Pain
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The need to document cost-benefit of comprehensive work rehabilitation services represents a critical requirement for its long-term viability as a treatment option for injured workers. One approach to improving cost-benefit is to identify patients who experience difficulty completing a rigorous goal-oriented treatment approach. This study examined a set of psychological, pain, perceived work environment, and patient expectation measures in order to determine whether such factors were associated with failure to complete rehabilitation. ⋯ In addition, this group was significantly younger and had been out of work longer. The groups did not differ on gender, marital status, ICD-9 diagnoses or perceived work environment. These findings indicate that patients displaying the pattern of low return to work expectations, heightened perceived disability, pain and somatic focus experience compliance problems in an intensive work rehabilitation program.(ABSTRACT TRUNCATED AT 250 WORDS)
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Randomized Controlled Trial Comparative Study Clinical Trial
Patient-controlled epidural analgesia in obstetric anaesthetic practice.
A randomised single-blind controlled study was made of 60 patients to evaluate the effectiveness of epidural patient-controlled analgesia (PCA) device for obstetric management compared with a continuous infusion system. In both cases 0.125% plain bupivacaine was used. It was found that epidural PCA is at least as effective as an infusion system in producing analgesia and has the advantages of increased satisfaction and reduction of local anaesthetic requirement. Whether there are also advantages resulting from less obstetric intervention at delivery has not been proven.
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Review Historical Article
The role of psychological factors in chronic pain. I. A half century of study.
This review examines a half century of thought about the role of psychological factors in chronic pain. Changing views are discussed, and representative examples of pain research based on psychoanalytic, behavioural, cognitive, and psychophysiological theories are presented and evaluated. ⋯ Studies reviewed show that an earlier concept, based on simple formulations of psychological causation, has been replaced by more comprehensive explanations comprising both physical and psychological influences. Further methodological and conceptual problems are discussed in the second paper of this 2-part review.