Articles: pain-management.
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Clinical Trial Controlled Clinical Trial
The COPE program: treatment efficacy and medical utilization outcome of a chronic pain management program at a major military hospital.
This study presents a treatment efficacy and medical utilization evaluation of a cognitive-behavioral, outpatient, chronic pain management program in a military hospital setting. A total of 61 nonmalignant chronic pain patients with heterogeneous pain syndromes who participated in sequential group programs were included in the study. Comprehensive and multi-dimensional outcome criteria were used, including pain ratings, relaxation skills, quality of life, satisfaction ratings, and medical utilization. ⋯ This reduction amounts to a projected net annual saving of $78,960 in the first year after behavioral medicine intervention. In light of the increasing cost of health care for chronic pain patients, psychological approaches as an adjunct to traditional medical care seem to present a sound solution for cost savings. This study also supports the notion that a strategic biopsychosocial pain program, which targets the multiple dimensions of persistent pain, provides effective treatment and increases patient satisfaction.
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In chronic pain patient's diagnostic and therapy planning many complex information must be evaluated and analysed. The variety of data cannot be mastered without assistance of a database tool adapted to these special need. ⋯ Due to its ability of export into other databases and already enclosed routines QUAST permits an internal assurance of quality of process and outcome in pain management. It also can be an instrument of an external quality assurance. QUAST is at present the only computer system available in Germany, to fulfil the required prerequisites for adequate quality control.
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Although morphine is the mainstay of pharmacological therapy in cancer pain, it remains feared and suboptimally used. Different formulations and the advent of 'new' opioids facilitate the attainment of pain control. ⋯ The optimal application of opioids is governed by their clinical pharmacology and hindered by unfounded fears and misunderstanding. Different formulations within different types of opioids augment a favourable balance in the pain relief versus adverse effects equation and used within a four point approach, should serve to deliver optimal pain control.
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Reg Anesth Pain Med · Nov 2000
Case ReportsSuccessful management of pleuritic pain with thoracic paravertebral block.
Thoracic paravertebral block (TPVB) is a unilateral analgesic technique that has been advocated in both acute and chronic thoracic and abdominal pain. Other blocks such as interpleural and epidural can be effectively used in pleuritic pain. This report illustrates that TPVB could also be effective for this kind of pain. ⋯ This case report supports the notion that, in practice, the paravertebral block could be an effective and safe alternative to relief of pleuritic pain.
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Research findings over the last 20 years show that critical care nurses (CCNs) continue to underestimate and under medicate their patients' pain, despite an allegedly strong commitment to pain relief. This literature review investigates the determinants of CCNs' pain assessment and management behaviours. Fishbein and Ajzen's theory of reasoned action' and Ajzen's theory of planned behaviour have been used as models to facilitate understanding of this phenomenon. ⋯ Through an analysis of the behavioural determinants following the models described by Fishbein and Ajzen, strategies can be formulated to address CCN deficiencies, improve patient outcomes and satisfaction with nursing care and CCN fulfilment. Cervantes was quoted as saying "It's a long way from saying to doing". This report aims to improve on this idea.