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1.
Medicine (Baltimore) ; 100(8): e23718, 2021 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-33663038

RESUMO

ABSTRACT: Pain as a result of cervical radiculopathy (CR) can be widespread, nondermatomal and individually specific, but the association between pain extent and other clinical features has never been explored. The objective of this study is to investigate whether pain extent relates to clinical variables including pain intensity in addition to health indicators including disability, general health, depression, somatic anxiety, coping strategies or self-efficacy.An observational cohort study was conducted. Participants were recruited from 4 hospital spinal centres in Sweden. Pain extent was quantified from the pain drawings of 190 individuals with cervical disc disease, verified with magnetic resonance imaging (MRI) and compatible with clinical findings (examined by a neurosurgeon), that show cervical nerve root compression. Pain extent was evaluated in relation to neck pain, arm pain, and headache intensity. Multiple linear regression analysis were then used to verify whether pain extent was associated with other health indicators including disability, health-related quality of life, depression, somatic anxiety, coping strategies and self-efficacy.Pain extent was directly related to neck, arm and headache pain intensity (all P < .01). Multiple linear regression revealed that pain extent was significantly associated only to the level of perceived disability (P < .01).Increased pain extent in people with CR is associated with higher headache, neck and arm pain intensity, and disability but not measures of general health, depression, somatic anxiety, coping strategies or self-efficacy.


Assuntos
Avaliação da Deficiência , Nível de Saúde , Dor/etiologia , Dor/psicologia , Radiculopatia/complicações , Adaptação Psicológica , Adulto , Fatores Etários , Idoso , Vértebras Cervicais , Depressão/etiologia , Pessoas com Deficiência , Exercício Físico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Qualidade de Vida , Autoeficácia , Fatores Sexuais , Fatores Socioeconômicos , Suécia , Avaliação da Capacidade de Trabalho , Adulto Jovem
2.
Public Health ; 191: 68-77, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33540186

RESUMO

OBJECTIVES: The goal of care at the end-of-life has changed in recent years to encompass not only the relief of suffering but also improve the quality of death. Palliative care offers a coordinated and multidisciplinary approach to improving the quality of life and quality of care of individuals and their families facing illness at the end-of-life. This manuscript examines the end-of-life of older adults in Mexico and the factors associated with pain in this period of their life. STUDY DESIGN: We used data from the Mexican Health and Aging Study (MHAS), a longitudinal panel study of adults 50 years and older in Mexico that is nationally representative of urban and rural areas and includes a next-of-kin questionnaire that captures the conditions during the last year of life of those who died. We used all four waves of data to construct a group of deceased individuals between 2001 and 2015, including information in the wave immediately before death and a complete next-of-kin questionnaire. We studied factors associated with pain at the end-of-life in this group. METHODS: The dependent variable was pain reported over time among deceased individuals. We constructed pain categories based on whether the pain was reported in one or two waves (occasional and persistent), and the pain intensity reported (mild, moderate, or severe). We included independent variables previously reported to be related to pain, including sociodemographic, functional, and health characteristics. We used descriptive statistics and a multinomial regression model to examine the factors associated with pain in this group. RESULTS: Pain was reported by 71.5% of older adults who died between 2001 and 2015. The prevalence of pain differed significantly by sociodemographic characteristics. Women had 1.69 higher odds of reporting severe pain than men. Compared to those with zero years of education, the odds of reporting severe pain were 0.72 for those with 1-6 years of education (P < 0.05) and 0.55 for those with more than 7 years (P < 0.001). Poor self-reported health, arthritis, taking more medications, depression, and functional limitations in the wave prior to death were associated with higher odds of persistent pain at the end-of-life (P < 0.05). Conversely, older age, more years of education, and diabetes were associated with lower odds of persistent pain (P < 0.001). CONCLUSIONS: The prevalence of pain among older Mexican adults is high at the end-of-life. Sociodemographic factors, some chronic diseases, number of medications, psychosocial factors, and functional status impact the odds of reporting pain in this group at the end-of-life. Providing education to families on psychosocial interventions to improve the quality of care at the end-of-life is a pressing need in Mexico. These findings provide information to help policymakers and healthcare providers in Mexico improve the quality of care at the end-of-life.


