Pain Management Commons^™

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.

And The Stars Look Very Different Today, Amy Rogin

The Transdisciplinary STEAM+ Journal

A personal reflection about synesthesia

Keep Calm Or Get Excited? Examining The Effects Of Different Types Of Positive Affect On Responses To Acute Pain, Amanda M. Acevedo, Kate A. Leger, Brooke N. Jenkins, Sarah D. Pressman

Psychology Faculty Articles and Research

Researchers typically assume that all forms of positive affect (PA) are equally beneficial for attenuating the physiological stress response. We tested whether this association is more nuanced by examining the role of arousal level of PA on physiological responses to acute pain. Participants (N = 283, 75.6% female, M_age = 20.6) were randomized to a low, mid, or high arousal (calm, happy, and excited, respectively) induction condition or to a neutral control and then completed an acute pain-inducing cold pressor task. Sympathetic and parasympathetic responses along with self-reported pain and distress were assessed. Results indicated that the calm condition …

Nursing Students’ Knowledge And Attitudes About Pain Management And Opioids, Hedieh Hatami Sirjani

Health Services Research Dissertations

Statement of the problem: healthcare professionals’ knowledge of using opioids for pain management safely is critical in preventing opioid abuse and overdose. Undergraduate curricula of health professional schools, including undergraduate nursing programs, need to improve and adopt a comprehensive education regarding this issue.

Method: the first project was a systematic analysis of the literature regarding the educational interventions’ impact on healthcare professional knowledge and practice behavior regarding prescription opioids. The second project was a qualitative study of nursing students to explore their experience, self-efficacy, and knowledge of prescription opioid use for pain management and whether they feel the need for …

Spinal Cord Injury Provider Knowledge And Attitudes Toward Bacteriuria Management And Antibiotic Stewardship, Felicia Skelton, Sarah May, Larissa Grigoryan, Ivy Poon, Sally Ann Holmes, Lindsey Martin, Barbara W Trautner

Faculty, Staff and Students Publications

INTRODUCTION: Bacteriuria, either asymptomatic or urinary tract infection, is common in persons with spinal cord injury or disorder (SCI/D). In the Veterans Health Administration (VHA), conflicting clinical practice guidelines make appropriate bacteriuria management and antibiotic stewardship challenging.

OBJECTIVE: To explore SCI/D provider knowledge, attitudes, and teamwork around bacteriuria management during the VHA SCI/D annual examination.

DESIGN: Mixed methods.

SETTING: VHA SCI/D centers.

PARTICIPANTS: SCI/D staff providers and physical medicine and rehabilitation resident physicians.

MAIN OUTCOME MEASUREMENTS: Knowledge, safety, and teamwork scores on bacteriuria management using a validated questionnaire. Themes on barriers and facilitators to bacteriuria management during the SCI/D annual …

The Impact Of Parental Health Mindset On Postoperative Recovery In Children, Alexandra Kain, Claudia Mueller, Brenda J. Goliamu, Brooke N. Jenkins, Michelle A. Fortier

Psychology Faculty Articles and Research

Background

Mindset, or one’s beliefs about the ability to change one’s outcomes, has been studied in the educational domain but not in surgical settings. The purpose of this study was to examine the role of parental health mindset on children’s recovery.

Methods

Participants were part of a larger National Institutes of Health‐funded trial that included 1470 children undergoing outpatient tonsillectomy and adenoidectomy. We used measures of parental coping style (Monitor Blunter Style Scale; MBSS) and medication attitudes (Medication Attitudes Questionnaire; MAQ) to validate the Health Beliefs Scale (HBS; Criterion validity, Cohen’s kappa). HBS categorizes parents as having a growth mindset, …

Race, Ethnicity, And Insurance: The Association With Opioid Use In A Pediatric Hospital Setting, Louis Ehwerhemuepha, Candice D. Donaldson, Zeev N. Kain, Vivian Luong, Michelle A. Fortier, William Feaster, Michael Weiss, Daniel Tomaszewski, Sun Yang, Michael Phan, Brooke N. Jenkins

Psychology Faculty Articles and Research

Background

This study examined the association between race/ethnicity and health insurance payer type with pediatric opioid and non-opioid ordering in an inpatient hospital setting.

Methods

Cross-sectional inpatient encounter data from June 2013 to June 2018 was retrieved from a pediatric children’s hospital in Southern California (N = 55,944), and statistical analyses were performed to determine associations with opioid ordering.

