Articles: chronic-pain.
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This study describes how pain practitioners can elicit the beliefs that are responsible for patients' judgments against considering a treatment change and activate collaborative decision making. ⋯ Initial opposition to a treatment change is a conditional judgment and subject to change as specific beliefs become incompatible with patients' current conditions. These beliefs can be elicited through dialog by asking 3 questions.
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In the past decade, more and more behavioral health providers have begun consultation practices in primary-care settings. Their availability makes multidisciplinary care a reality and the possibility of improved outcomes for patients with chronic pain more feasible. ⋯ This article presents two cases to illustrate the questions that arise in delivery of primary-care behavioral health services to patients with chronic pain. Relevant professional ethical guidelines for psychologists, social workers, and physicians are examined and recommendations for addressing the gaps in extant guides are offered.
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Today, opiate-based prescription painkillers account for significant morbidity and mortality in the U. S. According to the Centers for Disease Control and Prevention, prescription painkiller overdose has reached epidemic proportions over the past decade. ⋯ Since 2007, states have increasingly used their authority to address inappropriate prescribing. State strategies to address this complex problem have included: establishing and strengthening prescription drug monitoring programs, regulating pain management facilities, and establishing dosage thresholds above which a consult with a pain specialist is required. With chronic pain affecting at least 116 million adults in the United States, it will also be important to evaluate the impact these policies are having on legitimate access to pain care.
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The Pain Outcomes Profile (POP) is a brief, multidimensional measure intended to assess pain intensity, functioning, and affect. It is presented as a practical measure with clinical utility. Results of studies support its concurrent, construct and predictive validity at the scale level. ⋯ Five salient factors were obtained. Item-inclusion was generally consistent with factor loadings although noteworthy exceptions were observed in the Fear, Mobility and Vitality scales. Recommendations for further study and limitations of the current project are delineated.
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The latest generation of rechargeable implantable programmable generators (IPGs) for spinal cord stimulation may greatly extend IPG lifespan compared with previous nonrechargeable devices. This study explores patients' experiences with these devices. ⋯ Patients found the rechargeable IPG easy to recharge and those who had had previous experience with nonrechargeable devices preferred using the rechargeable device. Its benefits in terms of pain relief fell within the range expected from previous studies using nonrechargeable batteries. The main disadvantage of nonrechargeable devices as reported by the patients in this study was concern over the length of time they would have to wait without pain relief between battery replacements.