Pain Management Commons^™

Sleeping With The Enemy: Examining The Relationship Between Sleep And Pain In Post-9/11 Veterans, John L. Schwartz Jr.

Psychology Theses & Dissertations

United States veterans are a diverse group of individuals, yet as a result of their service, they share a unique set of customs, traditions, and values. Post-9/11 veterans are more likely to experience elevated levels of pain and poor sleep quality compared to their civilian counterparts; however, little is known about how beliefs related to veterans’ pain impact their sleep and how levels of pain acceptance influence the sleep-pain association. This study examined relationships between sleep and pain in a sample of 102 post-9/11 veterans. Results support associations between pain and sleep identified in other populations. Positive correlations were found …

The Subcomponents Of Affect Scale (Sas): Validating A Widely Used Affect Scale, Brooke N. Jenkins, Marie P. Cross, Candice Donaldson, Sarah D. Pressman, Michelle A. Fortier, Zeev N. Kain, Sheldon Cohen, Logan T. Martin, George Farkas

Psychology Faculty Articles and Research

Objective

There is a need for a brief affect scale that also encompasses different components of affect relevant for researchers interested in physiological and health outcomes. The Subcomponents of Affect Scale (SAS) meets this need. This 18-item scale has nine positive and nine negative affect items encompassing six subscales (calm, well-being, vigour, depression, anxiety, anger). Previous research using the SAS has demonstrated its predictive validity, but no work has tested its subscale structure or longitudinal validity.

Design

Data from the Common Cold Project in which individuals (N = 610) completed the SAS over the course of seven days were used. …

Shu Altop News Issue #4, Fall, Dr. Susan L. Davis, Rn & Richard J. Henley College Of Nursing

News, Magazines and Reports

Updates from the Davis & Henley College of Nursing Sacred Heart University Alternatives to Opioids for Pain Grant.

Alternatives to Opioids for Pain (ALTOP) is a HRSA funded project to help combat the opioid epidemic in Connecticut.

In this issue: • New Roles in Our Team • ANEW HRSA 2021-2022 Awardees • Southwest Community Health Center Chiropractic Care Services • Student Quality Improvement Project • Sacred Heart University Alumni Working at New Solutions Pain Management Clinic.

Black And White Health Disparities: Racial Bias In American Healthcare, Yasmeen Almomani

Bridges: An Undergraduate Journal of Contemporary Connections

This paper explores the historical implications of race in American society that have led to implicit racism in the healthcare system. Racial bias in healthcare against Black people is a factor in the health disparities between Black and white people in America, such as the gap in life expectancy, infant death, and maternal mortality. Black people are more likely to report racial discrimination from healthcare providers, which is a reason for the decreased quality of care received. The past justifications of slavery, the Tuskegee syphilis study, and the medical experimentations on Black women are horrifying but were considered acceptable in …

An Investigation Of Occupational Therapy Utilizing Sensory Modulation To Manage Co-Morbid Chronic Pain And Substance Use In Order To Promote Occupational Performance And Recovery, Claire Ruth

Student Capstone Papers

Background: Those with chronic pain have worse drug and alcohol treatment outcomes and higher rates of relapse compared to those without pain or with reduced pain (Ilgen et al., 2020).

Methods: A descriptive study was employed with the aim of determining what are the sensory processing pattens of those with co-morbid chronic pain and in recovery for substance use. All participants completed the Adolescent and Adult Sensory Profile, the Brief Pain Inventory, and the Personal Recovery Outcome Measure (PROM).

Results: From the preliminary findings, individuals with co-morbid chronic pain and substance use may have atypical sensory processing …

Shu Altop News Issue #3, Summer, Dr. Susan L. Davis, Rn & Richard J. Henley College Of Nursing

News, Magazines and Reports

Updates from the Davis & Henley College of Nursing Sacred Heart University Alternatives to Opioids for Pain Grant.

Alternatives to Opioids for Pain (ALTOP) is a HRSA funded project to help combat the opioid epidemic in Connecticut.

