British journal of pain
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British journal of pain · Aug 2014
Pain reporting in older adults: the influence of cognitive impairment - results from the Cambridge City >75 Cohort study.
Evidence suggests that while disabling back pain (BP), and rheumatic diseases associated with pain, continues to increase with age, the prevalence of non-disabling BP reaches a plateau, or even decreases, in the oldest old. This study aimed to determine whether this age-related pattern of non-disabling BP is a function of increasing cognitive impairment. ⋯ Prevalence of non-disabling back pain decreases in the oldest old.Some have proposed that this may be a function of cognitive impairment in older age, and an increasing inability to adequately report pain.Our findings do not support this hypothesis.
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British journal of pain · Aug 2015
Can pictorial images communicate the quality of pain successfully?
Chronic pain is common and difficult for patients to communicate to health professionals. It may include neuropathic elements which require specialised treatment. A little used approach to communicating the quality of pain is through the use of images. ⋯ Clearly, attention needs to be given not only to the content of images designed to depict the sensory qualities of pain but also to the differing audiences who may use them. Education, verbal ability, ethnicity and a multiplicity of other factors may influence the understanding and use of such images. Considerable work is needed to develop a set of images which is sufficiently culturally appropriate and effective for general use.
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British journal of pain · Aug 2014
Weighing the balance: how analgesics used in chronic pain influence sleep?
Pain and sleep share a bidirectional relationship, with each influencing the other. Several excellent reviews have explored this relationship. In this article, we revisit the evidence and explore existing research on this complex inter-relationship. ⋯ We conclude that antidepressants have both positive and negative effects on sleep, so do opioids, but in the latter case the evidence shifts towards the counterproductive side. Some anticonvulsants are sleep sparing and non-steroidal anti-inflammatory drugs (NSAIDs) are sleep neutral. Cannabinoids remain an underexplored and researched group.
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British journal of pain · May 2015
The epidemiology of regional and widespread musculoskeletal pain in rural versus urban settings in those ≥55 years.
To examine whether the prevalence of regional and chronic widespread pain (CWP) varies with rurality and to determine the characteristics of persons in rural locations in whom pain is found to be in excess. ⋯ This study provides no evidence that the prevalence of regional musculoskeletal pain is increased in rural settings, although there is some evidence of a modest increase in CWP. Risk factors for CWP are similar to those seen in the urban setting, including markers of general health, mental health and also aspects of social contact. It may be, however, that social networks are more difficult to maintain in rural settings, and clinicians should be aware of the negative effect of perceived social isolation on pain in rural areas.
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British journal of pain · Aug 2014
From traditional cognitive-behavioural therapy to acceptance and commitment therapy for chronic pain: a mixed-methods study of staff experiences of change.
Health care organizations, both large and small, frequently undergo processes of change. In fact, if health care organizations are to improve over time, they must change; this includes pain services. The purpose of the present study was to examine a process of change in treatment model within a specialty interdisciplinary pain service in the UK. ⋯ Quantitative results from closed questions showed a pattern of uncertainty about the superiority of one model over the other, combined with more positive views on progress reflected, and the experience of personal benefits, from adopting the new model. The psychological flexibility model, the model behind acceptance and commitment therapy, may clarify both processes in patient behaviour and processes of staff experience and skilful treatment delivery. This integration of processes on both sides of treatment delivery may be a strength of acceptance and commitment therapy.