Articles: patients.
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154 cancer pain patients were treated from 1988 to 1990 according to the three-step analgesic ladder (TSAL) recommended by the WHO. The patients were assigned into 4 groups: WHO-I: patients were treated only with non-opioids, WHO-II: patients received a combination of non-opioid plus a weak opioid, WHO-III: patients were treated with strong opioids or a combination of a strong opioid plus a non-opioid; and the 4th group consisted of patients receiving a strong opioid epidurally. ⋯ Also the mean duration of the patients' sleep was increased by more than one hour. An improvement of mood was observed, and the stabilisation of mood lasted longer.
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The outcome of disk surgery in 40 consecutive patients was predicted by pre-treatment assessments of sociodemographic and psychological variables and findings in a standardised orthopaedic and neurological examination. The pre-surgery variables that proved to be associated with outcome criteria six months post surgery by means of a multiple stepwise regression procedure were selected for discriminant analyses, using three outcome criteria: functional status, patient evaluation of the outcome, and vocational rehabilitation. ⋯ No prediction was possible for postoperative pain behaviour and postoperative orthopaedic and neurological status. Significant predictors were time off work before surgery, active search for information about disease and surgery, presence of conditions that reinforce pain behaviour, and cognitive variables indicating helplessness.
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In the therapy of chronic disease and functional disorders, art therapy is considered to be of increasing importance. The idea behind this type of therapy is that the stimulation of creative activities promotes the healing process and rehabilitation. Music therapy in particular has a long tradition in the treatment of pain and health disorders. ⋯ The conceptual framework of art therapy offers various explanations for the integration of these forms of therapy in complementary, supportive pain management programs: (1) enhancing the activity level and creative capacity as a healing source; (2) stimulation of positive emotional experience; (3) experiencing social communication and interaction; (4) facilitating projective coping; (5) stimulation of imaginative experience and awareness; (6) promotion of suggestive elements. Anecdotical experience indicates that there could be a broad field for the use of art therapy in pain management programs. The need to validate this form of therapeutic approach by appropriate methodological studies and well-documentated single case series is emphasized.
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Anesthesia and analgesia · Aug 1991
A survey of 800 patients' knowledge, attitudes, and concerns regarding anesthesia.
The present study was undertaken to assess patients' knowledge, attitudes, and concerns regarding anesthetic management. A survey of 34 items was developed and administered preoperatively to 800 consecutive patients. Included were 303 men and 497 women with a mean age 52 yr and a mean educational level of 12 yr. ⋯ Issues of least concern included disclosure of personal matters during anesthesia, experiencing impaired judgment postoperatively, and being asleep or bedridden for a prolonged period of time. It is suggested that anesthesiologists address significant patient concerns during the preoperative visit to enhance their effectiveness in patient care. Efforts to educate the public on the anesthesiologist's role in perioperative care should improve patient confidence.