Pain Management and Palliative Care

Altilio, Terry; Otis‐Green, Shirley; Hedlund, Susan; Fineberg, Iris Cohen

doi:10.1002/9781119420743.ch22

Cited by 13 publications

(4 citation statements)

References 108 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

Section: Introductionmentioning

confidence: 99%

“…3 This approach involves the identification and early treatment of pain, along with addressing psychological and spiritual symptoms that may arise in the context of terminal illness. [4][5][6][7] Despite the importance of palliative care service provision, nearly 86% lack access to this care. 8 The high unmet need for palliative care has been attributed to several factors including poor referral system, lack of national policies and frameworks on palliative care, lack of funding or reimbursement for palliative care and patients' misperceptions about palliative care.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

‘Completely by accident’: a qualitative analysis of service providers motivations to practice palliative care

Okyere

2023

Palliat�Care

View full text Add to dashboard Cite

Background: The lack of clarity about the factors that motivate service providers to take a career in palliative care presents a significant knowledge gap that must be filled. This is because gaining knowledge about the motivations for taking a career in palliative care would provide valuable insights that can potentially increase buy-in and interest among prospective healthcare professionals. By elucidating the motivations of service providers, the study aims to contribute to the broader field of palliative care research and inform the development of tailored interventions and training programmes to increase the pool of specialized palliative care providers. Objective: To explore palliative care service providers’ motivations to practice palliative care. Design: Exploratory descriptive design. Methods: In all, seven in-depth interviews were conducted using a semi-structured interview guide. Data were managed using NVivo-12. Inductive thematic analysis was performed by following Hasse’s adaptation of Colaizzi’s approach to qualitative thematic analysis. Results: Two main factors motivated service providers to take a career in palliative care. The first was the influence of professional training while the second motivation was from their personal experiences regarding providing care to a family member with palliative care needs. Conclusion: The study concludes that personal experiences with caring for a loved one with palliative care needs play a pivotal role in shaping the decision of service providers to pursue a career in palliative care. Also, investment in palliative care education and training is crucial to ensure a skilled workforce capable of meeting the growing needs of patients and families facing serious illnesses.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

‘Completely by accident’: a qualitative analysis of service providers motivations to practice palliative care

Okyere

2023

Palliat�Care

View full text Add to dashboard Cite

show abstract

“…As per the current definition of pain, a plethora of pain and pain states exist, such as nociceptive pain, neuropathic pain, acute pain, chronic pain, etc. Developing an effective treatment option for tackling acute and chronic pain is the main focus of pain management therapists, owing to the significant effects they have on the quality of life of patients, including disability, mood swings, anxiety, and overuse of medicine, to name a few [2]. Notably, acute pain lasts for less than three days and tends to diminish afterward with the passage of time as healing occurs, whereas chronic pain is the extension of acute pain that can go well beyond the expected healing duration post-injury or surgery and typically lasts for more than three months, and in some cases may last indefinitely [1,2].…”

Section: Introductionmentioning

confidence: 99%

“…Developing an effective treatment option for tackling acute and chronic pain is the main focus of pain management therapists, owing to the significant effects they have on the quality of life of patients, including disability, mood swings, anxiety, and overuse of medicine, to name a few [2]. Notably, acute pain lasts for less than three days and tends to diminish afterward with the passage of time as healing occurs, whereas chronic pain is the extension of acute pain that can go well beyond the expected healing duration post-injury or surgery and typically lasts for more than three months, and in some cases may last indefinitely [1,2]. A multitude of drug-based and non-drug based options exists for the management of pain, which often utilizes multimodal and multidisciplinary approaches, viz., pharmaceutical, physical therapy, rehabilitation and surgery [1][2][3][4].…”

Section: Introductionmentioning

confidence: 99%

Domain Heterogeneity in Radiofrequency Therapies for Pain Relief: A Computational Study with Coupled Models

