Pain management nursing : official journal of the American Society of Pain Management Nurses
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Chronic pain is a devastating amalgam of symptoms that affects millions of Americans at tremendous cost to our healthcare system and, more importantly, to patients' quality of life. Literature and research demonstrate that neuroimmune cells called glia are not only responsible for initiating and maintaining part of the chronic pain disease process, but also release inflammatory molecules responsible for decreasing the efficacy of one of the most prominent treatments for pain, opioid analgesia. This article describes chronic pain as a disease process that has ineffective treatment modalities, explores the mechanisms of glial cell activation and inflammatory responses that lead to chronic pain and decreased opioid treatment efficacy, and hypothesizes novel chronic pain treatment modalities based on the glial cell inactivation and anti-inflammatory pathways.
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Chronic pain is highly prevalent in older adults and often negatively associated with health-related quality of life (HRQoL). This study compared HRQoL, including physical health and mental health, in persons of differing ethnicities, and identified factors associated with pain intensity and HRQoL in ethnically diverse older adults. Older adults with chronic pain from four ethnic groups (African Americans, Afro-Caribbeans, Hispanics, and European Americans) were recruited from the Florida Atlantic University Healthy Aging Research Initiative (HARI) registry. ⋯ Multivariate linear regression analysis revealed that ethnicity, lower physical health scores, and lower mental health scores were significantly (p ≤ .01) associated with pain intensity. Understanding ethnic variations in response to pain intensity may address gaps in knowledge about HRQoL to reduce disparities in optimal care. Health care providers should consider ethnic norms and cultural diversity to provide optimal interventions for this population.
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An important dimension that influences the quality of life of hemodialysis patients is the pain they experience. Quality of life and self-efficacy in pain can play an important role in chronic kidney disease and treatment outcomes. The purpose of the study was to examine self-efficacy in pain and quality of life among patients with end stage renal disease undergoing hemodialysis. ⋯ The majority of respondents described the overall quality of life as "moderate," while the self-efficacy in pain depended on comorbidity or complications that accompany the process of hemodialysis. The findings of this study can be used in the development and improvement of health services for the management of patients. Healthcare professionals should understand the concerns and treat the symptoms of patients that affect quality of life, providing thereby holistic health care.
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Although central post-stroke pain is widely recognized as a severe chronic neuropathic pain condition, its consolidated definition, clinical characteristics, and diagnostic criteria have not been defined due to its clinically diverse features. The present study was undertaken to comprehensively review current literature and provide a more complete picture of central post-stroke pain with respect to its definition, prevalence, pathophysiology, clinical characteristics, and diagnostic problems, and to describe the range of therapies currently available. In particular, nursing care perspectives are addressed. It is hoped that this review will help nurses become knowledgeable about central post-stroke pain and provide valuable information for the drafting of effective nursing care plans that improve outcomes and quality of life for patients with central post-stroke pain.