Painful Situations Research Articles

Complementary, Traditional and Spiritual Practices Used by Cancer Patients in Turkey When Coping with Pain: An Exploratory Case Study.

This study was conducted to determine the complementary and traditional-spiritual practices applied by individuals diagnosed with cancer when experiencing significant pain. This descriptive and cross-sectional study was conducted with 110 patients who were receiving chemotherapy treatment in a university hospital outpatient treatment unit (Chemotherapy Unit) between 1st March and 30th June 2019. The study sample size was calculated using the 'unknown-population sample selection formula' (n = t2·p·q·/d2). Study data were collected using a patient information form comprising 13 questions about the participants' sociodemographic characteristics, diseases, and complementary practices. The data were analyzed using descriptive percentage tests and the Statistical Package for the Social Sciences (SPSS Inc., Chicago, IL, USA) software. The study found that 45.5% of the cancer patients took a walk, 38.2% listened to music, 27.3% watched movies, 24.5% received massages, 20.0% read newspapers or books, 20.0% did sports, and 10.9% dreamed in painful situations. Spiritual practices used by the patients were determined as praying (46.4%), engaging in salat (the daily ritual prayers of Islam) (30.9%) and reading religious books (23.6%). The herbal practices applied by the patients include the use of garlic, mulberry molasses, pomegranate, green tea; furthermore, herbs such as honey, sage, lime, black cumin, ginger, centaury, thyme, nettle, flaxseeds, and rosehip were also used. Most of the patients learned complementary practices from television programs (62.7%); only 8.2% learned these practices from healthcare professionals. Nurses should investigate patients' use of complementary practices and provide them with the necessary evidence-based information to prevent unconscious use of these practices. Considering that determining patients' spiritual needs and practices is seen as the first step in the holistic care of patients, it is important to satisfy cancer patients by providing necessary healthcare services and help them improve their physical and mental health.

Enhanced analgesic cholinergic tone in the spinal cord in a mouse model of neuropathic pain

Endogenous acetylcholine (ACh) is an important modulator of nociceptive sensory processing in the spinal cord. An increased level of spinal ACh induces analgesia both in humans and rodents while interfering with cholinergic signaling is allodynic, demonstrating that a basal tone of spinal ACh modulates nociceptive responses in naïve animals. The plasticity undergone by this cholinergic system in chronic pain situation is unknown, and the mere presence of this tone in neuropathic animals is controversial. We have addressed these issues in mice through behavioral experiments, histology, electrophysiology and molecular biology, in the cuff model of peripheral neuropathy. Our behavior experiments demonstrate the persistence, and even increased impact of the analgesic cholinergic tone acting through nicotinic receptors in cuff animals. The neuropathy does not affect the number or membrane properties of dorsal horn cholinergic neurons, nor specifically the frequency of their synaptic inputs. The alterations thus appear to be in the neurons receiving the cholinergic signaling, which is confirmed by the fact that subthreshold doses of acetylcholinesterase (AChE) inhibitors in sham animals become anti-allodynic in cuff mice and by the altered expression of the β2 nicotinic receptor subunit. Our results demonstrate that endogenous cholinergic signaling can be manipulated to relieve mechanical allodynia in animal models of peripheral neuropathy. Until now, AChE inhibitors have mainly been used in the clinics in situations of acute pain (parturition, post-operative). The fact that lower doses (thus with fewer side effects) could be efficient in chronic pain conditions opens new avenues for the treatment of neuropathic pain. Significance statementChronic pain continues to be the most common cause of disability that impairs the quality of life, accruing enormous and escalating socio-economic costs. A better understanding of the plasticity of spinal neuronal networks, crucially involved in nociceptive processing, could help designing new therapeutic avenues. We here demonstrate that chronic pain modifies the spinal nociceptive network in such a way that it becomes more sensitive to cholinergic modulations. The spinal cholinergic system is responsible for an analgesic tone that can be exacerbated by acetylcholinesterase inhibitors, a property used in the clinic to relief acute pain (child birth, post-op). Our results suggest that lower doses of acetylcholinesterases, with even fewer side effects, could be efficient to relieve chronic pain.

