Biomedical subjects

David W Swanson

Publications and source records attributed to David W Swanson.

7 recordsLinked to original sources

PubMed1990

Three year follow-up of patients with chronic pain who were treated in a multidisciplinary pain management center.

Between September 1979 and October 1982, 408 patients with chronic benign pain were evaluated for admission to a pain management program. Of the 408 patients, 249 completed the program; the success rate at the time of dismissal was 70% among these 249 patients. Of the 239 patients who entered the follow-up study, 87% responded to either a mailed questionnaire or a follow-up telephone call by an independent reviewer at the time of 3 year follow-up; the improvement had been maintained by 46.6% of the successfully treated patients (or a third of the original participants). The present finding is strikingly similar to that in a previous study from this institution - an indication of the long-term efficacy of the multidisciplinary pain management program. Further search for modifications for the existing program is indicated to accommodate the needs of patients who fail initially or cannot maintain the improvement.

Adolescent↗

PubMed1986

Ancient pain.

In a group of about 1000 patients with chronic pain, approximately 4% had pain of very prolonged duration--25 years or longer. These subjects were similar in general to other chronic pain patients but they did differ significantly in the following: a higher incidence of face and head pain, greater dependency on analgesics and sedatives, more frequent diagnoses of depression, and a greater elevation of nearly all clinical MMPI scales.

Adult↗

PubMed1985

Failure of a predictive scale in identifying patients who may benefit from a pain management program: follow-up data.

A 7-item scale to identify patients who may benefit from a pain management program was prospectively studied. The patient group consisted of 217 patients. The duration of follow-up was 2-3 years. Although an item-by-item analysis revealed some differences between successes, partial successes, and failures, the overlap was such that the total score was not predictive of outcome. Although this finding precludes clinical use of the 7-item scale in its present form, future modifications are suggested that may improve its predictive ability.

Adult↗

PubMed1984

Prescription medication dependence and neuropsychologic function.

The abuse of prescription drugs is an insidious complication among patients with chronic pain. This study examines cognitive intellectual functions in patients with chronic pain who are using prescribed analgesics, sedatives and hypnotics. A comprehensive battery of psychologic tests measuring intelligence, learning, memory, sensory-perceptual integrity, motor skills and general adaptive abilities was administered to 47 subjects. The subjects were patients admitted to a chronic pain management program, and they were divided into drug-dependent, drug-abusing and non-drug-abusing groups according to strictly defined criteria. Findings indicated that the prescribed use of these medications for pain over a prolonged time is detrimental to the cognitive function of such patients and complicates their clinical management.

Adult↗

PubMed1980

The family's viewpoint of chronic pain.

An indentical questionnaire are administered separately to 100 chronic pain patients and a close family member of each. The majority of patients and relatives agreed on the answers to these questions about the pain problem. Highest congruency between patient and relative was associated with cases in which there were management problems and an ultimately poor treatment result. Rather than reflecting excellent communication between patient and relative, this appears to indicate an undesirable mutuality. Patient answers indicate to us as examiners that their pain is greater than they have revealed to relatives, yet the relatives say the patient is showing more than he realizes.

Adult↗

PubMed1979

Chronic pain: which patients may a pain-management program help?

To ascertain whether chronic-pain patients who are likely to benefit from a pain-management program can be identified before treatment, we studied for differences discernible at the beginning of treatment a group who succeeded and did well at 1-year follow-up (n = 34) and a group who failed (n = 35). The two groups differed significantly (P less than 0.01) in regard to duration of pain, work time lost, number of operations, subjective pain level, and drug dependency. Deviations on the MMPI were greater in failures than in successes; but the differences were not statistically significant. A 7-item rating scale based on these data differentiated a favorable group (including 71% of the successes) from an unfavorable group (including 86% of the failures). This scale should be helpful in selection of candidates for a pain-management program, even though it needs further validation.

Chronic Disease↗

PubMed1978

The dissatisfied patient with chronic pain.

Patients with chronic pain may become dissatisfied because of their lack of improvement. Thirteen such patients, encountered in a pain-management program, registered formal complaints of their dissatisfaction. From their histories they were found to be the most chronic and treatment-refractory patients encountered, with problems of medication dependency, accident proneness, and dissatisfaction with previous treatment efforts. During hospitalization they opposed psychologic approaches, further manifested their dependency on medication, and some of them had circumscribed delusions. The pain-management program was difficult to apply to these patients; and further, they resisted other recommendations for treatment and even resisted discharge in in some instances. Further psychiatric screening is necessary to avoid the complications presented by this type of patient.

Adult↗