Medicine and Health Sciences Commons^™

Development And Validation Of The Pain Resilience And Optimism Scale (Pros), Wonjin Seo

Electronic Thesis and Dissertation Repository

Numerous self-report questionnaires have been used in pain research to explore patients' experiences. However, these questionnaires often employ negatively worded items that can potentially worsen patients' distress. In response to the emergence of positive psychology, this thesis aimed to develop a new questionnaire that adopts a positive and strengths-focused approach, incorporating resilience, to replace the negative items found in existing tools such as the Pain Catastrophizing Scale (PCS). First, the effectiveness of the Connor-Davidson Resilience Scale (CD-RISC) in measuring resilience following trauma was assessed through a systematic review using the COnsensus-based Standards for the selection of health status Measurement INstruments …

The Effectiveness Of Laser Acupuncture In Pain Management: A Systematic Review, June Park

Theses and Graduate Projects

Background: Pain is a common symptom across many medical conditions that patients experience. Pain management is complex and may need a combination of several management techniques. Laser acupuncture(LA) has been previously used as an adjunct to conventional pain treatments.

Objective: This systematic review aims to evaluate the effectiveness of laser acupuncture in various fields of medical situations such as chronic pain, low back pain, osteoarthritis, osteoporosis, postoperative pain and dental procedures.

Methods: A computer based literature search of databases through GoogleScholar and PubMed was used to identify randomized controlled trials(RCTs) published after 2018 that studied the effect of LA in …

The Lived Experiences Of Pain And Fatigue In Persons Living With Neurological Conditions: A Phenomenological Study, Lauren L. Kane

Electronic Thesis and Dissertation Repository

Purpose: The aim of the study was to understand the experiences and impact of pain and fatigue and to further explore the relationship between participants' descriptions of their lived experiences with these phenomena within and across multiple sclerosis, Parkinson's disease, and cerebral palsy. Methods: Semi-structured interviews were used to interview nine participants about their experiences of living with pain and fatigue in their respective conditions. A new phenomenological approach was adopted, and data was analyzed inductively using interpretive phenomenological analysis. Results: Three final themes including a lack of understanding, negative perceptions of pain and fatigue, and coping strategies used to …

Music As A Treatment For Perceived Postoperative Pain In Adults: A Critically Appraised Topic, Savannah G. Mcdaniel

Honors College Theses

Clinical Question: In postoperative patients, how does listening to music affect perceived pain levels? Clinical Bottom Line: There is consistent evidence to suggest music decreases perceived pain in postoperative patients undergoing nasal septal surgery, open heart surgery, total knee replacement surgery, and general orthopedic surgeries requiring hospitalization. Athletic trainers can confidently implement music during patients’ post-operative care sessions to help reduce pain.

The Genetics Of Pain: An Exploration Of Gene-By-Environment Interactions And Their Effects On Pain, Mohamad F. Fakhereddin

Electronic Thesis and Dissertation Repository

The findings presented in this dissertation are part of the bigger SYMBIOME project which aims to use the biopsychosocial model of pain to develop a prognostic clinical phenotype for people that experience musculoskeletal (MSK) trauma. Chapter 2 presents an exploratory analysis to assess the relationships between genetic polymorphisms and pain severity and interference. Early childhood trauma was also explored as a moderator between genetic polymorphisms and pain outcomes. For pain severity, major allele carriers (A/A and G/A) of FKBP5 rs9394314 reported significantly higher scores than minor allele carriers (G/G). Further, major allele carriers who had at least one adverse childhood …

Does The Application Of Kt Tape Decrease Pain In Chronic Low Back Pain?, Jordan Vitelli

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine “Does the application of KT tape decrease pain in chronic low back pain?”

Study Design: A systematic review of three randomized controlled trials (RCTs) published between 2018 and 2019.

Data Sources: The three RCTs were published in English in peer reviewed journals and obtained from PubMed. The studies were selected based on their relevance to the clinical question.

Outcome Measured: The outcome measured within all three RCTs was pain intensity using the Visual Analog Scale (VAS). The VAS scoring ranges from 0 to 10, defining 0 as no pain …

Does Acupuncture/Dry Needling Improve Pain And Itch In Abnormal Hypertrophic Scars, Catherine Tuckey

Theses

This research program investigated the use of acupuncture intervention as an adjunct for hypertrophic scar (HTS) management. Mechanistic evidence from ex vivo and animal studies suggests that acupuncture has the potential to modulate neurogenic inflammation to influence pain and itch associated with HTS. Further, acupuncture may mediate non-neuronal cells involved in the proliferation and remodelling stage of healing to promote scar maturation. Previous studies using acupuncture for scar management demonstrated positive outcomes, however low-quality clinical trials and case studies provide limited evidence for treatment benefit.