Assuntos
Envelhecimento , Morte , Dor/epidemiologia , Qualidade de Vida/psicologia , Idoso , Doença Crônica , Feminino , Humanos , Estudos Longitudinais , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Dor/psicologia , Prevalência , Autorrelato
3.
Schmerz ; 35(1): 21-29, 2021 Feb.
Artigo em Alemão | MEDLINE | ID: mdl-33534105

RESUMO

The question of pain prevention is becoming increasingly important, both in society and in science. According to the International Society for the Study of Pain, general areas for which pain prevention measures can be recommended have been defined. These approaches are mostly limited to unspecific recommendations with the aim of improving general health behaviour. Common to all of them is that they essentially address psychosocial and psychobehavioral aspects. In contrast to genetic factors or other non-modifiable environmental factors, psychosocial and psychobehavioral aspects are potentially modifiable variables, making them possible starting points for prevention programs. Furthermore, recent studies provide important knowledge about psychological and social risk factors of pain chronification and thus offer new approaches for future pain prevention strategies. At the same time, the efficacy and successful implementation of such programs is so complex that valid statements on effectiveness and benefit can only be made through care-related evaluation. This review addresses psychological and social factors in the prevention of pain. A selective literature search was carried out to this end. Based on selected studies, psychological and social predictors of pain development are presented and their potential for future pain prevention programs discussed. The article concludes with a discussion of possible implications.


Assuntos
Dor , Humanos , Dor/prevenção & controle , Dor/psicologia , Comportamento Social
4.
Rev Infirm ; 70(267): 42-43, 2021 Jan.
Artigo em Francês | MEDLINE | ID: mdl-33455682

RESUMO

Faced with complaints from patients in their day-to-day practice, health professionals are the main actors in the assessment and management of pain. Empathetic listening to the patient is an essential component in the patient's adherence to and participation in the therapeutic project developed by a multidisciplinary team.


Assuntos
Empatia , Pessoal de Saúde , Dor , Relações Profissional-Paciente , Pessoal de Saúde/psicologia , Humanos , Dor/psicologia , Manejo da Dor
5.
Artigo em Inglês | MEDLINE | ID: mdl-33466456

RESUMO

BACKGROUND AND OBJECTIVE: Pain is a bothersome issue that is common among newborns and children of all ages. Pain can be managed using various pharmacological and/or non-pharmacological strategies, which can be delivered by healthcare providers or parents. The aim of this study is to assess the attitude of mothers toward their children's pain and its management. METHODS AND MATERIALS: A descriptive cross-sectional web-based study was conducted using a developed self-reported questionnaire, from March 2018 to April 2018. Participants involved were Arabic-speaking mothers of children aged between 0 and 12. The data collected included pharmacological and non-pharmacological treatment methodologies utilized to treat pain and the mothers' attitude towards pain management. Statistical Package for Social Sciences, version 25 was applied to analyze the data, and descriptive statistics were performed. RESULTS: As per the results of this study, the most common site of children's pain as reported by the mothers was mouth/throat (211; 52.9%), abdomen (199; 49.9%), followed by head (58; 14.5%), and finally, ears (69; 17.3%). The frequency of children's pain, as stated by the mothers, was less than once a month (196; 49.1%), once in a month (137; 34.3%), and once in a week (48; 12%). The non-pharmacological methods used by mothers at home for the management of their children's pain were as follows: letting them take rest or sleep (250; 62.6%), feeding them with fluids (228; 57.1%), applying cold packs (161; 40.4%), providing massage therapy (147; 36.8%), using warm packs (141; 35.3%), and taking them to play (119; 29.8%). CONCLUSION: The misconceptions about pediatric pain management among Saudi mothers that can affect the children's quality of life are quite noticeable. Implementing educational and awareness programs about the management of child pain could play a major role in making the parents understand the impacts of their misconceptions.


Assuntos
Atitude , Mães/psicologia , Dor/psicologia , Qualidade de Vida , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , Recém-Nascido , Dor/epidemiologia , Arábia Saudita
6.
Science ; 371(6525): 153-159, 2021 01 08.
Artigo em Inglês | MEDLINE | ID: mdl-33414216

RESUMO

Empathy is an essential component of social communication that involves experiencing others' sensory and emotional states. We observed that a brief social interaction with a mouse experiencing pain or morphine analgesia resulted in the transfer of these experiences to its social partner. Optogenetic manipulations demonstrated that the anterior cingulate cortex (ACC) and its projections to the nucleus accumbens (NAc) were selectively involved in the social transfer of both pain and analgesia. By contrast, the ACC→NAc circuit was not necessary for the social transfer of fear, which instead depended on ACC projections to the basolateral amygdala. These findings reveal that the ACC, a brain area strongly implicated in human empathic responses, mediates distinct forms of empathy in mice by influencing different downstream targets.


