233 posts · 240,543 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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- August 2, 2010
- 04:25 AM
- 644 views
Measuring the total impact of a health condition
by Adiemusfree in Healthskills: Skills for Healthy Living
When I think of the ‘cost’ of having a disability, I have to say I usually think about the effect of the disorder alone on the ability to do valued activities – I haven’t usually thought about the impact of the treatment itself on how people live their lives. I came across this paper by … Read more... Read more »
Devins, G. (2010) Using the Illness Intrusiveness Ratings Scale to understand health-related quality of life in chronic disease. Journal of Psychosomatic Research, 68(6), 591-602. DOI: 10.1016/j.jpsychores.2009.05.006
- July 28, 2010
- 03:29 PM
- 559 views
What do we do about placebo?
by Adiemusfree in Healthskills: Skills for Healthy Living
Body in Mind recently featured a piece on the ‘Moral Dilemma of Offering a Known Placebo’ in which Neil O’Connell talks about how the ‘placebo effect … in part rests on the effects of expectation, belief in the treatment and possibly a re-evaluation by the patient of their symptoms’. He was referring to treatments like … Read more... Read more »
Moerman DE. (2002) The meaning response and the ethics of avoiding placebos. Evaluation , 25(4), 399-409. PMID: 12449083
- July 26, 2010
- 03:44 PM
- 303 views
Assessment as intervention
by Adiemusfree in Healthskills: Skills for Healthy Living
When you start to put together all the elements that people want from a health interaction, it’s not surprising that simply having an assessment can be an incredibly powerful experience. So much so that an assessment can be counted as an intervention in its own right. Does that make you think about the investment you … Read more... Read more »
Poston, J., & Hanson, W. (2010) Meta-analysis of psychological assessment as a therapeutic intervention. Psychological Assessment, 22(2), 203-212. DOI: 10.1037/a0018679
- July 25, 2010
- 03:32 PM
- 904 views
Mindfulness and exercise?
by Adiemusfree in Healthskills: Skills for Healthy Living
Now I know this might seem a strange heading when we think of mindfulness practice normally, but this isn’t ‘treatment as usual’. The definition of mindfulness in this study is ‘The body scan practice involves systematically moving awareness through each part of the body and noticing the presence of sensation in a detailed and precise … Read more... Read more »
Cusens, B., Duggan, G., Thorne, K., & Burch, V. (2009) Evaluation of the breathworks mindfulness-based pain management programme: effects on well-being and multiple measures of mindfulness. Clinical Psychology . DOI: 10.1002/cpp.653
- July 21, 2010
- 07:17 AM
- 632 views
Accepting what life throws at ya
by Adiemusfree in Healthskills: Skills for Healthy Living
I was looking to write about a new treatment, or something that is innovative, and you know, there isn’t a whole lot new out there in pain management land. If it wasn’t for Lorimer Moseley’s work on motor imagery and Lance McCracken’s work on acceptance, I think we’d be doing pretty much what I was … Read more... Read more »
McCracken, L., & Zhao-O’Brien, J. (2010) General psychological acceptance and chronic pain: There is more to accept than the pain itself. European Journal of Pain, 14(2), 170-175. DOI: 10.1016/j.ejpain.2009.03.004
- July 20, 2010
- 01:53 AM
- 573 views
What do people really do about their back pain? An on-line survey reveals…
by Adiemusfree in Healthskills: Skills for Healthy Living
There are many studies describing the way treatment providers fail to follow clinical guidelines for managing acute low back pain – and because there are inconsistencies between various guidelines for chronic low back pain, it’s not surprising that people with back pain (whether acute or chronic) get a little confused about what to do. Of … Read more... Read more »
Wilk V, Palmer HD, Stosic RG, & McLachlan AJ. (2010) Evidence and practice in the self-management of low back pain: findings from an Australian internet-based survey. The Clinical journal of pain, 26(6), 533-40. PMID: 20551729
- July 20, 2010
- 01:53 AM
- 542 views
What do people really do about their back pain? An on-line survey reveals…
by Adiemusfree in Healthskills: Skills for Healthy Living
There are many studies describing the way treatment providers fail to follow clinical guidelines for managing acute low back pain – and because there are inconsistencies between various guidelines for chronic low back pain, it’s not surprising that people with back pain (whether acute or chronic) get a little confused about what to do. Of … Read more... Read more »
Wilk V, Palmer HD, Stosic RG, & McLachlan AJ. (2010) Evidence and practice in the self-management of low back pain: findings from an Australian internet-based survey. The Clinical journal of pain, 26(6), 533-40. PMID: 20551729
- July 20, 2010
- 01:53 AM
- 579 views
What do people really do about their back pain? An on-line survey reveals…
by Adiemusfree in Healthskills: Skills for Healthy Living
