The Clinical journal of pain
-
Nonadherence to prescribed pain medication is common in chronic noncancer pain patients. Beliefs about pain medication have been reported to be associated with nonadherence behavior in cross-sectional studies. The aim of this study was to prospectively investigate the relationship between patients' beliefs about pain medication and their medication adherence and treatment outcome. ⋯ Attitudes and concerns toward pain medication are associated with adherence patterns and outcome parameters. To improve medication adherence and therapy outcome, patient beliefs about pain medication should be taken into account by providing tailored education, adequate follow-up, or alternate therapy.
-
Complex regional pain syndrome (CRPS) is a painful condition of a limb characterized by a constellation of symptoms. Little is known about the clinical features of pediatric CRPS, with fewer than a dozen studies published to date. The aim of this study was to explore the clinical course of pediatric CRPS, with emphasis on clinical features and disease outcomes. A secondary aim was to discern differences in clinical features of pediatric CRPS with and without related movement disorders, and between children who had a favorable and unfavorable outcome. ⋯ In this cohort, pediatric CRPS was most common in girls around the age of 12, usually in the lower extremity, and most experienced a favorable outcome. Further research is needed to better understand the prognosis and relapse rate of pediatric CRPS.
-
Various academic factors are known to influence pain and somatic symptoms in adolescents, but the roles of academic goal orientation, school motivational climate, and school engagement are unknown. This study examined how these understudied academic factors are associated with adolescent pain and somatic symptoms and whether sex moderates the relations. ⋯ This study demonstrates that adolescents from a high-achieving community report more somatic symptoms and pain when they are less engaged in school and when their academic focus is on grades and outperforming peers. Results suggest that de-emphasizing competition and performance outcomes may support physical well-being in adolescents.
-
The development and maintenance of pediatric chronic pain and anxiety are complex, underscoring the need to better understand the interactive forces contributing to their co-occurrence. The shared vulnerability model (SVM) was developed to explain the co-occurrence of chronic pain and posttraumatic stress disorder in adults. Although many core tenets have been well supported by pediatric research, the SVM has yet to be extended to pediatric pain populations. ⋯ Consequences of fear and anxiety, including avoidance behavior, further contribute to the development of chronic pain, anxiety, and their co-occurrence. The parental, school, and peer contexts in which these problems develop and are maintained in youth are pertinent to integrate into a SVM, as pediatric chronic pain and anxiety disorders share several social-contextual risk and maintenance factors. We also highlight new areas of inquiry.
-
The impact of pain on quality of life and mental health of women with endometriosis is well known. However, the role that personality traits and coping strategies might have in influencing pain experience is still poorly understood and was the chief purpose of this study. ⋯ From the study emerged a model of onset and maintenance of acute pain in women with endometriosis. Findings have clinical implications for the medical team and psychologists.