Emotional experience of various types of cyberaggression by adolescents and youth

IntroductionThe integration of digital technologies into everyday life leads to transformation of various socio-cultural practices, including related to destructive behavior. Among them, cyberaggression holds a leading position, especially in younger generation, and causes direct lasting negative impact on the psychological state of participants and affects (Martínez-Monteagudo et al., 2019; Wright, Wachs, 2020).ObjectivesThe goal of the study is to analyze the relationship between offline and online aggressions and the strength of negative emotional experiences of adolescents and youth, as well as parents’ awareness of this experience with their children.MethodsThe questionnaire was completed by 3395 people: 1554 adolescents aged 12-17 and 736 young people aged 18-30 from 8 federal districts of Russia.ResultsRespondents of all generations (64-74%) believe that people are more likely to experience painful or hostile situations in real life than online. Nevertheless, every fourth respondent (19-23%) says that events on the Internet can cause as much anxiety as events in real life. The least emotionally significant situations are flaming and cyberhate. Trolling causes strong feelings in every third adolescent, cyberstalking in every fifth, cyberbullying in every second. Both trolling and cyberstalking make girls more upset than boys, this is true for adolescents (12-13 and 14-17 years old) and youth (χ2=19.01-67.21, p<0.01, V=0.16-0.30).ConclusionsDifferences in emotional response to various types of cyberaggression require the development of differentiated approaches to the prevention of various situations of cyberaggression and the development of specific coping strategies in the collision with them. The reported study was funded by RFBR, project No. 20-013-00857.DisclosureThe reported study was funded by RFBR, project No. 20-013-00857.

Интерпретация эмоциональной речи пациента как элемент коммуникативной компетенции врача

The relevance of this study is due to the desire to propose one of the criteria that contributes to improving the effective communication with a patient: analyzing and interpreting patient’s emotional speech. The aim of this paper is to consider the usage features of figurative and expressive means in a patient’s speech which may characterize both the sick state and his attitude to health problems. To achieve this aim the following methods are used in the paper: distributive, contextual, semantic and stylistic methods. The material for analysis is the patent’s phrases taken from the various sources: real and designed for classes communication situations, mass media, teaching aids and science articles on the medical discourse. A patient is an equal partner in the communication with a doctor that is why the consideration of linguistic and paralinguistic factors influencing the patient’s choice of speech means is no less important. When studying the patient’s speech expressive means can be distinguished at all levels of the language: phonetic, morphemic, lexical and grammatical. Doctor’s understanding the explication of the patient’s intentions and analyzing the patient’s speech expressive means contribute to correct interpreting the patient’s story about himself and his state of health. We believe that the patient’s thinking creativity being expressed in using the emotional means is due to, on the one hand, his inability to describe internal pain sensations properly in detail. On the other hand, in the situation of a strong pain it is due to the patient’s desire to quickly find the right metaphor or other means to express his thought by a non-standard way that implies more emotionally and thus increases the function of influencing the interlocutor and creates more positive emotional background in communication with a doctor.

EEG changes reflecting pain: is alpha suppression better than gamma enhancement?

ObjectiveSuppression of alpha and enhancement of gamma electroencephalographic (EEG) power have both been suggested as objective indicators of cortical pain processing. While gamma activity has been emphasized as the best potential marker, its spectral overlap with pain-related muscular responses is a potential drawback. Since muscle contractions are almost universal concomitants of physical pain, here we investigated alpha and gamma scalp-recorded activities during either tonic pain or voluntary facial grimaces mimicking those triggered by pain. MethodsHigh-density EEG (128 electrodes) was recorded while 14 healthy participants either underwent a cold pressor test (painful hand immersion in 10 °C water) or produced stereotyped facial/nuchal contractions (grimaces) mimicking those evoked by pain. The scalp distribution of spectral EEG changes was quantified via vector-transformation of maps and compared between the pain and grimacing conditions by calculating the cosine of the angle between the two corresponding topographies. ResultsPainful stimuli significantly enhanced gamma power bilaterally in fronto-temporal regions and decreased alpha power in the contralateral central scalp. Sustained cervico-facial contractions (grimaces) gave also rise to significant gamma power increase in fronto-temporal regions but did not decrease central scalp alpha. While changes in alpha topography significantly differed between the pain and grimace situations, the scalp topography of gamma power was statistically indistinguishable from that occurring during grimaces. ConclusionGamma power induced by painful stimuli or voluntary facial-cervical muscle contractions had overlapping topography. Pain-related alpha decrease in contralateral central scalp was less disturbed by muscle activity and may therefore prove more discriminant as an ancillary pain biomarker.

