Der Schmerz
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This article focuses on the philosophical perspective of what pain actually is, how pain is defined and what functions pain has. It is unclear, for example, whether pain generally correlates with physical harm, if it is categorically unpleasant, if it can be objectified and how observable neuronal processes correlate with different experiences of pain. ⋯ The different functions of pain are presented, especially regarding the extent to which pain represents an experience that constitutes both the body and the identity. Some functions of pain discussed here are: defense and indicator, immediate bodily sensation, perceptibility of the body, self-reassurance of existence, congregating and materializing, psychological regulatory mechanism and communication.
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Medical Devices Law is a relatively new legal system, which has replaced the Medical Devices Regulations still well-known in Germany. German Medical Devices Law is based on European directives, which are, in turn, incorporated into national law by the Medical Devices Act. ⋯ Medical Devices Law is a very complex legal system, which needs to be permanently observed due to constant updating and adjustment. In the current article, the design and the structure of the system will be described, but special emphasis will be laid on important problem areas that need to be considered when applying and operating medical products, in this case by pain therapists in particular.
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Patients from different cultures, particularly from family-oriented societies, such as the Near and Middle East, southern Italy and Greece, have a different perception of pain and other healing expectations, even in contact with doctors, than for example patients in western societies. This aspect is not sufficiently taken into consideration by modern multimodal therapy approaches. ⋯ For therapy and the therapist-patient relationship, it is essential to understand the significance of the pain experienced in the construction and experience of interpersonal relationships. The diseased body is an expression of the social, collective, economic, migrational history, mental and cultural state of mind of the patient; therefore, in the treatment of patients from traditional cultures a multimodal, interdisciplinary and culturally sensitive approach is necessary for effective pain treatment.
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The number of invalidity pensions for mental and psychosomatic disorders has dramatically increased in the last decade. Given the experience in sociomedical assessment of people with chronical pain diseases, we developed the impression that primarily social problems-especially long-term unemployment-play an important role in the processes of chronification of pain diseases. We evaluated 100 expert opinions from 2002-2007 according to quantitative and qualitative critieria. ⋯ Only during the course of their disease-usually after the rejection of their application for pension by expert medical opinions-did they receive the diagnosis in the field of psychiatry and psychosomatics. In a next step they were assessed by experts in the field of psychiatry and psychosomatics. In this article, the important social factors that influence this development are discussed.
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From the point of view of healthcare policies, improvement in pain care has been required for years; however, there is a great discrepancy between the current need for pain care and the actual provision by healthcare services. This article seeks to demonstrate that while healthcare policies are one of the critical factors involved, a variety of conceptual, diagnostic and therapeutic causes should also be taken into account. Firstly, considering that pain care is primarily concerned with the suffering of pain by patients, the focus lies with their conscious experience in order to define the patients' understanding of pain. Additionally, in this article current biomedical and psychosocial comprehension concerning chronic pain will be illustrated and why it is necessary to broaden our horizons in order to do justice to patients with chronic pain.