233 posts · 242,844 views
This blog offers health care providers thoughtful commentary and resources so they can help people develop their skills for living well, while respecting individual values. Much of the blog is concerned with the management of chronic pain.
Adiemusfree
233 posts
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- January 9, 2011
- 10:02 PM
- 483 views
It’s really all about the brain
by Adiemusfree in Healthskills: Skills for Healthy Living
Neuroscience is such a geeky area to study. And I have to say I didn’t really study the brain all that well in my undergraduate training all those years ago – but oh, how the worm has turned! It’s so exciting to see how basic science directly influences treatments that we can use for people … Read more... Read more »
Flor, H. (2008) Maladaptive plasticity, memory for pain and phantom limb pain: review and suggestions for new therapies. Expert Review of Neurotherapeutics, 8(5), 809-818. DOI: 10.1586/14737175.8.5.809
Flor, H., Nikolajsen, L., & Staehelin Jensen, T. (2006) Phantom limb pain: a case of maladaptive CNS plasticity?. Nature Reviews Neuroscience, 7(11), 873-881. DOI: 10.1038/nrn1991
- December 14, 2010
- 03:53 PM
- 464 views
Looking at you, looking at me: The effect of clinical encounters
by Adiemusfree in Healthskills: Skills for Healthy Living
I’ve been browsing the databases for information on clinical encounters. I do this because while I’m well aware of many papers produced on the topic of patient-related predictors of outcome, the swing towards considering clinician characteristics as predictors of outcome means I hope to see more published on this incredibly important topic. A wee while … Read more... Read more »
Cvengros, J., Christensen, A., Cunningham, C., Hillis, S., & Kaboli, P. (2009) Patient preference for and reports of provider behavior: Impact of symmetry on patient outcomes. Health Psychology, 28(6), 660-667. DOI: 10.1037/a0016087
Stomski, N., Mackintosh, S., & Stanley, M. (2010) Patient Self-report Measures of Chronic Pain Consultation Measures: A Systematic Review. The Clinical Journal of Pain, 26(3), 235-243. DOI: 10.1097/AJP.0b013e3181c84e76
- December 13, 2010
- 01:31 PM
- 405 views
Knowing how is not equal to doing
by Adiemusfree in Healthskills: Skills for Healthy Living
There have been several attempts to develop a standardised approach to self management – one of the most popular in New Zealand is the Flinders Program (TM). This is a programme developed in Australia from the 1990 Australian Coordinated Care Trials. It’s based on cognitive behavioural therapy, includes problem solving and motivational interviewing techniques, and … Read more... Read more »
M Horsburgh, J Bycroft, F Goodyear-Smith, D Roy, F Mahony, E Donnell, D Miller. (2010) The Flinders Program of Chronic Condition Self-Management in New Zealand: Survey findings. Journal of Primary Health Care, 2(4), 288-293. info:/
- December 12, 2010
- 02:17 PM
- 584 views
The pain system is so complicated!
by Adiemusfree in Healthskills: Skills for Healthy Living
There are a couple of ways to approach the problem of pain – the one I grew up with is the medical one: diagnose the problem, fix the problem, life returns to normal. The person’s role in this is to be open about what is wrong, let the treatment provider know the information (and only … Read more... Read more »
Neugebauer, V., Galhardo, V., Maione, S., & Mackey, S. (2009) Forebrain pain mechanisms. Brain Research Reviews, 60(1), 226-242. DOI: 10.1016/j.brainresrev.2008.12.014
- November 30, 2010
- 04:49 PM
- 359 views
Evidence into practice: but wait, there’s more!
by Adiemusfree in Healthskills: Skills for Healthy Living
I pondered a bit about writing this post today. Yesterday I discussed some of the challenges of transferring research into daily practice, and maybe I’ve done enough on the topic – then again, there are some issues that can take a long time to explore. One of them for me is how to integrate client-centred … Read more... Read more »
Lin SH, Murphy SL, & Robinson JC. (2010) Facilitating evidence-based practice: process, strategies, and resources. The American journal of occupational therapy. : official publication of the American Occupational Therapy Association, 64(1), 164-71. PMID: 20131576
- November 29, 2010
- 01:31 PM
- 429 views
How to transfer research into practice – more questions than answers
by Adiemusfree in Healthskills: Skills for Healthy Living
With a background in a health profession not known for its love of science, I suppose when I came across evidence based health care I felt a strong sense of relief. Here, at last, was a way to work out what to do when faced with the task of helping people with pain. I was … Read more... Read more »
Ostelo, R., Croft, P., van der Weijden, T., & van Tulder, M. (2010) Challenges in using evidence to inform your clinical practice in low back pain. Best Practice , 24(2), 281-289. DOI: 10.1016/j.berh.2009.12.006
- November 28, 2010
- 04:06 PM
- 830 views
Can psychological management of fibromyalgia affect pain?
