Canadian Journal of Pain-Revue Canadienne de la Douleur最新文献

{"title":"Nociception and pain assessment during suctioning procedures in mechanically ventilated patients in the intensive care unit: A validation study of the Nociception Level index (NOL™).","authors":"Shiva Shahiri, Philippe Richebé, Marc O Martel, Patrick Lavoie, Céline Gélinas","doi":"10.1080/24740527.2025.2561576","DOIUrl":"https://doi.org/10.1080/24740527.2025.2561576","url":null,"abstract":"<p><strong>Background: </strong>Many patients in the intensive care unit (ICU) cannot communicate pain through self-reports or behaviors. Though individual physiologic parameters (e.g. heart rate, HR) lack validity for ICU nociception and pain assessment, a multiparameter approach (i.e. Nociception Level index, NOL) has shown promise in anesthesia, but its use in the ICU is new.</p><p><strong>Aim: </strong>The aim of this study was to validate the NOL for ICU nociception and pain assessment in mechanically ventilated patients.</p><p><strong>Methods: </strong>In this prospective observational study, NOL values (0-100) were recorded before, during, and 15 min after a nonnociceptive procedure (blood pressure cuff inflation) and a nociceptive procedure (mouth, endotracheal, or tracheal suctioning) in patients able or not to self-report. Validation included discriminative (nociceptive vs. nonnociceptive procedures), criterion (pain intensity and Critical Care Pain Observation Tool, CPOT) and convergent (procedural pain distress) strategies, and test-retest reliability. HR validity was also examined.</p><p><strong>Results: </strong>Of 53 enrolled patients, we had 14 losses (9 NOL-related), thus data from 39 were analyzed. Missing data occurred in 25% of patients at some time points. NOL median values were significantly higher during suctioning (>25) than cuff inflation (<10) and remained stable pre/postsuctioning. Positive correlations were found for pain intensity and CPOT but not for procedural pain distress. HR increased slightly during suctioning but was not correlated with pain criteria.</p><p><strong>Conclusions: </strong>The discriminative validity of the NOL was supported for ICU nociception in all patients and showed stable resting values. Criterion validity for pain assessment was only significant in patients able to self-report. Convergent validity was not supported. HR showed poor validity.</p>","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"10 1","pages":"2561576"},"PeriodicalIF":2.1,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13134404/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extending the boundaries of care: Collaboratively planning connections between rehabilitation and community resources for chronic pain self-management.","authors":"Nicole C George, Xavier Laplante, Catherine M Giroux, Catherine Lemyze, Mélanie Lussier, Marie-Noelle Leblanc, Amélie Quesnel-Vallée, Antoine Boivin, Sara Ahmed","doi":"10.1080/24740527.2026.2639116","DOIUrl":"https://doi.org/10.1080/24740527.2026.2639116","url":null,"abstract":"<p><strong>Background: </strong>Linkages (i.e. partnerships or referral pathways) between chronic pain management services and community resources can strengthen the continuum of care and address unmet needs, although implementing these connections is challenging.</p><p><strong>Aims: </strong>The aim of this study was to conduct exploratory, strategic planning to inform linkages between pain self-management within multidisciplinary rehabilitation and community resources that support the quality of life of individuals with chronic pain.</p><p><strong>Methods: </strong>Using a participatory design, the deliberative dialogue methodology actively engaged individuals living with chronic pain (<i>n</i> = 2), health care professionals (<i>n</i> = 3), and researchers (<i>n</i> = 2) in a collaborative planning process guided by the PRECEDE-PROCEED model. The dialogic data were analyzed repeatedly, with synthesis within the sessions followed by two cycles of inductive and deductive coding.</p><p><strong>Results: </strong>Following the adapted PRECEDE-PROCEED model, community linkages were guided by the goal for individuals living with pain to stay active socially, mentally, and physically, noting an environment lacking affordable, adapted resources. Participants identified linkage strategies to address predisposing (e.g. knowledge of resources), reinforcing (e.g. support of influential individuals), or enabling (e.g. accessibility) factors to promote a change in behavior and environment. Relevant community resources were described across the social determinants of health, reflecting access to necessary services (e.g. financial support, food banks, community-based health services) and engagement in meaningful activities (e.g. adapted exercise, recreation, peer support, and active listening groups).</p><p><strong>Conclusions: </strong>This study provides methodological, theoretical, and actionable contributions to help co-develop linkages between rehabilitation-based pain self-management and community resources for comprehensive, equity-oriented care that reflects the multidimensional experience of living with chronic pain.