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

{"title":"A systematic review of the efficacy of ketamine for craniofacial pain.","authors":"Yasmine Hoydonckx,&nbsp;Tyler McKechnie,&nbsp;Miki Peer,&nbsp;Marina Englesakis,&nbsp;Pranab Kumar","doi":"10.1080/24740527.2023.2210167","DOIUrl":"https://doi.org/10.1080/24740527.2023.2210167","url":null,"abstract":"<p><strong>Background: </strong>Craniofacial pain (CFP) poses a burden on patients and health care systems. It is hypothesized that ketamine, an <i>N</i>-methyl-d-aspartate (NMDA) receptor antagonist, can reverse central sensitization associated with causation and propagation of CFP. This systematic review aims to assess the role of ketamine for CFP.</p><p><strong>Methods: </strong>Databases were searched for studies published up to September 26, 2022, investigating the efficacy of ketamine for adults with CFP. Primary outcome was the change in pain intensity at 60 min postintervention. Two reviewers screened and extracted data. Registration with PROSPERO was performed (CRD42020178649).</p><p><strong>Results: </strong>Twenty papers (six randomized controlled trials [RCTs], 14 observational studies) including 670 patients were identified. Substantial heterogeneity in terms of study design, population, dose, route of administration, treatment duration, and follow-up was noted. Bolus dose ranged from 0.2-0.3 mg/kg (intravenous) to 0.4 mg/kg (intramuscular) to 0.25-0.75 mg/kg (intranasal). Ketamine infusions (0.1-1 mg/kg/h) were given over various durations. Follow-up was short in RCTs (from 60 min to 72 h) but longer in observational studies (up to 18 months). Ketamine by bolus treatment failed to reduce migraine intensity but had an effect by reducing intensity of aura, cluster headache (CH), and trigeminal neuralgia. Prolonged ketamine infusions showed sustainable reduction of migraine intensity and frequency of CH attacks, but the quality of the evidence is low.</p><p><strong>Conclusion: </strong>Current evidence remains conflicting on the efficacy of ketamine for CFP owing to low quality and heterogeneity across studies. Ketamine infusions are suggested to provide sustained improvement, possibly because of prolonged duration and higher dosage of administration. RCTs should focus on the dose-response relationship of prolonged ketamine infusions on CFP.</p>","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"7 1","pages":"2210167"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10294769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10564335","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":"Ultrasound-guided axial facet joint interventions for chronic spinal pain: A narrative review.","authors":"Michael J Wong,&nbsp;Manikandan Rajarathinam","doi":"10.1080/24740527.2023.2193617","DOIUrl":"https://doi.org/10.1080/24740527.2023.2193617","url":null,"abstract":"<p><strong>Background: </strong>Axial facet joint interventions (e.g., medial branch block and radiofrequency ablation, facet joint intra-articular injection) are commonly performed for managing chronic spinal pain. Although traditionally performed with fluoroscopy or computed tomography (CT) guidance, ultrasound-guided techniques have also been developed for these interventions.</p><p><strong>Aims: </strong>The aim of this study is to present contemporary ultrasound-guided techniques for facet joint interventions and synthesize data addressing their accuracy, safety, and efficacy.</p><p><strong>Methods: </strong>The PubMed, MEDLINE, CINAHL, Embase, and Cochrane Central Register of Controlled Trials databases were systematically searched for studies of ultrasound-guided facet joint interventions with human subjects from November 1, 1992, to November 1, 2022. Additional sources were drawn from reference lists and citations of relevant studies.</p><p><strong>Results: </strong>We found 48 studies assessing ultrasound-guided facet joint interventions. Ultrasound guidance for injection of the cervical facet joints and their innervating nerves had favorable accuracy (78%-100%), with lower procedural time compared to fluoroscopy or CT guidance and comparable pain relief. Accuracy with ultrasound-guided lumbar facet joint intra-articular injection (86%-100%) was more reliable than medial branch block (72%-97%); analgesia was comparable to fluoroscopy and CT guidance. In general, these procedures were more challenging for patients with obesity, and deeper structures were more difficult to accurately target (e.g., lower cervical levels, L5 dorsal ramus).</p><p><strong>Conclusions: </strong>Ultrasound-guided facet joint interventions continue to evolve. Some technically challenging interventions may be impractical for widespread usage or require further technical refinement. The utility of ultrasound guidance with obesity and abnormal anatomy may be reduced.