A treatment protocol was designed to investigate the effects of locally applied acupuncture compared to …

A Transformative Journey: The Lived Experience Of Healthcare Learners Participating In Pain Management Education, Zoe A. Leyland

Electronic Thesis and Dissertation Repository

There is little emphasis on pain management education for healthcare providers. In September 2019, the Master of Clinical Science (MClSc) program in Advanced Healthcare Practice at Western University in London, Ontario introduced a new, “Interprofessional Pain Management” (IPM) field. The program follows a competency-based framework, and the learners are all practicing healthcare providers with a special interest in pain. Part of the purpose of this thesis is to describe the process of development and implementation. The objective is to provide educators and healthcare providers an in-depth look at how the pain education is experienced. This includes exploring the lived experience …

Nature, Nurture, Or Both? Study Of Sex And Gender And Their Effects On Pain, Maryam Ghodrati

Electronic Thesis and Dissertation Repository

As a pain researcher, in order to have a better understanding of pain, we should adopt a multidimensional view, such as the biopsychosocial (BPS) model and consider physical, psychological, and social elements altogether. The studies in this dissertation are part of the bigger project of SYMBIOME in which the aim is to help to create and develop a prognostic clinical phenotype in people post musculoskeletal (MSK) trauma. Chapter 2 presents a Confirmatory Factor Analysis (CFA) in order to assess the structural validity of the first section of the new Gender Pain and Expectation Scale (GPES). Our analysis indicated a 3-factor …

Thermal Ultrasound, Manipulation And Exercise On Pain And Mouth Opening In Chronic Temporomandibular Joint Disorder: A Case Report, Suchita S. Rao

Kasturba Medical College, Mangalore Theses and Dissertations

No abstract provided.

Guided Imagery And Sentinel Lymph Node Biopsy Pain, Brandy Alicia Kirk

Evidence-Based Practice Project Reports

The standard of care in the treatment for women diagnosed with breast cancer includes identification and biopsy of the sentinel lymph nodes (SLN) of the breast (Chaterjee et al., 2017; Kneece, 2017). The process of identifying the SLNs involves radioisotope injections into or near the areola. Because this area is highly sensitive, women report this procedure to be considerably painful. The purpose of this evidence-based practice (EBP) project was to determine if the provision of a 5-minute session of guided imagery (GI), as a complementary alternative medicine, prior to SLN injections was effective in mitigating reports of procedural pain. A …

Preoperative Education In Lumbar Fusion Patients: Impact On Postoperative Disability Perception, Megan Curtis

Doctor of Nursing Practice Scholarly Projects

Background/Review of Literature: A lumbar fusion is a complex surgical intervention with many postoperative guidelines and restrictions. Preparing patients with surgery specific education has shown to decrease their sense of disability and postoperative pain in other surgical specialties, but a disparity exists in spinal surgery.
Purpose: To examine the effect of a preoperative education class for lumbar fusion patients on their perceived level of disability, the number of patient phone calls made to the neurosurgery office, the number of postoperative emergency room (ER) visits, and the number of hospital readmissions after surgery.
Methods: A quality improvement project utilizing a quantitative …

Effectiveness Of Virtual Reality On Reducing Pain In Burn Patients, Jillian R. Carr

Honors Undergraduate Theses

Burn patients undergo excruciating levels of pain throughout their treatment in the hospital. Pain levels increase during medical procedures, such as wound care and debridement. As a part of the treatment plan, traditional pharmacologic interventions are provided. Over time, patients become tolerant of pain medications, specifically opioids. The developed tolerance contributes to more pain felt by the patient. Medical providers limit the number of opioids prescribed to prevent addiction and other adverse effects, contributing to the challenge in treating burn pain. Virtual reality (VR) has been studied as an intervention across various settings to alleviate distressing symptoms in patients. Many …

The Symbiome Project: An Exploratory Investigation Of The Biological, Psychological, And Social Mechanisms That Contribute To The Transition From Acute To Chronic Musculoskeletal Pain, Joshua Y. Lee

Electronic Thesis and Dissertation Repository

This dissertation presents the initial findings of the SYMBIOME project; which attempts to combine the objective and subjective aspects of musculoskeletal pain to develop a prognostic clinical phenotype. Chapter 2 presents a moderator analysis of functional outcomes (pain interference and pain severity). Psychosocial moderators can affect the relationship between biomarkers and pain. For pain severity, TNF-α, TGF-β1, and CRP were moderated by employment status, pre-existing psychopathology, and sex. For pain interference, IL-1β, cortisol, TGF-β1, CRP, and IL-6 were moderated by pre-existing pain, peri-traumatic fear, region of injury, and peri-traumatic stress. Chapter 3 presents a latent growth curve analysis in determining …

An Examination Of Pain Education Of Medical Students In Australia And New Zealand, Elspeth Shipton

Theses

Background: Unrelieved pain is a significant public health challenge in Australia and New Zealand. Medical practitioners play an essential role in the management of acute, cancer and chronic non-cancer pain.

