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- Bjorkman, Berit, et al.
(author)
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Phantom Breast and Other Syndromes After Mastectomy : Eight Breast Cancer Patients Describe Their Experiences Over Time
- 2008
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In: Journal of Pain. - : Elsevier BV. - 1526-5900 .- 1528-8447. ; 9:11, s. 1018-1025
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Journal article (peer-reviewed)abstract
- Patients often experience hard-to-treat neuropathic pain and other sensations after surgery; consequently, they could develop chronic pain conditions. The phantom limb phenomenon is a well-documented postoperative pain condition. However, phantom phenomena after mastectomies are less documented. The reviews report several views on the prevalence of breast phantoms and coexisting distress. Researchers observed that new methodological approaches might facilitate further research of these issues. This prospective, qualitative study used semistructured interviews to acquire knowledge of if and how phantom breast phenomena appear within the range of other postmastectomy symptoms and sensations. The study revealed that a phantom breast could be difficult to describe and position spatially. The phantom breast phenomenon varied from classic phantom extremity phenomenon and did not seem to cause much distress. However, it proved to be a phenomenon so unknown and different that there is urgent need for more knowledge. This study highlights the importance of further investigation regarding how information and communication related to a phantom breast might be developed. Perspective: The phantom breast is only one piece of a complicated puzzle. Because it was relatively unknown for the women in the study, it is important that analyses of this phenomenon, as a part of a postmastectomy syndrome, be conducted in a dialogue with the patients, by scientifically using qualitative methods.
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| 2. |
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| 3. |
- Denison, Eva, et al.
(author)
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Musculoskeletal pain in primary health care : subgroups based on pain intensity, disability, self-efficacy, and fear-avoidance variables
- 2007
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In: Journal of Pain. - : Elsevier BV. - 1526-5900 .- 1528-8447. ; 8:1, s. 67-74
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Journal article (peer-reviewed)abstract
- The purpose of this study was to identify and describe subgroup profiles based on self-reported pain intensity, disability, self-efficacy, fear of movement/(re)injury, and catastrophizing in patients with musculoskeletal pain. Two primary health care samples (n = 215 and n = 161) were used. Self-report questionnaires were completed at the start of physical therapy treatment. Cluster analysis was used to generate subgroups. Three subgroups were identified in sample 1 and replicated in sample 2. These were labeled "High self-efficacy-Low fear-avoidance," "Low self-efficacy-Low fear-avoidance," and "Low self-efficacy-High fear-avoidance." The subgroups differed significantly in work-status in both samples (P < .001), but not in age, gender, or duration of pain. The results show the presence of subgroups based on pain intensity, disability, self-efficacy, fear of movement/(re)injury, and catastrophizing. The profile patterns suggest that different management strategies may be relevant in each subgroup. Perspective This article presents subgroups of patients with musculoskeletal pain with different profiles in pain intensity, disability, and psychosocial variables possible to modify by physical therapy management. The results could potentially aid clinicians in tailoring assessment and treatment approaches to each subgroup.
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| 4. |
- Leeuw, Maaike, et al.
(author)
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Measuring perceived harmfulness of physical activities in patients with chronic low back pain : The photograph series of daily activities-short electronic version
- 2007
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In: Journal of Pain. - : Elsevier BV. - 1526-5900 .- 1528-8447. ; 8:11, s. 840-849
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Journal article (peer-reviewed)abstract
- Cognitive-behavioral models of chronic low back pain (CLBP) predict that dysfunctional assumptions about the harmfulness of activities may maintain pain-related fear and disability levels. The Photograph Series of Daily Activities (PHODA) is an instrument to determine the perceived harmfulness of daily activities in patients with CLBP. This study examined the psychometric properties of a short electronic version of the PHODA (PHODA-SeV). The results show that the PHODA-SeV measures a single factor and has a high internal consistency. The test-retest reliability and stability of the PHODA-SeV over a 2-week time interval are good, with discrepancies between 2 measurements over 20 points suggesting true change. The construct validity is supported by the finding that both self-reported pain severity and fear of movement/(re)injury were uniquely related to the PHODA-SeV. Validity is further corroborated by the finding that patients who have received exposure in vivo, that aimed to systematically reduce the perceived harmfulness of activities, had significantly lower PHODA-SeV scores after treatment than patients receiving graded activity that did not address these assumptions. The findings support the PHODA-SeV as a valid and reliable measure of the perceived harmfulness of activities in patients with CLBP. Preliminary normative data of the PHODA-SeV are presented. Perspective: This article describes a pictorial measurement too/(PHODA-SeV) for the assessment of the perceived harmfulness of activities in patients with chronic low back pain. The PHODA-SeV has good psychometric properties and can be used to elaborate on the contribution of beliefs about harmful consequences of activities to pain and disability. (c) 2007 by the American Pain Society.
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| 5. |
- MacDonald, Shane, et al.
