Living with long-term pain after stroke

• ObjectivesThe general aim of this thesis was to classify and describe long-term pain two years after a stroke and to describe the experiences of pain, and the consequences it has on the persons’ lives.Material and methodsThe studies comprised 43 persons, 13 women and 30 men, aged 33-82 years, with pain after stroke and no other major pain conditions and able to participate in an interview and independently answer questionnaires.The studies were conducted from a multidimensional perspective on pain, combining quantitative and qualitative methods. Clinical examinations were somatic, neurological and Quantitative Sensory Testing (QST). The Pain-O-Meter, ADL staircase, Self-reported impairment, SF-36 and Hospital Anxiety and Depression Scale were used. Qualitative interviews were performed and analyzed with content analysis.ResultsThree types of pain were classified: Neuropathic (central post-stroke pain) (n=15), nociceptive/mainly shoulder pain (n=18) and tension-type headache (n=10). Pain onset, within one to six months in most of the cases was after discharge from the hospital. Continuous pain or pain almost every day was reported by nearly two-thirds. The pain was mostly described as troublesome, annoying and tiring in all groups. The rating of pain intensity revealed individual differences among the participants within the pain groups. In addition to long-term pain, the participants suffered several impairments and nearly half of them were dependent on others, and two-thirds on assistive devices. Several coping strategies were described, most often problem-focused. Their health-related quality of life was decreased, mostly related to their long-term pain and physical impairments. Their experiences of caring revealed the need of improvements in knowledge about long-term pain, attention and understanding among the professionals, and continuity in the contacts.ConclusionAll professionals need knowledge about pain conditions after stroke. Pain assessment and classification, regular follow-up and documentation are required in order to prevent unnecessary suffering. Patients need attention, understanding and continuity in contacts with professionals. Further, information and education about pain and treatment/caring interventions are required in the case of both the sufferer and next of kin.

Ämnesord

SAMHÄLLSVETENSKAP  -- Annan samhällsvetenskap -- Tvärvetenskapliga studier inom samhällsvetenskap (hsv//swe)

SOCIAL SCIENCES  -- Other Social Sciences -- Social Sciences Interdisciplinary (hsv//eng)

MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap -- Omvårdnad (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Health Sciences -- Nursing (hsv//eng)

Nyckelord

long-term pain

stroke

Nursing

Omvårdnad

INTERDISCIPLINARY RESEARCH AREAS

TVÄRVETENSKAPLIGA FORSKNINGSOMRÅDEN

Caring sciences

Vårdvetenskap

Vårdvetenskap

Nursing Science

Publikations- och innehållstyp

vet (ämneskategori)

kon (ämneskategori)