Articles: pain-management-methods.
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Perceived control over pain can attenuate pain perception by mechanisms of endogenous pain control and emotional reappraisal irrespective of whether this control is exerted or only perceived. Self-initiated termination of pain elicits different expectations of subsequent pain relief as compared to perceived pain control. It is unknown whether and how this perceived vs. exerted control on pain differs and affects subsequent pain relief. ⋯ Using controllability as factor, there was dissociable neural activity during pain relief: following the perceived control condition neural activity was found in the orbitofrontal and mediofrontal cortex and, following the exerted control condition, in the anterolateral and dorsolateral prefrontal cortex and posterior parietal cortex. We conclude that (i) pain controllability has an impact on pain relief and (ii) the prefrontal cortex shows dissociable neural activity during pain relief following exerted vs. perceived pain control. This might reflect the higher grade of uncertainty during pain relief following perceived pain control mediated by the orbitofrontal and medial prefrontal cortex and processes of working memory and updating expectations during pain relief following exerted control mediated by the lateral prefrontal cortex.
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Randomized Controlled Trial
Distracting children during blood draw: looking through distraction cards is effective in pain relief of children during blood draw.
This study aims to investigate the effects of distraction method by way of looking through distraction cards/Flippits® to reduce procedural pain and anxiety during blood draw. In this method we distract attention of the children with distraction cards/Flippits®. Flippits® consist of various eye-catching pictures and shapes. ⋯ Results show that pre-procedural anxiety did not differ significantly. However, the experimental group had significantly lower pain levels than the control group during the blood draw procedure. Also experimental group had significantly lower anxiety levels than the control group.
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Comparative Study
Using process analysis to assess the impact of medical education on the delivery of pain services: a natural experiment.
The medical, social, and economic effects of the teaching mission on delivery of care at an academic medical center (AMC) are not fully understood. When a free-standing private practice ambulatory clinic with no teaching mission was merged into an AMC, a natural experiment was created. The authors compared process measures across the two settings to observe the differences in system performance introduced by the added steps and resources of the AMC's teaching mission. ⋯ Although the teaching mission of the AMC adds processing steps and costs, the use of trainees within the process serves to increase throughput while decreasing waiting times and the use of overtime.
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Randomized Controlled Trial
The effects of guided imagery on affect, cognition, and pain in older adults in residential care: a randomized controlled study from Thailand.
Few studies have examined the effects of guided imagery on older adults in residential care. This study aimed to evaluate the outcome of group-delivered guided imagery over a 16-day period with a sample of Thai older adults in residential care (N = 31). ⋯ The results are discussed in relation to a ceiling effect and other methodological factors that may have contributed to the lack of positive outcomes. As the evidence base remains inconclusive, it is hoped that future studies will seek to establish the effects of using guided imagery with older adults in residential care.
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Little is known about the public's preferences for pain management prior to attending an Emergency Department (ED). Therefore, the aim of the study was to explore (i) triage documentation of pre-hospital analgesic patterns for patients presenting in pain; (ii) patient documented explanations for not self administering an analgesic in the pre-hospital setting; (iii) triage nurse documentation of pain descriptors and or pain scores; and (iv) the disposition of ED patients presenting in pain. ⋯ Unnecessary suffering may be avoided if the public had a better understanding of pain and the benefits of pain management. Further research is required to better understand the beliefs and attitudes towards pain and pain management by clinicians and the public.