Post-Operative Pain Management Modalities Employed In Clinical Trials For Adult Patients In Lmic; A Systematic Review, Gauhar Afshan, Robyna Irshad Khan, Aliya Ahmed, Ali Sarfraz Siddiqui, Azhar Rehman, Syed Amir Raza, Rozina Kerai, Khawaja Mustafa

Department of Anaesthesia

Background: Unrelieved postoperative pain afflicts millions each year in low and middle income countries (LMIC). Despite substantial advances in the study of pain, this area remains neglected. Current systematic review was designed to ascertain the types of clinical trials conducted in LMIC on postoperative pain management modalities over the last decade.
Methods: A comprehensive search was performed in June 2019 on PubMed, Cochrane Library, CINAHL Plus, and Web of Science databases to identify relevant trials on the management of postoperative pain in LMIC. Out of 1450 RCTs, 108 studies were reviewed for quality evidence using structured form of critical appraisal …

The Effectiveness Of Art Therapy As A Treatment Modality In Improving Quality Of Life For Adults With Chronic Pain, Kayley Nelson

Expressive Therapies Capstone Theses

The efficacy of art therapy is explored in the context of improving the quality of life and mental health of individuals experiencing chronic pain. The exploration and examination of previous research on chronic pain and art therapy have led to various interconnected themes that tie together the needs of this population with the healing aspects of this treatment method. Through gathering data on both the negative impact of chronic pain and the healing aspects of art therapy and exploring research on chronic pain art therapy groups already in action, it can be deduced that future research may further illuminate the …

Knowing What We Know: Leveraging Community Knowledge Through Automated Text-Mining, Justin Gardner, Jonathan Tory Toole, Hemant Kalia, Garry Spink Jr., Gordon Broderick

Advances in Clinical Medical Research and Healthcare Delivery

No abstract provided.

Reiki For Recovery: Incorporating Japanese Health Practices To Increase Contemporary Resiliency In American Health, Leif Peterson

Master's Projects and Capstones

The Japanese health practice of Reiki attempts to maximize the latent ability of the human system to heal itself. The Reiki system, established over a century ago, combines multiple Asian health traditions, experimenting with practices that maximize the natural processes of the body to perform its own repairs. Reiki encourages healthy behaviors that balance the mind and body, return the human system to a lowered stress level, and allow for an optimal recovery state for the patient. This paper illustrates how this Japanese health-affirming method can be integrated and utilized within existing health and medical practices. An area that is …

The Use Of Mindfulness Meditation To Increase The Efficacy Of Mirror Visual Feedback For Reducing Phantom Limb Pain In Amputees, Nicolas Sebastian Mills

Doctoral Dissertations

Phantom limb pain is a chronic pain condition that negatively impacts the lives of over half of amputees, and results in considerable morbidity. Currently, there is no gold standard for treatment for phantom limb pain. However, a frequently used intervention is the use of mirror visual feedback, in which the amputee watches the reflection of the adjacent non-amputated limb move and exercise. In the last few decades, mindfulness-based interventions have been increasingly used with individuals living with different types of chronic pain. This study attempts to discover if the addition of a mindfulness-based intervention, such as guided meditation, will augment …

Emotional And Social Functioning Of Parents Of Youth Presenting For Intensive Interdisciplinary Pain Treatment, Jenny Scheurich

Research Days

Background: Parents of youth with chronic pain experience significant emotional distress and social difficulties, and in turn, their distress impacts the health and functioning of youth with chronic pain. However, few studies have examined the specific emotional and social needs of these parents, and even fewer have tested intervention strategies specifically targeting these needs. Intensive interdisciplinary pain treatment (IIPT) for youth with chronic pain leads to improvement in the youth’s physical and mental health and has been associated with reduced anxiety and depression in parents. IIPT often include treatment modules aimed at parental pain management strategies, such as psychoeducation, parent …

Understanding Illness Encouragement And Pain Acceptance In Pediatric Patients With Abdominal Pain, Scott Wagoner

