Pain Management Commons^™

Children And Their Parents’ Assessment Of Postoperative Surgical Pain: Agree Or Disagree?, Olivia Kaminsky, Michelle Fortier, Brooke N. Jenkins, Robert S. Stevenson, Jeffrey I. Gold, Jeannie Zuk, Brenda Golianu, Sherrie H. Kaplan, Zeev N. Kain

Psychology Faculty Articles and Research

Objective

The purpose of this study is to compare postoperative pain scores between children undergoing tonsillectomy and adenoidectomy (T&A) surgery and their parents, identify potential predictors for this disagreement, and determine possible impact on analgesic administration.

Methods

This is a prospective longitudinal study conducted with children undergoing outpatient T&A in 4 major tertiary hospitals and their parents. Children and their parents were enrolled prior to surgery and completed baseline psychological instruments assessing parental anxiety (STAI), parental coping style (MBSS), child temperament (EAS) and parental medication administration attitude questionnaire (MAQ). Postoperatively, parents and children completed at-home pain severity ratings (Faces Pain …

Non-Pharmacological Approaches To Stress Reduction And The Treatment Of Migraines, Megan O'Connell

Senior Honors Projects

Migraines are a disabling neurological medical condition that affects about 12% of the population. Traditionally, migraines are managed with medication however many patients still experience migraines even while on medication. Stress reduction methods such as meditation, deep breathing, reiki, yoga and hypnosis can help with the treatment of a variety of diseases. This study examines the effects of these non-pharmacological treatments on migraines. First, a systematic literature review was completed to explore the effectiveness of alternative treatment approaches. Twenty-four studies were included in the review and the literature concluded patients with migraines can benefit from psychological interventions. Second, a qualitative …

Increasing Doses Of Intraoperative Hydromorphone Do Not Reduce Postoperative Pain, Craig S. Curry, Michael B. Henry, Wendy Craig, Janelle M. Richard, Denham S. Ward

MaineHealth Maine Medical Center

Introduction:

• Intermediate and long acting opioids are given intraoperatively to reduce pain during emergence from anesthesia.

• Recent evidence suggests that intraoperative opioids have inconsistent effects on nociception and pain in the immediate postoperative period.

• Multiple potent, short-acting opioids such as remifentanil, sufentanil and fentanyl have been shown to produce dose-related increases in pain scores and opioid consumption in the immediate postoperative recovery period.

• Intraoperative doses of longer acting opioids such as morphine and methadone6 have been shown to reduce pain scores and narcotic requirements in the immediate postoperative period.

• Hydromorphone is an intermediate duration narcotic …

A Program Evaluation Of Physician Medical Clinic’S Approach To Chronic Pain, William Summers

Doctor of Psychology (PsyD)

Chronic pain costs up to $635 billion dollars annually and impacts 25.3 million adult U.S. citizens (Nahin, 2015). Treatment options have typically included opioid medications, which potentially causes harm with long-term use and has contributed to an epidemic of opioid misuse. Treatment has expanded beyond monotherapy to include holistic approaches to health, such as occupational therapy and mental health therapy. The present study sought to evaluate the effectiveness of group therapy as it is conducted in a rural Oregon clinic using the Quadruple Aim to measure treatment outcomes (Bodenheimer, & Sinsky, 2014). Participants diagnosed with chronic pain and placed on …

Health And Quality Of Life Of Children Undergoing Elective Surgery, Vivian Luong

Student Scholar Symposium Abstracts and Posters

Multiple studies have found that poorer health is associated with significantly lower quality of life when comparing children and adults with health conditions such as cancer, diabetes, asthma, and ADHD to their normal healthy counterparts. The relationship between health and quality of life, however, has yet to be examined in children who have undergone elective surgery. More than 5 million children in the U.S. undergo surgery each year. These children are often undergoing surgery for a number of health issues that may impede quality of life. Consequently, this study analyzes the effects of health on the quality of life of …

Seerratus Anterior Plane Block (Sapb) Improves Paine Control In Rib Fractures, Randy Kring, Peter Croft, David Mackenzie, Christina Wilson, Joseph Rappold, Tania D. Strout

MaineHealth Maine Medical Center

Background:

•Trauma is a major cause of morbidity and mortality worldwide. Rib fractures are identified in at least 10% of all injured patients.

