.0 to 8 years 11 months, ASA physical status I or II, and scheduled for elective outpatient surgery with an anticipated PACU stay of >10 minutes were randomly assigned to the parent present group (n = 150) or parent absent group (n = 150) in the PACU. All parents underwent the same preparation program. Reunification occurred once children's eyes had opened for the parent present group. In the PACU, crying was scored each minute after eye opening using a 5-point scale. Negative behavior change 2 weeks after discharge was determined using the Post Hospitalization Behavior Questionnaire. Because the anesthesia technique to be used was not determined a priori, data on the technique used were collected to ensure that groups were similar. Multiple and logistic regression techniques were used to determine predictors of crying in the PACU and behavior change 2 weeks postoperatively. RESULTS Parental presence in the PACU made no difference in crying in the PACU. Negative behavior change 2 weeks postoperatively occurred more frequently in the parent absent group than the parent present group (45.8% vs 29.3%; P = 0.007). Multiple regression identified the following significant factors as predictive of larger proportion of time spent crying in the PACU (R(2) = 0.256, F[5, 273] = 15.66, P < 0.001): age <5 years (P < 0.001) and higher Children's Hospital of Eastern Ontario Pain Scale score at 15 minutes after arrival in day surgery (P < 0.001). Parental presence or absence from the PACU was not predictive of crying in the PACU, and neither were socioeconomic status nor intraoperative opioid analgesia. Logistic regression identified the following factors (chi(2)[4] = 26.62, P < 0.001) as predictive of negative behavior change at 2 weeks postoperatively: being younger than 5 years (P < 0.001) and being in the parent absent group (P = 0.003). CONCLUSION For fit healthy children undergoing outpatient surgery, parental presence in the PACU decreases negative behavior change at 2 weeks postoperatively but makes no difference in crying in the PACU. Future studies of behavior change postoperatively should consider parental presence in the PACU a factor and determine whether the effect persists with other interventions.
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Affiliation(s)
- David R Lardner
- Alberta Children's Hospital at the University of Calgary, Calgary, Alberta T3B 6A8, Canada.
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Simmonds MK, Rashiq S, Sobolev IA, Dick BD, Gray DP, Stewart BJ, Jamieson-Lega KI. The Effect of Single-Dose Propofol Injection on Pain and Quality of Life in Chronic Daily Headache: A Randomized, Double-Blind, Controlled Trial. Anesth Analg 2009; 109:1972-80. [DOI: 10.1213/ane.0b013e3181be3f86] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Abstract
BACKGROUND Research has found that chronic pain disrupts attention and that this disruption can lead to significant functional impairment and decreased quality of life. We conducted the present study to examine how attention and memory are disrupted by chronic pain. METHODS Computerized tests of working memory were given to participants with chronic pain along with a neuropsychological test of attention before and after procedures resulting in analgesia. RESULTS Two-thirds of participants with chronic pain had scores in the clinically impaired range on attentional tasks. These results were independent of age, education level, sleep disruption, and pain relief. Medication use was also recorded and is reported to account for potential effects of medication on task performance. Those participants with the highest level of impairment had significantly greater difficulties in maintaining a memory trace during a challenging test of working memory. CONCLUSIONS These findings point to a specific cognitive mechanism, the maintenance of the memory trace, that is affected by chronic pain during task performance. Cognitive function was not improved by short-term local analgesia.
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Affiliation(s)
- Bruce D Dick
- Department of Anesthesiology and Pain Medicine, University of Alberta, Edmonton, AB, Canada.
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Dick BD, Kaplan BJ, Crawford S. The Influence of Family History on Reading Remediation and Reading Skills in Children With Dyslexia. Canadian Journal of School Psychology 2006. [DOI: 10.1177/0829573506298691] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study examined whether family history of reading disability influences the efficacy of reading remediation. A retrospective review of children’s performance in a reading remediation program was carried out along with parental interviews for 102 families. Significant improvements were found in the areas of nonword decoding, phonological awareness, and spelling following the reading remediation program. Younger children and children with lower IQs tended to receive less benefit from the remediation program. Having a paternal history of dyslexia was associated with smaller improvements in nonword decoding scores. Maternal history of dyslexia was not a significant predictor of changes in nonword decoding. These findings suggest that some reading skills may be most effectively integrated at later stages of development. They also point to the possibility of unique relationships that may exist between parents and children who have reading disabilities.