</p>","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"10 1","pages":"2639116"},"PeriodicalIF":2.1,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13134408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"French-Canadian adaptation and validation of the adolescents' Pain Coping Questionnaire.","authors":"Jean Théroux, Laurence Lessard, Stanley Innes, Julien Gardner, Gabrielle Gilbert, Christine Genest, Kate St-Arneault, Janick Carmel, Stéphany Cara-Slavich, Caroline Larue, Stéfan Parent, Soraya Barchi, Isabelle Turgeon, Sylvie LeMay","doi":"10.1080/24740527.2026.2650298","DOIUrl":"https://doi.org/10.1080/24740527.2026.2650298","url":null,"abstract":"<p><strong>Background: </strong>Musculoskeletal pain affects one in four children, making it the fourth leading cause of disability among youth. The Pain Coping Questionnaire (PCQ) is a well-established instrument for assessing pain-related coping responses; however, no validated French-Canadian version currently exists.</p><p><strong>Aims: </strong>This research sought to adapt and validate a French-Canadian PCQ (PCQ-F) version for adolescents with musculoskeletal conditions.</p><p><strong>Methods: </strong>The PCQ was translated into French and reviewed for clarity before its administration to adolescents (ages 10-20) experiencing significant musculoskeletal pain. Validity was evaluated through exploratory factor analysis and its correlation with the Child Post-Traumatic Stress Reaction Index (CPTS-RI), and reliability was assessed using Cronbach's alpha.</p><p><strong>Results: </strong>The adaptation and validation of a French-Canadian version of the PCQ involved 176 participants and resulted in a 35-item instrument with seven first-order scales. Behavioral and Cognitive Distraction, Externalizing, Seeking Social Support, and Internalizing/Catastrophizing showed significant (<i>p</i> < 0.05) but weak correlation (<i>r_s</i> ≤ 0.36) with the CPTS-RI. The factorial structure explained 65.40% of the variance and demonstrated good to excellent internal consistency for both first- and second-order scales (α ≥ 0.608).</p><p><strong>Conclusion: </strong>This study addresses the lack of a validated French-Canadian version of the PCQ. Through a cross-cultural adaptation and validation, the resulting PCQ-F demonstrates similar psychometric properties and a factor structure largely consistent with the original instrument. The PCQ-F offers a valid and reliable tool for assessing pain-related coping responses and may support both clinical assessment and future research aimed at promoting adaptive coping and reducing maladaptive cognitive and behavioral responses to pain.</p>","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"10 1","pages":"2650298"},"PeriodicalIF":2.1,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13089925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147724511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient perspectives on buprenorphine/naloxone for chronic noncancer pain: A qualitative interview study.","authors":"Katelyn Halpape, Derek Jorgenson, Marla Rogers","doi":"10.1080/24740527.2026.2627924","DOIUrl":"10.1080/24740527.2026.2627924","url":null,"abstract":"<p><strong>Background: </strong>Buprenorphine/naloxone (Suboxone) is an emerging option for chronic noncancer pain (CNCP), but evidence on transitioning patients from full opioid agonists remains limited. At the University of Saskatchewan Chronic Pain Clinic (UCPC) in Saskatchewan, Canada, pharmacists support these transitions within a unique interdisciplinary model.</p><p><strong>Aim: </strong>The aim of this study was to explore patient perspectives on transitioning to and using buprenorphine/naloxone for CNCP.</p><p><strong>Methods: </strong>This qualitative study involved one-on-one semistructured interviews with current and former UCPC patients who had transitioned to buprenorphine/naloxone for CNCP. Participants were invited by email to complete semistructured interviews via Zoom or telephone with a trained facilitator. The interview guide was informed by a literature review and pretested. Recorded interviews were transcribed using an artificial intelligence-supported platform, reviewed for accuracy, and analyzed in NVivo 14 using thematic analysis.</p><p><strong>Results: </strong>Seven participants (five females, two males; average age 57 years) were interviewed. Most had used opioids long term for pain prior to transition. Experiences varied: some transitioned easily, whereas others required more time or experienced discomfort. Buprenorphine/naloxone tablet size and taste were the most common negative experiences. Side effects were mild (e.g. drowsiness, constipation). Some expressed concern about long-term use and desired clearer communication during transitions. Although buprenorphine/naloxone was not uniformly experienced as effective for pain relief, most would recommend buprenorphine/naloxone to others.