by Adiemusfree in Healthskills: Skills for Healthy Living
When I’m working with someone who has chronic pain, from the outset I’m pretty straight-up that the treatments I offer don’t directly affect pain intensity. It’s not my focus, and very often after the first session, I don’t even discuss pain – I’m more interested in what the person is doing! And for this focus, … Read more... Read more »
Glombiewski, J., Sawyer, A., Gutermann, J., Koenig, K., Rief, W., & Hofmann, S. (2010) Psychological treatments for fibromyalgia: A meta-analysis. Pain, 151(2), 280-295. DOI: 10.1016/j.pain.2010.06.011
- November 23, 2010
- 01:30 PM
- 727 views
Developing a set-back plan in pain management
by Adiemusfree in Healthskills: Skills for Healthy Living
Without a doubt, anyone reading my blog will have tried at some point to change a habit. Maybe to stop drinking coffee (why?!), start doing more exercise, say no to new projects, eat more fibre – even when a decision to make a change is not done of a New Year’s Eve, chances are that … Read more... Read more »
NAYLOR, M., KEEFE, F., BRIGIDI, B., NAUD, S., & HELZER, J. (2008) Therapeutic Interactive Voice Response for chronic pain reduction and relapse prevention. Pain, 134(3), 335-345. DOI: 10.1016/j.pain.2007.11.001
- November 22, 2010
- 04:34 PM
- 765 views
Flare-ups, breakthrough pain or set-backs: self managing exacerbations of pain
by Adiemusfree in Healthskills: Skills for Healthy Living
A couple of days ago I wrote about medication and managing flare-ups, and out of that post there was a bit of discussion about what exactly I meant by flare-up, and whether it might be better defined as break-through pain. I’ve found that there is not a lot of agreement in the literature – nor … Read more... Read more »
Turk, D.C., Swanson, K.S., & Tunks, E.R. (2008) Psychological approaches in the treatment of chronic pain patients--When pills, scalpels, and needles are not enough. The Canadian Journal of Psychiatry, 53(4), 213-223. info:/
- November 21, 2010
- 01:41 PM
- 393 views
Taking a closer look at health encounters for people with chronic pain
by Adiemusfree in Healthskills: Skills for Healthy Living
A theme of comments made by people I’ve seen clinically is that certain health care encounters they’ve had have not been especially helpful. Some people feel belittled, some patronised, some bamboozled, some dismissed – and yet in most surveys of health care satisfaction, the rating is pretty high (Jenkinson, Coulter, Bruster, Richards & Chandola, 2002). … Read more... Read more »
Stomski, N., Mackintosh, S., & Stanley, M. (2010) Patient Self-report Measures of Chronic Pain Consultation Measures: A Systematic Review. The Clinical Journal of Pain, 26(3), 235-243. DOI: 10.1097/AJP.0b013e3181c84e76
- November 16, 2010
- 01:37 PM
- 541 views
Medication and Self Managing Chronic Pain (ii)
by Adiemusfree in Healthskills: Skills for Healthy Living
If medication is to be part of a toolkit for self managing chronic pain, then it seems to me that it’s important to know as much about the medication and how it should be used as possible. Once again, today I’m not directly referring to the literature because I haven’t found an awful lot discussing … Read more... Read more »
Nicholas, M., Molloy, A., & Brooker, C. (2006) Using Opioids With Persisting Noncancer Pain: A Biopsychosocial Perspective. The Clinical Journal of Pain, 22(2), 137-146. DOI: 10.1097/01.ajp.0000154046.22532.fe
- November 15, 2010
- 01:26 PM
- 621 views
Medication and self management for chronic pain
by Adiemusfree in Healthskills: Skills for Healthy Living
Last week a reader asked me for my take on using medications for chronic pain, so today I’m going to take a stab at this rather emotive and certainly very complex topic. Before I do so, a word of warning – this is mainly my opinion and experience! I’m also not a medical doctor, I … Read more... Read more »
Nicholas, M., Molloy, A., & Brooker, C. (2006) Using Opioids With Persisting Noncancer Pain: A Biopsychosocial Perspective. The Clinical Journal of Pain, 22(2), 137-146. DOI: 10.1097/01.ajp.0000154046.22532.fe
- November 8, 2010
- 01:40 PM
- 772 views
Why bother with happiness? Broaden and build theory & Chronic pain
by Adiemusfree in Healthskills: Skills for Healthy Living
Readers may be wondering why I’ve come over all happy clappy and jolly joy germ – well, I realised I’d been writing a lot about experimental and theoretical factors found to influence vulnerability to chronic pain, but I had been writing less about ways to help people cope more effectively with chronic pain. I do … Read more... Read more »
Tugade, M., & Fredrickson, B. (2006) Regulation of Positive Emotions: Emotion Regulation Strategies that Promote Resilience. Journal of Happiness Studies, 8(3), 311-333. DOI: 10.1007/s10902-006-9015-4
- November 7, 2010
- 01:37 PM
- 663 views
Happy happy! Joy joy! Increasing positive experiences to improve mood
by Adiemusfree in Healthskills: Skills for Healthy Living
I am sure there will be people who read today’s post who will feel like giving me a bit of a slapping. “How”, they will say, “Are you supposed to get happy when you’re feeling bad?” And I would have been one of these people a few years ago too, given my history of low … Read more... Read more »
Tugade, M., & Fredrickson, B. (2006) Regulation of Positive Emotions: Emotion Regulation Strategies that Promote Resilience. Journal of Happiness Studies, 8(3), 311-333. DOI: 10.1007/s10902-006-9015-4
- November 2, 2010
- 04:49 AM
- 566 views
Resilience, catastrophising and positive emotions
by Adiemusfree in Healthskills: Skills for Healthy Living
Catastrophising, or thinking the worst, is one of those psychological factors that we know influences distress and disability in people with chronic pain. It’s quite a common phenomenon, and sometimes can stand us in good stead – after all, if we can think of the worst things that can happen, then plan to avert those … Read more... Read more »
Ong, A., Zautra, A., & Reid, M. (2010) Psychological resilience predicts decreases in pain catastrophizing through positive emotions. Psychology and Aging, 25(3), 516-523. DOI: 10.1037/a0019384
- October 27, 2010
- 02:39 PM
- 961 views
What’s missing from pain assessment?
