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Journal Cover British Journal of Pain
   Journal TOC RSS feeds Export to Zotero [11 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  [742 journals]
  • Editorial
    • Authors: Cox; F.
      Pages: 97 - 97
      PubDate: 2014-07-28T02:37:26-07:00
      DOI: 10.1177/2049463714543118|hwp:resource-id:spbjp;8/3/97
      Issue No: Vol. 8, No. 3 (2014)
  • From traditional cognitive-behavioural therapy to acceptance and
           commitment therapy for chronic pain: a mixed-methods study of staff
           experiences of change
    • Authors: Barker, E; McCracken, L. M.
      Pages: 98 - 106
      Abstract: Health care organizations, both large and small, frequently undergo processes of change. In fact, if health care organizations are to improve over time, they must change; this includes pain services. The purpose of the present study was to examine a process of change in treatment model within a specialty interdisciplinary pain service in the UK. This change entailed a switch from traditional cognitive–behavioural therapy to a form of cognitive–behavioural therapy called acceptance and commitment therapy. An anonymous online survey, including qualitative and quantitative components, was carried out approximately 15 months after the initial introduction of the new treatment model and methods. Fourteen out of 16 current clinical staff responded to the survey. Three themes emerged in qualitative analyses: positive engagement in change; uncertainty and discomfort; and group cohesion versus discord. Quantitative results from closed questions showed a pattern of uncertainty about the superiority of one model over the other, combined with more positive views on progress reflected, and the experience of personal benefits, from adopting the new model. The psychological flexibility model, the model behind acceptance and commitment therapy, may clarify both processes in patient behaviour and processes of staff experience and skilful treatment delivery. This integration of processes on both sides of treatment delivery may be a strength of acceptance and commitment therapy.
      PubDate: 2014-07-28T02:37:26-07:00
      DOI: 10.1177/2049463713498865|hwp:master-id:spbjp;2049463713498865
      Issue No: Vol. 8, No. 3 (2014)
  • Weighing the balance: how analgesics used in chronic pain influence
    • Authors: Bohra, M. H; Kaushik, C, Temple, D, Chung, S. A, Shapiro, C. M.
      Pages: 107 - 118
      Abstract: Pain and sleep share a bidirectional relationship, with each influencing the other. Several excellent reviews have explored this relationship. In this article, we revisit the evidence and explore existing research on this complex inter-relationship. The primary focus of the article is on the pharmacological treatment of chronic non-malignant pain and the main purpose is to review the effect of various pharmacological agents used in the management of chronic pain on sleep. This has not been comprehensively done before. We explore the clinical use of these agents, their impact on sleep architecture and sleep physiology, the mechanism of action on sleep parameters and sleep disorders associated with these agents. Pharmacological classes reviewed include antidepressants, opioid analgesics, anti-epileptics, cannabinoids and non-steroidal anti-inflammatory agents, drugs most commonly used to manage chronic pain. The objective is to help health professionals gain better insight into the complex effect that commonly used analgesics have on an individual’s sleep and how this could impact on the effectiveness of the drug as an analgesic. We conclude that antidepressants have both positive and negative effects on sleep, so do opioids, but in the latter case the evidence shifts towards the counterproductive side. Some anticonvulsants are sleep sparing and non-steroidal anti-inflammatory drugs (NSAIDs) are sleep neutral. Cannabinoids remain an underexplored and researched group.
      PubDate: 2014-07-28T02:37:27-07:00
      DOI: 10.1177/2049463714525355|hwp:master-id:spbjp;2049463714525355
      Issue No: Vol. 8, No. 3 (2014)
  • Pain reporting in older adults: the influence of cognitive impairment -
           results from the Cambridge City>75 Cohort study
    • Authors: Docking, R. E; Fleming, J, Brayne, C, Zhao, J, Macfarlane, G. J, Jones, G. T, The Cambridge City over-75s Cohort (CC75C) study collaboration
      Pages: 119 - 124
      Abstract: Objectives: Evidence suggests that while disabling back pain (BP), and rheumatic diseases associated with pain, continues to increase with age, the prevalence of non-disabling BP reaches a plateau, or even decreases, in the oldest old. This study aimed to determine whether this age-related pattern of non-disabling BP is a function of increasing cognitive impairment. Methods: Cross-sectional study of adults aged >77 years. Participants answered interviewer-administered questions on BP and cognitive function, assessed using the Mini-Mental State Examination, categorised into normal versus mild, moderate or severe impairment. The relationship between cognitive function and BP was examined using multinomial logistic regression, adjusted for age, sex and residence. Results: Of 1174 participants with BP data, 1126 (96%) completed cognitive assessments. The relationship between cognitive function and BP differed for disabling and non-disabling BP. Across categories of cognitive impairment, increasingly higher prevalence of disabling BP was reported, compared to those with normal cognition, although this was not statistically significant (odds ratio (OR) = 1.7; 95% confidence interval (CI) = 0.7–4.6). No association was found between cognitive function and non-disabling BP (OR = 0.8; 95% CI = 0.4–1.6). Conclusion: This study found no association between the reporting of BP and level of cognitive impairment, suggesting that increasing cognitive impairment is an inadequate explanation for age-related decline in self-reported non-disabling BP. Future research should determine the reasons for the decline in non-disabling pain in older adults, although, meanwhile, it is important to ensure that this group receive appropriate pain assessment and pain management. Key points
      Prevalence of non-disabling back pain decreases in the oldest old.
      Some have proposed that this may be a function of cognitive impairment in older age, and an increasing inability to adequately report pain.
      Our findings do not support this hypothesis.
      PubDate: 2014-07-28T02:37:27-07:00
      DOI: 10.1177/2049463714527437|hwp:master-id:spbjp;2049463714527437
      Issue No: Vol. 8, No. 3 (2014)
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