</p>","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"7 2","pages":"2193617"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10193888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10194077","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":"Cost-Effectiveness and Cost-Utility Analyses in Thailand of Continuous Intrathecal Morphine Infusion Compared with Conventional Therapy in Cancer Pain: A 10-year Multicenter Retrospective Study.","authors":"Arpawan Thepsuwan,&nbsp;Nuj Tontisirin,&nbsp;Pramote Euasobhon,&nbsp;Patt Pannangpetch,&nbsp;Borwornsom Leerapan,&nbsp;Oraluck Pattanaprateep,&nbsp;Steven P Cohen","doi":"10.1080/24740527.2023.2225564","DOIUrl":"https://doi.org/10.1080/24740527.2023.2225564","url":null,"abstract":"<p><strong>Background: </strong>Because of the high initial cost of intrathecal drug delivery (ITDD) therapy, this study investigated the cost-effectiveness and cost-utility of ITDD therapy in refractory cancer pain management in Thailand over the past 10 years.</p><p><strong>Methods: </strong>The retrospective study was conducted in patients with cancer pain who underwent ITDD therapy from January 2011 to 2021 at three university hospitals. Clinical outcomes included the numerical rating scale (NRS), Palliative Performance Scale, and the EQ-5D. The direct medical and nonmedical as well as indirect costs were also recorded. Cost-effectiveness and cost-utility analyses were performed comparing ITDD therapy with conventional therapy (extrapolated from costs of the same patient before ITDD therapy) from a societally oriented economic evaluation.</p><p><strong>Results: </strong>Twenty patients (F:M: 10:10) aged 60 ± 15 years who underwent implantation of an intrathecal percutaneous port (IT port; <i>n</i> = 15) or programmable intrathecal pump (IT pump; <i>n</i> = 5) were included. The median survival time was 78 (interquartile range = 121-54) days after ITDD therapy. At 2-month follow-up, the incremental cost-effectiveness ratio (ICER)/pain reduction of an IT port (US$2065.36 (CA$2829.54)/2-point NRS reduction/lifetime) was lower than for patients with an IT pump (US$5479.26 (CA$7506.58)/2-point NRS reduction/lifetime) compared with continued conventional therapy. The ICER/quality-adjusted life years (QALYs) gained for an IT port compared with conventional treatment was US$93,999.31(CA$128,799.06)/QALY gained, which is above the cost-effectiveness threshold for Thailand.</p><p><strong>Conclusion: </strong>The cost-effectiveness and cost-utility of IT port therapy for cancer pain was high relative to the cost of living in Thailand, above the cost-effectiveness threshold. Prospective cost analysis studies enrolling more patients with diverse cancers that investigate the benefit of early ITDD therapy with devices over a range of prices are warranted.</p>","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"7 1","pages":"2225564"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/59/3f/UCJP_7_2225564.PMC10392764.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10196193","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 Association between COVID-19 and Changes in Opioid Prescribing Patterns and Opioid-Related Overdoses: A Retrospective Cohort Study.","authors":"Alexandra Robins,&nbsp;Alan Dimitriev,&nbsp;Cameron MacKay,&nbsp;Hayden Wang,&nbsp;Abigail Kearney,&nbsp;Daniel P Borschneck,&nbsp;Amber Simpson","doi":"10.1080/24740527.2023.2176297","DOIUrl":"https://doi.org/10.1080/24740527.2023.2176297","url":null,"abstract":"<p><strong>Background: </strong>Recent data suggest that restrictions related to COVID-19 resulted in changes in the prescribing patterns of opioids.</p><p><strong>Aims: </strong>We sought to analyze Ontario health data for changes in frequencies among new and continuing users for the following opioid prescription characteristics: the type of opioid, the average daily dose, and the prescriber's specialty.</p><p><strong>Methods: </strong>Utilizing data on the Ontario Health Data Platform, we defined two 149-day windows as \"before\" and \"after\" based on the initial COVID-19 provincial lockdown. A total of 882,268 individuals met our inclusion criteria and were classified as either \"new\" or \"continuing\" users. Chi-square tests and Fisher's exact tests were applied for each level of our primary outcomes to determine whether there were significant changes in prescription proportions before and after the lockdown.</p><p><strong>Results: </strong>A decline of 28% was observed for the number of new users after the lockdown. Statistically significant changes were observed for new users across almost all opioid prescription characteristics between the before and after windows. The proportion of new users who received at least one dispensing event from a pharmacist increased by 26.32%, whereas continuing users increased by 378.61%. There were no statistically significant shifts in opioid prescriptions among individuals with a reported toxicity event during the study period.</p><p><strong>Conclusions: </strong>In terms of opioid prescribing patterns, new users experienced greater change following the onset of the pandemic lockdown than continuing users. Our findings potentially showcase the unintended impacts that COVID-19-related restrictions had on non-COVID-19-related health services, which can inform future policy decisions.