The Clinical journal of pain
-
Perceived injustice (PI) has been identified as an important risk factor for pain-related outcomes. To date, research has shown that pain acceptance and anger are mediators of the association between PI and pain-related outcomes. However, a combined conceptual model that addresses the interrelationships between these variables is currently lacking. Therefore, the current study aimed to examine the potential mediating roles of pain acceptance and anger on the association between PI and adverse pain-related outcomes (physical function, pain intensity, opioid use status). ⋯ This is the first study to provide a combined conceptual model investigating the mediating roles of pain acceptance and anger on the relationship between PI and pain outcomes. On the basis of our findings, low levels of pain acceptance associated with PI may help explain the association between PI and adverse pain outcomes. Clinical and theoretical implications are discussed.
-
Trigeminal neuralgia (TN) is a rare orofacial disorder characterized by severe unilateral paroxysmal pain in the region of the fifth cranial nerve. Clinical guidelines recommend carbamazepine (only US Food and Drug Administration-approved drug for TN) and oxcarbazepine as first-line therapies. We utilized the US Truven Health MarketScan database to examine treatment patterns among patients with TN. ⋯ In the 3 years after diagnosis, patients with TN in the United States receive a variety of pharmacological treatments, including opioids, despite carbamazepine being the only approved medication. A notable proportion utilize surgeries/injections. A high proportion of pharmacologically treated patients receive multiple treatment episodes, suggesting frequent therapy switching, perhaps because of suboptimal efficacy/tolerability. Our data suggest a high burden of illness associated with TN.
-
Acute postoperative pain remains inadequately assessed and managed. A valid instrument that assesses acute pain in sedated postanesthesia care unit (PACU) patients is needed. ⋯ Findings suggest that NVPS-R and CPOT can assess acute pain in sedated PACU patients. In patients with significant pain, the CPOT vocalization indicator was more consistent than physiological and respiratory indicators in detecting acute pain. Thus, our data do not support the exclusive use of vital sign indicators to assess acute pain, suggesting the superiority of the CPOT for the assessment of acute pain in sedated PACU patients.
-
The objective of this study was to investigate the frequency with which prediction studies for low back pain outcomes utilize prospective methods of prognostic model validation. ⋯ Unless researchers and clinicians consider sophisticated and rigorous methods of statistical/external validity for prediction/prognostic findings they will make incorrect assumptions and draw invalid conclusions regarding treatment effects and outcomes. Without proper validation methods, studies that claim to present prediction models actually describe only traits or characteristics of the studied sample.
-
The Pain-related Cognitive Processes Questionnaire (PCPQ) provides a multifaceted assessment of different styles of pain-related attentional processing. The present study examined the construct validity of the 4 PCPQ composite scales. ⋯ The associations found in the exploratory structural equation modeling approach, as well as the PCPQ scale content and intercorrelations, support the validity of the PCPQ Pain Diversion, Pain Distancing, and Pain Focus scales. Given the lack of strong associations with the validity criteria assessed in this study, questions remain regarding the construct validity of the Pain Openness scale.