</p><p><strong>Conclusion: </strong>Patient experiences at UCPC suggest that though buprenorphine/naloxone is not a universal solution for CNCP, it may be an effective option for carefully selected individuals. Side effects were tolerable, and most would recommend the treatment. Improved communication during transitions may enhance patient experiences.</p>","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"10 1","pages":"2627924"},"PeriodicalIF":2.1,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13022992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147576546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parental Validation and Invalidation in Parent-Adolescent Discussion of Worry and Pain.","authors":"Michelle M Gagnon, Alexandra Brilz, Courtney Cameron, Krista Baerg","doi":"10.1080/24740527.2026.2622315","DOIUrl":"https://doi.org/10.1080/24740527.2026.2622315","url":null,"abstract":"<p><strong>Background: </strong>Parental responses to an adolescent's pain impact pain-related variables, yet limited research has focused on parent-adolescent pain communication. Additionally, patterns have rarely been examined through comparisons of dyads where the adolescent has chronic pain versus those without.</p><p><strong>Aims: </strong>To examine the impact of parental validation and invalidation on adolescent pain-related variables (i.e. functional disability, pain catastrophizing, pain intensity).</p><p><strong>Methods: </strong>Parent-adolescent dyads, including adolescents with chronic pain (CP; <i>n</i> = 32) and with no chronic pain (NCP; <i>n</i> = 61), completed questionnaires and two discussion tasks: a worry discussion and a pain discussion. Parental responses were coded using the Validating and Invalidating Behaviors Coding Scale.</p><p><strong>Results: </strong>Parental invalidation was significantly greater in the worry task compared to the pain task (<i>F</i>(1, 91) = 4.16, <i>p</i> =.04). In the pain task, greater parental validation predicted higher adolescent functional disability (<i>β</i> = 0.32, <i>p</i> =.02), with significantly stronger effects in the CP group. Validation also predicted adolescent pain catastrophizing (worry: <i>β</i> =.35, <i>p</i> =.02; pain: <i>β</i> = 0.30, <i>p</i> =.03), with significantly greater effects in the CP group. In the worry task, validation showed both linear (<i>β</i> = -0.34, <i>p</i> =.03) and curvilinear (<i>β</i> = -0.25, <i>p</i> =.005) relationships with changes in adolescent pain intensity.</p><p><strong>Conclusions: </strong>Chronic pain status and discussion content are associated with adolescent-reported variables during parent-adolescent interactions. Greater attention to intra- and interpersonal variables is needed to understand how pain communication unfolds between parents and adolescents.</p>","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"10 1","pages":"2622315"},"PeriodicalIF":2.1,"publicationDate":"2026-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12998012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147488589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PAINscape-Exploring patient experiences with ketamine for chronic neuropathic pain: A qualitative study.","authors":"Nandana Parakh, Danielle Lessor, Kevin Dang, Paul Ritvo, Duminda N Wijeysundera, Victoria Tucci, Mariela Leda, Mindy Lu, Gabriella Mattina, Janneth Pazmino-Canizares, Zaaria Thomas, Roshni Nayar, John G Hanlon, Sérgio M Pereira, Karim S Ladha, Hance Clarke, Sakina J Rizvi, Cheryl Pritlove, Akash Goel","doi":"10.1080/24740527.2026.2615473","DOIUrl":"10.1080/24740527.2026.2615473","url":null,"abstract":"<p><strong>Background/aims: </strong>Chronic pain affects approximately 8 million Canadians annually and is defined by persistent pain lasting over 3 months. Ketamine is an anesthetic drug used to treat chronic neuropathic pain, a subset of chronic pain. To better understand ketamine's therapeutic benefits and feasibility as a treatment for chronic neuropathic pain, it is important to characterize patient experiences and perspectives with ketamine, as well as barriers and facilitators to accessing this treatment.</p><p><strong>Methods: </strong>Thirteen participants were recruited from the chronic pain ketamine infusion program at St. Michael's Hospital in Toronto, Canada. Each participant completed a survey that captured demographic information and chronic pain features, followed by a semistructured interview. Interview data were analyzed, and themes were generated using content analysis.</p><p><strong>Results: </strong>All participants described decreased pain intensity and increased functionality after receiving ketamine treatment. Barriers to ketamine treatment included fragmented health systems and long wait times, along with a struggle for pain validation by health care providers. Facilitators of ketamine treatment included support from individual health care providers and the provision of a supportive treatment environment.</p><p><strong>Conclusions: </strong>Although pain experiences differed among participants, all participants reported decreased pain with ketamine infusions. Addressing the stigma associated with ketamine infusions, further research around augmenting durability of ketamine, and providing a safe treatment environment can all improve ketamine's benefit for chronic neuropathic pain. Understanding the barriers and facilitators, as well as implementing participant suggestions, will not only help inform our ketamine program but can improve access to pain management and facilitate future research in this field.