</p>","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"7 1","pages":"2176297"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10081074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9637394","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":"Understand me: Youth with chronic pain on how knowledge gaps influence their pain experience.","authors":"Cara L Brown,&nbsp;Gayle Restall,&nbsp;Francis Austin S Diaz,&nbsp;Polina Anang,&nbsp;Kerstin Gerhold,&nbsp;Heidi Pylypjuk,&nbsp;Kristy Wittmeier","doi":"10.1080/24740527.2022.2146489","DOIUrl":"https://doi.org/10.1080/24740527.2022.2146489","url":null,"abstract":"<p><strong>Background: </strong>There is a perceived lack of readily available resources to support self-management skills in youth living with chronic pain. The perspectives of youth regarding information gaps may improve the effectiveness of resources developed for them.</p><p><strong>Aim: </strong>The aim of this study was to explore the perspectives of youth living with chronic pain on the interactions among their pain experiences, chronic pain resources and research.</p><p><strong>Methods: </strong>Using an interpretive paradigm, we interviewed seven participants (age range 12-19 years) diagnosed with chronic pain. Two frameworks for meaningful engagement of citizens in research and policy informed the interview guide. Data were analyzed inductively using content analysis approaches to examine patterns and develop themes.</p><p><strong>Results: </strong>The participants' perceptions were captured by the overarching theme of \"understand me.\" Four subthemes elaborate on the relationship between the participants' experiences and how their lives could be enhanced through research and knowledge mobilization. In the subtheme \"my unique pain experience,\" the participants help us understand them by chronicling the variation in presentation of their chronic pain. The subtheme \"people don't know it's a thing\" emphasizes that there is general misunderstanding of chronic pain by the public and in the participants' support systems. The first two subthemes influence the third, which describes how the pain \"kind of stops you from living.\" The fourth subtheme, \"knowledge offers hope,\" offers a solution to dismantling misunderstanding of youth living with chronic pain.</p><p><strong>Conclusion: </strong>Future work needs to focus on embedding health literacy and knowledge mobilization into health and education structures to promote developmentally relevant self-management skills.</p>","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"7 1","pages":"2146489"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9888456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9198013","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":"Healthcare provider knowledge, beliefs, and attitudes regarding opioids for chronic non-cancer pain in North America prior to the emergence of COVID-19: A systematic review of qualitative research.","authors":"Louise V Bell,&nbsp;Sarah F Fitzgerald,&nbsp;David Flusk,&nbsp;Patricia A Poulin,&nbsp;Joshua A Rash","doi":"10.1080/24740527.2022.2156331","DOIUrl":"https://doi.org/10.1080/24740527.2022.2156331","url":null,"abstract":"<p><strong>Background: </strong>Balance between benefits and harms of using opioids for the management of chronic noncancer pain (CNCP) must be carefully considered on a case-by-case basis. There is no one-size-fits-all approach that can be executed by prescribers and clinicians when considering this therapy.</p><p><strong>Aim: </strong>The aim of this study was to identify barriers and facilitators for prescribing opioids for CNCP through a systematic review of qualitative literature.</p><p><strong>Methods: </strong>Six databases were searched from inception to June 2019 for qualitative studies reporting on provider knowledge, attitudes, beliefs, or practices pertaining to prescribing opioids for CNCP in North America. Data were extracted, risk of bias was rated, and confidence in evidence was graded.</p><p><strong>Results: </strong>Twenty-seven studies reporting data from 599 health care providers were included. Ten themes emerged that influenced clinical decision making when prescribing opioids. Providers were more comfortable to prescribe opioids when (1) patients were actively engaged in pain self-management, (2) clear institutional prescribing policies were present and prescription drug monitoring programs were used, (3) long-standing relationships and strong therapeutic alliance were present, and (4) interprofessional supports were available. Factors that reduced likelihood of prescribing opioids included (1) uncertainty toward subjectivity of pain and efficacy of opioids, (2) concern for the patient (e.g., adverse effects) and community (i.e., diversion), (3) previous negative experiences (e.g., receiving threats), (4) difficulty enacting guidelines, and (5) organizational barriers (e.g., insufficient appointment duration and lengthy documentation).</p><p><strong>Conclusions: </strong>Understanding barriers and facilitators that influence opioid-prescribing practices offers insight into modifiable targets for interventions that can support providers in delivering care consistent with practice guidelines.