Pain medicine : the official journal of the American Academy of Pain Medicine
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The heightened interest in pain management is making the need for appropriate boundary setting within the clinician-patient relationship even more apparent. Unfortunately, it is impossible to determine before hand, with any degree of certainty, who will become problematic users of prescription medications. ⋯ This article describes a "universal precautions" approach to the assessment and ongoing management of the chronic pain patient and offers a triage scheme for estimating risk that includes recommendations for management and referral. By taking a thorough and respectful approach to patient assessment and management within chronic pain treatment, stigma can be reduced, patient care improved, and overall risk contained.
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Comparative Study
Disparities in occupational low back injuries: predicting pain-related disability from satisfaction with case management in African Americans and Caucasians.
To predict post-settlement pain-related disability from claimant race and satisfaction with Workers' Compensation case management. ⋯ For African Americans and lower socioeconomic status persons in the Workers' Compensation system, less treatment/compensation was associated with lower satisfaction with the process, which in turn predicted higher levels of post-settlement disability. Given that the function of Workers' Compensation is to reduce disability from work-related injuries, the current results suggest that the system produces inequitable outcomes for these groups.
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Comparative Study
Ethnicity, control appraisal, coping, and adjustment to chronic pain among black and white Americans.
To identify similarities and differences among non-Hispanic black and white patients in pain appraisal, beliefs about pain, and ways of coping with pain. We also examined the association between these factors (i.e., appraisals, beliefs, coping) and patient perception or subjective experience of their functioning in each ethnic group. ⋯ The current findings suggest similarities as well as differences between non-Hispanic black and white patients in the ways they view and cope with pain. However, the association between psychological factors (attitudes and beliefs, coping responses) and adjustment to chronic pain was comparable for both ethnic groups. If replicated, the findings suggest that specific tailoring of cognitive behavioral therapies to different racial/ethnic groups may not be needed to maximize treatment outcome.