Articles: pain-management.
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Observational Study
Persistence, not avoidance, is associated with low back pain-An observational cohort study.
Low back pain (LBP) is increasingly understood as a long-lasting condition with a variable course. Avoidance and persistence behaviour have been described to mediate pain persistence by potentially linking psychosocial factors and biomechanics. The resulting maladaptive changes in musculoskeletal structures can result in movement control impairment (MCI). This investigation aimed to observe avoidance and persistence behaviour and MCI in participants with acute LBP over 1 year and explore their association with pain persistence. ⋯ In acute low back pain (LBP), maintaining usual activities despite pain and distress can contribute to the continuation of LBP. Alongside a multidimensional approach that considers physical and psychological factors, attitudes toward daily activities are also important. Screening for both maladaptive and adaptive activity patterns in individuals with acute LBP is essential for effective LBP management, improving patient outcomes, and preventing persistent pain.
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Pain is a complex condition and affects one's life beyond physical symptoms. National pain management recommendations include a whole-person approach that includes strengths (or resilience). ⋯ This study has clinical implications for supporting the use of digital health tools such as mobile applications for capturing contextual data directly from patients to enable nurses to provide more accessible and personalized care to patients.
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Randomized Controlled Trial
Effect of a Non-pharmacological Intervention on Vaccine-related Pain: Randomized Clinical Trial.
Acute pain during vaccine administration is an expected event; however, some strategies, such as the use of high frequency vibration devices associated with cryotherapy, may minimize it. ⋯ The use of high frequency vibration associated with cryotherapy has been shown to be a viable non-pharmacological intervention for the reduction of pain associated with influenza vaccination in adults.
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Pain is a common presenting symptom to consultant physicians, both in the hospital and in the clinic or rooms. Biologically, pain serves as warning of tissue damage. But this is no longer the case when pain is present for months or years, especially when it has been fully investigated. ⋯ The response to the so-called 'opioid epidemic' has led to a renewed focus on how chronic pain should be managed. The aim of this article is to update fellows and trainees on the assessment and management of chronic pain in adult medical patients. In particular, we address the role of pharmacotherapy post-opioid epidemic (primarily antidepressants and anticonvulsants in neuropathic pain), the place of interventional procedures and the nature and effectiveness of pain self-management training in people with chronic pain, many of whom have had pain for a year or more and failed other treatments.
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To evaluate the quality of care, particularly in the case of new forms of healthcare interventions, the healthcare services to be provided are defined and documented in advance. The presented explanatory sequential mixed methods design combines quantitative and qualitative data collection and the analysis enables a deeper understanding of a new healthcare intervention. Using the example of the POET-Pain project, which investigates the effect of a perioperative transitional pain service (TPS), the methodological application of the explanatory sequential mixed methods design is demonstrated in order to present the structural and process evaluation of the new healthcare intervention (in this case TPS) and to understand its influence on the quality of care. The mixed methods design presented enables the results of the quantitative phase to be interpreted and expanded in depth using qualitative data, which leads to a comprehensive understanding of the subject matter (second pillar of health services research).