</p>","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"7 1","pages":"2156331"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9980668/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10848877","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":"Unacknowledged Pain and Disenfranchised Grief: A Narrative Analysis of Physical and Emotional Pain in Complex MAiD Bereavement Stories.","authors":"Kristie Serota,&nbsp;Michael Atkinson,&nbsp;Daniel Z Buchman","doi":"10.1080/24740527.2023.2231046","DOIUrl":"https://doi.org/10.1080/24740527.2023.2231046","url":null,"abstract":"<p><strong>Background: </strong>Pain can influence an individual's choice to pursue medical assistance in dying (MAiD) and may also influence how family members experience that decision. Family conflict or discordance surrounding a loved one's MAiD decision can cause unique challenges affecting grief and bereavement, including disenfranchised grief. There is limited knowledge of how individuals with complex MAiD bereavement experiences describe the role of physical and emotional pain in their bereavement stories.</p><p><strong>Aims: </strong>This article explores the role of physical and emotional pain in the stories of family members with complex MAiD bereavement and identifies opportunities to improve care for individuals and families experiencing disagreement around MAiD.</p><p><strong>Methods: </strong>We conducted qualitative interviews and utilized a narrative and ethics of care approach to analyze the data.</p><p><strong>Results: </strong>We conducted <i>N</i> = 12 narrative interviews with participants in three provinces: Ontario, British Columbia, and Alberta. Descriptions of physical pain were used to justify the morality, or immorality, of MAiD in the context of patient suffering. Emotional pain described experiences where participants' feelings about MAiD went unacknowledged by their family or friends, institutions, and sociopolitical environments. We conceptualize this unacknowledged emotional pain as disenfranchised grief and make recommendations to improve care for individuals experiencing complex MAiD bereavement.</p><p><strong>Conclusions: </strong>Experiences of physical and emotional pain leave a lasting impact on family members with complex MAiD bereavement. Health care professionals should continue to improve care for family members following MAiD, especially where there is disagreement or family conflict.</p>","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"7 2","pages":"2231046"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10431743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10198235","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":"Signs and symptoms of pediatric complex regional pain syndrome - type 1: A retrospective cohort study.","authors":"Giulia Mesaroli,&nbsp;Logan McLennan,&nbsp;Yvonne Friedrich,&nbsp;Jennifer Stinson,&nbsp;Navil Sethna,&nbsp;Deirdre Logan","doi":"10.1080/24740527.2023.2179917","DOIUrl":"https://doi.org/10.1080/24740527.2023.2179917","url":null,"abstract":"<p><strong>Background: </strong>Complex regional pain syndrome (CRPS) presents with an array of symptoms that can vary from child to child, making it difficult to diagnose and differentiate from other pain conditions such as chronic musculoskeletal (MSK) pain. Thirteen symptoms and signs are outlined in the Budapest criteria for CRPS (developed and validated for adults) but have not been well described in pediatrics.</p><p><strong>Aims: </strong>The aim of this study was to describe the signs and symptoms of pediatric CRPS type 1 (CRPS 1) and determine whether a cluster of symptoms can differentiate CRPS 1 from chronic MSK pain.</p><p><strong>Methods: </strong>A retrospective cohort study of pediatric patients with CRPS 1 and MSK pain in a pediatric pain program was conducted. Descriptive statistics were used to report demographics and pain characteristics. The chi-square test was used to evaluate differences in signs and symptoms between patients with CRPS and MSK pain. A logistic regression model was used to evaluate whether a cluster of symptoms could predict a diagnosis of CRPS 1.</p><p><strong>Results: </strong>The sample included 187 patients (99 with CRPS 1 and 88 with MSK pain); 81% were female with a mean age 14.1 years. The most prevalent CRPS symptoms were hyperalgesia (54%) and allodynia (52%). A cluster of symptoms (hyperalgesia, color changes, and range of motion) predicted the probability of a diagnosis of CRPS 1.</p><p><strong>Conclusions: </strong>A cluster of symptoms may be critical in differentiating pediatric CRPS 1 and MSK pain. Future research is needed to determine if this model is valid in external populations and to explore whether a similar model can differentiate CRPS 1 from other pain conditions (e.g., neuropathic pain).