Assuntos
Analgesia/psicologia , Comunicação , Empatia/fisiologia , Giro do Cíngulo/fisiologia , Núcleo Accumbens/fisiologia , Dor/psicologia , Animais , Complexo Nuclear Basolateral da Amígdala/fisiologia , Medo/fisiologia , Feminino , Masculino , Camundongos , Morfina/administração & dosagem , Optogenética , Dor/tratamento farmacológico
7.
Artigo em Inglês | MEDLINE | ID: mdl-33467061

RESUMO

Tailor's bunion (TB) disease should be considered one of the foot injuries that causes disability in feet as well as general health. This case-control descriptive study investigated and contrasted the effects of different TB types in a sociodemographic population using the Foot Health Status Questionnaire (FHSQ). A sample of 100 subjects with a mean age of 51.70 ± 17.78 years was recruited and requested to reply to a foot health survey. Results were self-reported. Subjects were scored. Participants with TB type III (TB3) registered lower scores for foot pain, foot function, footwear, and foot health. Physical activity and social capacity had higher scores, and vigor and general health were lower. A Kruskal-Wallis test was used for systematic differences between the FHSQ and different TB types. In all analyses, statistical significance was considered a p-value <0.05 with a 95% confidence interval. Statistically significant differences were found between all domains of the FHSQ and TB, except for the social capacity domain and vigor. The FHSQ is an important measurement tool in TB subjects, showing that factors such as sex, age, and footwear used throughout an individual's life are significantly associated with the development of TB3 and its influence on foot pain and foot health.


Assuntos
Joanete do Alfaiate/psicologia , Dor/epidemiologia , Qualidade de Vida , Adulto , Idoso , Idoso de 80 Anos ou mais , Joanete do Alfaiate/diagnóstico , Estudos de Casos e Controles , Exercício Físico , Feminino , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Dor/psicologia , Inquéritos e Questionários
8.
Am J Sports Med ; 49(2): 314-320, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33395318

RESUMO

BACKGROUND: Preoperative anxiety and depression are independent predictors of clinical outcomes after arthroscopic rotator cuff repair. However, few studies have evaluated correlations between outcomes such as pain and range of motion (ROM) after arthroscopic rotator cuff repair and preoperative anxiety and depression. PURPOSE: To evaluate the effects of preoperative anxiety and depression, measured using the Hospital Anxiety and Depression Scale (HADS), on early pain and ROM after rotator cuff repair. STUDY DESIGN: Cohort study; Level of evidence, 2. METHODS: A total of 144 consecutive patients who underwent arthroscopic rotator cuff repair were enrolled and divided into 2 groups according to HADS scores: group A, those with a healthy psychological status (n = 103; anxiety ≤7 and depression ≤7), and group B, those with psychological distress (n = 41; anxiety ≥8 or depression ≥8). Clinical outcomes were assessed using the visual analog scale for pain (pVAS) and ROM at 3 and 6 months postoperatively and annually. RESULTS: There were no significant preoperative differences in age, sex, tear size, pVAS scores, and ROM. However, at 3 months postoperatively, group A showed significantly lower mean pVAS scores (2.2 ± 1.3 vs 3.4 ± 1.8, respectively; P = .001) and significantly higher mean forward flexion (146.4°± 23.0° vs 124.1°± 28.2°, respectively; P < .001) than group B, as well as significantly higher mean levels of internal rotation at the back (T11.5 ± 2.8 vs L1.9 ± 2.5, respectively; P < .001) and significantly higher mean external rotation (42.4°± 15.9° vs 35.2°± 16.8°, respectively; P = .019). At 6 months postoperatively, the mean pVAS score was still significantly lower in group A than in group B (0.8 ± 1.6 vs 1.8 ± 2.1, respectively; P = .016), but other ROM measurements had no significant differences. There was also no significant difference in clinical and functional outcomes at the final follow-up. CONCLUSION: Anxiety and depression negatively affected clinical outcomes after rotator cuff repair. Recovery from pain and of ROM after arthroscopic rotator cuff repair occurred more quickly in patients with a healthy psychological status. Therefore, assessments of preoperative psychological status should be emphasized to improve early clinical outcomes after arthroscopic rotator cuff repair.


