Articles: chronic.
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Pain is a major public health issue in the United States. The ability to communicate the severity of pain with healthcare providers is crucial to receiving appropriate pain management. Many factors can limit this ability, including limited proficiency in the language spoken by providers. This body of research suggests gaps in the multidimensional approach to pain management for older adults with limited English proficiency (LEP). In this study, we describe the lived experiences of pain management of older adults with LEP living with chronic pain in the United States. ⋯ Farsi and Azeri-speaking older adults with LEP and chronic pain felt the US healthcare system ignored their social, cultural, and linguistic needs. Pain management training for healthcare providers should address language barriers and include cultural competency.
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This study aimed to report the incidence of chronic pelvic pain in women 12 to 24 months postpartum, to identify the independently associated factors, and to conduct a causal inference with C-section as the exposure. This was a cross-sectional study nested within 2 distinct prospective cohorts from 2 Brazilian cities. Chronic pelvic pain was the dependent variable. ⋯ Women who underwent C-sections had a 6.1% higher incidence of CPP compared to those who did not undergo the procedure. The incidence of CPP postpartum is high, and there is a potential causal effect of C-sections. City of birth, discrimination, anxiety, dissatisfaction with the care, and mental suffering were also associated with an increased odds.
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Guideline-based care for chronic pain is challenging to deliver in rural settings. Evaluations of programs that increase access to pain care services in rural areas report variable outcomes. We conducted a realist review to gain a deep understanding of how and why such programs may, or may not, work. ⋯ Many barriers can interfere with successful uptake, implementation, and sustainability of programs that increase access to pain care services in rural settings. It is important to tailor rural workforce programs to local community needs to increase the likelihood of success. Our findings include recommendations for future program planners to consider.
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Effective pain recognition and treatment in perioperative environments reduce length of stay and decrease risk of delirium and chronic pain. We sought to develop and validate preliminary computer vision-based approaches for nociception detection in hospitalized patients. ⋯ Automated nociception detection using computer vision alone is feasible but requires additional testing and validation given small datasets used. Future multicenter observational studies are required to better understand the potential for automated continuous assessments for nociception detection in hospitalized patients.
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Historically in medicine and beyond, the understanding of and treatment of pain is based on finding tissue injury. The fact that for chronic pain, there often is no (longer) any traceable tissue injury, in combination with the fact that pain essentially is a private experience, poses a challenge for clinical communication. This paper therefore examines how pain is linguistically and interactionally constructed as invisible. ⋯ The discussion explores how on these three levels, notions of the abnormal or deviant body come into play, in which patients and health professionals complexly construct pain both as not normal (i.e. not a neutral or desirable state of being), while, at the same time, the lack of traceable tissue injury is constructed as medically normal for chronic pain. This also shows how patients and healthcare providers often orient to the stigma around chronic pain.