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Bousché G, Koutris M, Su N, Verhoeff MC, Lobbezoo F. Predictors of patients' satisfaction after temporomandibular disorder treatment in a referral clinic. J Oral Rehabil 2024; 51:266-277. [PMID: 37727979 DOI: 10.1111/joor.13600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 04/26/2023] [Accepted: 09/07/2023] [Indexed: 09/21/2023]
Abstract
BACKGROUND Evaluating patients' satisfaction after received care for temporomandibular disorders (TMD) pain provides oral health care professionals with knowledge and tools to improve their clinical procedures. However, knowledge on patient characteristics that determine satisfaction with the received care for TMD pain is lacking. OBJECTIVE To identify potential baseline predictors for patients' satisfaction regarding the management of TMD pain upon treatment completion in a referral clinic. METHODS Eligible patients, viz., individuals of ≥16 years of age, with a TMD-pain diagnosis according the diagnostic criteria for TMD (DC/TMD), and who were treated in a referral clinic, were included. As part of their standard care, a set of diagnostic questionnaires was filled in (e.g. TMD-pain screener, graded chronic pain scale (GCPS), etc.). After completion of the received care, patients filled in a custom-made questionnaire based on patient reported experience measures (PREMs) to quantify their satisfaction with their treatment results and received care. To identify potential predictors associated with patients' satisfaction, univariate and multivariate linear regression analyses were used. RESULTS Twenty-seven patients (mean 39.6, SD 15.0) were included in this study. Overall, the patients were satisfied with the treatment results and the received care. Depressive feelings were negatively associated with satisfaction of treatment results (p = .01) and positively associated with satisfaction of received care (p = .01), while pain intensity was negatively associated with satisfaction of the received care. CONCLUSION Depressive feelings are a significant negative predictor of patients' satisfaction with the treatment result for TMD pain, while average pain intensity is a significant negative predictor of patients' satisfaction with the received care.
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Affiliation(s)
- G Bousché
- Department of Orofacial pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - M Koutris
- Department of Orofacial pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - N Su
- Department of Oral Public Health, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - M C Verhoeff
- Department of Orofacial pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - F Lobbezoo
- Department of Orofacial pain and Dysfunction, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Simons LE, Harrison LE, Boothroyd DB, Parvathinathan G, Van Orden AR, O’Brien SF, Schofield D, Kraindler J, Shrestha R, Vlaeyen JW, Wicksell RK. A randomized controlled trial of graded exposure treatment (GET living) for adolescents with chronic pain. Pain 2024; 165:177-191. [PMID: 37624900 PMCID: PMC10840960 DOI: 10.1097/j.pain.0000000000003010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 06/16/2023] [Indexed: 08/27/2023]
Abstract
ABSTRACT Graded exposure treatment (GET) is a theory-driven pain treatment that aims to improve functioning by exposing patients to activities previously feared and avoided. Combining key elements of GET with acceptance-based exposure, GET Living (GL) was developed for adolescents with chronic pain (GL). Based on robust treatment effects observed in our single-case experimental design pilot trial of GL (NCT01974791), we conducted a 2-arm randomized clinical trial comparing GL with multidisciplinary pain management (MPM) comprised of cognitive behavioral therapy and physical therapy for pain management (NCT03699007). A cohort of 68 youth with chronic musculoskeletal pain (M age 14.2 years; 81% female) were randomized to GL or MPM. Owing to COVID-19 restrictions, 54% of participants received zoom video delivered care. Assessments were collected at baseline, discharge, as well as at 3-month and 6-month follow-up. Primary outcomes were self-reported pain-related fear and avoidance. Secondary outcomes were child functional disability and parent protective responses to child pain. As hypothesized, GL improved in primary and secondary outcomes at 3-month follow-up. Contrary to our superiority hypothesis, there was no significant difference between GL and MPM. Patients reported both GL and MPM (in person and video) as credible and were highly satisfied with the treatment experience. Next steps will involve examining the single-case experimental design data embedded in this trial to facilitate an understanding of individual differences in treatment responses (eg, when effects occurred, what processes changed during treatment within the treatment arm). The current findings support GET Living and MPM for youth with chronic pain.
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Affiliation(s)
- Laura E. Simons
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, CA
| | - Lauren E. Harrison
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, CA
| | - Derek B. Boothroyd
- Quantitative Statistical Unit, Department of Medicine, Stanford University School of Medicine, Stanford, CA
| | - Gomathy Parvathinathan
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, CA
| | - Amanda R. Van Orden
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, CA
| | - Shannon F. O’Brien
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, CA
| | - Deborah Schofield
- Center for Economic Impacts of Genomic Medicine, Department of Economics, Macquarie University, Sydney, Australia
| | - Joshua Kraindler
- Center for Economic Impacts of Genomic Medicine, Department of Economics, Macquarie University, Sydney, Australia
| | - Rupendra Shrestha
- Center for Economic Impacts of Genomic Medicine, Department of Economics, Macquarie University, Sydney, Australia
| | - Johan W.S. Vlaeyen
- Center for Economic Impacts of Genomic Medicine, Department of Economics, Macquarie University, Sydney, Australia
| | - Rikard K. Wicksell
- Research group Behavior Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden & Pain Clinic, Capio St Goran Hospital, Stockholm, Sweden
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Leung T, Hess CW, Choate ES, Van Orden AR, Tremblay-McGaw AG, Menendez M, Boothroyd DB, Parvathinathan G, Griffin A, Caruso TJ, Stinson J, Weisman A, Liu T, Koeppen K, Koeppen K. Virtual Reality-Augmented Physiotherapy for Chronic Pain in Youth: Protocol for a Randomized Controlled Trial Enhanced With a Single-Case Experimental Design. JMIR Res Protoc 2022; 11:e40705. [PMID: 36508251 PMCID: PMC9793297 DOI: 10.2196/40705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 09/13/2022] [Accepted: 09/21/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Chronic musculoskeletal (MSK) pain is a prominent health concern, resulting in pain-related disability, loss of functioning, and high health care costs. Physiotherapy rehabilitation is a gold-standard treatment for improving functioning in youth with chronic MSK pain. However, increasing physical activity can feel unattainable for many adolescents because of pain-related fear and movement avoidance. Virtual reality (VR) offers an immersive experience that can interrupt the fear-avoidance cycle and improve engagement in physiotherapy. Despite promising initial findings, data are limited and often lack the rigor required to establish VR as an evidence-based treatment for MSK pain. OBJECTIVE This trial evaluates physiorehabilitation with VR in adolescents with MSK pain. This protocol outlines the rationale, design, and implementation of a randomized controlled trial enhanced with a single-case experimental design. METHODS This study is a 2-group randomized controlled trial assessing the use of physiorehabilitation with VR in adolescents with MSK pain. The authors will collaborate with physical therapists to integrate VR into their standard clinical care. For participants enrolled in standard physiotherapy, there will be no VR integrated into their physical therapy program. Primary outcomes include physical function and engagement in VR. Secondary outcomes include pain-related fear and treatment adherence. Moreover, we will obtain clinician perspectives regarding the feasibility of integrating the intervention into the flow of clinical practice. RESULTS The pilot study implementing physiorehabilitation with VR demonstrated that high engagement and use of physiorehabilitation with VR were associated with improvements in pain, fear, avoidance, and function. Coupled with qualitative feedback from patients, families, and clinicians, the pilot study results provide support for this trial to evaluate physiorehabilitation with VR for youth with chronic MSK pain. Analysis of results from the main clinical trial will begin as recruitment progresses, and results are expected in early 2024. CONCLUSIONS Significant breakthroughs for treating MSK pain require mechanistically informed innovative approaches. Physiorehabilitation with VR provides exposure to progressive challenges, real-time feedback, and reinforcement for movement and can include activities that are difficult to achieve in the real world. It has the added benefit of sustaining patient motivation and adherence while enabling clinicians to use objective benchmarks to influence progression. These findings will inform the decision of whether to proceed with a hybrid effectiveness-dissemination trial of physiorehabilitation with VR, serving as the basis for potential large-scale implementation of physiorehabilitation with VR. TRIAL REGISTRATION ClinicalTrials.gov NCT04636177; https://clinicaltrials.gov/ct2/show/NCT04636177. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/40705.
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Affiliation(s)
| | - Courtney W Hess
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, CA, United States
| | - Ellison S Choate
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, CA, United States
| | - Amanda R Van Orden
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, CA, United States
| | - Alexandra G Tremblay-McGaw
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, CA, United States
| | - Maria Menendez
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, CA, United States
| | - Derek B Boothroyd
- Quantitative Statistical Unit, Department of Medicine, Stanford University School of Medicine, Stanford, CA, United States
| | - Gomathy Parvathinathan
- Quantitative Statistical Unit, Department of Medicine, Stanford University School of Medicine, Stanford, CA, United States
| | - Anya Griffin
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, CA, United States
| | - Thomas J Caruso
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, CA, United States
| | - Jennifer Stinson
- Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, Toronto, ON, Canada.,The Research Institute, The Hospital for Sick Children, Toronto, ON, Canada
| | - Amy Weisman
- Department of Rehabilitation, Lucile Packard Children's Hospital, Stanford, CA, United States
| | - Timothy Liu
- Department of Rehabilitation, Lucile Packard Children's Hospital, Stanford, CA, United States
| | - Kurt Koeppen
- California Rehabilitation & Sports Therapy, Palo Alto, CA, United States
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Harrison LE, Webster SN, Van Orden AR, Choate E, Jehl N, Stinson J, Wicksell RK, Darnall BD, Simons LE. Agile development of a digital exposure treatment for youth with chronic musculoskeletal pain: protocol of a user-centred design approach and examination of feasibility and preliminary efficacy. BMJ Open 2022; 12:e065997. [PMID: 36109029 PMCID: PMC9478845 DOI: 10.1136/bmjopen-2022-065997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 08/23/2022] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Chronic pain affects a significant number of children and impacts multiple domains including social, emotional and behavioural functioning, and negatively impacts family functioning. Roughly 5% of youth with chronic pain experience moderate to severe pain-related disability, with pain-related fear and avoidance of activities being identified as substantial barriers to treatment engagement. Evidence supports targeted psychological and physical interventions to address these barriers (eg, graded-exposure treatment), but accessibility to intervention is undermined by a shortage of services outside of urban areas, high treatment-related costs, and long provider waitlists; highlighting the need to develop digitally delivered behavioural intervention, using agile and iterative study designs that support rapid development and timely dissemination. METHODS AND ANALYSIS This study seeks to develop an effective and scalable intervention for youth with chronic pain and their caregivers. This paper presents a user-centred protocol for the development and refinement of a digital exposure treatment for youth and caregivers, as well as the study design to examine feasibility and preliminary efficacy of the treatment using single-case experimental design (SCED). Assessments include daily diaries, completed from baseline and daily throughout the intervention (~6 weeks), and at 3-month follow-up, as well as self-report measures completed at baseline, end of intervention and 3-month follow-up. Primary outcomes include treatment satisfaction, treatment expectancy, adherence to daily dairies and functional disability. Secondary outcomes are pain-related fear and avoidance of activities, pain catastrophising and pain acceptance. We will present descriptive and model-based inference analyses, based on SCED reporting guidelines. We will calculate effect sizes for each individual on each outcome. We will examine mean treatment expectancy, credibility and satisfaction scores, and patient drop-out percentage. ETHICS AND DISSEMINATION This study is approved by the Institutional Review Board at Stanford University (protocol #53323). Findings will be actively disseminated through peer-reviewed journals, conference presentations and social media. TRIAL REGISTRATION NUMBER NCT05079984.
