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

{"title":"Youth and parent perceptions on participating in specialized multidisciplinary pain rehabilitation options: A qualitative timeline effect analysis.","authors":"Karen Hurtubise, Astrid Brousselle, Melanie Noel, Abbie Jordan, Jo White, Nivez Rasic, Chantal Camden","doi":"10.1080/24740527.2020.1858709","DOIUrl":"10.1080/24740527.2020.1858709","url":null,"abstract":"<p><p><b>Background</b>: Little is known about how the specialized treatment journey is perceived by youth with pain-related disability and their parents. <b>Aims</b>: Describe and compare the treatment effects and outcomes as perceived by youth and their parents enrolled in intensive interdisciplinary pain treatment (IIPT) or multimodal treatment (MMT). <b>Methods</b>: Eleven IIPT youth and five parents and three MMT youth and five parents were recruited. All were asked to complete a treatment journey timeline, followed by separately conducted semistructured interviews. Transcribed interviews were analyzed using reflective thematic analysis. <b>Results</b>: The main themes spanned the treatment trajectory. All participants described similar initial struggles (Theme 1). Positive and negative treatment effects associated with acquisitions and disruptions (Theme 2), and outcomes post-discharge related to supports and realities (Theme 3) emerged. Knowledge, skills, and support acquisition during treatment and feeling empowered and confident to self-manage postdischarge were identified as IIPT benefits. However, the change effort and life disruptions required and the difficulty transitioning to real life postprogram were acknowledged as detrimental IIPT impacts. Continuing with life as usual and maintaining supports in daily contexts (e.g., school personnel, friends) were reported MMT benefits. However, the challenges of managing pain, treatment adherence within the competing demands of daily realities, and the lack of support to integrate strategies were emphasized as detrimental MMT impacts. <b>Conclusions</b>: Detailed impacts of two specialized multidisciplinary pain rehabilitation interventions on the lives of youth with pain-related disability and their parents are described. The treatments benefits and previously unexplored detrimental effects are unveiled.</p>","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"5 1","pages":"1-21"},"PeriodicalIF":2.4,"publicationDate":"2021-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7951173/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38911130","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 effect of conditioning stimulus intensity on conditioned pain modulation (CPM) hypoalgesia.","authors":"Alexia Coulombe-Lévêque,&nbsp;Yannick Tousignant-Laflamme,&nbsp;Guillaume Léonard,&nbsp;Serge Marchand","doi":"10.1080/24740527.2020.1855972","DOIUrl":"https://doi.org/10.1080/24740527.2020.1855972","url":null,"abstract":"<p><p><b>Background</b>: The magnitude and duration of conditioned pain modulation (CPM) likely depends on the nature and intensity of the conditioning stimulus (CS). <b>Aims</b>: The aim of this study was to measure the effect of CS intensity on the duration of CPM hypoalgesia. <b>Methods</b>: In this single-blind, nonrandomized, repeated measures study, we assessed CPM hypoalgesia in 20 healthy participants following cold pressor tests (CPT) at 7°C and 12°C. The test stimulus, a 60-s heat stimulation, was administered before the CPT and immediately after, and again at 5-min intervals until participants' pain scores returned to pre-CS levels. Two hypoalgesia thresholds were used to establish return to pre-CS level: within -10/100 of baseline and within -20/100 of baseline. <b>Results</b>: CPM hypoalgesia, when defined as a reduction in pain levels >10/100, did not last longer following the more intense 7°C CPT compared to the 12°C CPT (32 min vs. 20 min, respectively; <i>P</i> = 0.06); similar results were obtained when CPM hypoalgesia was defined as a reduction in pain levels of >20/100 (16 min following the 7°C CPT vs. 9 min following the 12°C CPT; <i>P</i> = 0.33). The duration of CPM hypoalgesia was significantly longer when the 10/100 threshold was used compared to the 20/100 threshold, regardless of CPT temperature (<i>P</i> = 0.008 for the 12°C CPT; <i>P</i> < 0.001 for the 7°C CPT). <b>Conclusions</b>: The more intense CS did not induce CPM hypoalgesia of longer duration compared to the less intense CS. The choice of threshold for what constitutes CPM hypoalgesia did have a significant effect on the results.