Chronic pain-related patient-provider communication: The significance of health related quality of life and satisfaction

Chronic pain-related patient-provider communication: The significance of health related quality... 50Abstracts / Scandinavian Journal of Pain 8 (2015) 47–5480%. Sleeping disorders and tiredness were considered as the twomost problematic symptom to deal with. We found no correlationbetween the degree of pain and presence and severity of symptoms reported. Number of symptoms reported diminished whenthe dose of opioids increased.Conclusions: The pain patient considered too complex for regular pain-management programs are characterized by reportingmany symptoms other than pain. High pain intensity or highopioid-dose does not correlate to presence or severity of othersymptoms, and high dose of opioids does not have a connectionto low pain intensity. Many of the symptoms commonly reported –lethargy, tiredness, concentration difficulties and headache are realobstacles for successful rehabilitation, and have to be dealt with toachieve successful results.http://dx.doi.org/10.1016/j.sjpain.2015.04.010Increased C-fiber response induced byexperimental disc herniation is associated withupregulation of fractalkine and its receptor innucleus pulposus and dorsal root ganglionD.P. Jacobsen a,b,∗ , A. Moen a,b , F. Haugen a , J.Gjerstad a,baNational Institute of Occupational Health, Oslo,Norwayb Department of Biosciences, University of Oslo,NorwayE-mail address: dpja@stami.no (D.P. Jacobsen).Aims: Lumbar radicular pain following intervertebral disc herniation may be caused by a local inflammatory response inducedby nucleus pulposus (NP) cells. Here in an animal model mimicking the clinical situation following disc herniation we investigatedthe effect of NP on the spinal nociceptive signaling and local geneexpression.Methods: In anaesthetized Lewis rats, extracellular single unitrecordings of spinal nociceptive activity and qPCR were used toexplore the effect of NP application onto the dorsal nerve roots(L3-L5). All animal experiments were approved by the NorwegianAnimal Research Authority and were performed in conformity withthe laws and regulations controlling experiments and procedureson live animals in Norway.Results: A clear increase in C-fiber response was observedfollowing NP conditioning. In the NP tissue, the gene expression of interleuking-1␤ (IL-1␤), colony stimulating factor 1 (Csf1),fractakine (CX3CL1) and the fractalkine receptor CX3CR1 wasincreased. Minocycline, an inhibitor of microglial activation,inhibited the increase in neuronal activity, and attenuated theincrease in gene expression in NP tissue. Interestingly, gene expression analysis demonstrated an increase in the expression of TNF,CX3CL1 and CX3CR1 in the dorsal roots ganglion (DRG). An increasein the expression of IL-1␤ and TNF in cultured DRG cells was alsoinduced in vitro.Conclusions: The present study suggests that hyperexcitabilityin the pain pathways after disc herniation may involve upregulationof CX3CL1 signaling in NP – but also in the DRG.http://dx.doi.org/10.1016/j.sjpain.2015.04.011Chronic pain-related patient-providercommunication: The significance of healthrelated quality of life and satisfactionT. Jonsdottir a,∗ , S. Gunnarsdottir b,c , H. Jonsdottir baUniversity of Akureyri, Akureyri, IcelandUniversity of Iceland, Reykjavik, Icelandc Landspitali, The National University Hospital ofIceland, IcelandE-mail address: torbj@unak.is (T. Jonsdottir).bAims: To investigate patients’ perception of chronic pain relatedpatient-provider communication in relation to socio-demographicand pain-related variables.Methods: A postal questionnaire measuring socio-demographicvariables, pain characteristics, health-related quality of life(HRQoL), pain-related health care utilization and perceived patientprovider communication, was sent to a sample of 4500 individualsrandomly drawn from the national population of Iceland. Relationships between patient perceived patient–provider communicationand perceived outcome, satisfaction with care as well as sociodemographic and pain-related variables were tested by usingbivariate and multivariate statistical analysis.Results: The prevalence of chronic pain (≥3months) amongrespondents was 47.5%. Among participants reporting chronic pain,53.2% had consulted a health care provider for pain during the previous six months. Patients’ perception of providers’ behaviour andcontrol in the communication was mostly related to pain impact ondaily life and physical components of HRQoL as well as to patients’satisfaction with health care providers. The more pain interferedwith daily life and impaired patients’ physical health, the more theyfelt that the provider did not spend time to listen to their concernsand discuss symptoms and treatment options. Patients’ perceptionof own activity and control in the patient-provider communication and participation in care was related to socio-demographicvariables but not with pain related variables.Conclusions: To be understood as an individual and havingtheir concerns legitimized by the health care provider is crucial forpatients when consulting health care for chronic pain. The morepain interferes with daily life and impairs HRQoL, the more important this is. Patients’ perception of own control in patient-providercommunication and participation in care is more related to sociodemographics than pain related variables.http://dx.doi.org/10.1016/j.sjpain.2015.04.012Gender differences in chronic pain relatedhealth care utilizationT. Jonsdottir a,∗ , H. Jonsdottir b , S. Gunnarsdottir b,caUniversity of Akureyri, Akureyri, IcelandUniversity of Iceland, Reykjavik, Icelandc Landspitali, The National University Hospital ofIceland, IcelandE-mail address: torbj@unak.is (T. Jonsdottir).bAims: To investigate predictors for health-care utilization forchronic pain and whether there are gender differences in variablespredicting chronic pain-related health care utilization.Methods: A postal questionnaire measuring socio-demographicvariables, pain characteristics, health related quality of life (HRQoL)and pain related health care utilization, was sent to a sample of4500 individuals randomly drawn from the national populationof Iceland. The relationships between socio-demographic and painrelated variables and pain related health care utilization among http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Scandinavian Journal of Pain de Gruyter