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Affiliation(s)
- Lauren E Harrison
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto, California, USA
| | - Sarah N Webster
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto, California, USA
| | - Amanda R Van Orden
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto, California, USA
| | - Ellison Choate
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto, California, USA
| | - Nicole Jehl
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto, California, USA
| | - Jennifer Stinson
- The Hospital for Sick Children, Toronto, Ontario, Canada
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Rikard K Wicksell
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
- Pain Clinic, Capio St. Goran Hospital, Stockholm, Sweden
| | - Beth D Darnall
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto, California, USA
| | - Laura E Simons
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Palo Alto, California, USA
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External Auditory Stimulation as a Non-Pharmacological Sleep Aid. SENSORS 2022; 22:s22031264. [PMID: 35162009 PMCID: PMC8838436 DOI: 10.3390/s22031264] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 12/09/2021] [Accepted: 01/27/2022] [Indexed: 02/07/2023]
Abstract
The increased demand for well-being has fueled interest in sleep. Research in technology for monitoring sleep ranges from sleep efficiency and sleep stage analysis to sleep disorder detection, centering on wearable devices such as fitness bands, and some techniques have been commercialized and are available to consumers. Recently, as interest in digital therapeutics has increased, the field of sleep engineering demands a technology that helps people obtain quality sleep that goes beyond the level of monitoring. In particular, interest in sleep aids for people with or without insomnia but who cannot fall asleep easily at night is increasing. In this review, we discuss experiments that have tested the sleep-inducing effects of various auditory stimuli currently used for sleep-inducing purposes. The auditory stimulations were divided into (1) colored noises such as white noise and pink noise, (2) autonomous sensory meridian response sounds such as natural sounds such as rain and firewood burning, sounds of whispers, or rubbing various objects with a brush, and (3) classical music or a preferred type of music. For now, the current clinical method of receiving drugs or cognitive behavioral therapy to induce sleep is expected to dominate. However, it is anticipated that devices or applications with proven ability to induce sleep clinically will begin to appear outside the hospital environment in everyday life.
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Unnithan AS, Chidgey BA. Pre-Visit Education on Pain Management Options Prior to the First Clinic Visit Improves Chronic Pain Patient Satisfaction with Proposed Treatment Plans. PAIN MEDICINE 2021; 22:2566-2574. [PMID: 34180994 DOI: 10.1093/pm/pnab198] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVE This study sought to evaluate if actively informing new chronic pain patients about treatment options and setting realistic expectations for care, through the use of a pre-visit informational handout prior to the first clinic visit, improved patient satisfaction with subsequently proposed treatment plans. METHODS The study was divided into two 3-month periods. During the first 3 months, with our current pain clinic practices in place, new patients (n = 147) were given surveys to establish a baseline of patient satisfaction with treatment plans proposed on their first visit. During the second 3 months, a different group of new patients (n = 156) was given a detailed informational handout which described our clinic's multimodal approach to pain management and therapeutic expectations prior to their visit with a provider. Patient satisfaction with subsequently proposed treatment plans was then assessed and compared with the baseline group. RESULTS The average patient satisfaction score for the group of patients given the informational handout was 4.21 (on a 5-point Likert scale), compared to an average score of 3.25 for the baseline group (P < .0001, unpaired t-test). 77.6% of patients given the informational handout said their proposed treatment plan met their expectations compared to 46.3% of patients in the baseline group (χ2= 31.61, two-tailed P < .0001). CONCLUSIONS Patient satisfaction with proposed chronic pain treatment plans was improved when clinic approaches to pain were explicitly outlined and therapeutic expectations were clearly established in the form of an informational handout at the outset of the first visit.
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Affiliation(s)
- Ajay S Unnithan
- Department of Anesthesiology, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, USA
| | - Brooke A Chidgey
- Department of Anesthesiology, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, USA
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Majangara MBM, Limakatso K, Parker R. Patient satisfaction at the Chronic Pain Management Clinic at Groote Schuur Hospital. SOUTHERN AFRICAN JOURNAL OF ANAESTHESIA AND ANALGESIA 2021. [DOI: 10.36303/sajaa.2021.27.5.2508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- MBM Majangara
- Pain Management Unit, Department of Anaesthesia and Perioperative Medicine, University of Cape Town,
South Africa
| | - K Limakatso
- Pain Management Unit, Department of Anaesthesia and Perioperative Medicine, University of Cape Town,
South Africa
| | - R Parker
- Pain Management Unit, Department of Anaesthesia and Perioperative Medicine, University of Cape Town,
South Africa
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Vu HTT, Mai HT, Nguyen HTT, Nguyen TTH, Nguyen TX, Nguyen TN, Pham T, Nguyen LTM, Vu GT, Pham HQ, Phan HT, Tran BX, Latkin CA, Ho CSH, Ho RCM, Nguyen AT. Older Patient Satisfaction with Chronic Pain Management in the National Geriatric Hospital in Vietnam. Patient Prefer Adherence 2020; 14:1801-1809. [PMID: 33116425 PMCID: PMC7547775 DOI: 10.2147/ppa.s265873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 08/22/2020] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The high prevalence of chronic pain and difficulties in pain management in older people are challenging for healthcare providers globally. Patient satisfaction regarding pain management is one of the measures to assess efficacy of pain control as well as healthcare services. Thus, our study aimed to evaluate the older patients' satisfaction with pain management and its associated factors in Vietnam. PATIENTS AND METHODS A cross-sectional study was conducted at National Geriatric Hospital, Hanoi, Vietnam from May to October 2018. Face-to-face interviews were conducted on 495 older patients with chronic pain by using a structured questionnaire. The Pain Treatment Satisfaction Scale (PTSS) was used to assess the level of satisfaction with pain management. A Tobit regression model was used to estimate factors associated with satisfaction toward pain management. RESULTS The mean total satisfaction score was 1.77 (SD= 0.22). Older patients were most satisfied with the aspect of side effects of pain relief medication (mean=0.66, SD=0.56). On the contrary, they were most dissatisfied with information provided about pain and its treatment and efficacy of pain relief medication. Outpatients were less satisfied with information provided, the impact of current medication and pain management in general compared to inpatients. The regression model showed that patients with severe pain tended to be more dissatisfied with pain management than those with no pain. CONCLUSION This study indicated that the general satisfaction with chronic pain management in older patients was quite good especially in the aspect of pain medication's side effects. However, dissatisfactory factors remained, including information provided about pain and efficacy of current pain medication. Intensive training regarding pain in geriatric care, health education communication for older people, and improved quality of medical services should be performed to ensure the quality of pain management, especially in the older population.
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Affiliation(s)
- Huyen Thi Thanh Vu
- Department of Geriatrics, Hanoi Medical University, Hanoi, Vietnam
- Scientific Research Department, National Geriatric Hospital, Hanoi, Vietnam
| | - Hue Thi Mai
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Huong Thi Thu Nguyen
- Department of Geriatrics, Hanoi Medical University, Hanoi, Vietnam
- Scientific Research Department, National Geriatric Hospital, Hanoi, Vietnam
- Correspondence: Huong Thi Thu Nguyen Scientific Research Department, National Geriatric Hospital, 1A Phuong Mai - Dong Da, Hanoi100000, VietnamTel +84 973056334 Email
| | - Thu Thi Hoai Nguyen
- Department of Geriatrics, Hanoi Medical University, Hanoi, Vietnam
- Scientific Research Department, National Geriatric Hospital, Hanoi, Vietnam
| | - Thanh Xuan Nguyen
- Department of Geriatrics, Hanoi Medical University, Hanoi, Vietnam
- Scientific Research Department, National Geriatric Hospital, Hanoi, Vietnam
- Dinh Tien Hoang Institute of Medicine, Hanoi, Vietnam
| | - Tam Ngoc Nguyen
- Department of Geriatrics, Hanoi Medical University, Hanoi, Vietnam
- Scientific Research Department, National Geriatric Hospital, Hanoi, Vietnam
| | - Thang Pham
- Department of Geriatrics, Hanoi Medical University, Hanoi, Vietnam
- Scientific Research Department, National Geriatric Hospital, Hanoi, Vietnam
| | | | - Giang Thu Vu
- Center of Excellence in Evidence-Based Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
| | - Hai Quang Pham
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam
- Faculty of Medicine, Duy Tan University, Da Nang, Vietnam
| | - Hai Thanh Phan
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam
- Faculty of Medicine, Duy Tan University, Da Nang, Vietnam
| | - Bach Xuan Tran
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Carl A Latkin
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Cyrus S H Ho
- Department of Psychological Medicine, National University Hospital, Singapore, Singapore
| | - Roger C M Ho
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore, Singapore
| | - Anh Trung Nguyen
- Department of Geriatrics, Hanoi Medical University, Hanoi, Vietnam
- Scientific Research Department, National Geriatric Hospital, Hanoi, Vietnam
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Gruß I, Firemark A, McMullen CK, Mayhew M, DeBar LL. Satisfaction with Primary Care Providers and Health Care Services Among Patients with Chronic Pain: a Mixed-Methods Study. J Gen Intern Med 2020; 35:190-197. [PMID: 31637639 PMCID: PMC6957630 DOI: 10.1007/s11606-019-05339-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 07/03/2019] [Accepted: 08/21/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Chronic pain is a prevalent health concern in the United States (US) and a frequent reason for patients to seek primary care. The challenges associated with developing effective pain management strategies can be perceived as a burden on the patient-provider relationship. OBJECTIVE This study explored the relationship between patients' overall satisfaction with their primary care providers (PCPs) and their satisfaction with their chronic pain treatment, as well as the provider behaviors that contributed to chronic pain patients' satisfaction with their PCPs. DESIGN Concurrent nested mixed-methods design PARTICIPANTS: 97 patients with chronic pain who were assigned to the usual care arm of the Pain Program for Active Coping and Training (PPACT) study. APPROACH We analyzed phone interview and survey data (n = 97). Interviews assessed provider behaviors that led to patient satisfaction. Interview transcripts were analyzed based on a content analysis approach. Survey responses assessed patient satisfaction with primary care and pain services. We calculated a Pearson's correlation coefficient using five response categories. KEY RESULTS Interviews revealed that high satisfaction with primary care was driven by five concrete PCP behaviors: (1) listening, (2) maintaining communication with patients, (3) acting as an access point to comprehensive pain care, (4) providing an honest assessment of the possibilities of pain care, and (5) taking time during consultations with patients. In surveys, participants reported higher satisfaction with their primary care services than with the pain services they received; these variables were only moderately correlated (r = 0.586). CONCLUSIONS Results suggest that patients with chronic pain can view the relationship with their PCPs as positive, even in the face of low satisfaction with their pain treatment. The expectations that these patients held of PCPs could be met regardless of providers' ability to successfully relieve chronic pain.