Aim: This thesis aimed to examine the delivery of pain education at medical schools in Australia and New Zealand, and to determine how effectively it equips medical students with pain medicine competencies required for internship.

Methods: An explanatory sequential mixed methods approach was used. Quantitative studies focused on gathering information regarding the pain-related content of medical curricula of all medical schools; and on testing pain medicine competencies of final-year medical …

Systematic Literature Review Of Cognitive Behavioral Treatments For Patients With Classical, Secondary, And Idiopathic Trigeminal Neuralgia, Linnea B. Herzog

Honors Undergraduate Theses

Trigeminal neuralgia is a painful neuralgia with a complicated pathology that is not clearly understood. Due to the ambiguity of the condition, patients often have to search for medical providers that specialize in trigeminal neuralgia, and even with the guidance of a specialist, some patients do not respond well to treatment.¹ Despite the uncertainty surrounding the specifics of the disease, there are treatments available that can provide some level of pain relief for patients suffering from this disorder. When a patient does not respond well to medical therapy, surgery can be the next appropriate step in patient care management. …

Quantifying The Outcomes Of A Virtual Reality (Vr)-Based Gamified Neck Rehabilitation, Shahan Salim

Electronic Thesis and Dissertation Repository

Neck pain is a major global public health concern and adds a significant financial burden to both the healthcare system as well as people suffering from it. Additionally, it presents measurement and evaluation challenges for clinicians as well as adherence challenges and treatment barriers for the patients. We have developed a virtual reality (VR)-based video game that can be used to capture outcomes that may aid in the assessment and treatment of neck pain. We investigated: (i) performance metrics of overall accuracy, accuracy based on movement difficulty, duration, and total envelope of movement; (ii) stability across sessions; (iii) accuracy across …

Enhancing Chronic Pain Management Motivational Interview Among Lower Back Pain Patients, Melissa L. Hines-Antico

Doctor of Nursing Practice Final Manuscripts

Purpose: Untreated chronic pain is a nationwide epidemic affect individual physically, psychologically, and financially. Low back pain is the most common subset of chronic pain. Restricted clinic time and a focus on procedural/prescriptive methods for managing pain prohibits patient education regarding self-care, and formation of a relationship with the provider.

Design: Article review yielded 20 articles that supported the use of motivational interviewing for chronic pain in lower back pain patients. They were evaluated for their strength of evidence on a scale of 1-6. One article was ranked level I as a meta-analysis, and six were ranked as level II …

Caring For Children With Severe Cerebral Palsy: The Lived Experience Of Parents, Jason Eric Cook

Department of Physical Therapy Student Theses, Dissertations and Capstones

The purpose of this study is to explore the lived experience of parents who care for their child withcerebral palsy who function at Gross Motor Function Classification System (GMFCS) Level V. Additionally, the study also explores the parent’s understandings and beliefs about pain and non-pain related emotional distress, and the meaning of caring, providing care, and providing comfort for their child with GMFCS Level V cerebral palsy. The study was conducted using a qualitative, hermeneutic phenomenology approach with semi-structured interviews and participant-initiated journaling. The study included 11 participants who are caregiving parents of their child with GMFCS Level V cerebral …

"Current Anesthesia Education Practices Regarding Music As An Adjunct For Analgesia And Anxiolysis ", Taylor Hull

College of Science and Health Theses and Dissertations

Background: Music has been proven as an effective complementary and alternative medicine, and can be an important tool for nurse anesthetist.

Objectives: The purpose of this project was to assess if nurse anesthesia programs are including music as a part of the complementary and alternative medicine (CAM) curriculum for anxiety and pain in the perioperative setting.