</p>","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"5 1","pages":"22-29"},"PeriodicalIF":2.4,"publicationDate":"2021-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/24740527.2020.1855972","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38911131","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 of pain mitigation strategies for adult vaccine injections","authors":"K. Cull, S. Bowles, N. MacDonald, S. Mcneil, B. Taylor, K. Slayter, A. Steenbeek, A. Taddio, Lucie M. Bucci, J. Isenor","doi":"10.1080/24740527.2021.1967113","DOIUrl":"https://doi.org/10.1080/24740527.2021.1967113","url":null,"abstract":"ABSTRACT Aims The aim of this study was to evaluate an educational pamphlet that incorporates evidence-based pain mitigation strategies during adult vaccine injections and determine its effect on the knowledge, attitudes, and behaviors toward use of such strategies among adults in the community receiving immunizations. Methods An evidence-based pamphlet about how to reduce pain during vaccination in adults was distributed to a convenience sample of community sites that administer vaccines, including family physician offices, travel clinics, and pharmacies. Providers at the community sites distributed a baseline (pre) questionnaire followed by the pamphlet to study participants. Then participants were vaccinated. Six weeks later, participants were contacted to complete a follow-up (post) questionnaire. Participants’ knowledge, attitudes, and behaviors regarding pain mitigation strategies for vaccine injections were evaluated before and after access to the pamphlet. Results Seventy-four people receiving vaccines participated. Participants were predominantly university educated (69%) and female (66%), with a median age of 44.5 years (range, 18–71). Most participants received an injection at a travel or public health clinic (73%). Twenty-seven percent had prior accurate knowledge of pain mitigation strategies. Self-reported pain or fear of needle pain did not change from before access to the pamphlet to six weeks after. Twenty percent of participants used at least one strategy outlined in the pamphlet and found it helpful and 52% were interested in sharing the pamphlet with others. Conclusions An educational pamphlet about vaccination pain mitigation resulted in a positive change in knowledge and attitudes around pain mitigation strategies. Further research is needed to explore long-term impact.","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"5 1","pages":"183 - 191"},"PeriodicalIF":2.4,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48891164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“Power of Storytelling”: A Content Analysis of Chronic Pain Narratives on YouTube","authors":"H. Devan, Toa Elphick-laveta, Maxwell Lynch, K. MacDonell, D. Marshall, Leah Tuhi, R. Grainger","doi":"10.1080/24740527.2021.1929117","DOIUrl":"https://doi.org/10.1080/24740527.2021.1929117","url":null,"abstract":"ABSTRACT Background: First-person digital narratives are short videos produced independently by or in partnership with the person to tell their personal experience. Objectives: The objective of this study was to describe how first-person digital narratives of adults with non-cancer pain are represented on YouTube. A secondary aim was to analyze first-person digital narratives hosted on pain management websites of professional organizations to explore whether these videos represented chronic pain with the same content. Method: Guided by the methodological framework of Arksey and O’Malley, a conventional content analysis was undertaken analyzing the chronic pain videos published on YouTube and six global pain management websites. Results: Of the 78 videos (54 YouTube and 24 pain websites) that were analyzed, the overarching theme “power of storytelling” suggests that personal stories were used as a medium to share lived experiences of chronic pain, providing help and advice to similar others. The four supporting themes were (1) My pain journey, (2) Navigating health care, (3) Pain and the impact on me, and (4) What works for me. There was no major difference in subthemes between the YouTube and pain website videos. Conclusion: Digital narratives enable those living with chronic pain to voice their experiences and communicate their pain journeys and may thus provide a sense of validation. Digital narratives can be used as a therapeutic tool to provide insights for others into the lived experience of chronic pain and to provide peer support for people with pain. Future studies are needed to investigate the clinical effectiveness and implementation of digital stories in chronic pain management.","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"5 1","pages":"117 - 129"},"PeriodicalIF":2.4,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/24740527.2021.1929117","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48789856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The intersection of harm reduction and postoperative care for an illicit fentanyl consumer after major surgery: A case report","authors":"S. Ladak, G. Sapisochin, P. Slepian, H. Clarke","doi":"10.1080/24740527.2021.1952066","DOIUrl":"https://doi.org/10.1080/24740527.2021.1952066","url":null,"abstract":"ABSTRACT Background As Canada continues to address challenges related to the opioid crisis, individuals suffering from opioid use disorder (OUD) can be especially vulnerable to physical and psychological destabilization after surgery. Adopting a harm reduction approach postoperatively can be a success factor for safe recovery and satisfactory analgesia. Purpose We present the case of a 40-year-old patient (referred to as DC) with OUD using illicit fentanyl, heroin, and oxycodone preoperatively and admitted for an elective liver resection for steroid-induced hepatoma. Despite a preoperative anesthesia assessment and the initiation