Articles: chronic-pain.
-
Medical treatment with effective opioids for patients who suffer chronic pain is greatly lacking in Germany, as is supported by the documentation from Sorge and Zenz. The author comments on this documentation and adds an account of his own experience with the provision of opioid prescriptions over a period of almost 6 years. He asserts that the number of patients who suffer from pain has increased and argues for extending the indications for opioid therapy to include noncancer patients, giving reasons why pure morphine preparations are to be preferred. Finally, the author expresses his belief that only an expanded and appropriate application of today's concepts regarding treatment with analgesics and opioids will be able to clear the way for a liberalization of the laws regulating the prescription of opioids.
-
In the therapy of chronic disease and functional disorders, art therapy is considered to be of increasing importance. The idea behind this type of therapy is that the stimulation of creative activities promotes the healing process and rehabilitation. Music therapy in particular has a long tradition in the treatment of pain and health disorders. ⋯ The conceptual framework of art therapy offers various explanations for the integration of these forms of therapy in complementary, supportive pain management programs: (1) enhancing the activity level and creative capacity as a healing source; (2) stimulation of positive emotional experience; (3) experiencing social communication and interaction; (4) facilitating projective coping; (5) stimulation of imaginative experience and awareness; (6) promotion of suggestive elements. Anecdotical experience indicates that there could be a broad field for the use of art therapy in pain management programs. The need to validate this form of therapeutic approach by appropriate methodological studies and well-documentated single case series is emphasized.
-
The aim of the study was to evaluate an educational video designed to modify the pain concept of chronic pain patients. It is commonly described that chronic pain patients foster an illness model which is dominated by purely medical assumptions about causes of pain and its modulation and treatment. Furthermore the mostly unrealistic hope for total pain relief which is expected from the pain expert guides the patients' seek for help. ⋯ The Ss participating in the study were 47 chronic pain patients of a pain ambulance and 42 patients of a pain clinic (inpatient setting). The results showed that after viewing the pain video the groups differed significantly in their pain concept as predicted. The use of an educational video, like the one evaluated, seems useful to initiate first steps in illness concept modification by expanding and enriching the patients attitude by assumptions about the influence of psychological factors on pain maintenance and management and shaping realistic attitudes towards treatment.
-
The care of severely ill patients, whether in hospital, in residential homes or in their own homes, should be characterized by humanity and dictated by efforts to make life worth living for the person concerned. Preservation of the quality of life should be paramount if the doctor can no longer effect a cure. ⋯ Close contact with members of the family and with friends and neighbours is particularly important in this phase of life. A sick person's quality of life is what the legislator had in mind when domiciliary care was given priority over residential care at the time of the legal changes to reform the health care system.
-
Epidural or intrathecal opiate analgesia, combined with bupivacain by means of an implanted pump, represents a possibility for providing good pain management for cancer patients as well as other chronic pain patients. Several indications, for implantation of a percutanously refillable pump are demonstrated in 27 patients. Twenty-four patients were treated with epidural and 3 with intrathecal catheters. ⋯ In the course of 2 years there has been no significant increase in the daily dose of buprenorphin given epidurally to patients with chronic pain. There were no addiction problems with opiates given epidurally or intrathecally by means of implanted pumps. Because of a 13% complication rate, pumps and epidural or intrathecal catheters should only be implanted by an experienced team.