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Affiliation(s)
- Inga Gruß
- Kaiser Permanente Center for Health Research, Portland, OR, USA.
| | - Alison Firemark
- Kaiser Permanente Center for Health Research, Portland, OR, USA
| | | | - Meghan Mayhew
- Kaiser Permanente Center for Health Research, Portland, OR, USA
| | - Lynn L DeBar
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
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Russo M, Verrills P, Santarelli D, Gupta S, Martin J, Hershey B. A Novel Composite Metric for Predicting Patient Satisfaction With Spinal Cord Stimulation. Neuromodulation 2019; 23:687-697. [DOI: 10.1111/ner.13072] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 09/15/2019] [Accepted: 10/10/2019] [Indexed: 10/25/2022]
Affiliation(s)
- Marc Russo
- Hunter Pain Clinic Broadmeadow, NSW Australia
| | | | | | - Swati Gupta
- Boston Scientific Corporation Valencia CA USA
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Simons LE, Harrison LE, O'Brien SF, Heirich MS, Loecher N, Boothroyd DB, Vlaeyen JW, Wicksell RK, Schofield D, Hood KK, Orendurff M, Chan S, Lyons S. Graded exposure treatment for adolescents with chronic pain (GET Living): Protocol for a randomized controlled trial enhanced with single case experimental design. Contemp Clin Trials Commun 2019; 16:100448. [PMID: 31650069 PMCID: PMC6804549 DOI: 10.1016/j.conctc.2019.100448] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 08/22/2019] [Accepted: 09/05/2019] [Indexed: 01/06/2023] Open
Abstract
Chronic musculoskeletal pain in adolescence is a significant public health concern with 3-5% of adolescents suffering from significant pain-related disability. Pain-related fear and avoidance of activities has been found to have a significant influence on pain outcomes in children and adolescents and is a risk factor for less favorable response to treatment. To address this need, we developed graded exposure treatment for youth with chronic pain (GET Living). We describe the rationale, design, and implementation of a two-group randomized controlled trial (RCT) enhanced with single-case experimental design (SCED) methodology with a sample of 74 adolescents with chronic musculosketal pain and their parent caregivers. GET Living includes education, behavioral exposures, and parent intervention jointly delivered by pain psychology and physical therapy providers. The multidisciplinary pain management control group includes pain psychology delivered education and pain self-management skills training (e.g., relaxation, cognitive skills) and separate physical therapy. Assessments include brief daily diaries (baseline to discharge, 7-days at 3-month and 6-month follow-up), comprehensive in-person evaluations at baseline and discharge, and questionnaire across all time points (baseline, discharge, 3-month and 6-month follow-up). Primary outcome is pain-related fear avoidance. Secondary outcome is functional disability. We also outline all additional outcomes, exploratory outcomes, covariates, and implementation measures. The objective is to offer a mechanism-based, targeted intervention to youth with musculoskeletal pain to enhance likelihood of return to function.
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Affiliation(s)
- Laura E. Simons
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA
- Corresponding author. Stanford University School of Medicine, 1070 Arastradero Road, Palo Alto, CA, 94304, USA.
| | - Lauren E. Harrison
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Shannon F. O'Brien
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Marissa S. Heirich
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Nele Loecher
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Derek B. Boothroyd
- Quantitative Statistical Unit, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Johan W.S. Vlaeyen
- Research Group Health Psychology, KU Leuven, Leuven, Belgium
- Research Group Experimental Health Psychology, Maastricht University, Maastricht, The Netherlands
| | - Rikard K. Wicksell
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Deborah Schofield
- Center for Economic Impacts of Genomic Medicine, Department of Economics, Macquarie University, Sydney, Australia
| | - Korey K. Hood
- Division of Endocrinology and Diabetes, Diabetes Research Center, Stanford University School of Medicine, Stanford, CA, USA
| | - Michael Orendurff
- Motion and Sports Performance Lab, Department of Orthopedic Sports Medicine, Lucile Packard Children's Hospital, Stanford, CA, USA
| | - Salinda Chan
- Motion and Sports Performance Lab, Department of Orthopedic Sports Medicine, Lucile Packard Children's Hospital, Stanford, CA, USA
| | - Sam Lyons
- Motion and Sports Performance Lab, Department of Orthopedic Sports Medicine, Lucile Packard Children's Hospital, Stanford, CA, USA
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12
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Oliveira DS, Vélia Ferreira Mendonça L, Sofia Monteiro Sampaio R, Manuel Pereira Dias de Castro-Lopes J, Ribeiro de Azevedo LF. The Impact of Anxiety and Depression on the Outcomes of Chronic Low Back Pain Multidisciplinary Pain Management-A Multicenter Prospective Cohort Study in Pain Clinics with One-Year Follow-up. PAIN MEDICINE 2019; 20:736-746. [PMID: 30010966 DOI: 10.1093/pm/pny128] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE The psychological health of patients with chronic low back pain (CLBP) influences their response to a number of conservative and invasive pain treatments. However, evidence is still scarce regarding the impact of anxiety and depression in the clinical outcomes of multidisciplinary pain management over time. This study, based on longitudinal data from a clinical practice setting, aimed to assess the effectiveness of the usual multidisciplinary approach provided to CLBP patients and to explore the impact of anxiety and depression symptoms and their interaction on clinical outcomes. METHODS In this study, participants included were adult patients in their first consultation in a multidisciplinary chronic pain clinic. Anxiety and depression symptoms were assessed with the Hospital Anxiety and Depression Scale (HADS). The Brief Pain Inventory (BPI) and the Shortened Treatment Outcomes in Pain Survey (S-TOPS) were used to assess outcomes. Linear mixed effects models were used to assess the impact of anxiety, depression, and their interaction on treatment outcomes. RESULTS A total of 284 patients (age 60.4 ± 13.7 years, 74.6% female) with CLBP were included at baseline. The majority of patients had both anxiety and depression and experienced higher pain severity (P < 0.001) and higher pain-related disability (P < 0.001). Anxiety and depression mainly predicted changes in pain interference over time. Their interaction significantly predicted changes in pain interference. CONCLUSIONS Anxiety, depression, and their interaction are associated with changes in pain disability at one-year follow-up. These findings encourage the pretreatment screening of anxiety and depression as independent symptoms in patients with CLBP in order to design more tailored and effective multidisciplinary treatments.
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Affiliation(s)
| | | | - Rute Sofia Monteiro Sampaio
- Department of Biomedicine, Faculty of Medicine, University of Porto, Portugal.,Institute for Molecular and Cell Biology (IBMC), University of Porto, Portugal
| | - José Manuel Pereira Dias de Castro-Lopes
- Department of Biomedicine, Faculty of Medicine, University of Porto, Portugal.,Institute for Molecular and Cell Biology (IBMC), University of Porto, Portugal.,National Observatory for Pain (NOPain), Porto, Portugal
| | - Luís Filipe Ribeiro de Azevedo
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, Portugal.,Centre for Health Technology and Services Research (CINTESIS), University of Porto, Porto, Portugal.,National Observatory for Pain (NOPain), Porto, Portugal
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13
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Mitrić M, Seewald A, Moschetti G, Sacerdote P, Ferraguti F, Kummer KK, Kress M. Layer- and subregion-specific electrophysiological and morphological changes of the medial prefrontal cortex in a mouse model of neuropathic pain. Sci Rep 2019; 9:9479. [PMID: 31263213 PMCID: PMC6603192 DOI: 10.1038/s41598-019-45677-z] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 06/12/2019] [Indexed: 01/21/2023] Open
Abstract
Chronic neuropathic pain constitutes a serious public health problem, but the disease mechanisms are only partially understood. The involvement of different brain regions like the medial prefrontal cortex has already been established, but the comparison of the role of different subregions and layers is still inconclusive. In the current study, we performed patch-clamp recordings followed by anatomical reconstruction of pyramidal cells from different layers of the prelimbic and infralimbic subregions of the medial prefrontal cortex in neuropathic (spared nerve injury, SNI) and control mice. We found that in the prelimbic cortex, layer 2/3 pyramidal cells from SNI mice exhibited increased excitability compared to sham controls, whereas prelimbic layer 5 pyramidal neurons showed reduced excitability. Pyramidal cells in both layer 2/3 and layer 5 of the infralimbic subregion did not change their excitability, but layer 2/3 pyramidal cells displayed increased dendritic length and branching. Our findings support the view that chronic pain is associated with subregion- and layer-specific changes in the medial prefrontal cortex. They therefore provide new insights into the mechanisms underlying the chronification of pain.
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Affiliation(s)
- Miodrag Mitrić
- Division of Physiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Anna Seewald
- Department of Pharmacology, Medical University of Innsbruck, Innsbruck, Austria
| | - Giorgia Moschetti
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy
| | - Paola Sacerdote
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy
| | - Francesco Ferraguti
- Department of Pharmacology, Medical University of Innsbruck, Innsbruck, Austria
| | - Kai K Kummer
- Division of Physiology, Medical University of Innsbruck, Innsbruck, Austria.
| | - Michaela Kress
- Division of Physiology, Medical University of Innsbruck, Innsbruck, Austria
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14
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Veiga DR, Monteiro-Soares M, Mendonça L, Sampaio R, Castro-Lopes JM, Azevedo LF. Effectiveness of Opioids for Chronic Noncancer Pain: A Two-Year Multicenter, Prospective Cohort Study With Propensity Score Matching. THE JOURNAL OF PAIN 2019; 20:706-715. [DOI: 10.1016/j.jpain.2018.12.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 12/19/2018] [Accepted: 12/19/2018] [Indexed: 10/27/2022]
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15
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Forestier B, Anthoine E, Reguiai Z, Fohrer C, Blanchin M. A systematic review of dimensions evaluating patient experience in chronic illness. Health Qual Life Outcomes 2019; 17:19. [PMID: 30665417 PMCID: PMC6341593 DOI: 10.1186/s12955-019-1084-2] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 01/07/2019] [Indexed: 12/23/2022] Open
Abstract
Background Living with a chronic disease often means experiencing chronic treatments and regular multidisciplinary monitoring as well as a profound life-changing experience which may impact all aspects of a patients life. The patient experience of chronic disease is frequently assessed by patient reported measures (PRMs) which incorporate patients perspectives to better understand how illness, treatment and care impact the entirety of a patient’s life. The purpose of this review was to collect and review different kinds of available PRM instruments validated for chronic patients, to produce an inventory of explored concepts in these questionnaires and to identify and classify all dimensions assessing chronic patients experience. Methods A systematic review of PRM instruments validated for chronic patients was conducted from three databases (Medline, the Cochrane library, and Psycinfo). Articles were selected after a double reading and questionnaires were classified according to their targeted concept. Then, all dimensions of the questionnaires were clustered into different categories. Results 107 primary validation studies of PRM questionnaires were selected. Five kinds of instruments were recorded: 1) Questionnaires assessing health related quality of life or quality of life; 2) Instruments focusing on symptoms and functional status; 3) Instruments exploring patients’ feelings and attitude about illness; 4) Questionnaires related to patients’ experience of treatment or healthcare; 5) Instruments assessing patients attitudes about treatment or healthcare. Twelve categories of dimensions were obtained from these instruments. Conclusions This review provided an overview of some of the dimensions used to explore chronic patient experience. A large PRM diversity exists and none of the reviewed and selected questionnaires covered all identified categories of dimensions of patient experience of chronic disease. Furthermore, the definition of explored concepts varies widely among researchers and complex concepts often lack a clear definition in the reviewed articles. Before attempting to measure chronic patient experience, researchers should construct appropriate instruments focusing on well-defined concepts and dimensions encompassing patient’s personal experience, attitude and adaptation to illness, treatment or healthcare. Electronic supplementary material The online version of this article (10.1186/s12955-019-1084-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Bastien Forestier
- UMR U1246 SPHERE "methodS in Patient centered outcomes & HEalth REsearch", Université de Nantes, Université de Tours, INSERM, Nantes, France.,Pôle de santé publique, CHU de Nantes, Nantes, France
| | - Emmanuelle Anthoine
- UMR U1246 SPHERE "methodS in Patient centered outcomes & HEalth REsearch", Université de Nantes, Université de Tours, INSERM, Nantes, France.,Pôle de santé publique, CHU de Nantes, Nantes, France
| | - Ziad Reguiai
- Service de dermatologie, Polyclinique Courlancy, Reims, France
| | - Cécile Fohrer
- Service d'hématologie clinique, CHU de Strasbourg, Strasbourg, France
| | - Myriam Blanchin
- UMR U1246 SPHERE "methodS in Patient centered outcomes & HEalth REsearch", Université de Nantes, Université de Tours, INSERM, Nantes, France.