Assuntos
Ansiedade/diagnóstico , Depressão/diagnóstico , Dor/psicologia , Amplitude de Movimento Articular , Lesões do Manguito Rotador/psicologia , Manguito Rotador , Artroscopia , Estudos de Coortes , Hospitais , Humanos , Angústia Psicológica , Manguito Rotador/cirurgia , Lesões do Manguito Rotador/cirurgia , Resultado do Tratamento
9.
Psychopharmacology (Berl) ; 238(3): 725-734, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33410983

RESUMO

RATIONALE: Mu opioid receptor agonists are indispensable for the treatment of pain, but clinical use carries the inherent risk of transition from effective treatment to abuse. Abuse potential appears to increase rapidly during periods of initial opioid exposure in humans, and this increase in opioid reward during initial opioid exposure can be modeled in rats using an intracranial self-stimulation (ICSS) procedure. OBJECTIVES: The goal of the present study was to examine temporal parameters of this phenomenon. METHODS: Adult male Sprague-Dawley rats responded for electrical brain stimulation using a frequency-rate ICSS procedure. In the first experiment, rats received daily morphine injections for 6 days, and morphine effects on ICSS were re-determined 1 day, 1 week, or 1 month after the repeated morphine treatment regimen to evaluate the persistence of enhanced opioid reward. In the second experiment, rats received six repeated morphine injections with different interdose intervals (two per day, one per day, every other day, every fourth day), and morphine effects were re-determined 1 day after the last dose to determine dosing frequencies sufficient to produce enhanced opioid reward. RESULTS: Results of the first experiment indicated that enhanced opioid reward was greatest 1 day after the morphine treatment regimen and completely dissipated after 4 weeks. The second experiment indicated that all dosing frequencies tested were sufficient to produce enhanced reward. CONCLUSIONS: Taken together, these results suggest that enhancement of opioid reward after initial opioid exposure is relatively transient but can be produced by a range of different dosing frequencies.


Assuntos
Analgésicos Opioides/farmacologia , Morfina/farmacologia , Receptores Opioides mu/agonistas , Recompensa , Autoestimulação/efeitos dos fármacos , Analgésicos Opioides/administração & dosagem , Animais , Encéfalo/efeitos dos fármacos , Encéfalo/metabolismo , Estimulação Elétrica , Masculino , Morfina/administração & dosagem , Dor/tratamento farmacológico , Dor/metabolismo , Dor/psicologia , Ratos , Ratos Sprague-Dawley , Fatores de Tempo
11.
Cuad. bioét ; 31(103): 377-386, sept.-dic. 2020.
Artigo em Espanhol | IBECS | ID: ibc-196720

RESUMO

El objetivo principal de esta investigación es tratar de dar una respuesta, en un tiempo clave ante el COVID19, en la medida de lo posible, a la diferenciación entre el dolor y el sufrimiento. Para hacernos cargo de esta tarea partiremos de las reflexiones del filósofo alemán Robert Spaemann, aunque no solo ni exclusivamente. Para finalizar, abordaremos brevemente la cuestión de la muerte


The main aim of this paper is to define an answer, in a key time before COVID19, if it is indeed possible to do so, as to the difference between pain and suffering. In order to do so, we will refer to, although not exclusively, the reflexions of the German philosopher Robert Spaemann. To finish, the question of death will briefly be analysed


Assuntos
Humanos , Dor/psicologia , Estresse Psicológico/psicologia , Morte , Filosofia , Infecções por Coronavirus/psicologia , Religião e Psicologia
12.
Pain Res Manag ; 2020: 8846599, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33312317

RESUMO

Background: Pain is a major source of distress for children on admission, parents, and clinician. Hospitalized children continuously experience unrelieved pain; hence, the provision of effective pain management is an integral and important part of the nurse's role. Adequate knowledge and positive practices of nurses regarding pain management among children are key if optimal pain management is to be achieved among paediatric cases. However, there is a paucity of published data on paediatric management among nurses in the northern part of Ghana. Aim: The current study, therefore, evaluated nurse's knowledge and practices and identified the barriers to paediatric pain management in the Tamale Teaching Hospital, Ghana. Methodology. This was a descriptive cross-sectional facility-based study that employed a quantitative approach to data collection. A total of 180 nurses were selected conveniently from 10 selected wards of the hospital for the study. Data were collected using a questionnaire. The data were subsequently analyzed using the Statistical Package for Social Sciences version 23.0. Logistic regression analysis was done to determine the association between the dependent and independent variables of interest. Results: The findings revealed that the majority (61.1%) of all the nurses had an overall good knowledge of paediatric pain management while 57.8% demonstrated good practices of pain management. From the study, the most reported barriers to paediatric pain management by the nurses were insufficient knowledge in pain management (76.1%), inadequate paediatric pain assessment tools (73.9%), and inadequate staffing (72.2%). In further analysis, critical care nurses were 5.87 times more likely to engage in good practices of paediatric pain management than paediatric nurses (OR = 5.87 (95% CI : 1.07-32.00), p=0.041). Conclusion: The majority (61.1%) of all the respondents showed good knowledge of pain management and 57.8% demonstrated good pain management practices. Despite the high knowledge and practice, factors such as insufficient knowledge in pain management (76.1%), inadequate paediatric pain assessment tools (73.9%), and inadequate nurse staffing (72.2%) affect effective pain management. Paediatric pain management should be treated as a priority, and hence more efforts should be put in place to curtail the barriers that hinder its practice.