Method: A descriptive survey was sent to program directors of nurse anesthesia programs in the United States to assess the current level of awareness and education regarding music as an alternative medicine as well as barriers to the addition of music into curriculum. …

Laughter Frequency, Pain Perception, And Affect In Fibromyalgia Patients, Deidre Gayl Molchan

Walden Dissertations and Doctoral Studies

Fibromyalgia syndrome (FMS), a common chronic pain condition, is often incompletely treated by conventional medical therapies. It can cause disability, psychological distress, work-related absenteeism, increased use of healthcare resources, and result in the inability to carry out the tasks of daily living. The purpose of this quantitative, correlational study was to investigate the potential influence of laughter on affect and pain in individuals with FMS. Laughter produces beneficial effects on acute pain and on chronic pain in general and has been found to improve temporary affective states, but there have been no studies testing the effects of laughter on the …

Effects Of Lower Extremity Aerobic Exercise And Conditioned Pain Modulation On Evoked Shoulder Pain, Logan Lumpkins, Craig Wassinger

Undergraduate Honors Theses

Background: Emerging evidence suggests that aerobic exercise and conditioned pain modulation may be advocated in treating patients with musculoskeletal pain. The effects of lower extremity aerobic exercise and conditioned pain modulation on evoked shoulder pain are not known.

Purpose: To determine the acute effects of lower extremity aerobic exercise and conditioned pain modulation on outcomes of evoked shoulder pain from pain pressure threshold measurements.

Study Design: Repeated measures.

Methods: Thirty (30) healthy volunteers were tested over the course of two sessions. Session 1 consisted of collecting pain pressure threshold measurements over the infraspinatus before and immediately following a conditioned pain …

The Effect Of High Baseline Pain On Impairment Outcomes One Year After Distal Radius Fracture, Farrukh Riaz

Electronic Thesis and Dissertation Repository

Objective

The purpose of this study is to evaluate whether high baseline pain predicts impairment outcomes in grip strength or wrist range of motion (ROM) at one year after a distal radius fracture (DRF). Impairments occur for less than 15% of patients.

Methods:

In this cohort study patients with a DRF were recruited from a hand clinic in London, Ontario. This data was collected at two evaluation time points: at baseline (within the first 10 days after fracture) and at one year after fracture. Baseline pain was assessed using the pain subscale of the Patient-Rated Wrist Evaluation (PRWE) and classified …

Impact Of Osteoarthritis Self-Efficacy Toolkit On Adults With Osteoarthritis, Connie Hutley Kiser

Walden Dissertations and Doctoral Studies

Over 26 million U.S. citizens have a form of arthritis; osteoarthritis (OA) is the most common form. Self-efficacy (SE) is defined as a psychological construct which identifies an individual's confidence when performing a behavior. SE is deemed a vital judge of self-management (SM) in those with OA. The purpose of this evidence-based practice, quality improvement project was to improve SE in OA patients. The identified gap in nursing practice was the lack of SE in OA patients. The project question asked whether a toolkit with information regarding SE in OA can improve SE of management of disease-associated symptoms in adults …

The Association Between Soft Tissue Releases And Bony Resections Performed During Total Knee Arthroplasty And Patients' Pain And Satisfaction Postoperatively, Matt Carter

Electronic Thesis and Dissertation Repository

Total knee arthroplasty (TKA) is a surgical treatment of degenerative knee conditions such as osteoarthritis to reduce pain and increase function. Intraoperative soft tissue releases (STRs) and bony resections (BRs) are necessary for a balanced and aligned TKA. It is possible that the degree of STRs and BRs is related to final outcome following TKA and thus there may be implications for patient rehabilitation, patient expectations, pain medications, and timelines for recovery. Thus, our primary objective was to examine the association between the number of STRs and BRs performed intraoperatively and patients’ satisfaction and pain at three months. We performed …

Measuring Fatigue In Adolescents And Young Adults With Cerebral Palsy, Laura K. Brunton

Electronic Thesis and Dissertation Repository

Fatigue is a significant issue and has been estimated to affect between 30-50% of individuals with cerebral palsy (CP) in various studies; however, there is no validated measure of fatigue for this population. A systematic review revealed no one single measure with adequate psychometric properties for use with individuals with CP. As a result a new tool was created: the Fatigue Impact and Severity Self-Assessment (FISSA). Interviews were conducted with youth and young adults with CP to understand the bodily experience of living with CP and as a client-centered approach to item creation for the FISSA. Focus groups with healthcare …

Conservative Treatment Of De Quervain’S Tenosynovitis In Occupational Therapy: A Retrospective Outcome Study, Kevin R. Lang, Brittney S. Gibson, Kayleigh M. Oppenhuizen

Hand and Upper Extremity

Objective: De Quervain’s tenosynovitis (DQ) is a painful condition characterized by pain and inflammation at the first dorsal compartment of the wrist. This condition affects the wrist and thumb, and generally decreases an individual’s performance and engagement in daily occupations. Conservative management with occupational therapy (OT) can assist to diminish the associated symptoms and facilitate recovery of function; however, it is unclear what interventions are the most effective. The purpose of this study was to determine the effectiveness of conservative OT interventions for individuals diagnosed with DQ.

Study Design: An exploratory retrospective review of 148 de­‐identified electronic medical records provided …