The Clinical journal of pain
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To identify when and how nurses reassess patients' pain after analgesic administration in the postoperative context. ⋯ Despite the focus on meeting standards of care in the area of pain management, there was an extraordinary lack of patient reassessment by nurses after the administration of analgesics. Given the raised awareness internationally on assessment generally and a lack of evidence focused on reassessment after an intervention, this may explain why research is failing to identify shifts in pain severity scores and indeed patient pain.
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This study explores the fear-avoidance model in a sample of women with neck-shoulder pain related to computer work who were still functioning at the workplace. Exploring this model in this population could produce starting points for new treatment approaches in occupational health. ⋯ In line with the fear-avoidance model, the current results addressed the importance of pain-related fear in people with neck-shoulder pain disability related to computer work. Interestingly, and not in accordance with the fear-avoidance model, fear-avoidance beliefs directly influence disability levels in the current sample; regardless of lower levels of performance that is, physical impairment.
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The assessment of cognitive reactions to chronic pain is less well developed than other areas of pain assessment. The aim of the first study was to revise the Cognitive Evaluation Questionnaire of Philips whereas the second study examined its properties and validity in a new sample of people with chronic pain. ⋯ The revised cognitive scales in themselves were significant predictors in Study 2, and their contribution was more effective for depression than for psychosocial functioning. The results showed promise for the revised scale and are discussed in relation to previous research, with recommendations for future research into the cognitive reactions of individuals with chronic pain.
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Clinical Trial
Determinants of patient-controlled epidural analgesia requirements: a prospective analysis of 1753 patients.
Patient-controlled epidural analgesia (PCEA) has been widely used in postoperative pain management. Many factors may correlate with PCEA requirements but no previous study has ever investigated this subject. Therefore, we conducted this study to explore the relationship among patients' characteristics and total PCEA consumption during the 3-day postoperative course. ⋯ Our study demonstrated the association between patients' characteristics and total PCEA requirements from a large-scaled clinical data. Surgical procedures have more influence on PCEA consumption than demographic variables. Background infusion rate of PCEA could be determined from our predictive model.
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Clinical Trial
Managing cancer pain and symptoms of outpatients by rotation to sustained-release hydromorphone: a prospective clinical trial.
In this prospective clinical trial we examined the technique of opioid rotation to oral sustained-release hydromorphone for controlling pain and symptoms in outpatients with cancer pain. ⋯ Switching the opioid to oral hydromorphone may be a helpful technique to alleviate pain and several symptoms, but it is still not clear to what extent the underlying mechanisms, such as the technique of rotation itself, better dose adjustment, or using a different opioid have an impact.