Scandinavian journal of pain
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Comparative Study
Differences in Swedish and Australian medical student attitudes and beliefs about chronic pain, its management, and the way it is taught.
Background and aims Medical students receive training in the management of chronic pain, but the training is often suboptimal. Considering that the basis for physician's knowledge is their medical education, it is important to explore the attitudes and beliefs of medical students with respect both to chronic pain management and to their views on current pain education. Therefore, the aim of this study was to compare Swedish and Australian medical student's attitudes and beliefs about patients with chronic pain, and their perceptions regarding their chronic pain management education. ⋯ The majority of students in both cohorts perceived chronic pain management education in need of improvement. Implications This study highlights several areas of interest that warrant further investigation, for example, the impact of a changed medical curriculum in alignment with these clinical guidelines requested by students in this survey, and correspondingly if their attitudes towards chronic pain patients can be improved through education. Further, we conclude that it would be valuable to align the implementation of the HC-PAIRS instrument in order to achieve comparable results between future studies.
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Background and aims Health-related quality of life (Hr-QoL) reflects the burden of a condition on an overarching level. Pain intensity, disability and other factors influence how patients with chronic pain perceive their condition, e.g. Hr-QoL. ⋯ Demographic properties did not significantly influence variations in the investigated Hr-QoL variables. Conclusions Pain, mood and pain attitudes were significantly correlated with Hr-QoL variables, but these variables cannot explain most of variations in Hr-QoL variables. The results pinpoint that broad assessments (including pain intensity aspects) are needed to capture the clinical presentation of patients with complex chronic pain conditions.
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Background and aims Evaluating the degree to which pain has become chronic beyond mere duration poses several problems. The IASP Pain Taxonomy Axis IV employs intensity and duration combined to nine ordered categories. The Chronic Pain Grade links intensity and disability, but only the latter contributes to higher grades. ⋯ There is evidence for at least three weakly coupled core domains of chronicity, i.e. the primary clinical characteristics, the direct consequences of current interference with activities, and aspects of the patient history. Hence, multivariate assessment is recommended. The particular syndrome, the diagnostic context and the population under investigation should likewise be considered.
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Background Complex regional pain syndrome (CRPS) is a debilitating painful disorder, cryptic in its pathophysiology and refractory condition with limited therapeutic options. Type I CRPS with its variable relationship to trauma has often no discernible fractures or nerve injuries and remains enigmatic in its response to conservative treatment as well as the other limited interventional therapies. Neuromodulation in the form of spinal cord and dorsal root ganglion stimulation (SCS, DRGS) has shown encouraging results, especially of causalgia or CRPS I of lower extremities. ⋯ Conclusions In a case with difficult CRPS I involving upper extremity, a minimally invasive WPNS of radial and median nerves provided good symptomatic relief. The procedure was tolerated well and both electrodes remained in place without any adverse events. Implications In view of the very limited options currently available to manage CRPS, WPNS can be a promising therapeutic modality.
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Background and aims Chronic pelvic pain (CPP) impacts significantly on the lives of women. Negative coping responses such as pain catastrophizing are thought to be significant in predicting both pain severity and outcome. The combined effect of the individual's response to pain and its severity on their quality of life (QoL) has not been well studied in women with CPP. ⋯ Conclusions Pain catastrophizing is prevalent at clinically relevant levels in women with CPP across all domains. It is associated with higher pain levels and decreased QoL. Implications There is potential for further studies to investigate the predictive nature of pain catastrophizing and management targeting catastrophizing to improve outcomes in women with CPP.