Der Schmerz
-
With the help of specialized outpatient palliative care teams (German abbreviation: SAPV), seriously ill and dying patients in Germany can be adequately cared for in their home environment until the end of their lives; however, there are no uniform standards or guidelines for well-executed pain management right now. ⋯ This cross-sectional study is the first of its kind to provide a general overview of the treatment options for pain management in German outpatient palliative care. In comparison with international studies, the question arises as to whether uniform therapy schemes and a reduction in the medication available in the individual SAPV teams could lead to an improvement in patient care.
-
If we understand chronic pain not only as a disease but also as an existential crisis, it seems logical and reasonable to consider spiritual aspects in the treatment process. Spirituality is understood as an umbrella term for all activities and experiences that give meaning and significance to people's lives-irrespective of their religious affiliation. So far, spiritual aspects have been considered therapeutically mainly in the palliative context. ⋯ Professional competence generally involves all practitioners, but may also require qualified professionals for specialized assistance. The integration of authentic spiritual assistance into multimodal pain management should help to stabilize self-esteem and the experience of identity of the patients through resource activation and identification of burdensome spiritual beliefs. The detailed integration and investigation of the efficiency of spiritual interventions in multimodal pain therapy require further research.
-
The transition from acute to non-specific chronic low back pain (CLBP) is especially associated with psychological factors. However, working mechanisms of psychological factors have been little examined in non-specific CLBP, especially the mediator effect of pain self-efficacy. ⋯ To improve the success of work-related rehabilitation in the long-term, pain self-efficacy in particular, but also depressive symptoms should be targeted by treatments of non-specific CLBP.