Assuntos
Criança Hospitalizada/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Papel do Profissional de Enfermagem/psicologia , Manejo da Dor/métodos , Manejo da Dor/psicologia , Centros de Atenção Terciária , Adulto , Criança , Estudos Transversais , Feminino , Gana/epidemiologia , Humanos , Masculino , Dor/diagnóstico , Dor/epidemiologia , Dor/psicologia , Medição da Dor/métodos , Medição da Dor/psicologia , Inquéritos e Questionários
13.
BMC Med ; 18(1): 407, 2020 12 21.
Artigo em Inglês | MEDLINE | ID: mdl-33342434

RESUMO

BACKGROUND: The objectives of this study are to determine the effects of regularly scheduled administration of paracetamol (acetaminophen) on quality of life (QoL), discomfort, pain and neuropsychiatric symptoms of persons with dementia living in long-term care facilities (LTCFs). METHODS: A multicentre randomised double-blind placebo-controlled crossover trial for 13 weeks (January 2018 to June 2019) in 17 LTCFs across the west of the Netherlands. Inclusion criteria were age ≥ 65 years, (advanced) dementia and a moderate to low QoL, independent of the presence of pain (QUALIDEM ≤ 70). Exclusion criteria were the use of regular pain treatment, allergies to the study medication, severe liver disease, use of > 4 units of alcohol/day, weight < 50 kg and/or concomitant use of flucloxacillin. Participants received study medication (paracetamol/placebo) in two periods of 6 weeks each (1 week in between as a wash-out period). Randomisation decided in which order participants received paracetamol and placebo. Primary outcomes included QoL (QUALIDEM) and discomfort (DS-DAT), secondary outcomes included pain (MOBID-2) and neuropsychiatric symptoms (NPI-NH). RESULTS: Ninety-five LTCF residents (mean age 83.9 years [SD 7.6], 57.9% females) were included. Repeated linear mixed models showed no difference in mean differences of QUALIDEM (paracetamol +1.3 [95% CI -1.0-3.5], placebo +1.5 [95% CI -0.7-3.8]), DS-DAT (paracetamol -0.1 [95% CI -1.4-1.2], placebo 0.6 [95 CI -0.7-1.8]), MOBID-2 (paracetamol 0.0 [95% CI -0.5-0.5], placebo -0.2 [95% CI -0.7-0.3]) and NPI-NH (paracetamol +1.5 [95% CI -2.3-5.4], placebo -2.1 [95% CI -6.0-1.7]) in favour of either paracetamol or placebo. CONCLUSIONS: Compared to placebo, paracetamol showed no positive effect on QoL, discomfort, pain and neuropsychiatric symptoms in persons with advanced dementia with low QoL. It is important to find out more specifically which individual persons with advanced dementia could benefit from pain treatment with paracetamol, and for clinicians to acknowledge that a good assessment, monitoring and multidomain approach is vital for improving QoL in this vulnerable group. TRIAL REGISTRATION: Netherlands Trial Register NTR6766 . Trial registration date: 20 October 2017.


Assuntos
Acetaminofen/uso terapêutico , Demência/tratamento farmacológico , Dor/tratamento farmacológico , Conforto do Paciente , Qualidade de Vida , Acetaminofen/administração & dosagem , Acetaminofen/farmacologia , Idoso , Idoso de 80 Anos ou mais , Estudos Cross-Over , Demência/patologia , Demência/psicologia , Progressão da Doença , Método Duplo-Cego , Feminino , Avaliação Geriátrica , Humanos , Assistência de Longa Duração/métodos , Masculino , Países Baixos , Casas de Saúde , Dor/epidemiologia , Dor/psicologia , Manejo da Dor/métodos , Conforto do Paciente/normas , Placebos , Qualidade de Vida/psicologia , Resultado do Tratamento
14.
PLoS One ; 15(12): e0244429, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33378345

RESUMO

Past research has shown that pain experience reduces feelings of guilt for earlier wrongdoings. In this paper, we aim to investigate whether watching other people in pain can reduce feelings of guilt. In Study 1 (N = 60), we found that participants' levels of guilt and sadness decreased after they watched a one-minute movie clip showing a painful medical procedure. Study 2 (N = 156), eliminated an alternative explanation in which pain observation but not the misattribution of unrelated excitation reduced guilt. Finally, in Study 3 (N = 60), pain observation lowered participants' feelings of guilt but not their feelings of shame. Overall, these results suggest that the guilt-reducing effect of pain may appear even without the actual experience of physical pain.


