Der Schmerz
-
The concept of resilience is becoming increasingly disseminated from material science into various fields of science. It is infiltrating medical fields predominantly via psychology and is also recommended for coping with the special burdens in pain management and palliative care. A precise definition of the term and its operationalization pose problems. ⋯ There is a lack of qualified contributions of palliative research to the metadiscourse about resilience, especially in the context of affected patients. A successful operationalization of the term requires a highly complex multidimensionality of the palliative path of an interdisciplinary approach. There is a lack of ethical standards that prevent an affirmative instrumentalizing application of the term.
-
For a long time, biblical views of pain were used to relieve and legitimize suffering. Nowadays, however, pain is seen as an evil to be fought. Despite this difference, it is worth researching the variety of images of pain in the Old Testament in order to include them in current debates. ⋯ Social and political upheavals played a crucial role in the development of Old Testament images of pain. That is why the ultimate cause of pain is only partially attributed to the divine, but more to human violence structures. The texts focus their hope on God as a deliverer from distress because he allows himself to be affected by pain.
-
Clinical Trial Controlled Clinical Trial
[Less surgery and lower cost due to back pain in a care program with an interdisciplinary second opinion procedure : A controlled non-randomized intervention study based on claims data].
There is no evidence of effectiveness for interdisciplinary second opinion procedures (ISOP) for recommended back surgery (BS). Since 2015, AOK Nordost has been offering the care program RückenSPEZIAL comprising a preliminary examination, ISOP, and optional interdisciplinary multimodal pain therapy (IMPT). The objective of this study is to determine the effectiveness of RückenSPEZIAL to reduce BS and back pain-related costs (BPRC) compared to patients who likewise received a recommendation for back surgery but not RückenSPEZIAL. ⋯ The differences in BS were significant (p < 0.05) and in favor of RückenSPEZIAL. For the specific population it can be expected that mainly savings on BS can cover the intervention costs of RückenSPEZIAL (approximately significant, small case number). Bias due to self-selection needs to be assumed.
-
Macromastia often leads to physical complaints involving pain in the shoulder/neck area. In Germany, there are virtually no reliable data on the effects of breast reduction surgery with regard to neck and spine complaints. Therefore, the authors carried out a retrospective study to investigate the effect of breast-reducing surgery on neck pain and quality of life. ⋯ With this study, the authors were able to show that there are often several reasons why breast reduction surgery is performed in patients with macromastia. A high patient satisfaction rate can be achieved and orthopedic clinical complaints associated with macromastia can be treated with a very high success rate.
-
There is currently an emphasis on the biopsychosocial concept of pain in pain therapy programs. However, the complexity of chronic pain, in particular its importance for those affected by it, can only be insufficiently captured with this concept. This is due to the fact that, to date, one core aspect of the phenomenon chronic pain has only rarely been taken into account: its existential character. ⋯ Current treatment concepts, however, do not adequately consider the existential character of such challenges. Chronic pain should therefore always be perceived and treated from a holistic perspective. In this context, the aspects of recognizing its uniqueness, helping to express the pain and giving space to the experience are to be given special consideration in order to support chronic pain patients in dealing with their pain.