Results

There was a significant main effect of race/ethnicity on opioid and non-opioid orders. Physicians ordered significantly fewer opioid medications, but a greater number of non-opioid medications, for non-Hispanic African American children than non-Hispanic Asian, Hispanic/Latinx, and non-Hispanic White pediatric …

Parent Responses To Pediatric Pain: The Differential Effects Of Ethnicity On Opioid Consumption, Candice D. Donaldson, Brooke N. Jenkins, Michelle A. Fortier, Michael T. Phan, Daniel M. Tomaszewski, Sun Yang, Zeev N. Kain

Psychology Faculty Articles and Research

Objective

Within the context of the United States opioid epidemic, some parents often fear the use of opioids to help manage their children's postoperative pain. As a possible consequence, parents often do not dispense optimal analgesic medications to their children after surgery, putting their children at risk of suffering from postsurgical pain. The objective of this research was to assess ethnicity as a predictor of both pain and opioid consumption, and to examine how Hispanic/Latinx and Non-Hispanic White parents alter their child's opioid consumption in response to significant postsurgical pain.

Methods

Participants were 254 children undergoing outpatient tonsillectomy and/or adenoidectomy …

A Pilot Study Of The Preliminary Efficacy Of Pain Buddy: A Novel Intervention For The Management Of Children’S Cancer-Related Pain, John F. Hunter, Amanda M. Acevedo, Sergio Gago-Masague, Alexandra Kain, Christine Yun, Lilibeth Torno, Brooke N. Jenkins, Michelle A. Fortier

Psychology Faculty Articles and Research

Objectives

Cancer‐related pain in children is prevalent and undermanaged. Mobile health (mHealth) applications provide a promising avenue to address the gap in pain management in children with cancer. Pain Buddy is a multicomponent mHealth application developed to manage cancer‐related pain in children. The goal of this paper is to present preliminary efficacy data of the impact of Pain Buddy on children's pain severity and frequency.

Methods

In a randomized controlled trial over 60 days, children (N = 48) reported daily pain on a tablet while receiving usual care. Those in the intervention group (N = 20) received remote …

Creatively Exploring Self: Applying Organic Inquiry, A Transpersonal And Intuitive Methodology, Larisa J. Bardsley Phd

The Qualitative Report

This article explores the merit of using Organic Inquiry, a qualitative research approach that is most effectively applied to areas of psychological and spiritual growth. Organic Inquiry is a research approach where the psyche of the researcher becomes the instrument of the research, working in partnership with the experiences of participants and guided by liminal and spiritual influences. Organic Inquiry is presented as a unique methodology that can incorporate other non-traditional research methods, including intuitive, autoethnographic and creative techniques. The validity and application of Organic Inquiry, as well as its strengths and limitations are discussed in the light of the …

Role Of Micro-Rna For Pain After Surgery: Narrative Review Of Animal And Human Studies, Juan P Cata, Aysegul Gorur, Xiaoyi Yuan, Nathaniel K Berg, Anil K Sood, Holger K Eltzschig

Faculty, Staff and Student Publications

One of the most prevalent symptoms after major surgery is pain. When postoperative pain treatment is unsatisfactory, it can lead to poor surgical recovery, decreased quality of life, and increased health care costs. Current analgesics, single or in combination, have limited efficacy due to low potency, limited duration of action, toxicities, and risk of addiction. The lack of nonaddictive strong analgesics along with the over prescription of opioids has led to an opioid epidemic in the United States. Therefore, there is an urgent need for the development of newer analgesics. Microribonucleic acids (miRNAs) are small noncoding RNA molecules that modulate …

Student Wellbeing And Open Studio Process In The School Curriculum, Maria Kim

Expressive Therapies Dissertations

This study aimed to explore whether Open Studio Process (OSP) increased wellbeing of middle and high school students when facilitated by teachers as a part of the regular art curriculum. It was hypothesized that OSP might increase the sense of wellbeing among middle and high school students as well as facilitating teachers. The research was conducted as a mixed methods study in South Korea where students need preventative interventions for their wellbeing. The researcher trained eight teachers to facilitate OSP and five of them implemented it with their classes for seven sessions. Quantitative data (K-YSR; pre- and posttest) were collected …

Imaginary Grave, Bailey M. Tennery

Toyon: Multilingual Literary Magazine

I posted the work on my Wordpress blog Cinder-Bay.

https://cinderbay.wordpress.com/2018/01/08/pretend-grave/

Yes, I have permission to re-publish the work in Toyon because the blog is my personal site.