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16
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What Do Different Measures of Pain Tell Us? A Comparison in Sexually Active Women With Provoked Vestibulodynia. J Sex Med 2019; 16:278-288. [PMID: 30655181 DOI: 10.1016/j.jsxm.2018.12.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 11/23/2018] [Accepted: 12/03/2018] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Studies of pain measurement in women with provoked vestibulodynia (PVD) use various methods of capturing pain intensity. The degree to which these different measures of pain correspond with one another is not known. AIM To compare 3 different measures of pain intensity in sexually active women with PVD participating in a clinical treatment study. METHODS A total of 64 women (mean age 30.9 years) provided baseline measures of pain intensity using (i) a numeric rating scale that provided a self-report of pain during recalled vaginal penetration; (ii) the pain subscale of the female sexual function index; and (iii) pain elicited with a vulvalgesiometer, an objective method of eliciting pain. MAIN OUTCOME MEASURE Correlations among these 3 measures of pain were moderate in size (range r = 0.39-0.61). Moreover, the numeric rating scale of pain was more likely to be associated with self-reported measures of pain catastrophizing and pain hypervigilance than were scores on the pain subscale of the female sexual function index or scores from the vulvalgesiometer. CLINICAL IMPLICATIONS Overall, there was a moderate level of correlation between different often-used measures of pain in women with PVD. These findings suggest that, in addition to measuring a common dimension, these different measures tap into different aspects of women's experiences with vulvovaginal pain, and researchers should consider how the chosen measure addresses their primary research question when selecting pain measures in future PVD research. STRENGTHS & LIMITATIONS A strength of this study was the large sample size (n = 64 sexually active women) who had received confirmed clinical diagnoses of PVD. 1 limitation of the findings is that our self-report outcome measures are based on retrospective ratings of pain over 4 weeks, and it is possible that other variables, such as mood, could have impacted scores on these measures. CONCLUSION This study showed statistically significant and moderate correlations among 3 different pain measures widely used in PVD research and treatment. In addition, only 1 pain measure showed a significant independent association with emotion function measures. These findings provide a rationale for including multiple measures of pain and emotional function in treatment outcome studies of PVD. Wammen Rathenborg FL, Zdaniuk B, Brotto LA. What Do Different Measures of Pain Tell Us? A Comparison in Sexually Active Women With Provoked Vestibulodynia. J Sex Med 2019;16:278-288.
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17
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Caruso TJ, Kung TH, Good J, Taylor K, Ashland M, Cunningham C, Gonzalez E, Wood M, Sharek P. Improving Satisfaction with Pediatric Pain Management by Inviting the Conversation. Jt Comm J Qual Patient Saf 2018; 44:227-232. [DOI: 10.1016/j.jcjq.2017.10.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 10/12/2017] [Indexed: 10/17/2022]
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18
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Geurts JW, Willems PC, Lockwood C, van Kleef M, Kleijnen J, Dirksen C. Patient expectations for management of chronic non-cancer pain: A systematic review. Health Expect 2016; 20:1201-1217. [PMID: 28009082 PMCID: PMC5689237 DOI: 10.1111/hex.12527] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2016] [Indexed: 11/29/2022] Open
Abstract
Background Chronic pain is a major economic and social health problem. Up to 79% of chronic pain patients are unsatisfied with their pain management. Meeting patients’ expectations is likely to produce greater satisfaction with care. The challenge is to explore patients’ genuine expectations and needs. However, the term expectation encompasses several concepts and may concern different aspects of health‐care provision. Objective This review aimed to systematically collect information on types and subject of patients’ expectations for chronic pain management. Search strategy We searched for quantitative and qualitative studies. Because of the multidimensional character of the term “expectations,” the search included subject headings and free text words related to the concept of expectations. Data extraction and synthesis A framework for understanding patients’ expectations was used to map types of expectations within structure, process or outcome of health care. Main results Twenty‐three research papers met the inclusion criteria: 18 quantitative and five qualitative. This review found that assessment of patients’ expectations for treatment is mostly limited to outcome expectations (all 18 quantitative papers and four qualitative papers). Patients generally have high expectations regarding pain reduction after treatment, but expectations were higher when expressed as an ideal expectation (81‐93% relief) than as a predicted expectation (44‐64%). Discussion and conclusions For health‐care providers, for pain management and for pain research purposes, the awareness that patients express different types of expectations is important. For shared decision making in clinical practice, it is important that predicted expectations of the patient are known to the treating physician and discussed. Structure and process expectations are under‐represented in our findings. However, exploring and meeting patients’ expectations regarding structure, process and outcome aspects of pain management may increase patient satisfaction.
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Affiliation(s)
- Jose W Geurts
- Department of Anaesthesiology and Pain Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Paul C Willems
- Department of Orthopaedic Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Craig Lockwood
- The Joanna Briggs Institute, The University of Adelaide, Adelaide, SA, Australia
| | - Maarten van Kleef
- Department of Anaesthesiology and Pain Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jos Kleijnen
- School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.,Kleijnen Systematic Reviews Ltd, York, UK
| | - Carmen Dirksen
- Department of Clinical Epidemiology and Medical Technology, Maastricht University Medical Centre, Maastricht, The Netherlands
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Satisfaction With the Outcome of Physical Therapist-Prescribed Exercise in Chronic Whiplash-Associated Disorders: Secondary Analysis of a Randomized Clinical Trial. J Orthop Sports Phys Ther 2016; 46:640-9. [PMID: 27374016 DOI: 10.2519/jospt.2016.6136] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Study Design Secondary analysis of a randomized clinical trial. Background Patient perception of the benefits gained from treatment is important, yet satisfaction with the outcome of treatment for chronic whiplash-associated disorders (WADs) has not been investigated. Objectives To investigate whether satisfaction with the outcome of treatment for chronic WAD changed over time, and whether there were group differences. Methods Two hundred sixteen people with chronic WAD (66% women; mean age, 40.4 years) participated in a 3-month program of physical therapist-led neck-specific exercises with or without a behavioral approach, or received a prescription of general physical activity. The main outcome was satisfaction with the outcome of treatment, assessed at baseline and 3, 6, and 12 months later. Additional outcomes were enablement and expectation fulfillment. Results Satisfaction improved over time in the 3 groups (odds ratio = 1.15; 95% confidence interval: 1.10, 1.20; P<.001). There was a significant group-by-time interaction (P<.001), with increased odds of being satisfied in the groups receiving neck-specific exercises compared to general physical activity. Enablement increased after completion of the intervention in all groups (P<.001). People who received neck-specific exercises reported greater enablement and expectation fulfillment than people prescribed general physical activity (P<.01). Conclusion Exercise interventions for chronic WAD led to increased satisfaction for 12 months following treatment that was unrelated to the type of exercise intervention received. Level of Evidence Therapy, level 1b. Registered January 22, 2012 at www.ClinicalTrials.gov (NCT01528579). J Orthop Sports Phys Ther 2016;46(8):640-649. Epub 3 Jul 2016. doi:10.2519/jospt.2016.6136.
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Parpa E, Galanopoulou N, Tsilika E, Galanos A, Mystakidou K. Psychometric Properties of the Patients' Satisfaction Instrument FAMCARE-P13 in a Palliative Care Unit. Am J Hosp Palliat Care 2016; 34:597-602. [PMID: 27103067 DOI: 10.1177/1049909116645511] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
PURPOSE To investigate the psychometric properties of the Greek 13-item measure of patients' satisfaction (FAMCARE-P13) in palliative care setting. METHODS A hundred patients completed the FAMCARE-P13. Exploratory factor analysis and confirmatory factor analysis (CFA) have been conducted. Two factors' solution was revealed from CFA. The questionnaire was administered to an initial validation sample and then for test-retest in a sample of 40 patients 3 days later. The Rosenberg Self-Esteem Scale measuring global self-esteem has been also used as a gold standard for construct validity. Subscale and known groups validity have also been tested for FAMCARE-P13s' validity. RESULTS A reduced 13-item version of our measure (FAMCARE-P13) possessed 2-factor structure with high reliability. Patient satisfaction was correlated with physical distress, communication and relationship with health-care providers, and caregiver satisfaction. CONCLUSIONS We recommend the use of the Greek FAMCARE-P13 to assess care satisfaction of patients with advanced-stage cancer.
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Affiliation(s)
- Efi Parpa
- 1 Pain Relief and Palliative Care Unit, Department of Radiology, Areteion Hospital, School of Medicine, National & Kapodistrian University of Athens, Athens, Greece
| | | | - Eleni Tsilika
- 1 Pain Relief and Palliative Care Unit, Department of Radiology, Areteion Hospital, School of Medicine, National & Kapodistrian University of Athens, Athens, Greece
| | - Antonis Galanos
- 1 Pain Relief and Palliative Care Unit, Department of Radiology, Areteion Hospital, School of Medicine, National & Kapodistrian University of Athens, Athens, Greece
| | - Kyriaki Mystakidou
- 1 Pain Relief and Palliative Care Unit, Department of Radiology, Areteion Hospital, School of Medicine, National & Kapodistrian University of Athens, Athens, Greece
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21
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Scherer S, Alder J, Gaab J, Berger T, Ihde K, Urech C. Patient satisfaction and psychological well-being after internet-based cognitive behavioral stress management (IB-CBSM) for women with preterm labor: A randomized controlled trial. J Psychosom Res 2016; 80:37-43. [PMID: 26721546 DOI: 10.1016/j.jpsychores.2015.10.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Revised: 10/28/2015] [Accepted: 10/30/2015] [Indexed: 12/20/2022]
Abstract
OBJECTIVE AND METHODS Despite its value for the management of psychological burden, little is known about the efficacy of and patient satisfaction with internet-based cognitive behavioral stress management (IB-CBSM) for women with preterm labor. The present study sets out to analyze stress/anxiety reduction, patient satisfaction and patient's working alliance in a group of 58 women with preterm labor participating in an online psychological stress management project. As part of the project, women were randomly assigned to online stress management or a control condition. RESULTS Levels of stress and anxiety decreased significantly in both conditions from pre- to post-treatment measure. Participants in IB-CBSM reported significant higher working alliance inventory (WAI) scores in the task and goal subscale (p<.001; p<.05) than women in the control condition. In Addition the IB-CBSM group showed significant correlations of the WAI subscale task and goal and the stress/anxiety outcome. Regarding patient satisfaction, women in the IB-CBSM reported significantly higher satisfaction scores (p<.001) than women in the control condition. WAI explained nearly 40% of the variance in patient satisfaction. Furthermore, WAI mediates, at least in part, the relationship between group condition and patient satisfaction. CONCLUSION The current analysis indicated that participants in IB-CBSM had higher WAI scores and were more satisfied with the program. In addition only the IB-CBSM group showed significant correlations of the WAI with the stress/anxiety reduction outcome. Based on these findings, it can be presumed that measures of agreement with working alliance parameters, especially task and goal components, are substantially important for more effective and satisfactory therapeutic interventions.