Research Days

Background: Parents can respond to their child’s abdominal pain in a variety of ways, and parental illness encouragement (e.g., spoiling, letting child stay home from school) is known to relate to longer periods of illness. Modeling and reinforcement of the “sick role” has been used to explain these processes. Many pediatric patients with abdominal pain will continue to experience symptoms in adulthood, so having a full understanding of what pain management techniques patients adopt is crucial. This study explored the impact of parental illness encouragement on how patients engage in valued activities (i.e., activity engagement) and prioritize controlling their pain …

Sex As A Moderator In The Relationship Between Post-Operative Pain And Analgesics Administered In Children Undergoing Elective Surgery, Amber M. Osorno, Michelle A. Fortier, Zeev N. Kain, Brooke N. Jenkins

Student Scholar Symposium Abstracts and Posters

About 85% of children who undergo elective surgery experience pain post-operatively and many do not receive proper pain management care after discharge. Most parents lack an understanding of proper pain care management using analgesics upon discharge. Research reveals that adults rate girls as more sensitive to pain and that they display a greater amount of pain in a pediatric post-operative environment. In adulthood, women report more sensations of pain and have a higher pain tolerance, which can be attributed to physiological characteristics. Nonetheless, the social differences by which boys and girls experience pain and express their pain cannot be denied. …

Effects Of Sleep On Intrusive Symptoms And Emotional Reactivity In A Laboratory-Based Film Analog Study, Anna Marie Thi Thanh Nguyen

Graduate Theses and Dissertations

Posttraumatic stress disorder (PTSD) is characterized by four symptom clusters. Recently, research highlights the need to focus on the impact of intrusive symptoms as a possible risk factor for the development and maintenance of PTSD. Cognitive and sleep models contribute to further understanding of intrusive symptoms. Recent work also highlights disgust as an emotion closely associated with the emergence of posttraumatic stress symptomology following traumatic events. This study used a film eliciting disgust in order to examine the effects of sleep on the intensity of intrusion symptoms and emotion reactivity. The sample consisted of 49 college students randomly assigned to …

Prospective Patient-Reported Symptom Profiles Associated With Pediatric Acute Lymphoblastic Leukemia Relapse, Austin L Brown, Kimberly P Raghubar, Olga A Taylor, Melanie Brooke Bernhardt, Lisa S Kahalley, Wei Pan, Philip J Lupo, Marilyn J Hockenberry, Michael E Scheurer

Faculty, Staff and Students Publications

PURPOSE: Despite improvements in frontline pediatric acute lymphoblastic leukemia (ALL) treatment, relapse remains a concern. Research in adult cancer patients suggests that patient-reported symptoms may predict survival, but the relationship between symptoms and relapse for pediatric ALL has received little attention.

METHODS: Pediatric patients with ALL (age 2-18 years) and/or their primary caregivers completed symptom surveys at the end of induction, start of delayed intensification (DI), start of maintenance cycle 1 (MC1), and start of maintenance cycle 2 (MC2). Symptom clusters for co-occurring fatigue, pain, sleep disruptions, and nausea were defined using latent profile analysis. Hazard ratios (HR) and 95% …

A Systematic Review And Meta-Analysis On The Efficacy Of Repeated Transcranial Direct Current Stimulation For Migraine, Guoshuai Cai, Zhu Xia, Leigh Charvet, Feifei Xiao, Abhishek Datta, X Michelle Androulakis

Publications and Research

Purpose: Transcranial direct current stimulation (tDCS) may have therapeutic potential in the management of migraine. However, studies to date have yielded conflicting results. We reviewed studies using repeated tDCS for longer than 4 weeks in migraine treatment, and performed meta-analysis on the efficacy of tDCS in migraine.

Methods: In this meta-analysis, we included the common outcome measurements reported across randomized controlled trials (RCTs). Subgroup analysis was performed at different post-treatment endpoints, and with different stimulation intensities and polarities.