of a standard balanced multimodal analgesic regimen, suboptimal analgesia was evident in the first 24 h postoperatively. This lack of analgesic efficacy precipitated DC’s use of illicit self-injected intravenous (IV) opioid and significant emotional distress. To address this, a nurse practitioner and anesthesiologist within the Toronto General Hospital acute and transitional pain program and the surgical team quickly met and adopted a harm reduction approach to manage DC’s postoperative pain and emotional distress. The ultimate goal was to eliminate self-administration of illicit IV opioids and prevent DC from attempting to leave hospital against medical advice. Following an interprofessional team discussion that included DC, IV fentanyl was offered via a patient-controlled analgesia pump to DC’s satisfaction (exceeding standard settings), providing acceptable pain relief. To our knowledge, DC did not self-administer additional illicit drugs during the remainder of hospitalization. Outcome This harm reduction approach resulted in DC’s safe recovery, achievement of postoperative functional milestones, and continued engagement with outpatient pain treatment.","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"5 1","pages":"166 - 171"},"PeriodicalIF":2.4,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/24740527.2021.1952066","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43016765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Parent–child interactions during pediatric venipuncture: Investigating the role of parent traits, beliefs, and behaviors in relation to child outcomes","authors":"Rachel L. Moline, C. McMurtry, M. Noel, P. McGrath, C. Chambers","doi":"10.1080/24740527.2021.1952065","DOIUrl":"https://doi.org/10.1080/24740527.2021.1952065","url":null,"abstract":"ABSTRACT Background: The social context is critical to children’s pain, and parents frequently form a major aspect of this context. We addressed several gaps in our understanding of parent–child interactions during painful procedures and identified intrapersonal contributions to parental affective responses and behaviors. We used the pain empathy model framework to examine parent–child interactions during venipuncture to determine predictors of parent distraction and reassurance. Aims: We examined relations among parent and child behaviors along with parent fear and child pain and fear. We empirically tested the contribution of top-down influences in predicting the use of two common parent utterances, reassurance and distraction during venipuncture, including parent beliefs about these behaviors. Methods: Venipunctures of 100 5- to 10-year-old children were filmed, and parent–child interactions were coded using the full 35 item Child Adult Medical Procedure Interaction Scale. Two codes were of particular interest: reassurance and distraction. Self-report measures included child fear and pain, parent fear, trait anxiety, empathy, pain catastrophizing, and beliefs about reassurance and distraction. Results: Findings supported original Child–Adult Medical Procedure Interaction Scale codes linking parent “distress-promoting” behaviors with poorer child outcomes and parent “coping-promoting” behaviors with improved child outcomes. Parent traits accounted for a small portion of the variance in parent reassurance and distraction. Conclusions: Findings are consistent with research on coping and distress promoting behaviors. Using a novel framework of the pain empathy model, we found that parent traits largely did not predict their procedural behaviors, which were more strongly related to child distress behaviors during the needle and parent beliefs about the behaviors.","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"5 1","pages":"151 - 165"},"PeriodicalIF":2.4,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/24740527.2021.1952065","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42029393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting recovery after lumbar spinal stenosis surgery: A protocol for a historical cohort study using data from the Canadian Spine Outcomes Research Network (CSORN).","authors":"Erynne Rowe,&nbsp;Elizabeth Hassan,&nbsp;Lisa Carlesso,&nbsp;Janie Astephen Wilson,&nbsp;Douglas P Gross,&nbsp;Charles Fisher,&nbsp;Hamilton Hall,&nbsp;Neil Manson,&nbsp;Ken Thomas,&nbsp;Greg McIntosh,&nbsp;Brian Drew,&nbsp;Raja Rampersaud,&nbsp;Luciana Macedo","doi":"10.1080/24740527.2020.1734918","DOIUrl":"https://doi.org/10.1080/24740527.2020.1734918","url":null,"abstract":"<p><p><b>Background</b>: Symptomatic lumbar spinal stenosis (SLSS) is a condition in which narrowing of the spinal canal results in entrapment and compression of neurovascular structures. Decompressive surgery, with or without spinal fusion, is recommended for those with severe symptoms for whom conservative management has failed. However, significant persistent pain, functional limitations, and narcotic use can affect up to one third of patients postsurgery. <b>Aims</b>: The aim of this study will be to identify predictors of outcomes 1-year post SLSS surgery with a focus on modifiable predictors. <b>Methods</b>: The Canadian Spine Outcomes Research Network (CSORN) is a large database of prospectively