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Affiliation(s)
- S Scherer
- Women's Hospital, University Hospital Basel, Switzerland.
| | - J Alder
- Clinical Psychology and Psychotherapy, Department of Psychology, University of Basel, Switzerland
| | - J Gaab
- Clinical Psychology and Psychotherapy, Department of Psychology, University of Basel, Switzerland
| | - T Berger
- Clinical Psychology and Psychotherapy, Department of Psychology, University of Bern, Switzerland
| | - K Ihde
- Clinical Psychology and Psychotherapy, Department of Psychology, University of Basel, Switzerland
| | - C Urech
- Women's Hospital, University Hospital Basel, Switzerland
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22
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Au CPY, Fardell N, Williams M, Fraser-Bell S, Campain A, Gillies M. Patient experiences in retinal trials: a cross-sectional study. BMC Ophthalmol 2015. [PMID: 26202164 PMCID: PMC4511246 DOI: 10.1186/s12886-015-0071-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Background Patient-centered care recognizes the obligation to understand and meet patient’s expectations. An individual’s satisfaction has been found to affect health-related decisions and treatment-related behaviours, which in turn affect medical compliance, follow-up, the success of treatment and the appropriate use of services. We studied the expectations, experiences and satisfaction of patients who participated in clinical trials for retinal diseases at the Sydney Eye Hospital. Methods The study was undertaken at the research clinic of the major public quaternary eye hospital in New South Wales, Australia. A 37-question survey was conducted on patients enrolled in or who had finished a clinical trial for macular disease in the 12 months preceding this study in November 2012. Patient satisfaction was assessed using close-ended, multiple choice questions. First, the decision making process for entering into the clinical trial was evaluated. Then the level of patient understanding and experience during the study was assessed. Finally, there was a series of questions to gauge the participants’ perception of trial outcomes and overall impression gained from the experience. Results Eighty patients completed the questionnaire. Overall patient satisfaction was high with the majority of patients stating they would recommend participation in a retinal clinical trial (94 %) and participate in a subsequent trial (78 %). Most patients rated themselves as the most important factor in making the decision to join a trial. Patients felt well informed and expectations were generally felt to be met, however 14 % did not believe that they could withdraw from the study voluntarily. The most common reasons for trial participation were to contribute to medical science and to have improved treatment outcomes. Conclusions We found that patients generally found participation in retinal clinical trials to be a positive experience. Factors contributing to dissatisfaction mainly related to inconvenience experienced by transportation and waiting times. We also found that patients felt well informed about the study, but some did not have a complete understanding of their rights, which had been communicated to them when they entered the study. There were both altruistic and self-motivated reasons behind patients’ decisions to join a retinal trial. Electronic supplementary material The online version of this article (doi:10.1186/s12886-015-0071-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Cheryl Pui-Yan Au
- Department of Ophthalmology, Westmead Hospital, Sydney, Australia. .,Sydney Medical School, University of Sydney, Sydney, Australia.
| | - Nicole Fardell
- Sydney Medical School, University of Sydney, Sydney, Australia.
| | - Maria Williams
- Macular Research Group, Room 116, Level 1, Save Sight Institute, Campus of Sydney Eye Hospital, 8 Macquarie St, Sydney, NSW, 2000, Australia.
| | - Samantha Fraser-Bell
- Macular Research Group, Room 116, Level 1, Save Sight Institute, Campus of Sydney Eye Hospital, 8 Macquarie St, Sydney, NSW, 2000, Australia.
| | - Anna Campain
- Macular Research Group, Room 116, Level 1, Save Sight Institute, Campus of Sydney Eye Hospital, 8 Macquarie St, Sydney, NSW, 2000, Australia.
| | - Mark Gillies
- Sydney Medical School, University of Sydney, Sydney, Australia. .,Macular Research Group, Room 116, Level 1, Save Sight Institute, Campus of Sydney Eye Hospital, 8 Macquarie St, Sydney, NSW, 2000, Australia.
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23
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Wong WS, Chow YF, Chen PP, Wong S, Fielding R. A longitudinal analysis on pain treatment satisfaction among Chinese patients with chronic pain: predictors and association with medical adherence, disability, and quality of life. Qual Life Res 2015; 24:2087-97. [PMID: 25749925 DOI: 10.1007/s11136-015-0955-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Patient satisfaction research in chronic pain treatment is scarce internationally and is nonexistent in Chinese communities like Hong Kong. This longitudinal study examined the relationships between medical adherence, pain treatment satisfaction, disability, and quality of life (QoL) in a sample of Chinese patients with chronic pain. METHODS A total of 178 patients with chronic pain were assessed at baseline, 3 and 6 months following baseline. Medical adherence and pain treatment satisfaction were assessed by the Participant Compliance Reporting Scale and the Pain Treatment Satisfaction Scale (PTSS), respectively. QoL, depression, pain catastrophizing, and pain-related fear were assessed using SF-12, the depression subscale of the Hospital Anxiety and Depression Scale (HADS-D), the Pain Catastrophizing Scale, and the Tampa Scale for Kinesiophobia, respectively. Linear mixed effects models (LME) were fitted to identify predictors of pain treatment satisfaction, medical adherence, and QoL. RESULTS Results of univariate LME analyses showed significant quadratic time effects on four PTSS scores and significant associations between disability grade and PTSS scores (all p < 0.05). Medical adherence was not significantly associated with satisfaction regarding pain medication (model 1). Satisfaction with medication characteristics emerged as an independent predictor of medical adherence (model 2: std β = -0.11, p < 0.05) after controlling for sociodemographic and pain variables. Neither medical adherence nor pain treatment satisfaction predicted QoL outcomes (models 3 and 4). CONCLUSIONS Distinct trajectories in pain treatment satisfaction were displayed in the current sample of Chinese patients with different disability grading chronic pain. Within pain treatment, only medication characteristics significantly impacted patients' medical adherence.
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Affiliation(s)
- W S Wong
- Department of Psychological Studies and Centre for Psychosocial Health, The Hong Kong Institute of Education, 10 Lo Ping Road, Tai Po, Hong Kong SAR, China,
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Abstract
OBJECTIVE Despite treatment availability, many cancer patients experience severe pain. Although patient assessments of care are increasingly employed to evaluate quality of care, little is known about its association with cancer symptom burden. The objective of our study was to examine the association between patient-reported quality of care and pain severity in a nationally representative cohort of cancer patients. METHOD Quality of care was measured in three domains: physician communication, care coordination/responsiveness, and nursing care. Quality scores were dichotomized as optimal versus nonoptimal. Pain was measured on a scale of 0 (least) to 100 (worst). We utilized multivariable linear regression to examine the association between patient-reported quality of care and pain severity. RESULTS The analytic sample included 2,746 individuals. Fifty and 54% of patients, respectively, rated physician communication and care coordination/responsiveness as nonoptimal; 28% rated nursing care as nonoptimal. In adjusted models, rating physician communication as nonoptimal (versus optimal) was associated with a 1.8-point higher pain severity (p = 0.018), and rating care coordination/responsiveness as nonoptimal was associated with a 2.2-point higher pain severity (p = 0.006). SIGNIFICANCE OF RESULTS Patient-reported quality of care was significantly associated with pain severity, although the differences were small. Interventions targeting physician communication and care coordination/responsiveness may result in improved pain control for some patients.
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Blasche G, Marktl W, Eisenwort B, Skolka A, Pichlhöfer O. The treatment experience questionnaire: development and validation of a questionnaire assessing the individual's emotional, perceptual, and cognitive reactions to alternative, physical, and dental treatments. Complement Med Res 2014; 20:205-12. [PMID: 23860022 DOI: 10.1159/000351456] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
BACKGROUND The aim of this study was to develop and validate a questionnaire designed to assess the patient's affective, cognitive, and perceptual state during treatment administration. METHODS 362 individuals (214 females, 148 males, mean age 54.6 years) with predominantly musculoskeletal or dental problems participated in the study. Patients responded to the questionnaire immediately following a treatment. The questionnaire included items of 9 proposed scales devised to assess mood, psychological tension, sleepiness, mental absorption, treatment appraisal, perceived cooperation during treatment administration, perceived somatosensory intensity of treatment as well as negative and positive bodily sensations during treatment. Treatments were administered in 2 spa centers, a clinic for physical medicine and rehabilitation and a clinic for dentistry. Treatments investigated were among others dental treatment, massage, packs, baths, relaxation training, exercise, and acupuncture. RESULTS The proposed scales were confirmed. Scales had adequate to good reliability and validity. All scales significantly distinguished between treatments. CONCLUSION The devised questionnaire has adequate properties to assess patients' experiences during treatment administration.
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Affiliation(s)
- Gerhard Blasche
- Department of Environmental Hygiene, Center for Public Health, Medical University of Vienna, Vienna, Austria.
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Yi TI, Kim BK, Ha SA, Lim JY. The relationships between determination of treatment success and emotional factors in patients with chronic musculoskeletal pain. Ann Rehabil Med 2014; 38:77-83. [PMID: 24639930 PMCID: PMC3953368 DOI: 10.5535/arm.2014.38.1.77] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Accepted: 09/17/2013] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To investigate the relationship of the patient's criteria of successful treatment to emotional factors in patients with chronic musculoskeletal pain. METHODS Patients who visited our outpatient hospital due to chronic musculoskeletal pain were evaluated using a questionnaire survey. Patients were evaluated with the Patient-Centered Outcomes Questionnaire (PCOQ) to investigate their expectation and criteria for success regarding treatment of chronic musculoskeletal pain. Beck Depression Inventory and State-Trait Anxiety Inventory were used to check for psychological variables. Correlations among each of the variables were evaluated statistically. RESULTS Patients with higher levels of depression and anxiety needed larger improvements to consider the treatment as a success in the pain domain (depression, r=0.398, p=0.04; anxiety, r=0.447, p=0.02) and emotional distress domain (depression, r=0.617, p=0.001; anxiety, r=0.415, p=0.03), but had lower level of expectation of the treatment in the pain domain (depression, r=-0.427, p=0.01; anxiety, r=-0.441, p=0.004), emotional distress domain (depression, r=-0.454, p=0.01; anxiety, r=-0.395, p=0.04), and interference of daily activities domain (depression, r=-0.474, p=0.01; anxiety, r=-0.396, p=0.04). Patients were classified into 3 clusters based on the importance rating of each domain via a hierarchical analysis. The cluster of the patients with the higher rating of importance across all domains (importance of pain domain, 9.54; fatigue domain, 9.08; emotional distress domain, 9.23; interference of daily activities domain, 9.23) had the highest level of depression and anxiety. CONCLUSION Consideration of psychological factors, especially in patients who require larger improvements in all treatment domains, may be helpful for the successful treatment of chronic musculoskeletal pain.