Singh

Melnik

2020

Bioengineering

View full text Add to dashboard Cite

The objective of the current research work is to study the differences between the predicted ablation volume in homogeneous and heterogeneous models of typical radiofrequency (RF) procedures for pain relief. A three-dimensional computational domain comprising of the realistic anatomy of the target tissue was considered in the present study. A comparative analysis was conducted for three different scenarios: (a) a completely homogeneous domain comprising of only muscle tissue, (b) a heterogeneous domain comprising of nerve and muscle tissues, and (c) a heterogeneous domain comprising of bone, nerve and muscle tissues. Finite-element-based simulations were performed to compute the temperature and electrical field distribution during conventional RF procedures for treating pain, and exemplified here for the continuous case. The predicted results reveal that the consideration of heterogeneity within the computational domain results in distorted electric field distribution and leads to a significant reduction in the attained ablation volume during the continuous RF application for pain relief. The findings of this study could provide first-hand quantitative information to clinical practitioners about the impact of such heterogeneities on the efficacy of RF procedures, thereby assisting them in developing standardized optimal protocols for different cases of interest.

show abstract

Fetal Pain—Reply

2006

JAMA

View full text Add to dashboard Cite

To the Editor:We have a number of concerns about the Clinical Review of fetal pain by Dr Lee and colleagues. 1 First and foremost, none of the authors appear to routinely provide care for premature infants, including the administration of analgesia and anesthesia. Providing clinical care to pregnant patients does not make a caregiver an expert on fetal or neonatal pain, and a clinician with expertise in this area should have been included.While this was intended to be a current and comprehensive literature review of articles relating to pain, anesthesia, and analgesia in fetuses younger than 30 weeks' gestational age as well as articles specifically addressing fetal pain and nociception, many relevant articles and an entire textbook devoted to this topic were not cited. [2][3][4] We routinely provide care for premature infants, many of whom are as young as 24 weeks' gestation. We regularly administer anesthesia and analgesia to these premature infants for painful interventions and surgery, even though this article would suggest that might be unnecessary. We also routinely provide anesthesia and analgesia to fetuses as early as 19 weeks' gestation undergoing certain interventions and surgery. Pediatric anesthesiologists are often faced with a patient population who may not have the ability to convey thoughts and desires, including the presence of pain. We must then look for indirect measures of pain, such as stress responses; physiologic alterations in heart rate and blood pressure; and, at times, facial grimacing, crying, and withdrawal. Even though these infants cannot verbally express that they feel discomfort, most practitioners in the medical community would not withhold analgesia or anesthesia if the same procedure would require this treatment in an older patient.Although the article reviews neuroanatomical development, the gestational ages the authors cite can be argued. Definitive gestational dates are not known because of ethical challenges in fetal research. As such, the data discussed in this article should be viewed as gestational age ranges, not precise dates of gestational development.We do not know for certain whether a fetus has the capacity to feel pain prior to 29 weeks' gestation. We as clinicians should focus on methods to deliver effective fetal analgesia safely while minimizing maternal risk. As stated by Glover and Fisk, 5 "We don't know; better to err on the safe side from mid-gestation." Financial Disclosures: None reported. 1. Lee SJ, Ralston HJP, Drey EA, Partridge JC, Rosen MA. Fetal pain: a systematic multidisciplinary review of the evidence. JAMA. 2005;294:947-954. 2. Myers LB, Bulich LA, eds. Anesthesia for Fetal Intervention and Surgery. Lewiston, NY: BC Decker Inc; 2005. 3. Fenton KN, Heinemann MK, Hickey PR, Klautz RJ, Liddicoat JR, Hanley FL. Inhibition of the fetal stress response improves cardiac output and gas exchange after fetal cardiac bypass. J Thorac Cardiovasc Surg. 1994;107:1416-1422. Gitau R, Fisk NM, Teixeira JM, Cameron A, Glover V. Fetal hypothalamicpituitary-adrena...

show abstract

Pain Management and Palliative Care

Cited by 13 publications

References 108 publications

‘Completely by accident’: a qualitative analysis of service providers motivations to practice palliative care

‘Completely by accident’: a qualitative analysis of service providers motivations to practice palliative care

Domain Heterogeneity in Radiofrequency Therapies for Pain Relief: A Computational Study with Coupled Models

Fetal Pain—Reply

Contact Info

Product

Resources

About