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Journal Cover British Journal of Pain
  [12 followers]  Follow
    
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 2049-4637 - ISSN (Online) 2049-4645
   Published by Sage Publications Homepage  [835 journals]
  • Editorial
    • Authors: Cox; F.
      Pages: 7 - 7
      PubDate: 2016-01-21T01:34:21-08:00
      DOI: 10.1177/2049463715624995
      Issue No: Vol. 10, No. 1 (2016)
       
  • Assessing knowledge, perceptions and attitudes to pain management among
           medical and nursing students: a review of the literature
    • Authors: Ung, A; Salamonson, Y, Hu, W, Gallego, G.
      Pages: 8 - 21
      Abstract: Introduction: Chronic pain results in significant personal, societal and economic burden. Doctors and nurses have a pivotal role in patient pain management. In order to determine the effectiveness of current pain education on knowledge, attitudes and perceptions of medical and nursing students, there needs to be a valid measure to assess and quantify these domains. We reviewed the literature to identify approaches for assessing knowledge, perceptions and attitudes to pain management among nursing and medical students. Methods: Databases of peer-reviewed literature including CINAHL, EMBASE, ERIC, PsycInfo, Medline and PubMed were searched for articles published between 1993 and December 2014 using the following search terms: student, graduate, intern, junior, pain, pain management, analgesia, analgesic, pharmacology, pharmacological, knowledge, competence, attitude, preparedness, practice, nursing, medical, doctor, nurse. Results: The search revealed over 3500 articles, and on application of the inclusion criteria, 26 articles were included in the review. A total of 14 instruments were used in these studies with the Knowledge and Attitudes Survey Regarding Pain (KASRP) as the main instrument in 9 out of the 26 articles. The various instruments used different question formats such as multiple-choice questions (MCQs), true/false statements and Likert scales that went from 3 points to 7 points. Clinical skills examinations were also used in four studies to assess pain management. Conclusion: There is no gold standard instrument currently used to assess knowledge, perceptions and attitudes to pain management. The results of this review showed, despite the diversity of standardised instruments that have been used to assess knowledge, perceptions and attitude to pain management, the literature has consistently reported that knowledge about pain management among nursing and medical students was generally poor among both groups.
      PubDate: 2016-01-21T01:34:21-08:00
      DOI: 10.1177/2049463715583142
      Issue No: Vol. 10, No. 1 (2016)
       
  • Introducing Acceptance and Commitment Therapy to a physiotherapy-led pain
           rehabilitation programme: an Action Research study
    • Authors: Barker, K. L; Heelas, L, Toye, F.
      Pages: 22 - 28
      Abstract: Background: Recent developments in pain rehabilitation emphasise the importance of promoting psychological flexibility. Acceptance and Commitment Therapy (ACT) is one approach that has been shown to be effective for the treatment of chronic musculoskeletal pain. However, studies have shown that introducing innovative approaches such as ACT into established health care can cause some anxiety for professional groups. We used Action Research to evaluate the implementation of ACT to a physiotherapy-led pain rehabilitation programme. Methods: All staff in the pain service were invited to participate. Participants took part in focus groups, engaged in reflective sessions/meetings and completed reflective diaries. The analysis was undertaken by an experienced qualitative researcher using constant comparison. Participants reviewed emerging themes and validated the findings. Results: Four key themes emerged from the study: (a) the need to see pain as an embodied, rather than dualistic, experience; (b) the need for a more therapeutic construction of ‘acceptance’; (c) value-based goals as profound motivation for positive change; and (d) it’s quite a long way from physiotherapy. Integral to a therapeutic definition of acceptance was the challenge of moving away from ‘fixing’ towards ‘sitting with’. Participants described this as uncomfortable because it did not fit their biomedical training. Conclusion: This article describes how Action Research methodology was used in the introduction of ACT to a physiotherapy-led pain rehabilitation programme. The innovation of this study is that it helps us to understand the potential barriers and facilitators to embedding an ACT philosophy within a physiotherapy setting.
      PubDate: 2016-01-21T01:34:21-08:00
      DOI: 10.1177/2049463715587117
      Issue No: Vol. 10, No. 1 (2016)
       
