Der Schmerz
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Editorial Comment
[Quality in (acute) pain therapy: plea for a paradigm shift].
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Measurement of functional interference (FI) of pain is crucial for postoperative pain management. This study examined the external validity of three FI items (respiration, mobilization and sleep) within the framework of the German quality improvement in postoperative pain management (QUIPS) project. ⋯ The QUIPS outcome questionnaire achieved satisfactory reliability (r(tt) =0 .783-0.954, internal consistency 0.597-0.941). The three FI items under examination achieved a significant correlation (r =0 .407-0.469) with the external criteria.
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The care of patients, suffering from acute, chronic, or malignant pain, requires systematic and interprofessional collaboration between all team members to ensure a holistic approach to pain management. In doing so, the different professions are often in a competitive, tense, or dependent relationship resulting from a lack of precise definitions and concepts regarding their responsibilities in the wide field of pain management. Considering pain management as a whole, we can define numerous interfaces concerning competencies and tasks which may open up some new perspectives on concepts of interprofessional education (IPE). ⋯ In Germany, only a few efforts have been made with regard to interprofessional pain education. In the following paper, different challenges, tasks, and roles within the field of pain management are discussed in the sense of potential areas of collaboration in the context of interprofessional education. Against this background, the Regensburg model for interprofessional pain management education is described as one national program to enhance the effectiveness of pain management.
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Review
[Cytokines in psychoneuroendocrine immunological context of nonspecific musculoskeletal pain].
Cytokines are coordinators of immune homeostasis. Evidence for the participation of cytokines in neurogenic inflammation, peripheral and central sensitization and hyperalgesia as well as for induction of inflammatory immune responses by pain-related catastrophizing is well documented. ⋯ In this model avoidance and pain-related nonrecognition as key components of systemic pain behavior lead to maintenance of the virtuous circle by generating of a local inflammation with local and systemic consequences. This model can explain the success of established therapy concepts from the point of view of psychoneuroimmunology, such as fear avoidance, which are effectively used as principal components in multimodal pain therapy.