</p>","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"10 1","pages":"2615473"},"PeriodicalIF":2.1,"publicationDate":"2026-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12962686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147379403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"You know, we're all human beings\": A qualitative study on the perceived needs of people experiencing chronic pain with regard to physiotherapy services.","authors":"Jonathan Gervais-Hupé, Arthur Filleul, Kadija Perreault, Isabelle Gaboury, Timothy H Wideman, Céline Charbonneau, Fatiha Loukili, Anne Hudon","doi":"10.1080/24740527.2026.2615474","DOIUrl":"https://doi.org/10.1080/24740527.2026.2615474","url":null,"abstract":"<p><strong>Background: </strong>Chronic pain has many deleterious effects on the lives of those living with it. Though understanding the needs of people living with chronic pain is crucial to providing patient-centered care, current knowledge remains limited regarding the needs of this population in relation to the physiotherapy services they regularly use.</p><p><strong>Aims: </strong>This study aimed to understand the perceived needs of people living with chronic pain regarding physiotherapy services in Quebec, Canada.</p><p><strong>Methods: </strong>This qualitative study followed an interpretative description methodology. Semistructured individual interviews were conducted with adults living with chronic pain who had used physiotherapy services in any type of setting. Transcripts were analyzed using reflexive thematic analysis following an inductive approach with the constant comparative method.</p><p><strong>Results: </strong>Among the 27 participants, the majority were White women living in urban areas who were highly educated. They mainly used physiotherapy services in private clinics for musculoskeletal chronic pain. Four overarching themes related to patients' perceived physiotherapyrelated needs were identified: (1) being respected in an empathetic human-to-human relationship; (2) obtaining the care you need; (3) desiring a warm, welcoming, and tailored environment; and (4) feeling the organization practices and policies are adapted to persons living with chronic pain.</p><p><strong>Conclusion: </strong>Our findings show that the needs of people living with chronic pain are multiple, deeply interconnected, and shaped by organizational and systemic contexts. Improving the responsiveness of physiotherapy services therefore requires moving beyond individual-level strategies to address these broader forces. A comprehensive, systemwide approach is essential to meaningfully meet patients' needs.</p>","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"10 1","pages":"2615474"},"PeriodicalIF":2.1,"publicationDate":"2026-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12962706/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147379434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of combined spinal-epidural analgesia (CSEA) on postpartum depression: A Mendelian randomization study.","authors":"Mingyue Zhang, Shaoxing Liu","doi":"10.1080/24740527.2026.2617362","DOIUrl":"10.1080/24740527.2026.2617362","url":null,"abstract":"<p><strong>Background: </strong>Postpartum depression (PPD) develops within the first few weeks or months following delivery and causes severe emotional and psychological problems. Pain has been closely linked to the occurrence of depression. Observational studies have suggested that effective pain relief during childbirth can reduce the incidence of PPD. However, these studies are fraught with numerous confounding factor. Combined spinal-epidural analgesia (CSEA) is a commonly used pain relief method during childbirth. It is currently unclear whether a causal relationship exists between CSEA and PPD.</p><p><strong>Methods: </strong>An analysis was conducted using five methods in Mendelian randomization (MR) to study the use of CSEA during childbirth and PPD. The data were obtained from the United Kingdom Biobank database for CSEA and from FinnGen for PPD. The analysis included MR-Egger, weighted median, inverse variance weighted (IVW), simple mode, and weighted mode. We then conducted exposure heterogeneity testing using Cochran's <i>Q</i> statistics and assessed the pleiotropy of exposure single nucleotide polymorphisms (SNPs) using MR-Egger.</p><p><strong>Results: </strong>IVW odds ratio (OR) = 0.978; 95% confidence interval (CI) 0.407, 1.031; <i>P</i> = 0.408. The results of the weighted median (OR = 1.035; 95% CI 0.995; 1.118, <i>P</i> = 0.377), simple mode (OR = 0.929; 95% CI 0.773, 1.116; <i>P</i> = 0.435), and weighted mode (OR = 0.995; 95% CI 0.930, 1.065; <i>P</i> = 0.888) suggest that there is no significant link between CSEA and PPD.