(author)
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Reconstructing the Past on the Original Pain Recall Assessment Form (OPRA)
- 2009
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In: Journal of Pain. - Amsterdam : Elsevier. - 1526-5900 .- 1528-8447. ; 10:8, s. 809-817
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Journal article (peer-reviewed)abstract
- The Original Pain Recall Assessment form (OPRA) is a technique that allows people to report on their pattern of pain over time. This investigation reports on the psychometric properties of the OPRA. Our results are analyzed from a cognitive-behavioral perspective. Correlation analyses on data from 72 respondents indicate that participants' patterns of symptoms recalled on the OPRA over a 28-day period were positively related to previous daily diary reports. Symptom ratings on an adapted OPRA showed different patterns of association with past symptom reports in distinct subgroups. A hypothesized, primacy recency effect of the diary procedure on symptom recall was supported. Statistics designed for use with paired, ordered categorical data showed acceptable agreement between diary ratings and those made at recall. In a basic research setting, the form offers the potential to evaluate individual correlates of pain recall. It can also be used at an individual level to describe the character of disagreement with prior ratings.PerspectiveThis article presents the psychometric properties of a pain-assessment procedure. Our results suggest that the way people recall their symptoms is related to cognitive, emotional, and behavioral correlates of the pain experience. The importance of individual differences in overt and covert behaviors and their relationship to persistent pain complaints warrants further attention.
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| 6. |
- McGrath, Patrick J., et al.
(author)
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Core outcome domains and measures for pediatric acute and chronic/recurrent pain clinical trials : PedIMMPACT recommendations
- 2008
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In: Journal of Pain. - : Elsevier BV. - 1526-5900 .- 1528-8447. ; 9:9, s. 771-83
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Journal article (peer-reviewed)abstract
- Under the auspices of the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT), 26 professionals from academia, governmental agencies, and the pharmaceutical industry participated in a 2-stage Delphi poll and a consensus meeting that identified core outcome domains and measures that should be considered in clinical trials of treatments for acute and chronic pain in children and adolescents. Consensus was refined by consultation with the international pediatric pain community through announcement of our recommendations on the Pediatric Pain List and inviting and incorporating comments from external sources. There was consensus that investigators conducting pediatric acute pain clinical trials should consider assessing outcomes in pain intensity; global judgment of satisfaction with treatment; symptoms and adverse events; physical recovery; emotional response; and economic factors. There was also agreement that investigators conducting pediatric clinical trials in chronic and recurrent pain should consider assessing outcomes in pain intensity; physical functioning; emotional functioning; role functioning; symptoms and adverse events; global judgment of satisfaction with treatment; sleep; and economic factors. Specific measures or measurement strategies were recommended for different age groups for each domain. PERSPECTIVE: Based on systematic review and consensus of experts, core domains and measures for clinical trials to treat pain in children and adolescents were defined. This will assist in comparison and pooling of data and promote evidence-based treatment, encourage complete reporting of outcomes, simplify the review of proposals and manuscripts, and facilitate clinicians making informed decisions regarding treatment.
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| 7. |
- Sjölund, Bengt H, et al.
(author)
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Pressure pain threshold changes after repeated mechano-nociceptive stimulation of the trapezius muscle : possible influence of previous pain experience
- 2007
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In: Journal of Pain. - Edinburgh : Churchill Livingstone. - 1526-5900 .- 1528-8447. ; 8:4, s. 355-362
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Journal article (peer-reviewed)abstract
- We examined the relation between repeated noxious pressure over the trapezius muscle and changes in pressure pain thresholds (PPTs) in a before-after trial design. A conditioning series of 30 mechano-nociceptive stimuli was applied manually with a handheld algometer probe, and PPTs were measured over 1 trapezius muscle (skin anaesthetized) in 27 healthy women before and after the intervention. With a mean stimulation rate of 0.40 Hz and a mean nociceptive stimulation intensity of 1.78 x Threshold, subjects were found to systematically react with a change in PPT, either a decrease or an increase. Normalized data, transformed into mean unidirectional PPT differences, showed statistically highly significant changes after intervention. The relative risk of reacting with lowered PPTs on noxious stimulation was 3.7 times higher for subjects who had not given birth to children than for subjects who had given birth to 1 or several children (P <.046). When 11 subjects were tested at a second session, a clear correlation of PPT reactions (r = 0.527; P <.001) was found. In summary, repetitive mechano-nociceptive stimulation of the trapezius muscle in healthy females evokes moderate and temporary changes in PPT that last for at least 35 minutes after cessation of stimulation. Perspective: A possible development of the response with transiently decreased PPTs into a model for human muscle pain is an intriguing possibility, since other models usually involve the introduction of chemical or thermal agents in the muscle, but this must await further research.
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| 8. |
- Åsenlöf, Pernilla, et al.
(author)
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Individually tailored treatment targeting activity, motor behavior, and cognitions reduces pain-related disability : a randomized controlled trial in patients with musculoskeletal pain
- 2005
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In: Pain forum. - : Elsevier BV. - 1082-3174. ; 6:9, s. 588-603
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Journal article (peer-reviewed)abstract
- This study compares the outcomes of an individually tailored behavioral medicine intervention (experimental) with physical exercise therapy (control). The experimental intervention was systematically individualized according to each participant’s behavioral treatment goals and functional behavioral analyses. One hundred twenty-two patients seeking care at 3 primary health care clinics because of musculoskeletal pain were randomized. Ninety-seven completed the trial. Data were collected at baseline, immediately after treatment, and at a 3-month follow-up. Analyses of data from completers, as well as intention-to-treat analyses, showed that the experimental group experienced lower levels of disability (P = .01), lower maximum pain intensity (P = .02), higher levels of pain control (P = .001), and lower fear of movement (P = .022) as a result of treatment condition. Self-efficacy (P = .0001) and physical performance (P = .0001) increased over time for both groups. Participants in the experimental group generally reported more positive effects after treatment. Treatment fidelity was maintained during the course of the study. Activity can be resumed and pain might be managed by the patients themselves if treatment incorporates the biopsychosocial explanatory model of pain and strategies are tailored according to individual’s priorities of everyday life activities and empirically derived determinants of pain-related disability.
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