  • Towards a pain free hospital: an in-depth qualitative analysis of the pain
           experiences of head and neck cancer patients undergoing radiotherapy
    • Authors: Pattison, N; Brown, M. R, Gubbay, A, Peacock, J, Ross, J. R, Chapman, S, Sauzet, O, Williams, J.
      Pages: 29 - 37
      Abstract: Background: Treatment for head and neck cancer can frequently be a painful experience with implications for patients in terms of quality of life, nutrition and ultimately treatment outcomes. Pain may arise for a number of reasons in this patient group including the influence of localised tissue damage from radiotherapy, the effects of chemotherapeutic agents as well as the disease process itself. Early identification of cancer pain, through screening and early analgesic and pain management are thought to be the most appropriate approaches to the problem. Aim: To explore in-depth, patients’ views of the experience of pain related to radiotherapy for head and neck cancer, within the context of a randomised controlled trial (RCT) of pain screening and intervention. Sample: A purposive sample of head and neck cancer patients undergoing radiotherapy who were participating in a separate RCT of a proactive pain screening intervention. Methods: A qualitative design using one-off, face-to-face, in-depth interviews. Data were inductively analysed for themes using thematic analysis. Data were collected from September 2012 to January 2013. Findings: Eight participants were interviewed. Several issues around pain management arose and the influence of various factors became apparent. Four dominant themes emerged: facets of radiotherapy pain in head and neck cancer, facilitators and barriers to pain management, pain services and finally interdisciplinary working. Conclusion: The specific issues faced by head and neck cancer patients undergoing radiotherapy highlight the need for pain relieving interventions delivered by pain specialists, in tandem with the development of robust self-management strategies. An integrated approach to care is optimal, comprising pain screening at each outpatient encounter, and review by specialists as necessary.
      PubDate: 2016-01-21T01:34:21-08:00
      DOI: 10.1177/2049463715599995
      Issue No: Vol. 10, No. 1 (2016)
       
  • Brief psychologically informed physiotherapy training is associated with
           changes in physiotherapists attitudes and beliefs towards working with
           people with chronic pain
    • Authors: Jacobs, C. M; Guildford, B. J, Travers, W, Davies, M, McCracken, L. M.
      Pages: 38 - 45
      Abstract: This study aimed to investigate the impact of a brief psychologically informed physiotherapy training (PIPT) course on physiotherapists’ attitudes and beliefs towards working with people with chronic pain. Specifically, the training aimed to help the participants better recognise the role of psychosocial factors in chronic pain and to better target the key processes of the psychological flexibility (PF) model in their treatment interactions. A total of 26 physiotherapists working in an outpatient musculoskeletal (MSK) department participated in the 7-hour training session. A total of 25 participants completed self-report questionnaires on attitudes and beliefs, burnout and PF-relevant processes pre- and post-training. The pre- and post-measures were completed on the day of training. PIPT was associated with significant changes in the expected direction in physiotherapists’ attitudes towards treatment of people with chronic pain, including a moderate effect size on the Health Care Provider–Pain and Impairment Relationship Scale (HC-PAIRS) (decreased biomedical scores) and a large effect size on the Pain Attitudes and Beliefs Scale for Physiotherapists (PABS-PT) (increased biopsychosocial scores and decreased biomedical scores). In conclusion, brief PIPT could help physiotherapists working in non-specialist centres with complex patients, many of whom present with significant emotional distress and pain-related disability. Further research is required to determine whether the changes in attitudes detected in this study translate into clinical practice and whether changes are maintained over a follow-up period.
      PubDate: 2016-01-21T01:34:21-08:00
      DOI: 10.1177/2049463715600460
      Issue No: Vol. 10, No. 1 (2016)
       
  • Clinical effectiveness of a residential pain management programme -
           comparing a large recent sample with previously published outcome data
    • Authors: Smith, J. G; Knight, L, Stewart, A, Smith, E. L, McCracken, L. M.
      Pages: 46 - 58
      Abstract: Objective: Observational studies using routinely collected data indicate that pain management programmes (PMPs) based on cognitive-behavioural principles are associated with clinically meaningful improvements for individuals with chronic pain. This study evaluated change across functional measures in a sample of chronic pain patients attending a 4-week residential PMP between 2006 and 2010. The findings were directly compared with published outcomes from an earlier period (1989–1998) at the same service. Methods: Participants included 760 consecutive completers of a multidisciplinary PMP. Data were collected at pre-PMP, post-PMP (1-month post-discharge) and at a 9-month follow-up session. Group-based treatment effects and the reliability and clinical significance of change across functional measures were calculated and compared across cohorts. Results: Effect sizes for the recent cohort ranged from small to medium (.43–.67) for pain and physical functioning outcomes to large (.90–1.12) for psychological outcomes at post-treatment (n = 654), and from small (.30–.51) to medium (.58–.71) at 9-month follow-up (n = 493). Clinically significant gains on pain and psychological measures were achieved by 19–55% of patients at post-treatment and 17–44% at follow-up. Comparisons with the earlier cohort showed significantly stronger post-treatment outcomes but differences at follow-up were less marked. Discussion: These results add to the evidence base supporting the effectiveness of cognitive-behavioural therapy (CBT)-based pain management interventions. There were significantly larger gains in patient functioning in the recent dataset, suggesting improved programme delivery. But effects were less marked in the longer term, indicating a need for improvements in therapeutic models and related methods to promote meaningful and lasting changes.
      PubDate: 2016-01-21T01:34:21-08:00
      DOI: 10.1177/2049463715601445
      Issue No: Vol. 10, No. 1 (2016)
       
 
 
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