</p><p><strong>Conclusion: </strong>We have concluded that there is no causal link between CSEA and PPD. This information can assist clinical professionals in gaining a better understanding of this condition.</p>","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"10 1","pages":"2617362"},"PeriodicalIF":2.1,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12962691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147379415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers and facilitators to implementing parent-led infant pain care in rural settings: A qualitative descriptive study using the Theoretical Domains Framework and COM-B Model.","authors":"Britney Benoit, Christine Cassidy, Jacqueline van Wijlen, Marsha Campbell-Yeo, Sionnach Hendra, Ruth Martin-Misener, Jennifer MacDougall, Ashley Cameron, Hannah McGee, Ripu Daman","doi":"10.1080/24740527.2025.2602540","DOIUrl":"10.1080/24740527.2025.2602540","url":null,"abstract":"<p><strong>Aims: </strong>To support the implementation of parent-led infant pain care by identifying barriers and facilitators during acute procedures.</p><p><strong>Methods: </strong>We conducted a qualitative descriptive study guided by the Theoretical Domains Framework (TDF) and COM-B Model. We completed individual, virtual, semi-structured interviews with health system participants (hospital and community-based health care providers, clinical leaders, and administrators; <i>n</i> = 10) and parent participants (who had used hospital or community-based perinatal services in the last 12 months; <i>n</i> = 14) and analyzed the data using deductive-inductive qualitative content analysis.</p><p><strong>Results: </strong>Thirty-two themes were identified across the capability (9 themes), opportunity (13 themes), and motivation (10 themes) domains of the COM-B Model. Participants emphasized the influence of environmental context, resources, and social factors on the use of breastfeeding and skin-to-skin contact to manage infant pain across rural acute and community care settings. Health system and parent participants described similar barriers and facilitators, highlighting the inconsistent implementation of parent-led infant pain care.</p><p><strong>Conclusions: </strong>The barriers and facilitators identified in this study will inform the development of theory-informed, contextually relevant implementation interventions to support the use of best practice infant pain care in rural contexts.</p>","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"10 1","pages":"2602540"},"PeriodicalIF":2.1,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12885414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146159194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Substance use frequency and associations with chronic pain among a cohort of people who inject drugs in Montreal, Canada.","authors":"Sasha Udhesister, Sarah Larney, M Gabrielle Pagé, Nanor Minoyan, Stine Bordier Høj, Valérie Martel-Laferrière, Didier Jutras-Aswad, Julie Bruneau","doi":"10.1080/24740527.2025.2598284","DOIUrl":"10.1080/24740527.2025.2598284","url":null,"abstract":"<p><strong>Background: </strong>The relationship between substance use and chronic pain is bidirectional. Although chronic pain and polysubstance use are highly prevalent among people who inject drugs (PWID), few studies have examined how the frequency of use of different substances relates to chronic pain.</p><p><strong>Aims: </strong>The aim of this study was to examine associations between substance use frequency and chronic pain in a sample of PWID.</p><p><strong>Methods: </strong>A cross-sectional analysis was conducted among PWID participating in a community-based cohort in Montreal, Canada. Chronic pain measures were introduced in the interviewer-administered questionnaire in February 2017. The first questionnaire was used for analyses, which covers data up to November 2022. Logistic regression analyses were conducted to examine associations between alcohol, stimulants, opioid and cannabis frequency and chronic pain.</p><p><strong>Results: </strong>Six hundred and eight participants were included; 84% were men and mean age was 44.7 years old. Prevalence of chronic pain was 48%. Age (adjusted odds ratio [aOR] = 1.38, 95% confidence interval [CI] 1.15-1.65) and regular alcohol consumption in the past month (aOR = 1.76, 95% CI 1.13-2.75) were associated with chronic pain in univariable and multivariable logistic regression models. The frequency of use for all other substances was not found to be significantly associated with chronic pain.</p><p><strong>Conclusion: </strong>The prevalence of chronic pain in our sample was high. The positive association between high frequency of alcohol use and chronic pain could be explained by alterations of pain pathways by heavy use and withdrawal episodes, potentially increasing hyperalgesia. This study underscores the importance of addressing alcohol use along with other substances among PWID.</p>","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"10 1","pages":"2598284"},"PeriodicalIF":2.1,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12885412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}