Assuntos
Dor/psicologia , Tristeza/psicologia , Adulto , Feminino , Culpa , Humanos , Masculino , Vergonha , Adulto Jovem
15.
Geriatr Gerontol Int ; 20(11): 1056-1060, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32974982

RESUMO

AIM: Psychological pain refers to the torment that results from adverse experiences, such as loneliness, guilt, frustration, hopelessness or loss. Psychological pain may impair physical and psychosocial functioning of older adults. Death anxiety is associated with cognitive function deterioration, change to social environment and increased risk of depression. This study investigated associations among components of comprehensive geriatric assessment (CGA), death anxiety and psychological pain. METHODS: In total, 100 patients aged ≥65 years were included in this study. Demographic characteristics and CGA test scores were examined. The Templer scale was used to evaluate death anxiety; the Psychache scale was used to evaluate psychological pain. Multivariate logistic regression analysis was performed to identify parameters independently associated with poor cognitive performance and death anxiety. RESULTS: The patients' median age was 73 (65-92) years. Death anxiety was detected in 34% of patients. Psychological pain and death anxiety levels were significantly associated with Mini-Mental State Examination, clock drawing test, Geriatric Depression Scale-15 and Instrumental Activities of Daily Living (IADL) scores. Psychological pain levels were independently associated with cognitive performance. Finally, psychological pain and IADL scores were independently associated with death anxiety. CONCLUSIONS: During a CGA, practitioners should note that psychological pain and death anxiety may negatively affect cognitive function and IADL scores. Patients should be re-evaluated, following suitable psychotherapeutic interventions. Geriatr Gerontol Int 2020; 20: 1056-1060..


Assuntos
Ansiedade/psicologia , Morte , Avaliação Geriátrica , Dor/psicologia , Atividades Cotidianas , Idoso , Idoso de 80 Anos ou mais , Atitude Frente a Morte , Cognição , Depressão/psicologia , Feminino , Humanos , Masculino , Testes de Estado Mental e Demência , Testes Neuropsicológicos , Turquia
16.
Rev Med Suisse ; 16(708): 1796-1800, 2020 Sep 30.
Artigo em Francês | MEDLINE | ID: mdl-32997449

RESUMO

Behavioural disorders in adults with mental disabilities are very common and represent a diagnostic challenge. In fact, they often hide a somatic problem, which is more frequent in this population compared to the general population. These somatic symptoms may cause or enhance psychiatric symptoms. People with mental disabilities often have difficulties expressing their pain, which often manifests itself as mood changes. Consequently, it is important to be able to identify the pain as a priority and to treat it. The general practitioner should therefore check for the most common somatic complaints in people with mental disabilities, with the help of the acronym DODUGO (Dental, Otic, Digestive, UroGenital, Orthopaedic).


Assuntos
Deficiência Intelectual , Sintomas Inexplicáveis , Comportamento Problema , Adulto , Humanos , Deficiência Intelectual/complicações , Deficiência Intelectual/psicologia , Dor/complicações , Dor/diagnóstico , Dor/psicologia , Transtornos da Personalidade/complicações , Transtornos da Personalidade/diagnóstico , Transtornos da Personalidade/psicologia
17.
Inflamm Res ; 69(12): 1271-1282, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32886146