There are many studies describing the way treatment providers fail to follow clinical guidelines for managing acute low back pain – and because there are inconsistencies between various guidelines for chronic low back pain, it’s not surprising that people with back pain (whether acute or chronic) get a little confused about what to do. Of … Read more... Read more »
Wilk V, Palmer HD, Stosic RG, & McLachlan AJ. (2010) Evidence and practice in the self-management of low back pain: findings from an Australian internet-based survey. The Clinical journal of pain, 26(6), 533-40. PMID: 20551729
- July 18, 2010
- 03:29 PM
- 607 views
Intuition and other failings in clinical reasoning
by Adiemusfree in Healthskills: Skills for Healthy Living
Einstein is accredited with saying “The important thing is not to stop questioning” while Euripedes apparently said “Question everything. Learn something. Answer nothing.” I’m sure of the origins of neither quote – but I think I must have inhaled both of them when I was a toddler because I have never stopped asking ‘why’! In … Read more... Read more »
Croskerry, P. (2002) Achieving Quality in Clinical Decision Making: Cognitive Strategies and Detection of Bias. Academic Emergency Medicine, 9(11), 1184-1204. DOI: 10.1197/aemj.9.11.1184
- July 14, 2010
- 03:43 PM
- 485 views
Online self management: works for some
by Adiemusfree in Healthskills: Skills for Healthy Living
Given that you’re reading this, I suspect that the thought of an on-line approach to managing pain wouldn’t take a terrible stretch of the imagination. The idea is certainly appealing – after all, there are many, many people with chronic low back pain in the community, and not nearly so many clinicians specialised (or even … Read more... Read more »
Chiauzzi E, Pujol LA, Wood M, Bond K, Black R, Yiu E, & Zacharoff K. (2010) painACTION-Back Pain: A Self-Management Website for People with Chronic Back Pain. Pain medicine (Malden, Mass.). PMID: 20545873
- July 11, 2010
- 03:36 PM
- 925 views
Self report or functional assessment – or both?
by Adiemusfree in Healthskills: Skills for Healthy Living
One of the more vexing problems in pain management is how to measure functional performance. I’ve written before about the problems with functional capacity evaluations (lack of predictive validity, poor reliability and so on), and these problems also apply to assessments of the ability to carry out activities of daily living. Amongst some of the … Read more... Read more »
Wæhrens, E., Amris, K., & Fisher, A. (2010) Performance-based assessment of ADL ability among women with chronic widespread pain. Pain. DOI: 10.1016/j.pain.2010.06.008
- July 5, 2010
- 03:32 PM
- 526 views
Who looks for treatment when they have back pain?
by Adiemusfree in Healthskills: Skills for Healthy Living
I’m not a primary care clinician. The people I see with pain have long-term, chronic, persistent pain that has been around for ages. I think the shortest time someone might have had pain before I see them is 4 months! The average is something like more than 4 years. But I AM interested in who … Read more... Read more »
Ferreira, M., Machado, G., Latimer, J., Maher, C., Ferreira, P., & Smeets, R. (2009) Factors defining care-seeking in low back pain – A meta-analysis of population based surveys. European Journal of Pain. DOI: 10.1016/j.ejpain.2009.11.005
- June 28, 2010
- 03:43 PM
- 918 views
Physical and Organisational Ergonomic Interventions: so far not effective
by Adiemusfree in Healthskills: Skills for Healthy Living
A million years ago (truly, ask my daughter if I’m that old!) I completed several papers in postgraduate ergonomics, primarily physical and organisational ergonomics rather than cognitive, and for a while there I could recall the NIOSH lifting equation and even discuss biomechanics with some confidence. Sad to say, over the years, my familiarity with … Read more... Read more »
Driessen, M., Proper, K., van Tulder, M., Anema, J., Bongers, P., & van der Beek, A. (2010) The effectiveness of physical and organisational ergonomic interventions on low back pain and neck pain: a systematic review. Occupational and Environmental Medicine, 67(4), 277-285. DOI: 10.1136/oem.2009.047548
- June 27, 2010
- 03:37 PM
- 828 views
Hi ho! Hi Ho! It’s off to work we go!
by Adiemusfree in Healthskills: Skills for Healthy Living
I know, it’s Monday and such cheer about work should be reserved for people with no life – but helping people return to work has been and still is one of my favourite parts of pain management. A pity that work rehabilitation has become somewhat far removed from pain management as it is practiced in … Read more... Read more »
Ammendolia, C., Cassidy, D., Steensta, I., Soklaridis, S., Boyle, E., Eng, S., Howard, H., Bhupinder, B., & Côté, P. (2009) Designing a workplace return-to-work program for occupational low back pain: an intervention mapping approach. BMC Musculoskeletal Disorders, 10(1), 65. DOI: 10.1186/1471-2474-10-65
- June 21, 2010
- 03:38 PM
- 618 views
What obstacles get in the way of self managing chronic pain?