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Affiliation(s)
- Tae Im Yi
- Department of Rehabilitation Medicine, Bundang Jesaeng General Hospital, Seongnam, Korea
| | - Bo Kyoung Kim
- Department of Rehabilitation Medicine, Bundang Jesaeng General Hospital, Seongnam, Korea
| | - Seung A Ha
- Department of Rehabilitation Medicine, Bundang Jesaeng General Hospital, Seongnam, Korea
| | - Ji Young Lim
- Department of Rehabilitation Medicine, Bundang Jesaeng General Hospital, Seongnam, Korea
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Kung F, Gibson SJ, Helme RD. Development of a pain management strategies survey questionnaire - preliminary findings. ACTA ACUST UNITED AC 2013. [DOI: 10.1163/156856900750233794] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Slater H, Briggs AM, Watkins K, Chua J, Smith AJ. Translating evidence for low back pain management into a consumer-focussed resource for use in community pharmacies: a cluster-randomised controlled trial. PLoS One 2013; 8:e71918. [PMID: 23977178 PMCID: PMC3748095 DOI: 10.1371/journal.pone.0071918] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2013] [Accepted: 07/02/2013] [Indexed: 11/24/2022] Open
Abstract
Background This cluster-randomised controlled trial determined the effectiveness of an evidence-based, pamphlet intervention in improving low back pain (LBP)-related beliefs among pharmacy consumers. Methods Thirty five community pharmacies were randomised to three groups: pamphlet+education intervention [n = 11]; pamphlet only intervention [n = 11]; control: usual care [n = 13]. Eligibility requirements for clusters included: community-based pharmacies and proprietor participation consent. Pharmacy consumers (N = 317) aged 18–65 years currently experiencing LBP participated. Intervention group allocation depended on the pharmacy attended. Individual-level outcomes were measured at pre-intervention (T0), at two (T1) and eight (T2) weeks post-intervention and included beliefs about LBP [Back Pain Beliefs Questionnaire (BBQ); Fear Avoidance Beliefs Questionnaire (FABQ)]. Secondary outcomes included pain severity, activity impairment and pamphlet perceived usefulness. Blinding to group allocation included primary investigators, outcome assessors and the statistician. Pharmacy staff and consumers were un-blinded. Results Of 35 pharmacies recruited (317 consumers), no clusters were lost to follow-up. Follow-up was available for n = 24 at 2 weeks only; n = 38 at 8 weeks only; n = 148 at both time points, with n = 148+24+38 = 210 analysed (107 excluded: no follow up). Adjusting for baseline scores demonstrated no significant differences in beliefs (2 or at 8 weeks) between pamphlet (with or without education) versus control, or between ‘pamphlet with’ versus ‘without’ education. Work-related fear (FABQ) was significantly lower in consumers receiving pamphlet (with or without education) versus control (difference −2.3, 95%CI: −4.4 to −0.2). There was no significant difference between “pamphlet with” versus “pamphlet without” groups. Consumers receiving the “pamphlet with” reported greater perceived usefulness than consumers receiving the “pamphlet without” (difference 0.9 (95%CI: 0.0 to 1.8)). Conclusion Community pharmacies provided a feasible primary care portal for implementing evidence-based information. The associated improvement in work-related LBP-beliefs for consumers receiving the pamphlet suggests this simple intervention may be a useful component of care. Trial Registration ACTR.org.au ACTRN12611000053921
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Affiliation(s)
- Helen Slater
- School of Physiotherapy, Curtin University, Perth, Western Australia, Australia
- Curtin Health Innovation Research Institute, Curtin University, Perth, Western Australia, Australia
- * E-mail:
| | - Andrew M. Briggs
- Curtin Health Innovation Research Institute, Curtin University, Perth, Western Australia, Australia
- Department of Health, Government of Western Australia, Perth, Western Australia, Australia
- Arthritis and Osteoporosis Victoria, Melbourne, Victoria, Australia
| | - Kim Watkins
- School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia
| | - Jason Chua
- Curtin Health Innovation Research Institute, Curtin University, Perth, Western Australia, Australia
| | - Anne J. Smith
- School of Physiotherapy, Curtin University, Perth, Western Australia, Australia
- Curtin Health Innovation Research Institute, Curtin University, Perth, Western Australia, Australia
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Lua PL, Talib NS, Ismail Z. Methadone maintenance treatment versus methadone maintenance treatment plus auricular acupuncture: impacts on patient satisfaction and coping mechanism. J Pharm Pract 2013; 26:541-50. [PMID: 23764566 DOI: 10.1177/0897190013489574] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study intended to (1) describe the baseline patient satisfaction level and preferred coping strategies and (2) assess patient satisfaction and coping mechanisms pre- and postintervention. Patients on methadone maintenance treatment (MMT) in Terengganu, Malaysia, were randomized into either MMT or MMT plus auricular acupuncture (MMT + AA) groups. All received the standard MMT, while participants on MMT + AA underwent concurrent AA session thrice weekly for 2 months (each session = 30 minutes). Data analysis was carried out using SPSS 16.0, employing descriptive and nonparametric statistics. Participations were received from 97 eligible male patients (median age = 36.0 years; Malay = 97.9%). After screening for dropouts, only 69 patients were considered for subsequent analysis (MMT = 40; MMT + AA = 29). At preintervention, both groups did not differ significantly in the parameters investigated. During postintervention, no significant difference was detected for satisfaction level but coping-wise, substance use was significantly and frequently adopted by MMT + AA patients compared to MMT respondents (P < .05). On separate analysis, those who received MMT alone adopted active coping, venting, and self-blame significantly more frequently postintervention (P < .05). Nevertheless, no significant difference for coping styles of MMT + AA patients was exhibited over time (P >.05). The addition of AA therapy into the standard MMT treatment did not seem to influence patient satisfaction and their coping ways.
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Affiliation(s)
- Pei Lin Lua
- Faculty of Medicine and Health Sciences, Universiti Sultan Zainal Abidin (UniSZA), Kota Campus, Jalan Sultan Mahmud, 20400 Kuala Terengganu, Malaysia
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Gebhardt S, Wolak AM, Huber MT. Patient satisfaction and clinical parameters in psychiatric inpatients--the prevailing role of symptom severity and pharmacologic disturbances. Compr Psychiatry 2013; 54:53-60. [PMID: 22534034 DOI: 10.1016/j.comppsych.2012.03.016] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2011] [Revised: 02/19/2012] [Accepted: 03/17/2012] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVE A high degree of satisfaction is probably one of the most important aims for each patient during medical treatment. However, database on the influencing variables in a general psychiatric inpatient sample is still small. Therefore, the objective of this study is to identify clinical variables related to patients' treatment satisfaction. METHODS In 113 patients (59 females; mean age, 48.3 ± 16.6 years; mean treatment duration, 1.4 ± 1.2 months) admitted to a psychiatric hospital, data were assessed on treatment satisfaction using the ZUF-8 questionnaire ("Fragebogen zur Patientenzufriedenheit"; questionnaire of patient satisfaction) at discharge and on general treatment variables as well as the psychosocial functioning using the "Basisdokumentation" (basic documentation) questionnaire including Clinical Global Impression scale (CGI) and Global Assessment of Functioning scale (GAF) at admission and discharge. Student t tests, univariate variance analyses, and Pearson correlations were performed. RESULTS ZUF-8 sum score correlated significantly negatively with CGI score at discharge (part 1: P = .036), positively with GAF at discharge (P = .011), and as a trend with the reduction of CGI during the treatment (CGI change; P = .050). Patients with pharmacologic disturbances (P = .003) and with a schizophrenia spectrum disorder or a personality disorder were less content (trend; P = .071). Satisfaction did not differ in dependency of the variables age, sex, native language, number of inpatient treatments, therapeutic setting of the ward, duration of disorder or treatment, level of school education, bodily impairment, number of somatic diagnoses, psychopharmacologic treatment (vs none), antidepressants, body weight, or body weight change. CONCLUSION The results of the study suggest that patient satisfaction is dependent on symptom severity and global functioning at discharge, on pharmacologic disturbances during treatment, and on the diagnostic group. Therefore, symptom relief and reduction of adverse side effects as far as possible should be the primary aim of an inpatient treatment.
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Affiliation(s)
- Stefan Gebhardt
- Department of Psychiatry and Psychotherapy, University of Marburg, Rudolf-Bultmann-Str. 8, D-35033 Marburg, Germany.
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Jordanian patients' satisfaction with pain management. Pain Manag Nurs 2012; 15:116-25. [PMID: 23273825 DOI: 10.1016/j.pmn.2012.07.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2011] [Revised: 06/19/2012] [Accepted: 07/09/2012] [Indexed: 11/22/2022]
Abstract
Pain is still undertreated among hospitalized patients. Recently, patient satisfaction with pain management has received significant attention. This field has not yet been explored among Jordanian patients. The purpose of this study was to determine the knowledge regarding pain characteristics, beliefs, and satisfaction that can be included in planning pain management strategies and protocols within Jordanian hospitals. Using descriptive cross-sectional methodology, the American Pain Society Patient Outcome Questionnaire (APS-POQ) was used to survey 375 inpatients from Jordanian hospitals. Participants reported relatively severe pain and pain interferences while being hospitalized and seemed to be well informed regarding pain and pain management. Participants reported high levels of pain management satisfaction. Also, the Arabic version of the APS-POQ was found to be reliable among the Jordanian population. Findings of this study are similar to those reported by earlier studies in other countries and support the need for applying the caring attitude in managing patients' reports of having pain. This study is the first in Jordan, opening the door for future studies to be conducted in this important field.
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Macrodimitris S, Sherman EMS, Williams TS, Bigras C, Wiebe S. Measuring patient satisfaction following epilepsy surgery. Epilepsia 2011; 52:1409-17. [PMID: 21762442 DOI: 10.1111/j.1528-1167.2011.03160.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE To systematically review primary research examining patient satisfaction with epilepsy surgery in order to obtain evidence-based estimates of this surgical outcome; to assess methods used to measure epilepsy surgery satisfaction, overall epilepsy surgery satisfaction ratings, and predictors of epilepsy surgery satisfaction. METHODS Systematic review of published studies in English up to June 2009, focusing on patient satisfaction with all types of epilepsy surgery in patients of all ages. We excluded studies that focused on satisfaction with epilepsy treatment in general, on quality of life without specific exploration of patient satisfaction with surgery, and on satisfaction with the process of health care delivery, rather than with surgery and its outcomes. KEY FINDINGS Eight studies met inclusion criteria. Satisfaction was assessed using one or more global questions. Four epilepsy surgery satisfaction question content patterns emerged: (1) satisfied or dissatisfied, (2) perceived success or failure, (3) overall positive or negative impact, and (4) willingness to repeat surgery or regretting surgery. Overall 71% were satisfied; 64% considered it a success; it had a positive effect for 78%; and 87% would repeat surgery. Seizure freedom was the most common predictor of epilepsy surgery satisfaction, whereas postoperative neurologic deficit predicted dissatisfaction. SIGNIFICANCE Patient satisfaction with interventions is an important aspect of patient-centered care, but it has received little attention in epilepsy surgery. Future research is required to develop and validate epilepsy surgery satisfaction tools. We provide preliminary guiding principles for measuring satisfaction after epilepsy surgery.