Social Exclusion Down-Regulates Pain Empathy at the Late Stage of Empathic Responses: Electrophysiological Evidence

Social exclusion has a significant impact on cognition, emotion, and behavior. Some behavioral studies investigated how social exclusion affects pain empathy. Conclusions were inconsistent, and there is a lack of clarity in identifying which component of pain empathy is more likely to be affected. To investigate these issues, we used a Cyberball task to manipulate feelings of social exclusion. Two groups (social exclusion and social inclusion) participated in the same pain empathy task while we recorded event-related potentials (ERP) when participants viewed static images of body parts in painful and neutral situations. The results showed early N2 differentiation between painful and neutral pictures in the central regions in both groups. The pattern at the late controlled processing stage was different. Parietal P3 amplitudes for painful pictures were significantly smaller than those for neutral pictures in the social exclusion group; they did not differ in the social inclusion group. We observed a parietal late positive potential (LPP) differentiation between painful and neutral pictures in both groups. LPP amplitudes were significantly smaller in the social exclusion group than those in the social inclusion group for painful stimuli. Our results indicate that social exclusion does not affect empathic responses during the early emotional sharing stage. However, it down-regulates empathic responses at the late cognitive controlled stage, and this modulation is attenuated gradually. The current study provides neuroscientific evidence of how social exclusion dynamically influences pain empathy.

Nociception pain and autism

Autistic subjects frequently display sensory anomalies. Those regarding nociception and its potential outcome, pain, are of crucial interest. Indeed, because of numerous comorbidities, autistic subjects are more often exposed to painful situation. Despite being often considered as less sensitive, experimental studies evaluating this point are failing to reach consensus. Using animal model can help reduce variability and bring, regarding autism, an overview of potential alterations of the nociceptive system at the cellular and molecular level.

Emotivity in the Voice: Prosodic, Lexical, and Cultural Appraisal of Complaining Speech.

Emotive speech is a social act in which a speaker displays emotional signals with a specific intention; in the case of third-party complaints, this intention is to elicit empathy in the listener. The present study assessed how the emotivity of complaints was perceived in various conditions. Participants listened to short statements describing painful or neutral situations, spoken with a complaining or neutral prosody, and evaluated how complaining the speaker sounded. In addition to manipulating features of the message, social-affiliative factors which could influence complaint perception were varied by adopting a cross-cultural design: participants were either Québécois (French Canadian) or French and listened to utterances expressed by both cultural groups. The presence of a complaining tone of voice had the largest effect on participant evaluations, while the nature of statements had a significant, but smaller influence. Marginal effects of culture on explicit evaluation of complaints were found. A multiple mediation analysis suggested that mean fundamental frequency was the main prosodic signal that participants relied on to detect complaints, though most of the prosody effect could not be linearly explained by acoustic parameters. These results highlight a tacit agreement between speaker and listener: what characterizes a complaint is how it is said (i.e., the tone of voice), more than what it is about or who produces it. More generally, the study emphasizes the central importance of prosody in expressive speech acts such as complaints, which are designed to strengthen social bonds and supportive responses in interactive behavior. This intentional and interpersonal aspect in the communication of emotions needs to be further considered in research on affect and communication.

Necessity to empower clinical teachers, especially surgeons and emergency medicine specialists in Breaking Bad News