by Adiemusfree in Healthskills: Skills for Healthy Living
Learning to manage pain using self management strategies ain’t easy – as we know, changing habits and doing things differently is not something any of us do without a bit of effort. It’s especially difficult when life in general is full of challenges, but so much more so when pain is the problem,you have a … Read more... Read more »
Bair, M., Matthias, M., Nyland, K., Huffman, M., Stubbs, D., Kroenke, K., & Damush, T. (2009) Barriers and Facilitators to Chronic Pain Self-Management: A Qualitative Study of Primary Care Patients with Comorbid Musculoskeletal Pain and Depression. Pain Medicine, 10(7), 1280-1290. DOI: 10.1111/j.1526-4637.2009.00707.x
- June 13, 2010
- 03:42 PM
- 957 views
How “social” is your biopsychosocial model?
by Adiemusfree in Healthskills: Skills for Healthy Living
It’s called the biopsychosocial model, but how much attention do we really pay to the social part of this model? While we know the medical model has its limitations (especially when we’re looking at how people respond to having health problems), in pain management I wonder whether we now have a ‘psychological’ model of pain … Read more... Read more »
Engel, G. (1979) The biopsychosocial model and the education of health professionals. General Hospital Psychiatry, 1(2), 156-165. DOI: 10.1016/0163-8343(79)90062-8
Harding G, Campbell J, Parsons S, Rahman A, & Underwood M. (2010) British pain clinic practitioners' recognition and use of the bio-psychosocial pain management model for patients when physical interventions are ineffective or inappropriate: results of a qualitative study. BMC musculoskeletal disorders, 51. PMID: 20298540
- June 8, 2010
- 08:03 PM
- 944 views
Group-based CBT for pain in primary care
by Adiemusfree in Healthskills: Skills for Healthy Living
I briefly discussed yesterday the content of this six-session group-based cognitive behavioural approach for chronic pain, delivered in the community. Today I want to look a little more closely at the way the programme was delivered and how the findings might differ from what happens in New Zealand. To refresh your memory, this is a … Read more... Read more »
Lamb, S., Hansen, Z., Lall, R., Castelnuovo, E., Withers, E., Nichols, V., Potter, R., & Underwood, M. (2010) Group cognitive behavioural treatment for low-back pain in primary care: a randomised controlled trial and cost-effectiveness analysis. The Lancet, 375(9718), 916-923. DOI: 10.1016/S0140-6736(09)62164-4
- June 7, 2010
- 03:35 PM
- 1,138 views
Group-based CBT for troublesome low back pain
by Adiemusfree in Healthskills: Skills for Healthy Living
These two papers have created a bit of a storm in the health news recently – a six-session CBT group programme for chronic low back pain that not only provides good outcomes, but is also cost-effective? Unbelievable! And it’s not delivered exclusively by any specific health professionals. AND it’s delivered in primary care! My take … Read more... Read more »
Hansen, Z., Daykin, A., & Lamb, S. (2010) A cognitive-behavioural programme for the management of low back pain in primary care: a description and justification of the intervention used in the Back Skills Training Trial (BeST; ISRCTN 54717854). Physiotherapy, 96(2), 87-94. DOI: 10.1016/j.physio.2009.09.008
Lamb, S., Hansen, Z., Lall, R., Castelnuovo, E., Withers, E., Nichols, V., Potter, R., & Underwood, M. (2010) Group cognitive behavioural treatment for low-back pain in primary care: a randomised controlled trial and cost-effectiveness analysis. The Lancet, 375(9718), 916-923. DOI: 10.1016/S0140-6736(09)62164-4
- May 31, 2010
- 03:35 PM
- 798 views
Oh… to sleep – CBT for insomnia in chronic pain
by Adiemusfree in Healthskills: Skills for Healthy Living
There are very few people who have chronic pain who have sweet dreams all night and wake feeling refreshed – having disturbed sleep and waking feeling grouchy seems to come with the territory for so many of the people I’ve seen with chronic pain! If it’s not difficulty staying asleep, it’s difficulty getting off to … Read more... Read more »
Jungquist CR, O'Brien C, Matteson-Rusby S, Smith MT, Pigeon WR, Xia Y, Lu N, & Perlis ML. (2010) The efficacy of cognitive-behavioral therapy for insomnia in patients with chronic pain. Sleep medicine, 11(3), 302-9. PMID: 20133188
- May 30, 2010
- 03:43 PM
- 872 views
Talking pain – seeking validation: Social interaction in pain
by Adiemusfree in Healthskills: Skills for Healthy Living
While we might laugh about the so-called typical ‘I will fix it’ response of some men when their partners talk about problems (when what the woman really wants is a hug), it seems that much of our research into pain behaviour, particularly verbal expressions of pain, has missed something. I’m not a major reader of … Read more... Read more »
Cano, A., & Williams, A. (2010) Social interaction in pain: Reinforcing pain behaviors or building intimacy?. Pain, 149(1), 9-11. DOI: 10.1016/j.pain.2009.10.010
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