collected data on pre- and postsurgical outcomes among surgical patients. We include participants with a primary diagnosis of SLSS undergoing their first spine surgery. Outcomes are measured at 12 months after surgery and include back and leg pain, disability (Oswestry Disability Index, ODI), walking capacity (ODI item 4), health-related quality of life, and an overall recovery composite outcome (clinically important changes in pain, disability, and quality of life). Predictors include demographics (education level, work status, marital status, age, sex, body mass index), physical activity level, smoking status, previous conservative treatments, medication intake, depression, patient expectations, and other comorbidities. A multivariate partial least squares model is used to identify predictors of outcomes. <b>Conclusion</b>: Study results will inform targeted SLSS interventions, either for the selection of best candidates for surgery or the identification of targets for presurgical rehabilitation programs.</p>","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"4 4","pages":"19-25"},"PeriodicalIF":2.4,"publicationDate":"2020-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/24740527.2020.1734918","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38911126","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 role of anxiety and related states in pediatric postsurgical pain.","authors":"Cheryl H T Chow, Louis A Schmidt, D Norman Buckley","doi":"10.1080/24740527.2020.1847600","DOIUrl":"10.1080/24740527.2020.1847600","url":null,"abstract":"<p><p><b>Background:</b> Nearly 20% of children and adolescents have pain with disability 1 year after surgery, and they experience poor sleep, school absence, and decreased activities. Negative clinical, psychological, and developmental effects include greater pain medication use, longer recovery, and fear of future medical care. Research has found psychological and family influences (i.e., child and parental anxiety) on pediatric chronic postsurgical pain (CPSP), but a better understanding of the role of perioperative anxiety and its related states in predicting pediatric postsurgical pain is needed. The poor understanding of the causes of child CPSP can lead to misdiagnosis and inadequate treatment, with significant short- and long-term effects. <b>Objectives:</b> The aim of this review was to summarize the literature on children's perioperative anxiety and parental anxiety in relation to acute postsurgical pain, CPSP, and pain trajectories. We also examined other related psychological factors (i.e., anxiety sensitivity, catastrophizing, pain anxiety, and fear of pain) in relation to pediatric acute and chronic postsurgical pain. Lastly, we discuss the interventions that may be effective in reducing children's and parents' preoperative anxiety. <b>Conclusions:</b> Our findings may improve the understanding of the causes of CPSP and highlight the gaps in research and need for further study.</p>","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"4 4","pages":"26-36"},"PeriodicalIF":2.4,"publicationDate":"2020-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7942768/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38911127","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":"CJP Special Edition-Proceedings of the Michael G. Degroote Institute for Pain Research and Care Annual Symposium-Director's introduction.","authors":"Norm Buckley","doi":"10.1080/24740527.2020.1854043","DOIUrl":"https://doi.org/10.1080/24740527.2020.1854043","url":null,"abstract":"","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"4 4","pages":"1-2"},"PeriodicalIF":2.4,"publicationDate":"2020-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/24740527.2020.1854043","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38898895","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":"What's new in chronic pain pathophysiology.","authors":"Ivan Cohen,&nbsp;Mark J Lema","doi":"10.1080/24740527.2020.1752641","DOIUrl":"https://doi.org/10.1080/24740527.2020.1752641","url":null,"abstract":"<p><p>The understanding of pain pathophysiology is continuously evolving. Identifying underlying cellular and subcellular pathways helps create opportunities for targeted therapies that may prove to be effective interventions. This article is an update on four areas of developing knowledge as it pertains to clinical management of patients with pain: nerve growth factor antagonists, microglial modulation, AMP-activated protein kinase activators, and genetic pain factors. Each of these areas represents novel targets for targeted therapies to prevent, treat, and modify the disease course of acute, chronic, and neuropathic pain. Currently most pain management techniques do not target these pathways directly, but there is promising evidence to suggest that the field is advancing toward available therapies in the near future.</p>","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"4 4","pages":"13-18"},"PeriodicalIF":2.4,"publicationDate":"2020-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/24740527.2020.1752641","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38911125","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}