In the medical field, “breaking bad news” usually includes conditions in which a person has developed symptoms of a deadly disease, such as AIDS and cancer. However, in some other definitions, breaking bad news involved other situations, such as the symptoms of chronic diseases and painful situations, such as diabetes, failure of treatment plans, difficult and costly treatment plans, disability, amputation, and paralysis (1). Breaking bad news is the most critical type of relationship between a doctor or medical staff and patients. During this process, the doctor or another medical staff is required to convey bad news and other unpleasant information to patients. This news and information can include diagnosis with a dangerous illness, recurrence of a bad condition, or treatment failure, or even death. The issue of breaking bad news was first raised by Buck man in clinical research. According to Buck man, the bad news is defined as any news that leads to negative changes in a person’s attitude toward his future and can have significant psychological consequences for the person (2). The way bad news is conveyed is very important. In ancient times, people who transmitted bad news were called bad people and it was believed that bad fate awaited these people. Therefore, it is natural for patients or their companions who receive bad news on patient’shealth status or his death from an inexperienced doctor to blame the doctor for the mentioned conditions and to behave aggressively toward the doctor(3). Most patients expect to be approached with empathy and compassion when presented with bad news. They also expect to receive information clearly and are concerned about ambiguities during a dangerous illness (4).

Self-Compassion and Coping: a Meta-Analysis

Self-compassion, a positive and caring attitude toward oneself, has been identified as an important correlate of coping in stressful situations. High self-compassion is related to higher use of adaptive and less maladaptive coping in demanding or painful situations. However, estimates of these relations in terms of specific adaptive and maladaptive coping strategies have remained inconclusive. Therefore, the present meta-analysis investigates the relation between self-compassion and different forms of adaptive and maladaptive coping. It also takes into account potential moderators such as age, gender, and regional background. A systematic literature search resulted in k = 136 samples with an overall sample size of N = 38,913. Random-effects models were used to integrate the z-transformed Pearson correlation coefficients. Analyses yielded a positive correlation between self-compassion and adaptive coping (r = .306) and a negative correlation between self-compassion and maladaptive coping (r = − .500). The association of self-compassion with emotional approach coping was positive (r = .340), as was the association with problem-focused coping (r = .205). Participants’ age appeared to be a significant moderator of the relation between self-compassion and coping. Self-compassion is important for understanding the mechanisms involved in coping with stress and demanding life events. The size and direction of correlations depend on the coping strategies considered, with protective effects of self-compassion with respect to maladaptive coping being the most pronounced. Further research should examine the relation between self-compassion and coping in more detail and focus on additional moderators. The registration identifier is CRD42018104926.

“Casa: lar, doce lar ou prisão domiciliar?” uma perspectiva fenomenológica segundo codependentes de usuários de substâncias psicoativas

Objetivou-se refletir sobre o ambiente domiciliar de codependentes como um ambiente de convivência com adictos de substâncias psicoativas numa perspectiva fenomenológica. Investigação descritiva, delineada na abordagem fenomenológica à luz do referencial teórico-metodológico-filosófico de Michel Maffesoli, realizada numa Unidade Básica de Saúde em Minas Gerais, Brasil, com oito codependentes. Coletaram-se dados de caracterização e foram realizadas entrevistas individuais em profundidade gravadas. Trataram-se os dados com análise de conteúdo fenomenológico com apoio dos softwares SPSS versão 24 e NVivo Pro11. Atenderam-se todos os aspectos ético-legais de pesquisa. Os oito sujeitos eram mulheres. Compreendeu-se que o “lar” pode se tornar uma verdadeira “Prisão domiciliar” quando a realidade cotidiana for marcada pelos múltiplos papéis ocupados pelas participantes, os quais são gerenciados juntamente com o cuidado ao familiar dependente químico. Portanto, as situações estressoras, dolorosas, que geram sentimentos ruins, como medo, insegurança, tristeza, e os conflitos familiares devem ser alvo do cuidado de enfermagem.

On the Edge of the abyss—Observations on Some Essential Difficulties in Psychoanalytic Psychotherapy with Survivors of Prolonged Childhood Abuse

This article explores situations of interpersonal catastrophe during psychoanalytic psychotherapy with survivors of prolonged childhood abuse; situations of unbearable psychic pain focused on the therapeutic relationship, accompanied by functional deterioration, that is, mutual but not symmetrical. Through analyzing Orpheus’s failure to save his wife from the underworld, I look at the analyst’s unconscious motivation to treat others: What is drawing us to other people’s hell? I will describe how the analyst’s identification with the aggressor when facing the patients’ inability to mourn, as well as the patient’s own tendency to identify with the aggressor, may trap the therapy in a fantasy of rebirth or a wish to go back to the roots and correct or erase the trauma. In doing so, this may push the treatment into a malignant whirlpool. I explore the clinical manifestations of the mutual fantasy of overcoming the limits of reality and offer an analytic meaning to the concept of rehabilitation versus recovery that may be helpful in working with these challenging cases.