•Rib fractures can lead to significant respiratory complications, with pneumonia and respiratory failure occurring in up to 31% of patients with rib fractures. Early initiation of aggressive pain control and pulmonary hygiene with incentive spirometry are standard of care to prevent complications from developing.

•In the Emergency Department, patients with rib fractures typically receive systemic analgesia that is largely narcotic-based. This pain control strategy puts patients at risk for the side effects of narcotics such as constipation, …

Increasing Adult's Awareness Of The Importance Of End-Of-Life Care Discussions, Taylor Gardner

Capstone Projects and Master's Theses

For many American families, end-of-life care is often not discussed, until advanced illness or injury has fully disrupted everyday life. There are many benefits to discussing end-of-life care prior to any medical complications. Research has shown that individuals who plan their end-of-life processes with a hospice service provider and family members report a higher quality of death than individuals receiving common health care during their final six months of life. In order to make families and friends more comfortable with end-of-life discussions, I will conduct two one-hour educational sessions to students at California State University, Monterey Bay.

Availability And Nursing Implementation Of Measurement Tools In The Co-Occurrence Of Depression And Chronic Pain: An Integrative Literature Review, Ashley Thomas

Grace Peterson Nursing Research Colloquium

Availability and Nursing Implementation of Measurement Tools in the Co-Occurrence of Depression and Chronic Pain: An Integrative Literature Review

Ashley Thomas

Faculty Sponsor: Barbara Harris

Background: There is high correlation between chronic pain and depression. They are seen throughout the literature to interact and feedback symptoms upon each other. However, there is not a comprehensive screening tool that assess both symptoms and not a clear indication of nursing responsibility in assessment of the co-occurrence.

Objectives: The purpose of this literature review is to create a comprehensive review of current research concerning the availability of screening tools that measure the co-occurrence …

The Effects Of Medical Cannabis Use Among Adults With Chronic Pain: An Integrative Review Of The Literature, Bridget A. Asevedo

Honors Undergraduate Theses

The purpose of this integrative literature review was to understand the effects of medical cannabis for chronic pain management in adults. Anecdotal reports suggest the use of medical marijuana as a pain management therapy could be an alternative to opioids and other medications which have long term consequences. Potential uses span the health care continuum, from prescribed outpatient symptom management, to acute care, extended care, home care, and hospice treatment settings. The methodology included a review and synthesis of relevant research articles from 2012 to 2018, written in the English language. The findings suggest medical cannabis has the potential of …

The Use Of Behavioral Pain Assessment Tools And Pain Outcomes In Nonverbal Patients, Patrick A. Healy

Honors Undergraduate Theses

Acute and critical care patients experience significantly more pain than those patients on a general nursing unit. Due to the severity of their condition, acute care patients may be nonverbal and unable to self-report their pain. Behavioral pain assessment tools are a method of objectively measuring pain in patients who are unable to communicate. While the use of these tools has been shown to improve short- and long-term outcome for patients, there is a paucity of evidence as to nurses' perceptions related to their use. The purpose of this study is to investigate acute care nurses' perceptions of the relationship …

Impact Of Serratus Plane Block On Pain Scores And Incentive Spirometry Volumes After Chest Trauma, Nadia Hernandez, Johanna De Haan, Dallis Clendeninn, David E Meyer, Semhar Ghebremichael, Carlos Artime, George Williams, Holger Eltzschig, Sudipta Sen

Faculty, Staff and Student Publications

Background: Adequate pain control is difficult to achieve in patients with multiple rib fractures (MRF). Serratus plane block (SPB) is a novel technique for alleviating rib fracture pain. Several published case reports support this hypothesis.

Purpose: The purpose of this study was to evaluate the use of SPB in MRF at our level 1 trauma center.

