The Clinical journal of pain
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Comparative Study
Depression and the experience of chronic back pain: a study of related variables and age differences.
To document the prevalence of depression and examine the relationship between depression and selected pain-related variables associated with chronic back pain among elderly and nonelderly samples. ⋯ There is a high prevalence of dysphoria in both the elderly and nonelderly with chronic back pain. The relationships between pain-related constructs and depressed mood in chronic back pain patients are similar in the elderly and nonelderly. The impact of the pain experience on the individual's activities, functioning, and feelings of life control should be considered in theoretical and clinical explanations of the association between pain and depression.
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Randomized Controlled Trial Clinical Trial
Pediatric PCA: the role of concurrent opioid infusions and nurse-controlled analgesia.
We designed a clinical study to determine: a) the safety and efficacy of patient-controlled analgesia (PCA) therapy in children and adolescents undergoing major operations, b) if the use of a concurrent opioid infusion improved the efficacy of conventional PCA therapy, and c) if nurse control of the PCA device was a useful alternative in the intensive care unit (ICU) setting. ⋯ Both PCA and NCA were safe and efficient methods of analgesic administration in the pediatric ICU setting. However, use of a concurrent opioid infusion with PCA therapy did not provide any clinically significant advantages over intermittent bolus doses of the analgesic medication after scoliosis surgery. For patients unable to use a conventional PCA device, NCA is an acceptable alternative for the management of acute pain in the ICU setting.
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To assess the overall efficiency of an outpatient behavioral rehabilitation program for excess disability and chronic pain and to describe the program staff, treatment components and outcomes in sufficient detail to facilitate comparison with similar programs. ⋯ A brief, inexpensive, outpatient behavioral rehabilitation program for chronic pain and excess disability can achieve a clinically significant and lasting reduction of pain and improvement in function at work and at home.
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To determine whether chronic pain patients' beliefs and attributions about pain control are amenable to change in a short-term inpatient multidisciplinary pain management program. ⋯ Chronic non-terminal pain patients' beliefs about pain and attributions of pain control are amenable to change in a short-term inpatient multidisciplinary pain management program. These results suggest that an intensive multidisciplinary program involving psychotherapy might be more effective in treating chronic pain patients similar to those in this study than outpatient treatment without psychotherapy.