RESUMO

OBJECTIVE: To investigate the role of IL-33 in gouty arthritis. MATERIAL: 174 Balb/c (wild-type) and 54 ST2-/- mice were used in this study. In vitro experiments were conducted in bone marrow-derived macrophages (BMDMs). Synovial fluid samples from gouty arthritis (n = 7) and osteoarthritis (n = 8) hospital patients were used to measure IL-33 and sST2 levels. METHODS: Gout was induced by injection of monosodium urate (MSU) crystals in the knee joint of mice. Pain was determined using the electronic von Frey and static weight bearing. Neutrophil recruitment was determined by H&E staining, Rosenfeld staining slides, and MPO activity. ELISA was used for cytokine and sST2 measurement. The priming effect of IL-33 was determined in BMDM. RESULTS: Synovial fluid of gout patients showed higher IL-33 levels and neutrophil counts than osteoarthritis patients. In mice, the absence of ST2 prevented mechanical pain, knee joint edema, neutrophil recruitment to the knee joint, and lowered IL-1ß and superoxide anion levels. In macrophages, IL-33 enhanced the release of IL-1ß and TNF-α, and BMDMs from ST2-/- showed reduced levels of these cytokines after stimulus with MSU crystals. CONCLUSION: IL-33 mediates gout pain and inflammation by boosting macrophages production of cytokines upon MSU crystals stimulus.


Assuntos
Artrite Gotosa/patologia , Inflamação/induzido quimicamente , Interleucina-1beta/metabolismo , Interleucina-33/farmacologia , Macrófagos/metabolismo , Dor/induzido quimicamente , Animais , Artrite Gotosa/induzido quimicamente , Artrite Gotosa/metabolismo , Feminino , Humanos , Inflamação/psicologia , Proteína 1 Semelhante a Receptor de Interleucina-1/genética , Macrófagos/efeitos dos fármacos , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Knockout , Pessoa de Meia-Idade , Infiltração de Neutrófilos/efeitos dos fármacos , Dor/psicologia , Peroxidase/metabolismo , Superóxidos/metabolismo , Membrana Sinovial/patologia , Ácido Úrico
18.
PLoS One ; 15(9): e0237650, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32881940

RESUMO

BACKGROUND: Healthcare experiences associated with perceived racial/ethnic discrimination among patients are poorly understood. OBJECTIVE: Identify domains of patient dissatisfaction associated with perceived racial/ethnic discrimination among patients with pain. DESIGN: Semi-structured telephone surveys completed in 2013-2015. PARTICIPANTS: White, African American, and Latino participants who reported receiving pain management from 25 Veterans Affairs (VA) Medical Centers. MAIN MEASURES: Surveys included open-ended questions about healthcare satisfaction/dissatisfaction and a measure of perceived racial/ethnic-based discrimination while seeking VA healthcare. Binary indicators for ten qualitative domains of dissatisfaction were derived from open-ended questions. We used multilevel models to identify dissatisfaction domains associated with perceived discrimination, adjusting for patient characteristics and site. Within domains associated with discrimination, we identified the most frequent codes and examined whether patients primarily referenced clinical or non-clinical staff in their experiences. KEY RESULTS: Overall, 622 participants (30.4% White, 37.8% African American, 31.8% Latino; 57.4% female; mean age = 53.4) reported a median discrimination score of 1.0 (IQR: 1.0-1.3) on a scale of 1 to 5; 233 (37.5%) perceived any racial/ethnic discrimination in healthcare. Individually, 7 of 10 qualitative domains were significantly associated with perceived discrimination: dissatisfaction with care quality, facilities, continuity of care, interactions with staff, staff demeanor, unresolved pain, and pharmacy services (ps<0.005). In combined models stratified by racial/ethnic group, 3 domains remained statistically significant: poor interactions for Latinos (adjOR = 5.24, 95% CI = 2.28-12.06), negative demeanor for African Americans (adjOR = 2.82, 95% CI = 1.45-5.50), and unresolved pain for Whites (adjOR = 6.23, 95% CI = 2.39-16.28). Clinical staff were referenced more often than non-clinical staff for all domains (interactions: 51% vs. 30%; demeanor: 46% vs. 15%; unresolved pain: 18% vs. 1%, respectively). CONCLUSION: Negative interpersonal experiences and unresolved pain are strong correlates of perceived racial/ethnic discrimination among patients with pain. Future studies should test whether interventions targeting these domains reduce patient perceptions of racial/ethnic discrimination in healthcare.