</p>","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"7 1","pages":"2179917"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10116922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9742644","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":"A formal evaluation of The Ottawa Hospital Pain Clinic orientation session: A quality improvement project.","authors":"Patricia A Poulin,&nbsp;Louise Bell,&nbsp;Danielle Rice,&nbsp;Yaadwinder Shergill,&nbsp;Sarah Fitzgerald,&nbsp;Rosemee Cantave,&nbsp;Renée Gauthier,&nbsp;Rose Robbins,&nbsp;Cristin Kargus,&nbsp;Susan Ward","doi":"10.1080/24740527.2022.2111993","DOIUrl":"https://doi.org/10.1080/24740527.2022.2111993","url":null,"abstract":"<p><strong>Background: </strong>Chronic pain affects approximately one in every five Canadians and has a substantial impact on psychological well-being, relationships, ability to attend work or school, and overall functioning.The Ottawa Hospital Pain Clinic introduced orientation sessions, with the aim of providing new patients with pain education to help prepare patients for engagement with multimodal pain management strategies. This report summarizes the results of a formative evaluation of the orientation session at The Ottawa Hospital Pain Clinic to determine whether patients perceived the orientation session as beneficial.</p><p><strong>Methods: </strong>Interviews were conducted, transcribed, and then thematically analyzed to understand patients' perspectives on the orientation session. Coding was done by two team members using the constant comparison analyses method with key ideas, concepts, and patterns identified and compared to identify similarities.</p><p><strong>Results: </strong>Between September 6 and October 18, 2019, 18 patients attended an orientation session and 12 consented to participation and completed telephone interviews. The six themes identified included (1) feeling of community, (2) participants feeling heard by providers, (3) appreciation of the holistic approach, (4) availability of community resources, (5) barriers to access, and (6) discordant feelings of preparedness for the physician appointment.</p><p><strong>Conclusion: </strong>Results from this evaluation indicate that the orientation session offered at The Ottawa Hospital Pain Clinic improves chronic pain literacy, reduces feeling of isolation, and instills hope. As such, it appears to be a valuable component of pain clinic programs.</p>","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"7 1","pages":"2111993"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9839373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9084835","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":"Examining the roles of depression, pain catastrophizing, and self-efficacy in quality of life changes following chronic pain treatment.","authors":"Landon T Montag,&nbsp;Tim V Salomons,&nbsp;Rosemary Wilson,&nbsp;Scott Duggan,&nbsp;Etienne J Bisson","doi":"10.1080/24740527.2022.2156330","DOIUrl":"https://doi.org/10.1080/24740527.2022.2156330","url":null,"abstract":"<p><strong>Background: </strong>Adults with chronic pain have a lower quality of life (QOL) compared to the general population. Chronic pain requires specialized treatment to address the multitude of factors that contribute to an individual's pain experience, and effectively managing pain requires a biopsychosocial approach to improve patients' QOL.</p><p><strong>Aim: </strong>This study examined adults with chronic pain after a year of specialized treatment to determine the role of cognitive markers (i.e., pain catastrophizing, depression, pain self-efficacy) in predicting changes in QOL.</p><p><strong>Methods: </strong>Patients in an interdisciplinary chronic pain clinic (<i>N</i> = 197) completed measures of pain catastrophizing, depression, pain self-efficacy, and QOL at baseline and 1 year later. Correlations and a moderated mediation were completed to understand the relationships between the variables.</p><p><strong>Results: </strong>Higher baseline pain catastrophizing was significantly associated with increased mental QOL (<i>b</i> = 0.39, 95% confidence interval [CI] 0.141; 0.648) and decreased depression (<i>b</i> = -0.18, 95% CI -0.306; -0.052) over a year. Furthermore, the relationship between baseline pain catastrophizing and the change in depression was moderated by the change in pain self-efficacy (<i>b</i> = -0.10, 95% CI -0.145; -0.043) over a year. Patients with high baseline pain catastrophizing reported decreased depression after a year of treatment, which was associated with greater QOL improvements but only in patients with unchanged or improved pain self-efficacy.</p><p><strong>Conclusions: </strong>Our findings highlight the roles of cognitive and affective factors and their impact on QOL in adults with chronic pain. Understanding the psychological factors that predict increased mental QOL is clinically useful, because medical teams can optimize these positive changes in QOL through psychosocial interventions aimed at improving patients' pain self-efficacy.</p>","PeriodicalId":53214,"journal":{"name":"Canadian Journal of Pain-Revue Canadienne de la Douleur","volume":"7 1","pages":"2156330"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9980521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10848878","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}