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Rashiq S, Edlund D, Dick BD. Utilities of the post-anesthesia state derived by the standard gamble method in surgical patients. BMC Med Inform Decis Mak 2006; 6:8. [PMID: 16480502 PMCID: PMC1388206 DOI: 10.1186/1472-6947-6-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2005] [Accepted: 02/15/2006] [Indexed: 11/10/2022] Open
Abstract
Background There are no published utilities for the post-anesthesia state obtained by the standard gamble method (SG). Methods We obtained utilities for postoperative pain, nausea, vomiting, urinary retention and myalgia from 100 adults prior to elective surgery using SG. Results 20% of volunteer participants could not demonstrate a satisfactory understanding of the SG process. Median utilities for each adverse effect were all very close to 1.0, and no statistically significant differences were found between them. Conclusion Our results suggest that the avoidance of anesthesia related side effects and pain is not viewed by patients prior to surgery as being worthy of the taking of even a miniscule risk of death. This may affect the decision to utilize anesthesia techniques that trade a lower incidence of common side effects for a very low but finite risk of a catastrophic complication.
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Affiliation(s)
- Saifudin Rashiq
- Department of Anesthesiology & Pain Medicine, University of Alberta, 8-120 Clinical Sciences Building, Edmonton, AB T6G 2G3, Canada
| | - Diane Edlund
- Department of Anesthesiology & Pain Medicine, University of Alberta, 8-120 Clinical Sciences Building, Edmonton, AB T6G 2G3, Canada
| | - Bruce D Dick
- Department of Anesthesiology & Pain Medicine, University of Alberta, 8-120 Clinical Sciences Building, Edmonton, AB T6G 2G3, Canada
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Abstract
Abstract: Previous research has found that pain can exert a disruptive effect on cognitive processing. This experiment was conducted to extend previous research with participants with chronic pain. This report examines pain's effects on early processing of auditory stimulus differences using the Mismatch Negativity (MMN) in healthy participants while they experienced experimentally induced pain. Event-related potentials (ERPs) were recorded using target and standard tones whose pitch differences were easy- or difficult-to-detect in conditions where participants attended to (active attention) or ignored (passive attention) the stimuli. Both attention manipulations were conducted in no pain and pain conditions. Experimentally induced ischemic pain did not disrupt the MMN. However, MMN amplitudes were larger to difficult-to-detect deviant tones during painful stimulation when they were attended than when they were ignored. Also, MMN amplitudes were larger to the difficult- than to the easy-to-detect tones in the active attention condition regardless of pain condition. It appears that rather than exerting a disruptive effect, the presence of experimentally induced pain enhanced early processing of small stimulus differences in these healthy participants.
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Affiliation(s)
- Bruce D. Dick
- Department of Anesthesiology and Pain Medicine, University of Alberta, Canada
| | - John F. Connolly
- Cognitive/Clinical Neuroscience Unit (CCNU), Department of Psychology & Neuroscience Institute, Dalhousie University, Halifax, Canada
| | | | | | - G. Allen Finley
- Department of Anesthesia, Dalhousie University, Halifax, Canada
| | - Gerhard Stroink
- Department of Physics, Dalhousie University, Halifax, Canada
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Abstract
OBJECTIVE To investigate the effect of chronic pain on processes that generate the mismatch negativity (MMN). METHODS Twelve participants with a diagnosis of chronic intractable pain were tested before and after pain treatment. During testing, event-related potentials were recorded while participants performed tasks of varying difficulty. RESULTS The amplitude of the MMN was found to be greater following a nerve block procedure compared to MMN amplitude when participants were experiencing chronic pain. This effect was found to occur in the MMN for difficult-to-detect tones elicited while participants were performing a simultaneous cognitively demanding visual task. MMN amplitude was found to be greater with attention to difficult-to-detect deviants during pain but not in no pain conditions. CONCLUSIONS These results provide an electrophysiological correlate of previous findings that high levels of pain disrupt cognition during the performance of demanding tasks.
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Affiliation(s)
- B D Dick
- Dalhousie University, IWK Health Centre, QEII Health Sciences Centre, Halifax, NS, Canada.
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