Assuntos
Grupos Étnicos/psicologia , Dor/psicologia , Percepção , Racismo/psicologia , Inquéritos e Questionários , Veteranos/psicologia , Adolescente , Adulto , Estudos Transversais , Assistência à Saúde , Feminino , Pessoal de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Aceitação pelo Paciente de Cuidados de Saúde , Satisfação do Paciente , Adulto Jovem
19.
Gerokomos (Madr., Ed. impr.) ; 31(3): 144-148, sept. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-197349

RESUMO

La prevalencia de dolor en personas mayores de 65 años oscila entre el 30-50% en la comunidad hasta el 70% en institucionalizados. El dolor debe considerarse como un síndrome geriátrico. Para la evaluación apropiada del dolor se deben usar herramientas validadas.La demencia en sí misma no es dolorosa; se estima que el 30-50% de mayores que tienen demencia experimentan dolor crónico. Este dolor puede contribuir a aumentar los síntomas conductuales y psicológicos de la demencia.Los objetivos de esta revisión fueron examinar las escalas observacionales para el dolor validadas en español e identificar cuáles son las intervenciones no farmacológicas para tratar el dolor en personas con demencia moderada-severa.La evaluación del dolor en personas con demencia moderada o avanzada ha de ser multicontextual; siempre se aconseja preguntar directamente a la persona si refiere dolor. Las cuatro herramientas recomendadas en esta revisión son: DOLOPLUS2, PACSLAC, PAINAD y Abbey Pain Scale; estas dos últimas son las más sencillas y rápidas. La implementación de medidas no farmacológicas durante el tratamiento del dolor es positiva, por la disminución del dolor y porque también evita la polimedicación innecesaria, pero aún hay que vencer los prejuicios del personal sanitario y los problemas logísticos de su aplicación.Por último, lo más importante de esta revisión es la propuesta de intervenciones no farmacológicas concretas para tratar el dolor en personas con demencia moderada-severa y que pueden ser prescritas y llevadas a cabo por enfermería


The prevalence of pain in people over 65 years of age oscillates between 30 and 50% within the community, and reaches 70% in institutionalized patients. Pain must be considered a geriatric syndrome. In order to appropriately evaluate pain, validated must be used.Dementia in itself is not painful; it is estimated that 30-50% of older people with dementia have chronic pain. This pain may contribute to an increase in the behavioral and psychological symptoms of dementia.The aims of this revision were to examine the observational scales in pain, validated in Spanish, and identify the non-pharmacological interventions to treat pain in people with moderate to severe dementia.Evaluating pain in people with moderate to severe has to be multidimensional. It is always advised to question pain directly regarding the experience of pain. The four recommended tools in this revision are: DOLOPLUS2, PACSLAC, PAINAD and Abbey Pain Scale; the last two being simpler and quicker. The implementation of non-pharmacological measures during treatment is positive, because of pain reduction and the avoidance of unnecessary medication. However, prejudices from health professionals and organizational problems in applying these, must be overcome.The proposal of concrete non-pharmacological interventions in the treatment of pain is the most important contribution of this review, as they may be prescribed and implemented by nursing staff


Assuntos
Humanos , Manejo da Dor , Demência/epidemiologia , Dor Crônica/epidemiologia , Dor/psicologia , Demência/psicologia , Dor Crônica/psicologia , Disfunção Cognitiva/epidemiologia , Disfunção Cognitiva/psicologia
20.
Pain Res Manag ; 2020: 7409396, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32774569

RESUMO

Objectives: This study investigated the relationship between quality of life (QOL) and several factors, including pain assessments, in patients with rheumatoid arthritis (RA). Methods: This cross-sectional, single-center study enrolled 85 patients with RA. The variables investigated included demographic characteristics, the 28-joint disease activity score with C-reactive protein (DAS28-CRP), painDETECT questionnaire (PDQ), pain self-efficacy questionnaire (PSEQ), and pain catastrophizing scale (PCS). QOL was measured using the Japanese validated version of the European Quality of Life questionnaire with five dimensions and five levels (EQ-5D-5L). Results: The use of oral steroids and oral analgesics was significantly associated with low EQ-5D-5L scores (P < 0.05). EQ-5D-5L score had a significant positive association with PSEQ (r = 0.414) and significant negative association with age, disease duration, DAS28-CRP, PDQ, and PCS (r = -0.217, -0.343, -0.217, -0.277, and -0.384, respectively). Multiple regression analysis showed that the use of oral analgesics and PSEQ were independent predictors of EQ-5D-5L score (ß = -0.248, P < 0.05 and ß = 0.233, P < 0.05). Conclusions: The use of oral analgesics by RA patients may influence their QOL, which, in turn, may affect their feelings of self-efficacy. Various pain management strategies, including surgical treatment, may be explored for the treatment of RA. Furthermore, the PSEQ may be a prominent part of the patient's overall assessment.


Assuntos
Analgésicos/uso terapêutico , Artrite Reumatoide/psicologia , Qualidade de Vida , Autoeficácia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Artrite Reumatoide/tratamento farmacológico , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Dor/etiologia , Dor/psicologia , Inquéritos e Questionários , Adulto Jovem
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