Methods: Our hospital’s Regional Anesthesia Registry was queried for all trauma patients with MRF who underwent SPB between August 2014 and January 2018. Data were compared in each patient as a matched pair for the time periods before and after undergoing SPB. Thirty-four patients …

Predictors And Health Outcomes Of Treatment-Resistant Depression Among Adults With Chronic Non-Cancer Pain Conditions And Major Depressive Disorder, Drishti Shah

Graduate Theses, Dissertations, and Problem Reports (ETD)

Understanding major depressive disorder (MDD) as a comorbidity in patients with chronic non-cancer pain conditions (CNPC) is of importance because of the high prevalence and well documented bi-directional relationship between MDD and pain. Furthermore, presence of CNPC among adults with MDD often reduces benefits of antidepressant therapy, thereby increasing the possibility of treatment resistance. Treatment-resistant depression (TRD) commonly defined as insufficient response to multiple antidepressant trials, often worsens depression and pain symptoms and can amplify the clinical and economic burden among adults with CNPC and MDD. Additionally, long-term opioid therapy (LTOT) may be prescribed at a higher rate to adults …

Art In The Stages Of Suffering And Death, Joanna Aramini

Visual Arts Department Student Scholarship

There has always been a strong link between art and the study of science and medicine, and one of the most iconic images of suffering and death in history to date is Christ suffering on the cross. In this thesis, I examine if and how art can make it possible to transcend human pain and overcome suffering, especially in our modern society where pain is seen as something we cannot deal with, and where we look to medicine and prescriptions to diminish it. I argue that art in the states of suffering and death, closely examining Michelangelo’s La Pieta and …

Dancing, Mindfulness, And Our Emotions: Embracing The Mind, Body, And Sole, Alisha M. Collins

Dissertations, Theses, and Capstone Projects

This capstone project examines dance, as an intervention and mindfulness practice that assists with managing our emotions. There is a need for dance therapy in social institutions such as, healthcare facilities, schools, and community centers. Dance therapy has the potential to reduce negative emotions, create mindfulness, improve self-expression, and promote a healthy well-being. I am proposing that dance therapy is applied as a regular practice in social institutions to develop mindfulness and promote emotional stability.

In this study, I argue that dance therapy can contribute to our well-being long term. In addition to this written thesis, a visual component of …

The Impact Of Prosthetics On Amputee Quality Of Life, Courtney Tabor

Liberal Arts Capstones

After someone has a limb amputated, their lifestyle must be rearranged to accommodate for the loss of the limb. This can include adjusting to an inability to do tasks that used to come easily and a drastic reduction in mobility. They may now require assistance with caring for themselves. As a side effect, amputees often experience a significant level of depression and anxiety related to their situation. A selection of literature was analyzed for the physiological, psychological, and sociological effects of losing a limb, and then for the ways in which a prosthetic limb would alleviate some of these issues. …

Emotion Regulation And Positive Affect In The Context Of Salivary Alpha-Amylase Response To Pain In Children With Cancer, Brooke N. Jenkins, Douglas A. Granger, Ryan J. Roemer, Ariana Martinez, Tara K. Torres, Michelle A. Fortier

Psychology Faculty Articles and Research

Background

Children with cancer routinely undergo painful medical procedures invoking strong physiological stress responses. Resilience to this pain may be conferred through resources such as emotion regulation strategies and positive affect.

Procedure

This study measured dispositional positive affect in children with cancer (N = 73) and randomly assigned participants to one of three emotion regulation strategy conditions (distraction, reappraisal, or reassurance). Children applied their assigned strategy during an experimental pain procedure (the cold pressor task [CPT]) and provided saliva samples before, immediately after, and 15 min after the CPT. Saliva samples were later assayed for salivary alpha amylase (sAA)—a surrogate …

Prescription Drug Abuse, Jiaxi Tian

Global Issues in Public Health

Prescription drug abuse is an action that portrayed as misuse or overuse of prescription drugs. It is a prevalent problem all over the world. U.S is a particular country that has drug abuse as a serious problem has several different causes of the drug abuse. In the U.S., most prescription drugs are pain killers. The outcomes of drug abuse vary but may lead to death.