by Adiemusfree in Healthskills: Skills for Healthy Living
I am stumped. Here is a common clinical quandary – one of the most important outcomes from pain management is to increase participation in daily activity (occupation), yet the measures we use just don’t quite cut it for me. Here’s a couple of examples: in the IMMPACT recommendations from 2008 (in the paper I’ve cited … Read more... Read more »
Dworkin, R., Turk, D., Farrar, J., Haythornthwaite, J., Jensen, M., Katz, N., Kerns, R., Stucki, G., Allen, R., & Bellamy, N. (2005) Core outcome measures for chronic pain clinical trials: IMMPACT recommendations. Pain, 113(1-2), 9-19. DOI: 10.1016/j.pain.2004.09.012
- October 26, 2010
- 02:37 PM
- 754 views
‘Psychological therapy’ works for fibromyalgia!
by Adiemusfree in Healthskills: Skills for Healthy Living
An ‘enigmatic’ disorder – this is what Perry Nicassio calls fibromyalgia. I hadn’t thought of it that way, because so many chronic pain problems seem to be equally ‘enigmatic’! It’s a common disorder, affects many more women than men, has a multiplicity of effects on people ranging from fatigue, poor sleep, widespread aching, other pain … Read more... Read more »
Nicassio, P. (2010) Psychological approaches are effective for fibromyalgia: Remaining issues and challenges. Pain, 151(2), 245-246. DOI: 10.1016/j.pain.2010.08.011
Glombiewski, J., Sawyer, A., Gutermann, J., Koenig, K., Rief, W., & Hofmann, S. (2010) Psychological treatments for fibromyalgia: A meta-analysis. Pain, 151(2), 280-295. DOI: 10.1016/j.pain.2010.06.011
- October 25, 2010
- 02:29 PM
- 486 views
What matters to people with persistent pain?
by Adiemusfree in Healthskills: Skills for Healthy Living
I’ve read many written expectations of people coming for pain management – and without a doubt, the majority of people want to get on with life, go back to doing what they enjoy, and feel better in themselves. The only problem with that? Most of them preface their goals with ‘reduce my pain so I … Read more... Read more »
Turk, D., Dworkin, R., Revicki, D., Harding, G., Burke, L., Cella, D., Cleeland, C., Cowan, P., Farrar, J., & Hertz, S. (2008) Identifying important outcome domains for chronic pain clinical trials: An IMMPACT survey of people with pain. Pain, 137(2), 276-285. DOI: 10.1016/j.pain.2007.09.002
- October 20, 2010
- 02:38 PM
- 879 views
How to translate research into practice
by Adiemusfree in Healthskills: Skills for Healthy Living
Well, maybe that’s a misnomer for today’s post, but it does strike to the very heart of some of the more heated debates that I see when I browse the interweb. With all the conflicting research reports into all the various interventions for chronic pain (well, for anything really), how does a clinician decide when … Read more... Read more »
Ostelo, R., Croft, P., van der Weijden, T., & van Tulder, M. (2010) Challenges in using evidence to inform your clinical practice in low back pain. Best Practice , 24(2), 281-289. DOI: 10.1016/j.berh.2009.12.006
- October 18, 2010
- 02:37 PM
- 686 views
Working and chronic pain
by Adiemusfree in Healthskills: Skills for Healthy Living
If there is one aspect of chronic pain management that has received more attention than returning to work, I don’t know it! In 1995 when I started working at my current workplace, work was almost a dirty word. I was accused at one time of being a ‘Siberian workcamp’ Commandante because some people thought it … Read more... Read more »
Costa-Black, K., Loisel, P., Anema, J., & Pransky, G. (2010) Back pain and work. Best Practice , 24(2), 227-240. DOI: 10.1016/j.berh.2009.11.007
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