Pain Management Commons^™

The Effect Of The Implementation Of A Quarterly Triad Tool In The Pain Clinic Setting On The Assessment And Mitigation Of Risks In Patients On Chronic Opioid Therapy, Caroline Asava

Evidence-Based Practice Project Reports

The concurrent use of opioids and benzodiazepines (BZDs poses a formidable challenge for clinicians who manage chronic pain. While the escalating use of opioid analgesics for the treatment of chronic pain and the concomitant rise in opioid-related abuse and misuse are widely recognized trends, the contribution of combination use of BZDs, alcohol, and/or other sedative agents to opioid-related morbidity and mortality is underappreciated, even when these agents are used appropriately. Patients with chronic pain who use opioid analgesics along with BZDs have a defined increase in rates of adverse events, overdose, and death, warranting close monitoring. To improve patient outcomes, …

Pain-Related Fear: Metacognitive And Health Belief Predictors Of Cogniphobia, Maddison Miles

Masters Theses, 2010-2019

Individuals who have an unreasonable fear of headache pain or painful re-injury during cognitive exertion are said to suffer from a pain-related fear referred to as cogniphobia. Specifically, individuals high in cogniphobia avoid cognitive tasks in an attempt to reduce the risk of initiating or exacerbating headache-related pain. While health beliefs concerning pain-related fear have been examined through the concept of kinesiophobia, defined as the unreasonable fear of pain or painful re-injury during physical movement, little research has been done through a cognitive framework. The health anxiety beliefs, metacognitive factors, and negative thinking patterns related to cogniphobia remain unclear. This …

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 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.

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 …

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 …

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

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 …

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

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, …

Development Of The State Optimism Measure, Rachel A. Millstein, Wei-Jean Chung, Bettina B. Hoeppner, Julia K. Boehm, Sean R. Legler, Carol A. Mastromauro, Jeff C. Huffman

Psychology Faculty Articles and Research

Background

Optimism, or positive expectations about the future, is associated with better health. It is commonly assessed as a trait, but it may change over time and circumstance. Accordingly, we developed a measure of state optimism.

Methods

An initial 29-item pool was generated based on literature reviews and expert consultations. It was administered to three samples: sample 1 was a general healthy population (n = 136), sample 2 was people with cardiac disease (n = 96), and sample 3 was persons recovering from problematic substance use (n = 265). Exploratory factor analysis and item-level descriptive statistics were used to select …

Influence Of Biomedical Risk Factors On Chronic Low Back Pain Among Women, Jennifer Kawi

Nursing Faculty Publications

Purpose Nurses and nurse practitioners are highly involved in managing patients with chronic low back pain (CLBP). Management remains challenging with persistent biomedical risk factors (e.g, high opioid use, Body Mass Index [BMI], chronic widespread pain). Due to pervasive pain care disparities among women, this quantitative pilot study evaluated biomedical risk factors among adult females with CLBP. Findings can assist in targeting risk factors to help address known undertreatment of pain in women. Methods This IRB-approved, descriptive, and cross-sectional study was conducted in a pain center to identify significant associations of relevant biomedical factors with pain/pain-related variables. Self-report questionnaires were …

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 …

Trespassing Physical Boundaries: Transgression, Vulnerability And Resistance In Sarah Kane’S Blasted (1995), Paula Barba Guerrero, Ana Mª Manzanas Calvo

CLCWeb: Comparative Literature and Culture

Sarah Kane’s Blasted has been analyzed from various perspectives that address the layers of destruction it exposes. From the questioning of its title and meaning, to the unravelling of the protagonists’ abusive relationship, the analyses have emphasized the depiction of vulnerability as the defining human trait that Jean Ganteau observes in contemporary British literature. However, a key aspect has been overlooked in the critical response to the play: for Kane vulnerability does not equal helplessness, but rather stands in opposition to it. Hence, this article concentrates on how Blasted formulates a new understanding of vulnerability that fits Judith Butler’s later …

How Hugging Mom Teaches Me The Meaning Of Love And Perhaps Beyond, Ethan Trinh

The Journal of Faith, Education, and Community

Hugging mom is unconventional in a traditional Vietnamese family. I write this piece to articulate my thoughts to describe different ways to look at the meanings of hugging. During my writing process, I use a walking meditation as a Buddhist practice to calm my mind so that I can see my true self and a clearer picture of different layers of the act of hugging. I believe hegemonic gender roles and patriarchy happen everywhere in the world, not particularly in Vietnam. I do not plan to devalue my home country’s cultural values in this paper. This is not the purpose …

Coping With Medically Unexplained Physical Symptoms: The Role Of Illness Beliefs And Behaviors, Lisa M. Mcandrew, Nicole Sullivan, L. Alison Phillips, Wilfred R. Pigeon, Karen S. Quigley, Fiona Graff, David R. Litke, Drew A. Helmer, Joseph F. Rath

Educational & Counseling Psychology Faculty Scholarship

Background: Medically unexplained syndromes (MUS) are both prevalent and disabling. While illness beliefs and behaviors are thought to maintain MUS-related disability, little is known about which specific behavioral responses to MUS are related to disability or the way in which beliefs and behaviors interact to impact functioning. The purpose of the present study was to examine the relationship between illness beliefs and disability among patients with MUS, and assess the extent to which behaviors mediate this relationship. Methods: The study examined data from the baseline assessment of a multi-site randomized controlled trial (RCT). Participants were 248 veterans with MUS. Illness …

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 …

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

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 …

Psychological And Family Variables Associated With The Treatment Of Pediatric Idiopathic Pain, Rachael Hoffman

Electronic Theses and Dissertations

The present study examined variability in treatment outcomes of children with idiopathic chronic pain. Specifically, the biopsychosocial model was used as a framework to consider the way that symptoms of depression and anxiety as well as parent response to pain contributed to the change in a child’s confidence in participating in daily activities following treatment in an inpatient chronic pain treatment program.