Finding the Person Behind the Pain: Chronic Pain Management in a Patient With Traumatic Brain Injury

Gallagher, Romayne; Drance, Elisabeth; Higginbotham, Susan

doi:10.1016/j.jamda.2006.04.010

Cited by 8 publications

(11 citation statements)

References 13 publications

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“…The literature also provides limited evidence to guide clinicians in selecting among non‐surgical pain treatments in patients with polytrauma. Aside from one study indicating that inpatient rehabilitation may improve outcomes among patients with trauma‐related amputation [9], and a number of case reports/series [10–31], we did not find any rigorous studies of pain intervention studies in this population. Finally, although several studies have suggested that headache is common among blast injury patients [50,51,91], we found no published studies describing how blast‐related headache might differ in terms of phenomenology or treatment from other types of headache pain.…”

Section: Discussionmentioning

confidence: 73%

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Systematic Review of the Literature on Pain in Patients with Polytrauma Including Traumatic Brain Injury

Dobscha¹,

Clark²,

Morasco³

et al. 2009

Pain Med

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Objective To review the literature addressing the assessment and management of pain in patients with polytraumatic injuries including traumatic brain injury (TBI) and blast-related headache, and to identify patient, clinician and systems factors associated with pain-related outcomes. Design Systematic review. Methods We conducted searches in MEDLINE of literature published from 1950 through July 2008. Due to a limited number of studies using controls or comparators, we included observational and rigorous qualitative studies. We systematically rated the quality of systematic reviews, cohort, and case-control design studies. Results One systematic review, 93 observational studies, and one qualitative research study met inclusion criteria. The literature search yielded no published studies that assessed measures of pain intensity or pain-related functional interference among patients with cognitive deficits due to TBI, that compared patients with blast-related headache with patients with other types of headache, or that assessed treatments for blast-related headache pain. Studies on the association between TBI severity and pain reported mixed findings. There was limited evidence that the following factors are associated with pain among TBI patients: severity, location, and multiplicity of injuries; insomnia; fatigue; depression; and post-traumatic stress disorder. Conclusions Very little evidence is currently available to guide pain assessment and treatment approaches in patients with polytrauma. Further research employing systematic observational as well as controlled intervention designs is clearly indicated.

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Section: Discussionmentioning

confidence: 73%

“…We also identified a number of case reports and case series that described pain treatment approaches and pain outcomes among patients with polytrauma including TBI [10–31]. Several case reports supported that intrathecal baclofen may be helpful for spasticity associated with TBI and related injuries [21–25].…”

Section: Resultsmentioning

confidence: 99%

Systematic Review of the Literature on Pain in Patients with Polytrauma Including Traumatic Brain Injury

Dobscha¹,

Clark²,

Morasco³

et al. 2009

Pain Med

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“…Brain injury often causes severe pain, which increases the patient's cognitive disorders. Cognitive disorders hinder assessment of pain (Gallagher, Drance, & Higginbotham, 2006) when the pain assessment tools are not appropriate for expressing the amount of pain (Breivik et al, 2008;Hutchison, Tucker, Kim, & Gilder, 2006;Iggulden, 2006).…”

Section: Conceptual Frameworkmentioning

confidence: 99%

Support for Traumatic Brain Injury Patients’ Family Members in Neurosurgical Nursing

Coco

Tossavainen

Jääskeläinen

et al. 2011

Journal of Neuroscience Nursing

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This systematic literature review describes how adult traumatic brain injury (TBI) patients' family members received support. The research question was "What in healthcare constitutes support for a TBI patient's family members?" The data for this review were based on 22 empirical studies published in scientific journals in 2004-2010, which were found in the Cinahl, PsychINFO, and ISI Web of Knowledge databases. The review includes the study design, sample, method, and main results. The data were analyzed using content analysis. Social support for brain injury patients' family members was divided into 3 main categories: informational, emotional, and practical support. The subcategories of informational support were information about the patient's symptoms, information about care, quality of information, and information about the prognosis. The subcategories of emotional support were taking emotions into account, caring, listening, and respecting. The subcategories of practical support were support in decision making, promoting the welfare of the family, encouraging family members to participate in care, cooperation with the family members, and counseling services. The results are available for nurses in practical work. The review offers nurses a structure for supporting TBI patients' families, and according to this review, supporting TBI patients' families appears to have many dimensions. The results suggest that nurses should be informed that it is important for family members to know the facts about TBI to understand the condition and to receive practical advice on how to help their significant other with TBI with daily activities. In addition, the results provide a basis for further research and development of interventions that support brain injury patients and their family members.

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“…Medications should be chosen based on their mechanism of action and then combined in a rational manner to target pain and associated impairment. This approach to prescriptive practice has been labeled rational polypharmacy (Gallagher, Drance, & Higginbotham, 2006).…”

Section: Pharmacologic Management Of Nonheadache Painmentioning

confidence: 99%

Traumatic brain injury, polytrauma, and pain: Challenges and treatment strategies for the polytrauma rehabilitation.

Gironda¹,

Clark²,

Ruff³

et al. 2009

Rehabilitation Psychology

134

113

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The available data signal the need for the incorporation of early and aggressive pain management strategies into existing treatment models. Challenges to providing effective pain management for OEF/OIF veterans are numerous and include comorbid cognitive, medical, and emotional impairments that complicate readjustment to civilian life. It is likely that the problem of polytrauma pain and associated comorbid conditions such as posttraumatic stress disorder and postconcussive syndrome will require the development of integrated approaches to clinical care which bridge traditional subspecialty divisions. A proposed model of treatment is presented.

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Finding the Person Behind the Pain: Chronic Pain Management in a Patient With Traumatic Brain Injury

Cited by 8 publications

References 13 publications

Systematic Review of the Literature on Pain in Patients with Polytrauma Including Traumatic Brain Injury

Systematic Review of the Literature on Pain in Patients with Polytrauma Including Traumatic Brain Injury

Support for Traumatic Brain Injury Patients’ Family Members in Neurosurgical Nursing

Traumatic brain injury, polytrauma, and pain: Challenges and treatment strategies for the polytrauma rehabilitation.

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