Calling Attention To The Growing Heroin Epidemic And How To Fight It, Kendal Rozaieski

Williams Honors College, Honors Research Projects

The purpose of this study was to explore the experience of creating a grassroots heroin awareness organization on a university campus through qualitative research. Various meeting types were attended as the grassroots efforts began: a student organization dedicated to the cause, the campus Alcohol and Other Drug Board, a local community treatment center agency, multiple University of Akron faculty members, and other heroin awareness groups in the community. Through observation and journaling of these meetings, I am sharing my experience based off analyzed field notes. After analyzation of these notes, common themes related to the formation of this kind of …

Evaluating The Relationship Between Phq9 And Global Pain Scale (Gps) Scores In Opioid Dependent Adults: A Retrospective Correlational Study, Lori Nolan

DNP Projects

Background: Depression, chronic pain and opioid dependence are conditions commonly encountered in primary care settings. These comorbidities create treatment challenges while negatively influencing outcomes of care. The Patient Health Questionnaire (PHQ9) and Global Pain Scale (GPS) are valid screening tools used to score depression and pain symptoms. The purpose of this study was to determine the relationship between the PHQ9 and Global Pain Scale (GPS) scores in opioid dependent adults with chronic pain to determine whether both tools are necessary.

Methods: This was a descriptive study using a retrospective correlational research design. Data was obtained from the electronic medical records …

End-Of-Life Care And Opioid Use In India: Challenges And Opportunities, Aasems Jacob, Aju Mathew

Markey Cancer Center Faculty Publications

No abstract provided.

The Nyc Board Of Education Mandates Pledging Allegiance [Poem], Kate Abell

Occasional Paper Series

Kate Abell shares a poem following September 11. It is a criticism of the requirement of pledging allegiance to the flag in school.

Provider Based Interventions To Mitigate Risk For Opioid Pain Medication Abuse Among Adult Patients In A Primary Care Setting, Sheree Lamara Conley-Donaldson

Doctoral Projects

Mental and substance use disorders are predicted to exceed all physical disease processes causing major disability by 2020. Misuse and overdose of opioid pain medications is a significant public health concern in the United States. Approximately 1 in 4 patients receiving prescription opioids in primary care settings struggle with misuse. Half of all opioid prescriptions are written by primary care providers, including nurse practitioners. The purpose of this DNP project was to determine if nurse practitioner providers are implementing evidence-based practice guidelines including screening, brief intervention, and referral to treatment (SBIRT) to mitigate risk of prescription opioid pain medication misuse …

Reconnecting The Mind And Body: A Pilot Study Of Developing Compassion For Persistent Pain, Sarah L. Parry Dr, Zoey Malpus Dr

Patient Experience Journal

As an alternative to the more typical cognitive behavioural approach to pain management, a novel pain management group based on the principles of compassionate mind training was developed for a particular sub-group of patients. Participants were patients of a community pain clinic, who were invited to participate in this alternative approach to pain management. The eight-week Compassion in Pain Groups included psychoeducation around persistent pain, the underlying principles of compassionate mind training, practical exercises such as diaphragmatic breathing, followed by a series of compassionate imagery exercises and group discussions. Both quantitative and qualitative analyses were undertaken to gain further insights …

Prescription Opioids: A Band-Aid For Chronic Low Back Pain, Rebekah Dunn

Physician Assistant Scholarly Project Posters

Pain is one of the most common reasons patients seek medical care in the outpatient clinic and emergency department setting.

 • In the last decade, per the Centers for Disease Control (CDC), prescription drug abuse and overdose, specifically opioids, has become the leading cause of injury and deaths in the United States.

• “Opioids—primarily prescription pain relievers and heroin—are the main driver of overdose deaths and were involved in 28,647 deaths in 2014…opioid overdoses have quadrupled (an increase of 200%) since 2000” (Rudd et al. 2016).