Basic pain terms in Beserman Udmurt

This paper is devoted to semantic structure and syntactic properties of predicates of pain in Beserman Udmurt. Beserman is a variety of Udmurt spoken in northwestern Udmurtia, which has undergone contact infl uence of Russian dialects and of Turkic languages. We analyze meanings and compatibility of units which denote pain, describe grammatical encoding of diff erent participants of the situation of pain — the experiencer, the body part where pain is located, and the cause of pain. We consider the following parameters to be relevant for encoding the situation of pain in Beserman Udmurt: type of experiencer, location of pain and its cause (including a human making someone feel pain), pure pain vs. pain accompanied by functionality loss, physical pain vs. painful emotions, intensity of pain and its type. We compare Beserman Udmurt data with those from idioms which either are closely related to Udmurt genetically or are in the situation of close contact with it — namely, with the data from Komi-Zyrian, certain Russian dialects, and Turkic languages. We show that unlike Komi-Zyrian, its relative, Beserman Udmurt encodes diff erent types of pain on the lexical level (i. e. by verbal roots and ideophones), not on the grammatical one (i. e. through morphological derivation). In this respect, Beserman Udmurt resembles certain Turkic languages. The diversity of argument encoding in expressions of pain is a common trait of Beserman Udmurt and Komi-Zyrian; it seems to be supported by the infl uence of Russian dialects.

Acute pain management among patients with opioid maintenance therapy: specificities and difficulties identified in primary care: a qualitative study

ObjectivesIn the last 30 years, opioid maintenance treatment prescription (OMT) has changed patients’ and also changed physicians’ practices. General practitioners (GPs) have to deal with patients on OMT who are...

Treatment of dentin hypersensitivity with laser: systematic review

ABSTRACT BACKGROUND AND OBJECTIVES: hypersensitivity is an exacerbated response to a stimulus, causing acute and short-term pain. Over the years, several treatments for dentin hypersensitivity have emerged, including laser therapy. Thus, the objective of this work was to carry out a review about the available devices and the existing procedures of laser therapy in the treatment of dentin hypersensitivity. CONTENTS: A systematic review of studies published from 2016 to 2020 was carried out through bibliographic search in the electronic databases Pubmed and the Biblioteca Virtual em Saude - (Virtual Health Library), using the following descriptors: Laser And Dentin Hypersensitivity. Of the total of 51 articles found in the search, 14 were eligible for a review. There was an evaluation of the possible risks of bias for each of the articles included. CONCLUSION: As a result, a variety of devices available on the market and different protocols that prove to be effective for the treatment of dentin hypersensitivity when compared to the initial pain situation (baseline) were found. When laser treatment is compared with other existing therapies, it's not so clear which would be the most effective, due to the wide variety of study methodologies. However, an association of therapies that act in the two mechanisms of pain interception (neural and blocker) seems to be an appropriate conduct in the control of dentin hypersensitivity, and this combination can happen through physical methods (High and low intensity laser) and chemical (neural and blocker agents).

Raynaud Fenomenine Bağlı Dijital İskemide Stellat Ganglion Blokajı: Olgu Sunumu

Stellate ganglion block is used as an adjunctive therapy method in various painful situations mediated by the sympathetic nervous system, especially complex regional pain syndrome. The process after medical and stellate ganglion block treatment in a 66-year-old female patient diagnosed with hypertension, ischemic heart disease, heart failure, Raynaud phenomenon, who presented to our algology outpatient clinic for complaints of bruising and severe pain at the fingertip, is presented with literature information.

Pediyatrik Kalp Cerrahisi Sonrası Postoperatif COVID-19 Enfeksiyonu: İki Vaka

Stellate ganglion block is used as an adjunctive therapy method in various painful situations mediated by the sympathetic nervous system, especially complex regional pain syndrome. The process after medical and stellate ganglion block treatment in a 66-year-old female patient diagnosed with hypertension, ischemic heart disease, heart failure, Raynaud phenomenon, who presented to our algology outpatient clinic for complaints of bruising and severe pain at the fingertip, is presented with literature information.

