Biomedical subjects

Cecilia Norrbrink Budh

Publications and source records attributed to Cecilia Norrbrink Budh.

7 recordsLinked to original sources

PubMed2007

Life satisfaction in individuals with a spinal cord injury and pain.

OBJECTIVE: To assess and describe life satisfaction in individuals with spinal cord injury (SCI) with regard to pain. DESIGN: A cross-sectional descriptive study of self-reported life satisfaction in individuals with SCI, with and without pain. SETTING: Spinal outpatient clinic. SUBJECTS: Two hundred and thirty patients with SCI were mailed a questionnaire. INTERVENTIONS: Mailed survey. MAIN MEASURES: Ratings of pain intensity, pain unpleasantness, mood, and life satisfaction (LiSat-9). RESULTS: In total 191 (83%) of the questionnaires were returned and analysed. Patients with pain experienced lower life satisfaction compared with individuals who were pain free. Continuous pain interfered to a greater extent than did intermittent pain. In logistic regression analysis the univariate relationship between pain and low life satisfaction was removed. Predictive for lower scores of life satisfaction were higher ratings of mood disorders. CONCLUSION: Life satisfaction is negatively affected in patients with SCI and pain compared to patients with SCI but without pain. Higher levels of anxiety and depression seem to be predictive for this decreased life satisfaction.

Adult↗

PubMed2006

A comprehensive pain management programme comprising educational, cognitive and behavioural interventions for neuropathic pain following spinal cord injury.

OBJECTIVE: To assess whether a comprehensive multidisciplinary pain management programme could contribute to improvement regarding sleep quality, mood, life satisfaction, health-related quality of life, sense of coherence and pain for patients with a spinal cord injury and neuropathic pain. DESIGN: A prospective intervention study. PATIENTS: Twenty-seven patients with spinal cord injury and neuropathic pain participated in a pain management programme in parallel with 11 patients in a control group. METHODS: A comprehensive pain management programme comprising educational, cognitive, and behavioural interventions was created for patients with spinal cord injury and neuropathic pain. The pain management programme consisted of 20 sessions over a 10-week period and included educational sessions, behavioural therapy, relaxation, stretching, light exercise and body awareness training. All patients were followed-up 3, 6 and 12 months after completion of the programme. RESULTS: At the 12-month follow-up, levels of anxiety and depression in the treatment group decreased compared with baseline values, and a tendency towards better quality of sleep was seen. In comparison with the control group, patients in the treatment group improved regarding sense of coherence and depression. CONCLUSION: This study implies that a multidimensional pain management programme can be a valuable complement in the treatment of spinal cord injured patients with neuropathic pain.

Adaptation, Psychological↗

PubMed2005

Lack of interchangeability between visual analogue and verbal rating pain scales: a cross sectional description of pain etiology groups.

BACKGROUND: Rating scales like the visual analogue scale, VAS, and the verbal rating scale, VRS, are often used for pain assessments both in clinical work and in research, despite the lack of a gold standard. Interchangeability of recorded pain intensity captured in the two scales has been discussed earlier, but not in conjunction with taking the influence of pain etiology into consideration. METHODS: In this cross-sectional study, patients with their pain classified according to its etiology (chronic/idiopathic, nociceptive and neuropathic pain) were consecutively recruited for self-assessment of their actual pain intensity using a continuous VAS, 0-100, and a discrete five-category VRS. The data were analyzed with a non-parametric statistical method, suitable for comparison of scales with different numbers of response alternatives. RESULTS: An overlapping of the VAS records relative the VRS categories was seen in all pain groups. Cut-off positions for the VAS records related to the VRS categories were found lower in patients with nociceptive pain relative patients suffering from chronic/idiopathic and neuropathic pain. When comparing the VAS records transformed into an equidistant five-category scale with the VRS records, systematic disagreements between the scales was shown in all groups. Furthermore, in the test-retest a low percentage of the patients agreed to the same pain level on the VAS while the opposite hold for the VRS. CONCLUSION: The pain intensity assessments on VAS and VRS are in this study, not interchangeable due to overlap of pain records between the two scales, systematic disagreements when comparing the two scales and a low percentage intra-scale agreement. Furthermore, the lower VAS cut-off positions relative the VRS labels indicate different meaning of the rated pain intensity depending on pain etiology. It is also indicated that the scales have non-linear properties and that the two scales probably have different interpretation. Our findings are in favor of using the VRS in pain intensity assessments but if still the VAS is preferred, the VAS data should be analyzed as continuous using statistical methods suitable for ordinal data. Furthermore, our findings indicate a risk to over or under estimate the patient's perceived pain when interpreting condensed VAS data.

Adult↗

PubMed2005

Use of analgesic drugs in individuals with spinal cord injury.