Chronic pain-related patient-provider communication: The significance of health related quality of life and satisfaction

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De Gruyter
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© 2015 Scandinavian Association for the Study of Pain
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1877-8860
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1877-8879
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10.1016/j.sjpain.2015.04.012
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Abstract

50Abstracts / Scandinavian Journal of Pain 8 (2015) 47–5480%. Sleeping disorders and tiredness were considered as the twomost problematic symptom to deal with. We found no correlationbetween the degree of pain and presence and severity of symptoms reported. Number of symptoms reported diminished whenthe dose of opioids increased.Conclusions: The pain patient considered too complex for regular pain-management programs are characterized by reportingmany symptoms other than pain. High pain intensity or highopioid-dose does not correlate to presence or severity of othersymptoms, and high dose of opioids does not have a connectionto low pain intensity. Many of the symptoms commonly reported –lethargy, tiredness, concentration difficulties and headache are realobstacles for successful rehabilitation, and have to be dealt with toachieve successful results.http://dx.doi.org/10.1016/j.sjpain.2015.04.010Increased C-fiber response induced byexperimental disc herniation is associated withupregulation of fractalkine and its receptor innucleus pulposus and dorsal root ganglionD.P. Jacobsen a,b,∗ , A. Moen a,b , F. Haugen a , J.Gjerstad a,baNational Institute of Occupational Health, Oslo,Norwayb Department of Biosciences, University of Oslo,NorwayE-mail address: dpja@stami.no (D.P. Jacobsen).Aims: Lumbar radicular pain following intervertebral disc herniation may be caused by a local inflammatory response inducedby nucleus pulposus (NP) cells. Here in an animal model mimicking the clinical situation following disc herniation we investigatedthe effect of NP on the spinal nociceptive signaling and local geneexpression.Methods: In anaesthetized Lewis rats, extracellular single unitrecordings of spinal nociceptive activity and qPCR were used toexplore the effect of NP application onto the dorsal nerve roots(L3-L5). All animal experiments were approved by the NorwegianAnimal Research Authority and were performed in conformity withthe laws and regulations controlling experiments and procedureson live animals in Norway.Results: A clear increase in C-fiber response was observedfollowing NP conditioning. In the NP tissue, the gene expression of interleuking-1␤ (IL-1␤), colony stimulating factor 1 (Csf1),fractakine (CX3CL1) and the fractalkine receptor CX3CR1 wasincreased. Minocycline, an inhibitor of microglial activation,inhibited the increase in neuronal activity, and attenuated theincrease in gene expression in NP tissue. Interestingly, gene expression analysis demonstrated an increase in the expression of TNF,CX3CL1 and CX3CR1 in the dorsal roots ganglion (DRG). An increasein the expression of IL-1␤ and TNF in cultured DRG cells was alsoinduced in vitro.Conclusions: The present study suggests that hyperexcitabilityin the pain pathways after disc herniation may involve upregulationof CX3CL1 signaling in NP – but also in the DRG.http://dx.doi.org/10.1016/j.sjpain.2015.04.011Chronic