Results: Five RCTs were included in the quantitative meta-analysis with a total of 104 migraine patients. We found a significant reduction of …

Experience Of Loss And Resilience In Persons With Chronic Pain, Lauren Abshire

Doctor of Psychology (PsyD)

Chronic pain is one of the most common concerns people seek medical treatment for, yet it is historically difficult to treat. The current best evidence practice in chronic pain treatment is through a multidisciplinary team with psychologists implementing cognitive behavioral therapy or acceptance commitment therapy. These approaches are efficacious in decreasing pain-related behaviors and improving mood and quality of life. Resilience has also been shown to mitigate the impact of chronic pain. However, the sense of loss or grief related to the experience of chronic pain has been inadequately explored in the research literature and may be related to poor …

Sickle Cell Disease: Development Of An Acute Pain Management Program In A Hematology/Oncology Practice, Elizabeth Pohl

Doctoral Projects

Background: Patients with sickle cell disease experience can experience acute episodes of severe pain that require prompt pain medication. Treating uncomplicated, acute sickle cell disease pain in the emergency department setting has been shown to be costly and lead to higher rates of hospitalization than similar care in a dedicated outpatient setting.

Objectives: The aim of this article is to outline the program development efforts undertaken to apply current literature findings and evidence-based practice guidelines to create a program development toolkit and business plan for a sickle cell disease acute pain management program in an outpatient hematology practice.

Methods: A …

The Association Between Type-2 Diabetes Pathophysiology & Exercise Adherence, Sydney Raymond

Senior Honors Projects

According to the American Diabetes Association, 1 in 3 Americans will be diagnosed with diabetes. While some of these individuals will be prescribed medications as part of their treatment, most will also be advised to begin an exercise program to assist with blood glucose control. Additionally, while regular exercise is associated with lower HbA1C and decreased insulin/medication dependence, it is estimated that only about half of those diagnosed with diabetes will adhere to their exercise plans. Social, psychological, and physiological factors all play roles in affecting ones ability to adhere to an exercise regiment, and individuals with Type 2 Diabetes …

Mechanisms, Diagnosis, Prevention And Management Of Perioperative Opioid-Induced Hyperalgesia, Sylvia H Wilson, Kevin M Hellman, Dominika James, Adam C Adler, Arvind Chandrakantan

Faculty, Staff and Students Publications

Opioid-induced hyperalgesia (OIH) occurs when opioids paradoxically enhance the pain they are prescribed to ameliorate. To address a lack of perioperative awareness, we present an educational review of clinically relevant aspects of the disorder. Although the mechanisms of OIH are thought to primarily involve medullary descending pathways, it is likely multifactorial with several relevant therapeutic targets. We provide a suggested clinical definition and directions for clinical differentiation of OIH from other diagnoses, as this may be confusing but is germane to appropriate management. Finally, we discuss prevention including patient education and analgesic management choices. As prevention may serve as the …

Super Placebos: A Feasibility Study Combining Contextual Factors To Promote Placebo Effects, Jay A. Olson, Michael Lifshitz, Amir Raz, Samuel P. L. Veissière

Psychology Faculty Articles and Research

Background: Ample evidence demonstrates that placebo effects are modulated by contextual factors. Few interventions, however, attempt to combine a broad range of these factors. Here, we explore the therapeutic power of placebos by leveraging factors including social proof, positive suggestion, and social learning. This study aimed to test the feasibility of an elaborate “super placebo” intervention to reduce symptoms of various disorders in a pediatric population.

Methods: In a single-arm qualitative study, participants entered an inactive MRI scanner which they were told could help their brain heal itself through the power of suggestion. The sample included 11 children (6–13 years …

Anxiety And Mood Disorders Impacting Physician Opioid Prescribing In The Pediatric Hospital Setting, Candice D. Donaldson, Zeev N. Kain, Louis Ehwerhemuepha, Michelle A. Fortier, Michael T. Phan, Daniel M. Tomaszewski, Sun Yang, William Feaster, Brooke N. Jenkins

Psychology Faculty Articles and Research

This research examined whether pediatric inpatients without an anxiety/mood disorder are more likely to receive opioids in response to pain compared to patients diagnosed with a mental health condition. Research questions were tested using cross-sectional inpatient electronic medical record data. Propensity score matching was used to match patients with a disorder with patients without the disorder (anxiety analyses: N = 2892; mood analyses: N = 1042). Although patients with anxiety and mood disorders experienced greater pain, physicians were less likely to order opioids for these patients. Analyses also disclosed an interaction of anxiety with pain—the pain-opioid relation was stronger for …

Shu Altop News Issue #2, Spring, Dr. Susan L. Davis, Rn & Richard J. Henley College Of Nursing

News, Magazines and Reports

Updates from the Davis & Henley College of Nursing Sacred Heart University Alternatives to Opioids for Pain Grant.