Art And The Pursuit Of Happiness: How Artists Use Art To Promote Their Emotional Well-Being, August Namuth, Bruce Chase

Theses/Capstones/Creative Projects

Artists have used art’s positive mental and physical health effects for as long as art has been around. Art is known to have many therapeutic and mood benefiting effects, from reduced anxiety and stress levels, to increased confidence and a sense of purpose. Many different clinical studies have found art to be beneficial to people who have suffered from PTSD, bipolar disorder, strokes, and cancer pain. Despite the clearly beneficial effects of creativity associated with art, artists suffer from disorders such as depression, bipolar disorder, and schizophrenia at a much higher rate than the general population. This study sought to …

Pediatric Postoperative Pain Medication: Child Sex And Ethnicity Interact To Predict Parent Medication Attitudes, Vivian Luong, Harshitha V. Venkatesh, Michelle Fortier, Zeev N. Kain, Brooke N. Jenkins

Student Scholar Symposium Abstracts and Posters

Over 85% of children experience significant pain after surgery. Despite this presence of pain, research suggests that a quarter of these children receive very little or even no pain medication at home. Such poor pain management in children can have harmful long-term consequences, both physically and psychologically. Previous research indicates that the amount of pain medication administered to children in the home may be significantly impacted by beliefs and attitudes parents have regarding analgesics. Given this, the purpose of the present study is to identify which demographic factors are associated with certain parent analgesic attitudes or misconceptions among pediatric patients …

Spiritual And Religious Interventions For Medically High-Risk Adults: A Systematic Review, Nathanael J. Strissel

Senior Honors Theses

This systematic review is an update and expansion to the population and methods of a previous systematic review concerning spiritual and religious interventions for the well-being of terminally ill adults. After expanding the criteria to incorporate a more diverse population and including non-randomized experimental studies that contained relatively few concerns of bias, the results of the review are inconclusive due to insufficient data. The lack of usable data in the field highlights the ethical and theoretical issues with the use of experimental trials in analyzing the efficacy of spiritual and religious interventions. The development of spirituality in healthcare will remain …

Shu Altop News, Vol. 1, Dr. Susan L. Davis, Rn & Richard J. Henley College Of Nursing, Susan M. Denisco, Kerry A. Milner

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. Through the creation and support of academic clinical practice partnerships at two federally qualified health centers, family nurse practitioner students are gaining clinical training and experience in the appropriate use of opioids and alternative pain modalities, in primary care settings. This project directly benefits the medically underserved areas in Bridgeport.

In Vitro And In Vivo Effects Of Flavonoids On Peripheral Neuropathic Pain, Paramita Basu, Arpita Basu

Kinesiology and Nutrition Sciences Faculty Research

Neuropathic pain is a common symptom and is associated with an impaired quality of life. It is caused by the lesion or disease of the somatosensory system. Neuropathic pain syndromes can be subdivided into two categories: central and peripheral neuropathic pain. The present review highlights the peripheral neuropathic models, including spared nerve injury, spinal nerve ligation, partial sciatic nerve injury, diabetes-induced neuropathy, chemotherapy-induced neuropathy, chronic constriction injury, and related conditions. The drugs which are currently used to attenuate peripheral neuropathy, such as antidepressants, anticonvulsants, baclofen, and clonidine, are associated with adverse side effects. These negative side effects necessitate the investigation …

The Phenomenology Of Pain, Saulius Geniusas

Ohio University Press Open Access Books

The Phenomenology of Pain is the first book-length investigation of its topic to appear in English. Groundbreaking, systematic, and illuminating, it opens a dialogue between phenomenology and such disciplines as cognitive science and cultural anthropology to argue that science alone cannot clarify the nature of pain experience without incorporating a phenomenological approach. Building on this premise, Saulius Geniusas develops a novel conception of pain grounded in phenomenological principles: pain is an aversive bodily feeling with a distinct experiential quality, which can only be given in original first-hand experience, either as a feeling-sensation or as an emotion.

Geniusas crystallizes the fundamental …

Doctor Recommendations Are Related To Patient Interest And Use Of Behavioral Treatment For Chronic Pain And Addiction, Lisa M. Mcandrew, Alexandria Brunkow, Margeaux Cannon, Fiona S. Graff, Jessica L. Martin, Leslie R.M. Hausmann

Educational & Counseling Psychology Faculty Scholarship

The opioid crisis has highlighted the importance of improving patients’ access to behavioral treatments for chronic pain and addiction. What is not known is if patients are interested in receiving these treatments. In this cross-sectional study, over 1000 participants with chronic pain were surveyed using an anonymous online questionnaire on Amazon Mechanical Turk (Mturk) to investigate participants’ use of and interest in pharmacological and behavioral treatments for chronic pain and addiction. Participants also indicated whether their doctor had recommended these treatments. The majority of participants reported using medication for their pain (83.19%) and that their doctor recommended medication (85.05%), whereas …

The Impact Of Virtual Reality On Chronic Pain, Alexis Whitehead

Honors Undergraduate Theses

Chronic pain remains a prevalent problem across the United States. Chronic pain does not seem to have a function and relief of this symptom remains elusive for many sufferers. Virtual reality has been used as an adjunct therapy to decrease acute pain with promising results, but there is little research on whether virtual reality could be used as a successful intervention for those with chronic pain. Virtual reality has few side effects, so it warrants consideration for the treatment of chronic pain. There is growing evidence that there is potential for virtual reality to produce desired results with patients having …