Biomedical subjects

Nicola Adams

Publications and source records attributed to Nicola Adams.

6 recordsLinked to original sources

PubMed2006

Psychological approaches to chronic pain management: part 1.

AIMS AND OBJECTIVES: The aim of this paper is to provide an overview of the theoretical basis and application of psychological interventions used in the management of chronic pain. In doing this, psychological factors mediating pain and disability will also be reviewed. BACKGROUND: A biopsychosocial model of chronic pain is widely purported and pain management is often based upon cognitive-behavioural principles as psychological factors meditating pain and disability have been found to include emotional, cognitive and behavioural components. CONCLUSIONS: This paper provides support for a biopsychosocial model of and for the effectiveness and efficacy of psychological interventions for the management of chronic pain conditions. RELEVANCE TO CLINICAL PRACTICE: The application of psychological approaches to chronic pain management is reviewed and discussed. The way in which psychological approaches may be integrated specifically into nursing management of chronic pain is discussed in a later paper.

Adaptation, Psychological↗

PubMed2006

Psychological approaches for the nursing management of chronic pain: part 2.

AIMS AND OBJECTIVES: The aim of this article was to present the ways that nurses can integrate psychological approaches into their management of chronic pain conditions using a biopsychosocial framework. Communication, the importance of the patient-practitioner interaction, the role of education and provision of information, reassurance and reduction of anxiety and the use of coping strategies training in the management of chronic pain are reviewed alongside the key skills of nursing. BACKGROUND: This is the second part of a two-part article. Part 1 was a discussion of psychosocial factors associated with chronic pain conditions and the psychological approaches used in the management of these conditions. CONCLUSIONS: It is identified that key nursing skills often equate to the requirements of the psychological approaches, therefore specific techniques from a cognitive-behavioural framework can be readily applied, integrated and used by nurses in the management of chronic pain conditions. RELEVANCE TO CLINICAL PRACTICE: Commonly utilized nursing skills are similar to those required for cognitive-behavioural therapy. It is reasonable to assume therefore that nurses can and should be involved in effectively managing the psychological aspects associated with chronic pain conditions.

Activities of Daily Living↗

PubMed2005

Rehabilitation approaches in fibromyalgia.

PURPOSE: This paper provides an overview of the evidence for the principal approaches taken to the rehabilitation of patients with fibromyalgia (FM): exercise, psychologically-based approaches, multimodal approaches, self-management approaches, and complementary and alternative therapies. METHOD: A review of current published evidence. RESULTS: Owing to factors such as methodological shortcomings of existing studies, and the lack of evidence on individual modalities, it is difficult to draw definitive conclusions as to which is the most appropriate rehabilitation approach in FM. However, there is growing evidence for the role of exercise training, and clear indications that if appropriately prescribed, this can be undertaken without adverse effects. Similarly, psychologically-based interventions such as cognitive-behavioural therapy have received some support from the literature. Evidence for other interventions is more equivocal. CONCLUSIONS: It appears that a combination of interventions, in a multimodal approach (e.g., exercises combined with education and psychologically-based interventions) is the most promising means of managing patients with FM.

Biofeedback, Psychology↗

PubMed2004

Knee injuries.

Explore the source record for details and available documents.

Bandages↗

PubMed2003

Therapeutic approaches to fibromyalgia syndrome in the United Kingdom: a survey of occupational therapists and physical therapists.

BACKGROUND AND PURPOSE: This study sought information from occupational therapists (OTs) and physical therapists (PTs) working in rheumatology in the UK on their usual methods of treatment and management of patients with fibromyalgia syndrome (FMS). METHODS: Data were gathered by self-completion questionnaire on: work setting; referrals of FMS patients; usual treatment objectives; assessment and treatment approaches; perceived responsiveness of patients; and other perceptions of the management of FMS. Most data were in the form of frequency counts, with some ordinal scales and open responses. RESULTS: Responses were obtained from 142 therapists (71% response rate), of whom 47 OTs and 39 PTs managed patients with FMS. The foremost therapeutic objective was increased functional ability for OTs, and increased exercise tolerance and general fitness for PTs. Pain reduction or management was rated as the second objective for both groups. An endurance-based exercise program and energy conservation techniques were the most frequently utilized interventions. Patients with FMS were thought to be 'moderately responsive' to physical management. Predictors of outcome were considered to be largely psychosocial, rather than physical, in nature. CONCLUSION: These data provide a preliminary profile of current practice in the management of FMS among UK therapists and indicate certain differences in approach between OTs and PTs.

Data Collection↗

PubMedDate not supplied

Systematic review of randomized controlled trials of nonpharmacological interventions for fibromyalgia.

OBJECTIVE: Little is known of the effectiveness of nonpharmacological interventions for fibromyalgia syndrome (FMS). The authors therefore carried out a systematic review from 1980 to May 2000 of randomized controlled trials (RCTs) of nonpharmacological interventions for FMS. METHOD: A search of computerized databases was supplemented by hand searching of bibliographies of key publications. The methodological quality of studies included in the review was evaluated independently by two researchers according to a set of formal criteria. Discrepancies in scoring were resolved through discussion. RESULTS: The review yielded 25 RCTs, and the main categories of interventions tested in the studies were exercise therapy, educational intervention, relaxation therapy, cognitive-behavioral therapy, acupuncture, and forms of hydrotherapy. Methodological quality of studies was fairly low (mean score = 49.5/100). Most studies had small samples (median for individual treatment groups after randomization = 20), and the mean power of the studies to detect a medium effect ( > or = 0.5) was 0.36. Sixteen studies had blinded outcome assessment, but patients were blinded in only 6 studies. The median longest follow-up was 16 weeks. Statistically significant between-group differences on at least one outcome variable were reported in 17 of the 24 studies. CONCLUSIONS: The varying combinations of interventions studied in the RCTs and the wide range of outcome measures used make it hard to form conclusions across studies. Strong evidence did not emerge in respect to any single intervention, though preliminary support of moderate strength existed for aerobic exercise. There is a need for larger, more methodologically rigorous RCTs in this area.

Complementary Therapies↗