Alternatives to Opioids for Pain (ALTOP) is a HRSA funded project to help combat the opioid epidemic in Connecticut.

Medical Knowledge As A Recalcitrant Epistemological System: An Application Of Standpoint Epistemology In The Analysis Of Marginalization Within U.S Healthcare, Abby Deshazo

CMC Senior Theses

Research on healthcare disparities outside the field of epistemology tend to miss the true origins of oppressions imposed on marginalized individuals by the U.S healthcare system. This happens because of the false belief that these oppressions are reducible to social or political oppressions. By employing the perspective of a standpoint epistemologist, we can better identify the origins of these oppressions and subsequently consider more appropriate solutions. The standpoint epistemologist’s perspective (1) provides an intuitive case for the role individuals’ schemas play in the evaluation of what healthcare professionals know; (2) situates medical knowledge within epistemology, leading us to …

A One-Session, Brief Acceptance And Commitment Therapy Workshop For Chronic Pain Patients: A One-Sample Pretest-Posttest Prospective Exploratory Study, Kelly Anne Thomas Ms

Graduate Theses, Dissertations, and Problem Reports (ETD)

Chronic pain affects one in every four persons (NIH, 2010). For individuals residing in rural communities where chronic pain treatment is often not accessible (Artnak et al., 2011), a one-session brief mental health intervention is a critical healthcare need. More specifically, acceptance and commitment therapy (ACT) for chronic pain is a novel treatment approach in need of more research (Society of Clinical Psychology, 2016). This current study contributes to the gap in the literature by implementing an ACT workshop in a rural healthcare setting for individuals with chronic pain. It was hypothesized that the workshop would increase adaptive coping mechanisms …

Interscalene Block For Analgesia In Orthopedic Treatment Of Shoulder Trauma: Single-Dose Liposomal Bupivacaine Versus Perineural Catheter, Andrzej P Kwater, Nadia Hernandez, Carlos Artime, Johanna Blair De Haan

Faculty, Staff and Student Publications

BACKGROUND: Interscalene brachial plexus block is frequently utilized to provide perioperative analgesia to patients undergoing shoulder surgery to optimize recovery, minimize opioid consumption, and decrease overall hospital length of stay. The use of an indwelling perineural interscalene catheter provides extended analgesia and is efficacious in managing severe postoperative pain following major shoulder surgery. Currently, the only alternative to perineural catheters for extended analgesia with interscalene block involves the perineural infiltration of liposomal bupivacaine. However, there is limited published data regarding the overall analgesic effectiveness of using interscalene liposomal bupivacaine in the setting of shoulder surgery.

METHODS: We performed a retrospective …

Buprenorphine For Chronic Pain: A Safer Alternative To Traditional Opioids, Suhani Dalal, Ahish Chitneni, Amnon A Berger, Vwaire Orhurhu, Bilal Dar, Bennett Kramer, Anvinh Nguyen, John Pruit, Charles Halsted, Alan D Kaye, Jamal Hasoon

Faculty, Staff and Students Publications

With the ongoing public health crisis with prescription opioids, there is a need for safer alternatives for medication management in chronic pain patients. Buprenorphine is a partial mu-opioid agonist which is commonly utilized to treat patients with opioid-use disorders. The purpose of this review is to discuss the potential use of this medication for the treatment of chronic pain instead of resorting to more traditional Schedule II opioids. Buprenorphine offers a safer alternative for patients who require opioids to manage chronic pain, given the unique pharmacological properties that allow it to provide adequate analgesia with less abuse potential.