Journal of pain and symptom management
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J Pain Symptom Manage · Jan 2010
Randomized Controlled TrialEfficacy and side effects of diclofenac patch in treatment of patients with myofascial pain syndrome of the upper trapezius.
Locally administered nonsteroidal anti-inflammatory drugs have been widely used in acute soft-tissue damage and articular musculoskeletal pain. This double-blind, placebo-controlled, randomized study was designed to evaluate the efficacy and safety of a topical diclofenac sodium patch in the relief of pain and inflammation as a result of myofascial pain syndrome (MPS) in the upper trapezius. After sample size calculations indicated that 147 patients would be needed to detect a 25% difference between drug and control, 153 patients with MPS were recruited and randomized to receive either a diclofenac sodium patch or control (menthol) patch. ⋯ Tolerability assessment similarly showed the diclofenac patch to be comparatively superior. When assessed at the end of the study, 20 diclofenac patch patients, but only four control patients, considered the tolerability of treatment to be "very good." Significant differences in adverse reactions were observed between the diclofenac and control patches, with the control patch more likely to produce overall skin irritation. This study demonstrate that the diclofenac sodium patch was superior to the control patch in terms of reducing pain and improving functional outcomes, and did not result in significant adverse effects.
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J Pain Symptom Manage · Jan 2010
ReviewMind-body treatments for the pain-fatigue-sleep disturbance symptom cluster in persons with cancer.
Co-occurring pain, fatigue, and sleep disturbance comprise a common symptom cluster in patients with cancer. Treatment approaches that target the cluster of symptoms rather than just a single symptom need to be identified and tested. ⋯ Efficacy studies are needed to test the impact of relaxation, imagery/hypnosis, CBT/CST, meditation, and music interventions in persons with cancer experiencing concurrent pain, fatigue, and sleep disturbance. These mind-body interventions could help patients manage all the symptoms in the cluster with a single treatment strategy.
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J Pain Symptom Manage · Jan 2010
Randomized Controlled TrialA randomized clinical trial of the effectiveness of photon stimulation on pain, sensation, and quality of life in patients with diabetic peripheral neuropathy.
Peripheral neuropathy is one of the most common complications of diabetes. ⋯ Four treatments with photon stimulation resulted in significant improvements in some pain qualities, sensation, and QOL outcomes in a sample of patients with a significant amount of pain and disability from their diabetes. A longer duration study is needed to further refine the photon stimulation treatment protocol in these chronically ill patients and to evaluate the sustainability of its effects.
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J Pain Symptom Manage · Jan 2010
The Quality of Dying and Death Questionnaire (QODD): empirical domains and theoretical perspectives.
We used exploratory factor analysis within the confirmatory analysis framework, and data provided by family members and friends of 205 decedents in Missoula, Montana, to construct a model of latent-variable domains underlying the Quality of Dying and Death questionnaire (QODD). We then used data from 182 surrogate respondents, who were survivors of Seattle decedents, to verify the latent-variable structure. ⋯ In anticipation of possible future research tying the quality of dying and death to theoretical constructs, we linked the inferred domains to concepts from identity theory and existential psychology. We conclude that research based on the current version of the QODD might benefit from the use of composite measures representing the four identified domains, but that future expansion and modification of the questionnaire are in order.
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J Pain Symptom Manage · Jan 2010
Comparative StudyPhysicians' beliefs and attitudes about end-of-life care: a comparison of selected regions in Hungary and the United States.
Unlike primary care physicians in the U.S., it is only recently that Hungarian primary care physicians have had the educational resources for providing end-of-life care and the availability of hospice services as part of the Hungarian health care system. ⋯ These results illustrate some of the important differences in physicians' beliefs about the care of terminally ill patients between the two countries and can be used to guide medical education and practice.