OBJECTIVE: This study set out to elucidate which factors are associated with or predictive for the use of analgesic drugs in patients with spinal cord injury and pain. DESIGN: A cross-sectional descriptive study with a partly prospective cohort. PATIENTS: One hundred and twenty-three patients with a spinal cord injury matched for gender, age, level of lesion and completeness of injury. METHODS: Questionnaires consisting of ratings in the areas of pain intensities, pain unpleasantness, life satisfaction, anxiety and depression, and questions about consumption of analgesic drugs were posted to the 123 patients. RESULTS: Of the 101 patients (82.1%) who returned the questionnaire, 90 (46 women and 44 men) still suffered from pain and were thus included in the study. Statistical analysis showed that although the number of pain medications used per person had increased in the last 3 years, the ratings of pain were unaffected. Logistic regression analyses also revealed that the use of pain-relieving medication was associated with higher ratings on the affective component of pain, lower ratings of leisure activities and the presence of stabbing/cutting pain. CONCLUSION: The affective component of pain is the main predictor for the use of analgesics in patients with a spinal cord injury. Complementary strategies, including a multidisciplinary approach, for relieving the unpleasantness of pain need to be explored further.

Adult↗

PubMed2004

Non-pharmacological pain-relieving therapies in individuals with spinal cord injury: a patient perspective.

OBJECTIVE: To assess the non-pharmacological treatments used and preferred by patients with spinal cord injury and pain. DESIGN: A cross-sectional descriptive study. INTERVENTIONS: One hundred and twenty three patients with spinal cord injury, matched for gender, age, level of lesion and completeness of injury were assessed in 1999 at the Spinalis SCI unit, Stockholm, Sweden and followed-up in a mailed survey 3 years later. In total, 82.1% of the questionnaires (n=101) were returned. Ninety of these patients still suffered pain and were thus included in the study. MAIN OUTCOME MEASURES: Pain questionnaires, visual analogue scale (VAS), Hospital Anxiety and Depression Scale and Life Satisfaction instrument. RESULTS: 63.3% of the patients had tried non-pharmacological treatments, where acupuncture, massage and transcutaneous electrical nerve stimulation (TENS) were the most commonly tried. Predictive for having tried non-pharmacological treatment were high ratings of pain intensity, presence of aching pain, and cutting/stabbing pain. CONCLUSION: Massage, and heat were the non-pharmacological treatments reported to result in the best pain alleviation. Results from our study suggest that we need to (re)evaluate the treatments offered to patients with spinal cord injury and pain and combine non-pharmacological and pharmacological treatments.

Acupuncture Therapy↗

PubMed2003

Pain in a Swedish spinal cord injury population.

OBJECTIVE: To describe pain and associated variables in a prevalence group of persons with a sustained spinal cord injury (SCI) in the Swedish capital and its surroundings. SETTING: Spinalis SCI Unit (outpatient clinic), Stockholm, Sweden. DESIGN: Assessment over a 12-month period in a yearly health control. SUBJECTS: Four hundred and fifty-six SCI patients. RESULTS: Two hundred and ninety-one out of 456 SCI patients (63.7%) suffered from pain, and in 45.7% of these it was classified as being neurogenic. Aching pain was the most used descriptor (38.5%). The onset of pain was commonly within three months (73.5%). In 70.4% of patients pain occurred below the level of the lesion. Most patients identified pain as coming from one (55.0%) or two (28.2%) body regions. Rating of the general pain intensity on a visual analogue scale (VAS) was 46 out of 100 and rating of the worst pain intensity was 78 out of 100. Ninety-four out of 276 patients (32.3%) considered that their quality of life was significantly affected by pain. CONCLUSION: Pain was most common in patients with incomplete lesions (ASIA impairment grade D) and there was a correlation between pain and higher mean age at injury and between pain and female gender.

Adolescent↗

PubMedDate not supplied

Evaluation of variations in sensory and pain threshold assessments by electrocutaneous stimulation.

Assessed sensory and pain thresholds can change consequently to disturbances associated with ongoing pain. Such assessments could be an additional method in the daily clinical evaluation of perceived pain. To study the test-retest variability within-day and between-day of such procedures a newly developed instrument producing electrocutaneous stimulation, PainMatcher (PM), was used to assess the electrical sensory thresholds (EST) and pain thresholds (EPT) in healthy volunteers and in patients with pain. The produced data were considered ordinal and analyzed with rank-invariant statistics with properties of analyzing systematic disagreement, bias, and individual variations. The percentage agreements within +/- 1PM value for EST were in the two groups of healthy volunteers and patients in pain 94% and 92%, and for EPT assessments 49% and 78%, respectively. The variability in the EST assessments is possibly explained by a slight bias while the individual variations were negligible between the two occasions. The assessed EPT were unbiased in both groups while individual variations were significant among the healthy volunteers but negligible among the patients in pain. The EST was found to be increased in pain patients compared to healthy volunteers, p < 0.03, and the EPT decreased in pain patients compared to healthy volunteers, p < 0.001. The results in this study indicate stable and reliable assessments of EST and EPT except for a possible bias. The threshold assessment procedure followed in this study may be a valuable tool in the clinical evaluation of sensory and pain assessments in pain patients.

Case-Control Studies↗