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Affiliation(s)
- Sophia Macrodimitris
- Department of Clinical Neurosciences, Alberta Health Services, Calgary, Alberta, Canada.
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Chou PL, Lin CC. A pain education programme to improve patient satisfaction with cancer pain management: a randomised control trial. J Clin Nurs 2011; 20:1858-69. [DOI: 10.1111/j.1365-2702.2011.03740.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Schatman ME. The Role of the Health Insurance Industry in Perpetuating Suboptimal Pain Management. PAIN MEDICINE 2011; 12:415-26. [DOI: 10.1111/j.1526-4637.2011.01061.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Green L, Kerney D. Patient experience with darifenacin - results of a short-term community-based survey in managing overactive bladder. Curr Med Res Opin 2011; 27:431-7. [PMID: 21194391 DOI: 10.1185/03007995.2010.541432] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE This community-based program evaluated patients' experiences with darifenacin over 3 weeks' treatment in a predominantly primary care clinical practice setting. METHODS Physicians (n = 2117, 50% primary care physicians, 35% urologists, 10% obstetrician/gynecologist, 5% other) were asked to introduce the program to patients with overactive bladder (OAB). Patients received an enrollment kit including a 30-day darifenacin voucher, activated if patients registered for the program via telephone or online. Patients (≥ 18 years of age) completed a brief automated survey to evaluate frequency of urge urinary incontinence episodes (UUIEs), micturitions/24 hours, urge severity/24 hours (10 point scale: 0 = not at all severe; 10 = very severe), and treatment tolerability (10 point scale: 0 = very poorly tolerated; 10 = very well tolerated). Patients also completed a second survey 3 weeks after starting darifenacin. Statistical analyses were not prospectively planned or performed. RESULTS A total of 2165 patients completed both surveys. At baseline, mean age of completers was 66 years, 76% were female, and 47% reported prior use of OAB medications. After 3 weeks' treatment, patients experienced reductions in UUIEs and micturitions. Urge severity was reduced by >30% after 3 weeks (mean scores: 6.7 at baseline vs. 4.6 after 3 weeks' treatment) and treatment was well tolerated (mean score: 7.7). Overall, 85% of patients who participated in the program did so due to physician influences. CONCLUSIONS The results of this 3-week, self-reported community-based survey indicate that patients were generally satisfied with darifenacin treatment and experienced a reduction in OAB symptoms. Darifenacin was generally well tolerated.
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Affiliation(s)
- Lonny Green
- Virginia Women's Center, Richmond, VA 23233, USA.
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Abstract
Relief from pain is itself a marker of high-quality medical care. Quality assurance in the case of pain management could simply mean successful elimination of pain. Because the means of controlling pain are imperfect, it is essential to consider whether pain interventions actually achieve the primary goal of pain relief and also whether they are safe, cost-effective, and even capable of producing secondary benefits such as early recovery from surgery. Quality assurance and assessment in pain management therefore becomes a complex undertaking that must incorporate into its processes the often-conflicting goals of comfort versus safety versus patients' rights.
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Nitti VW, Kopp Z, Lin ATL, Moore KH, Oefelein M, Mills IW. Can we predict which patient will fail drug treatment for overactive bladder? A think tank discussion. Neurourol Urodyn 2010; 29:652-7. [PMID: 20432330 DOI: 10.1002/nau.20910] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The treatment of overactive bladder (OAB) has evolved over the past 20 years to include a number of behavioral, pharmacological, and minimally invasive treatments. After behavioral therapy, pharmacological therapy with antimuscarinics remains the mainstay of treatment. Despite this, a large number of patients will "fail" or be unsatisfied with drugs therapy. It would be extremely helpful to patients and clinicians to be able to predict who those patients are. However, there are a number of barriers. First and foremost are defining "success" and "failure" and this can vary dramatically from one patient to another. Endpoints other than the traditional variables used in clinical trials may be more effective in evaluating treatments and helping to predict outcomes. Along similar lines, there are various definitions for OAB that is "refractory" to conventional treatments and this term needs clarification. In many cases, response to therapy may be affected by factors such as comorbidities, metabolism of drugs, concurrent therapies, etc. These factors are sometimes obvious and sometimes not, and for a variety of reasons it can be quite difficult to predict or determine their effect on outcome. Finally, many patients with OAB include have mixed (stress and urgency) symptoms. It is important to sort out the OAB component of mixed symptoms and mixed urinary incontinence (MUI) when determining effects of therapy.
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Affiliation(s)
- Victor W Nitti
- Urogynaecology Department, Cambridge Wing, St Mary's Hospital, Imperial College Healthcare NHS Trust, Praed St, London, UK.
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French HP, Keogan F, Gilsenan C, Waldron L, O'Connell P. Measuring patient satisfaction with exercise therapy for knee osteoarthritis: evaluating the utility of the physiotherapy outpatient survey. Musculoskeletal Care 2010; 8:61-7. [PMID: 20077576 DOI: 10.1002/msc.166] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVES To assess patient satisfaction with exercise for knee osteoarthritis (OA). METHODS A convenience sample of 27 patients recruited to a randomized controlled trial (RCT) comparing open kinetic chain and closed kinetic chain exercises for knee OA were reassessed at nine months post-randomization. Clinical outcomes included self-report and physical performance measures of function and pain severity. Patients also completed the Physiotherapy Outpatient Survey (POPS), which is a multi-dimensional measure of patient satisfaction with physiotherapy. RESULTS There was no significant difference in satisfaction between the two intervention groups. Overall mean satisfaction for the entire cohort was 4.07 of a maximum score of 5 (standard deviation (SD) = 0.52). Lower levels of satisfaction with outcome (mean = 3.56, SD = 0.8) were reported compared with other domains of expectations, communication, organization and the therapist (mean = 3.79-4.49; SDs = 0.42-0.92). Both intervention groups improved from baseline on clinical outcomes of pain, self-report function and walking distance, with no significant differences between the two groups. CONCLUSIONS High levels of satisfaction were reported in this subsample of knee OA patients participating in an RCT evaluating the effects of different exercise approaches for knee OA. Satisfaction varied depending on the satisfaction domain, with lower satisfaction with outcome compared with other aspects of care. The POPS questionnaire can be used to measure the multi-dimensional aspects of satisfaction with physiotherapy.
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Affiliation(s)
- H P French
- School of Physiotherapy, Royal College of Surgeons in Ireland, Dublin, Ireland.
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Engagement in multidisciplinary interventions for pediatric chronic pain: parental expectations, barriers, and child outcomes. Clin J Pain 2010; 26:291-9. [PMID: 20393263 DOI: 10.1097/ajp.0b013e3181cf59fb] [Citation(s) in RCA: 86] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To examine the adherence to the recommendations of pain treatment among children and adolescents evaluated for a variety of chronic and recurrent pain conditions. METHODS Several measures during initial evaluation and after 3 months were collected to assess satisfaction with initial evaluation, adherence to multidisciplinary recommendations, pain ratings, somatic symptoms, functional limitations, and school attendance. RESULTS Of the 120 patients who initially enrolled in the study, 70 parents and 57 children participated in 3-month follow-up interviews and reported significantly fewer doctor visits, decreased somatic symptoms, fewer functional limitations, and decreased pain compared with their initial evaluation. Adherence to multidisciplinary recommendations ranged from 46.7% to 100% with the highest level of overall adherence to physical therapy. Factors associated with adherence varied across type of recommendation. For medical recommendations, higher parent-reported patient satisfaction and expectations that medical tests would be beneficial were associated with engagement in medical treatment, whereas parent reports of negative attitude-type barriers and experience with surgery were associated with less frequent engagement in recommended treatment. With regard to physical therapy recommendations, only earlier experience with exercise was associated with better adherence. For psychologic recommendations, familiarity with hypnosis and biofeedback in addition to positive expectations regarding psychologic treatment and biofeedback were all associated with subsequent engagement in psychologic treatment. Lastly, we identified modest associations between functional improvements and adherence to specific recommendations. DISCUSSION Results of this study support the importance of examining adherence to multidisciplinary interventions among children and adolescents with chronic pain.
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Preference, expectation, and satisfaction in a clinical trial of behavioral interventions for acute and sub-acute low back pain. THE JOURNAL OF PAIN 2010; 11:1074-82. [PMID: 20466596 DOI: 10.1016/j.jpain.2010.02.016] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 10/20/2009] [Revised: 01/14/2010] [Accepted: 02/04/2010] [Indexed: 11/21/2022]
Abstract
UNLABELLED The equivalency of behavioral interventions has led to the consideration of whether patient-related factors influence clinical trial outcomes. The primary purpose of this secondary analysis was to determine if treatment preference and patient expectation were predictors of trial outcomes and if selected patient-satisfaction items were appropriate as outcome measures. Perceived effectiveness, treatment preference, and patient expectation were assessed before random assignment, and patient satisfaction was assessed 6 months later. Patient preference was associated with perceived effectiveness for those with no treatment preference and those preferring graded exposure. Higher patient expectation was associated with higher perceived effectiveness ratings for all treatments in the clinical trial. Patients with no strong treatment preferences had larger 6-month improvements in pain intensity and disability, while patients with higher expectations had lower disability at baseline, 4 weeks, and 6 months. Patient satisfaction rates did not differ based on treatment received. Patient satisfaction was highest with treatment delivery and much lower with treatment effect. Patient satisfaction was uniformly associated with expectations being met, but only satisfaction with treatment effect was associated with lower pain and disability scores. These data support assessment of treatment preference and patient expectation as predictors and patient satisfaction as an outcome measure in low back pain (LBP) clinical trials. PERSPECTIVE These data indicate treatment preference potentially impacts rate of improvement for patients with low back pain. Patient expectation did not impact rate of improvement, but those with higher expectations had lower pain and disability scores throughout the trial. Optimal assessment of patient satisfaction should include items that separately consider treatment delivery and effect.