The nursing experience of caring a patient with metastatic brain tumor in surgical pain management ward: a case study report

Brain metastases are related to the poor prognosis of patients. It is not clear why certain cancers are more likely to metastasize to the brain than others. Lung cancer, breast cancer and melanoma noted as the highest incidence of brain tumor metastasis. The purpose of this report was to describe the nursing care of a patient with malignant tumor on the left breast who received multiple chemotherapy and radiotherapy, targeted therapy and mastectomy, and the tumor metastasized to the right occipital lobe of the skull. This study was conducted in surgical pain management ward within 3 days observation. Gordon's eleven health function types’ assessment framework was used. Observations, physical assessments, interviews, medical records were attempted to collect physical, psychological, social and spiritual data. Two specific nursing problems were found. Special attention need to be paid for the pain situation and take individualized nursing measures by evaluating individual patients.

Investigation of The Pain and Disability Situation of The Individuals Working "Home-Office" At Home At The Covid-19 Isolation Process

The aim of our study is to examine pain and disability in low back, knee and shoulder regions of individuals working at home during COVID-19 isolation process. In our study, 87 volunteers were included in digital media by questionnaire with data collection method. Individuals who worked in the office before COVID-19 isolation but started working from home during the isolation were included in our study. In addition to the socio-demographic characteristics of the individuals, their situation about the working environment at home was questioned. In addition, pain in the low back, knee and shoulder regions was evaluated with an 11-point pain scale (EPPS). In order to determine the level of disability, individuals were asked to fill in the Oswestry Disability Index (for the lumbar region), Lysholm Knee Score (for the knee region) and the Disability of Arm, Shoulder and Hand Questionnaire (DASH) (for the shoulder region). It was seen that 86.2% preferred desk environment more frequently as home working environment and 65.5% spent 3 to 8 hours in this environment. During the home isolation process, the highest pain was observed for low back pain (50.6%) in individuals (EPPS:4-5), then shoulder pain (44.8%) (EPPS:5) and knee pain (35.6%) (EPPS:4-5). When the levels of disability were evaluated, the Oswestry score was found 13.08±11.98, the Lysholm score was found 91.20±12.23 and the DASH score was found 9.61±16.78. It has been observed that individuals working at home during COVID-19 isolation process may develop shoulder and knee pain, and mostly in the low back region, and all these pain are defined as moderate severity pain. However, when we look at the levels of disability, it was seen that low back pain, knee pain or shoulder pain did not pose a significant problem in the life of the patient and the level of disability was low.

The Pain Situation of Older Home-Care Recipients and Influencing Factors

Chronic pain is a common symptom among older people. The international prevalence rate reaches 50% for older home-care recipients (aged ≥60). The most common causes of pain among older people are degenerative arthropathy and musculoskeletal diseases. Care recipients (81% aged ≥65) constitute a specific sub-group among pain patients, due to the restrictions they experience. In Germany, the prevalence rate in this group is 70%. Currently, no comprehensive information on the pain situation of older home-care recipients exists in Germany. The findings presented are based on a cross-sectional study of older (aged ≥65) home-care recipients (SGB XI) in Berlin, with chronic pain (n=225), capable of self-report (MMST≥18). Structured interviews comprised the primary data source. The pain situation was determined using the German Brief Pain Inventory (BPI-NH). Multiple regression analysis was applied to test how the most severe pain (dependent variable) was influenced by socio-demographic and medical parameters, mental and physical restrictions and pain medication. Analyses of the pain situation show a value of M=4.81 (SD±1.88) on the BPI intensity index, and a BPI pain interference index of M=5.47 (SD±2.15). The most intense pain averaged 6.96 (SD±2.15). On average, respondents reported 16.20 (SD±13.25) pain locations (range: 0-65). The number of pain locations, alongside other factors, had a significant influence, R²=0.038 (corrected R²=0.034), F (1.219) = 8.760, p<0.01), on pain intensity. The findings show severe pain intensity among older home-care recipients not reported in previous findings (e.g. in long-term in-patient care). Action in medical care, nursing care and educational aspects is urgently needed.