• In 2016 the CDC established guidelines of clinical practice regarding management of …

Play It Again! Individualized Music Improves Social Interaction Of Women, But Not Men, With Dementia, Emily Farrer

Undergraduate Honors Thesis Collection

Dementia is tragic both for patients with the disease and for their family members. As this neurodegenerative disorder progresses, cognitive functions deteriorate, agitation and aggression increase, and mood worsens (McDermott, Orrell, et al., 2014; Spiro, 2010; Vasionyté & Madison, 2013). Non-pharmacological approaches, such as active music therapy or passive music listening, can be effective in reducing these symptoms. However, no past studies have examined how music listening affects the social interactions of patients with dementia. As such, this study examined whether nursing home residents with dementia are more engaged and interactive if they listen to individually selected music for 15 …

Self-Reported Pain In Male And Female Iraq/Afghanistan-Era Veterans: Associations With Psychiatric Symptoms And Functioning, Jennifer C. Naylor, H. Ryan Wagner, Mira Brancu, Megan Shepherd-Banigan, Eric Elbogen, Michelle Kelley, Teresa Fecteau, Karen Goldstein, Nathan A. Kimbrel, Christine E. Marx

Psychology Faculty Publications

Objective. To examine pain symptoms and co-occurring psychiatric and functional indices in male and female Iraq/Afghanistan-era veterans.

Design. Self-reported data collection and interviews of Iraq/Afghanistan-era veterans who participated in a multisite study of postdeployment mental health.

Setting. Veterans were enrolled at one of four participating VA sites.

Subjects. Two thousand five hundred eighty-seven male and 662 female Iraq/Afghanistan-era veterans.

Methods. Nonparametric Wilcoxon rank tests examined differences in pain scores between male and female veterans. Chi-square tests assessed differences between male and female veterans in the proportion of respondents endorsing moderate to high levels of pain vs no pain. Multilevel …

Healthcare Providers’ Perceptions Of Socioeconomically Disadvantaged Patients With Chronic Pain: A Qualitative Investigation, Nicole A. Hollingshead, Marianne S. Matthias, Matthew Bair, Adam T. Hirsh

Journal of Health Disparities Research and Practice

Socioeconomically disadvantaged individuals are at-risk for chronic pain and disparate care. In this qualitative study, we explored providers’ experiences with socioeconomically disadvantaged patients, with a particular focus on providers’: (1) perceptions of socioeconomically disadvantaged patients’ barriers to pain care, (2) attitudes towards this patient population, and (3) chronic pain decisions for these patients. Individual interviews were conducted with twenty-four healthcare providers. Providers discussed several patient-level access barriers, such as not having health insurance, financial constraints, and scheduling difficulties. Providers believed socioeconomically disadvantaged patients were at-risk to misuse prescription opioids and were less comfortable prescribing opioids to these patients. This investigation …

Medical Cannabis: Miracle Or Myth?, Blair Henry, Arnav Agarwal, Edward Chow, Hatim A. Omar, Joav Merrick

Pediatrics Faculty Publications

No abstract provided.

Pharmacology Of Cannabis, Mandakini Sadhir

Pediatrics Faculty Publications

Cannabis has been used for recreational purposes around the world. It is derived from the plant cannabis sativa which has various other compounds known as cannabinoids. Most common form of cannabis used for recreational purpose is marijuana, which is prepared from dried flowering tops and leaves. The primary psychoactive component is delta 9-tetrahydrocannabinol (δ-9THC), which exerts its physiological and psychological effects through its interaction with CB1 and CB2 receptors. Smoking is the most commonly used method with onset of effects within minutes after inhalation. Oral ingestion of cannabis has varied absorption with delayed onset but longer duration of action. Urine …

The Implementation Of Alternative Pain Control Methods By Dental Hygienists, Alejandra Valadez Rodriguez

Mahurin Honors College Capstone Experience/Thesis Projects

As a dental hygienist, it is important to understand new concepts and techniques that can contribute to a more comfortable setting for patients who experience dental anxiety. Alternative pain control methods can assist in alleviating patient anxiety, therefore, providing a more efficient and relaxed clinical atmosphere for both patient and clinician. Some of the methods discussed are: guided imagery, deep breathing, muscle relaxation, hypnosis, acupressure, essential oil diffusion, audio distraction, and visual stimuli. After reviewing the literature the researcher found that dental anxiety affects patient compliance, their overall health, and willingness to attend regular dental visits. The purpose of this …