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Shaw S, Lee A. Student Nurses' Misconceptions of Adults with Chronic Nonmalignant Pain. Pain Manag Nurs 2010; 11:2-14. [DOI: 10.1016/j.pmn.2008.10.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2008] [Accepted: 10/22/2008] [Indexed: 11/17/2022]
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Older CG, Carr EC, Layzell M. Making sense of patients’ use of analgesics following day case surgery. J Adv Nurs 2010; 66:511-21. [DOI: 10.1111/j.1365-2648.2009.05222.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Brod M, Hammer M, Kragh N, Lessard S, Bushnell DM. Development and validation of the Treatment Related Impact Measure of Weight (TRIM-Weight). Health Qual Life Outcomes 2010; 8:19. [PMID: 20137088 PMCID: PMC2841109 DOI: 10.1186/1477-7525-8-19] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2009] [Accepted: 02/05/2010] [Indexed: 11/10/2022] Open
Abstract
Background The use of prescription anti-obesity medication (AOM) is becoming increasingly common as treatment options grow and become more accessible. However, AOM may not be without a wide range of potentially negative impacts on patient functioning and well being. The Treatment Related Impact Measure (TRIM-Weight) is an obesity treatment-specific patient reported outcomes (PRO) measure designed to assess the key impacts of prescription anti-obesity medication. This paper will present the validation findings for the TRIM-Weight. Methods The online validation battery survey was administered in four countries (the U.S., U.K., Australia, and Canada). Eligible subjects were over age eighteen, currently taking a prescription AOM and were currently or had been obese during their life. Validation analyses were conducted according to an a priori statistical analysis plan. Item level psychometric and conceptual criteria were used to refine and reduce the preliminary item pool and factor analysis to identify structural domains was performed. Reliability and validity testing was then performed and the minimally importance difference (MID) explored. Results Two hundred and eight subjects completed the survey. Twenty-one of the 43 items were dropped and a five-factor structure was achieved: Daily Life, Weight Management, Treatment Burden, Experience of Side Effects, and Psychological Health. A-priori criteria for internal consistency and test-retest coefficients for the total score and all five subscales were met. All pre-specified hypotheses for convergent and known group validity were also met with the exception of the domain of Daily Life (proven in an ad hoc analysis) as well as the 1/2 standard deviation threshold for the MID. Conclusion The development and validation of the TRIM-Weight has been conducted according to well-defined principles for the creation of a PRO measure. Based on the evidence to date, the TRIM-Weight can be considered a brief, conceptually sound, valid and reliable PRO measure.
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Affiliation(s)
- Meryl Brod
- The Brod Group, 219 Julia Avenue, Mill Valley, California 94941, USA.
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Beck SL, Towsley GL, Berry PH, Lindau K, Field RB, Jensen S. Core aspects of satisfaction with pain management: cancer patients' perspectives. J Pain Symptom Manage 2010; 39:100-15. [PMID: 19879107 DOI: 10.1016/j.jpainsymman.2009.06.009] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2009] [Revised: 06/01/2009] [Accepted: 06/17/2009] [Indexed: 11/18/2022]
Abstract
CONTEXT The coexistence of high levels of satisfaction and high levels of pain has been perplexing. OBJECTIVES The aims of this study were to 1) describe patient expectations related to the experience of cancer-related pain, 2) explore the cognitive processes and meaning that underlie patient judgments about satisfaction and dissatisfaction with pain management, and 3) explore the discrepancies between ratings of high satisfaction with pain management with high pain intensity. METHODS The sample included 33 patients: 18 with advanced cancer and 15 experiencing pain after a surgery for a cancer diagnosis. All patients had experienced "worst pain" of at least moderate intensity and were interviewed using standard pain measures from the American Pain Society Patient Outcome Questionnaire and open-ended questions about the underlying meaning of their answers. We systematically analyzed the transcribed qualitative data using NVivo software. RESULTS Fifty-five percent of patients were females and were aged 25-78 years. Most (75%) were satisfied or very satisfied with their overall pain management. Key findings indicate that for some, the worst pain rating was often brief, even momentary. Most patients expected pain relief. Four key themes were important to the quality of pain management: being treated right, having a safety net, being in a partnership with their health care team, and having pain treatment that was efficacious. Key aspects of the patient-provider relationship that mattered were how the nurses and doctors behaved toward them and how quickly they responded to reports of pain. For some, an important factor was whether they had control of the amount of pain they experienced. CONCLUSION The findings inform measurement of patient satisfaction with the quality of pain management.
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Affiliation(s)
- Susan L Beck
- University of Utah College of Nursing, Salt Lake City, Utah 84112-5880, USA.
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Martinez LS, Schwartz JS, Freres D, Fraze T, Hornik RC. Patient-clinician information engagement increases treatment decision satisfaction among cancer patients through feeling of being informed. PATIENT EDUCATION AND COUNSELING 2009; 77:384-90. [PMID: 19815365 PMCID: PMC3279194 DOI: 10.1016/j.pec.2009.09.008] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2008] [Revised: 09/02/2009] [Accepted: 09/09/2009] [Indexed: 05/07/2023]
Abstract
OBJECTIVE Examine how patient-clinician information engagement (PCIE) may operate through feeling informed to influence patients' treatment decision satisfaction (TDS). METHODS Randomly drawn sample (N=2013) from Pennsylvania Cancer Registry, comprised of breast, prostate and colon cancer patients completed mail surveys in the Fall of 2006 (response rate=64%) and Fall of 2007. Of 2013 baseline respondents, 85% agreed to participate in follow-up survey (N=1703). Of those who agreed, 76% (N=1293) completed follow-up surveys. The sample was split between males and females. The majority of participants were White, over the age of 50, married, and with a high school degree. Most reported having been diagnosed with in situ and local cancer. RESULTS PCIE was related to concurrent TDS (beta=.06) and feeling informed (beta=.15), after confounder adjustments. A mediation analysis was consistent with PCIE affecting TDS through feeling informed. Baseline PCIE predicted feeling informed (beta=.04) measured 1 year later, after adjustments for baseline feeling informed and other confounders. Feeling informed was related to concurrent TDS (beta=.35) after confounder adjustment and follow-up TDS (beta=.13) after baseline TDS and confounder adjustment. CONCLUSION Results suggest PCIE affects TDS in part through patients' feeling informed. PRACTICE IMPLICATIONS PCIE may be important in determining patients' level of feeling informed and TDS.
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Affiliation(s)
- Lourdes S Martinez
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA 19104, USA.
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Curran S, Brotto LA, Fisher H, Knudson G, Cohen T. The ACTIV study: acupuncture treatment in provoked vestibulodynia. J Sex Med 2009; 7:981-95. [PMID: 19912491 DOI: 10.1111/j.1743-6109.2009.01582.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Provoked vestibulodynia (PVD) is a distressing genital pain condition affecting 12% of women. Treatment modalities vary and although vestibulectomy has the highest efficacy rates, it is usually not a first-line option. Acupuncture has a long history in the traditional Chinese medicine (TCM) system and operates on the premise that pain results from the blockage or imbalance of important channels. The main principle of treatment is to move Qi and blood to cease genital pain. AIM To explore effect sizes and feasibility in a pilot study of acupuncture for women with PVD. METHODS Eight women with PVD (mean age 30 years) underwent 10 1-hour acupuncture sessions. Specific placement of the needles depended on the woman's individual TCM diagnosis. TCM practitioners made qualitative notes on participants' feedback after each session. Main Outcome Measures. Self-reported pain (investigator-developed), pain-associated cognitions (Pain Catastrophizing Scale [PCS], Pain Vigilance and Awareness Questionnaire), and sexual response (Female Sexual Function Index) were measured before and after treatment sessions 5 and 10. Qualitative analyses of TCM practitioner notes were performed along with one in-depth case report on the experience of a participant. RESULTS A repeated measures analysis of variance revealed significant decreases in pain with manual genital stimulation and helplessness on the PCS. An examination of effect sizes also revealed strong (though nonsignificant) effects for improved ability to have intercourse and sexual desire. Qualitative analyses were overall more positive and revealed an improvement in perceived sexual health, reduced pain, and improved mental well-being in the majority of participants. CONCLUSIONS Effect sizes and qualitative analyses of practitioner-initiated interviews showed overall positive effects of acupuncture, but there were statistically significant improvements only in pain with manual genital stimulation and helplessness. These findings require replication in a larger, controlled trial before any definitive conclusions on the efficacy of acupuncture for PVD can be made.
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Ballantyne JC, Fleisher LA. Ethical issues in opioid prescribing for chronic pain. Pain 2009; 148:365-367. [PMID: 19906487 DOI: 10.1016/j.pain.2009.10.020] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2009] [Revised: 10/21/2009] [Accepted: 10/23/2009] [Indexed: 11/26/2022]
Affiliation(s)
- Jane C Ballantyne
- Penn Pain Medicine Center, Department of Anesthesiology and Critical Care, Tuttleman Building, 1840 South Street, Philadelphia, PA 19146, USA Department of Anesthesiology and Critical Care, University of Pennsylvania Health System, 3400 Spruce Street, 6 Dulles Building, Philadelphia, PA 19104, USA
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Bhosle M, Benner JS, DeKoven M, Shelton J. Difficult to swallow: patient preferences for alternative valproate pharmaceutical formulations. Patient Prefer Adherence 2009; 3:161-71. [PMID: 19936158 PMCID: PMC2778440 DOI: 10.2147/ppa.s5691] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2009] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE To determine the degree to which swallowing valproate (VP) tablets is an issue, the proportion of patients who would prefer an alternative formulation, and the predictors of preference. METHODS A quantitative telephone survey of eligible adults (n = 400, >/=18 years old) who currently take (n = 236) or previously took (n = 164) VP tablets within the past 6 months was conducted. RESULTS More than half of the patients indicated that VP tablets were 'uncomfortable to swallow' (68.5%, n = 274) and were 'very interested' (65.8%, n = 263) in medications that were easier to swallow. When choosing conceptually between taking VP tablet once/day or an equally safe and effective but significantly smaller soft gel capsule twice per day, the 82.8%, (n = 331) preferred the soft gel capsule. In the multivariate regression analysis, perceiving soft gel capsules to be easier to swallow (OR = 73.54; 95% CI = 15.01 to 360.40) and taking VP more frequently (OR = 2.02; 95% CI = 1.13 to 3.61) were significant predictors of soft gel capsule treatment preference. CONCLUSION VP users would prefer a formulation that is easier to swallow, even if it is needed to be taken twice per day. When choosing between medications with similar efficacy and safety, physicians can consider patient preferences to optimize conditions for medication adherence.
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Affiliation(s)
- Monali Bhosle
- Health Economics and Outcomes Research, IMS Health Inc, Falls Church, VA, USA
| | - Joshua S Benner
- Health Economics and Outcomes Research, IMS Health Inc, Falls Church, VA, USA
| | - Mitch DeKoven
- Health Economics and Outcomes Research, IMS Health Inc, Falls Church, VA, USA
| | - Jeff Shelton
- Answers and Insights Market Research, Inc, Indianapolis, IN, USA
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Ballantyne JC. Patient-centered health care: are opioids a special case? Spine J 2009; 9:770-2. [PMID: 19643676 DOI: 10.1016/j.spinee.2009.06.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2009] [Accepted: 06/12/2009] [Indexed: 02/03/2023]
Affiliation(s)
- Jane C Ballantyne
- Department of Anesthesiology and Critical Care, Penn Pain Medicine Center, Tuttleman Building, 1840 South St, Philadelphia, PA 19146, USA.
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Tasmuth T, Saarto T, Kalso E. How palliative care of cancer patients is organised between a university hospital and primary care in Finland. Acta Oncol 2009; 45:325-31. [PMID: 16644576 DOI: 10.1080/02841860500423898] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The aim of this study was to find out how palliative care is organised between the Helsinki University Central Hospital (University Hospital) and primary care. The study consisted of 102 patients whose oncological treatment was terminated and the responsibility of palliative care was transferred to primary care. The patients were interviewed by phone using a structured questionnaire. Another questionnaire form was sent to the primary care physicians. Half of the patients were treated in more than one primary care unit. One third of the outpatients were unaware who was responsible for the care. Most of the patients wanted to be at home but this was achieved in less than half of the cases. Most patients were symptomatic while leaving the University Hospital and no improvement was seen thereafter. Every third patient reported of poor quality of palliative care in the primary care. Also the physicians reported a need for training in palliative care.
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