pain-related patient-providercommunication: The significance of healthrelated quality of life and satisfactionT. Jonsdottir a,∗ , S. Gunnarsdottir b,c , H. Jonsdottir baUniversity of Akureyri, Akureyri, IcelandUniversity of Iceland, Reykjavik, Icelandc Landspitali, The National University Hospital ofIceland, IcelandE-mail address: torbj@unak.is (T. Jonsdottir).bAims: To investigate patients’ perception of chronic pain relatedpatient-provider communication in relation to socio-demographicand pain-related variables.Methods: A postal questionnaire measuring socio-demographicvariables, pain characteristics, health-related quality of life(HRQoL), pain-related health care utilization and perceived patientprovider communication, was sent to a sample of 4500 individualsrandomly drawn from the national population of Iceland. Relationships between patient perceived patient–provider communicationand perceived outcome, satisfaction with care as well as sociodemographic and pain-related variables were tested by usingbivariate and multivariate statistical analysis.Results: The prevalence of chronic pain (≥3months) amongrespondents was 47.5%. Among participants reporting chronic pain,53.2% had consulted a health care provider for pain during the previous six months. Patients’ perception of providers’ behaviour andcontrol in the communication was mostly related to pain impact ondaily life and physical components of HRQoL as well as to patients’satisfaction with health care providers. The more pain interferedwith daily life and impaired patients’ physical health, the more theyfelt that the provider did not spend time to listen to their concernsand discuss symptoms and treatment options. Patients’ perceptionof own activity and control in the patient-provider communication and participation in care was related to socio-demographicvariables but not with pain related variables.Conclusions: To be understood as an individual and havingtheir concerns legitimized by the health care provider is crucial forpatients when consulting health care for chronic pain. The morepain interferes with daily life and impairs HRQoL, the more important this is. Patients’ perception of own control in patient-providercommunication and participation in care is more related to sociodemographics than pain related variables.http://dx.doi.org/10.1016/j.sjpain.2015.04.012Gender differences in chronic pain relatedhealth care utilizationT. Jonsdottir a,∗ , H. Jonsdottir b , S. Gunnarsdottir b,caUniversity of Akureyri, Akureyri, IcelandUniversity of Iceland, Reykjavik, Icelandc Landspitali, The National University Hospital ofIceland, IcelandE-mail address: torbj@unak.is (T. Jonsdottir).bAims: To investigate predictors for health-care utilization forchronic pain and whether there are gender differences in variablespredicting chronic pain-related health care utilization.Methods: A postal questionnaire measuring socio-demographicvariables, pain characteristics, health related quality of life (HRQoL)and pain related health care utilization, was sent to a sample of4500 individuals randomly drawn from the national populationof Iceland. The relationships between socio-demographic and painrelated variables and pain related health care utilization among

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Scandinavian Journal of Painde Gruyter

Published: Dec 29, 2017

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