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- Title
- AN EXPLORATION OF CHRONIC PAIN EXPERIENCE, COPING, AND THE NEO FIVE FACTORS IN HIGH FUNCTIONING ADULTS.
- Creator
-
Stalter, Juliana, Mottarella, Karen, University of Central Florida
- Abstract / Description
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Chronic pain affects nearly 48 million Americans (Haggard, Stowell, Bernstein, & Gatchel, 2008). Established guidelines for pain management encourage the use of personality assessment in chronic pain evaluation (Karlin, Creech, Grimes, Clark, Meagher, & Morey, 2005). In relation to the Big Five personality factors, low Openness relates negatively to treatment success, (Hopwood, Creech, Clark, Meagher, & Morey, 2008), and elevated Neuroticism scores also correlate with increased pain levels...
Show moreChronic pain affects nearly 48 million Americans (Haggard, Stowell, Bernstein, & Gatchel, 2008). Established guidelines for pain management encourage the use of personality assessment in chronic pain evaluation (Karlin, Creech, Grimes, Clark, Meagher, & Morey, 2005). In relation to the Big Five personality factors, low Openness relates negatively to treatment success, (Hopwood, Creech, Clark, Meagher, & Morey, 2008), and elevated Neuroticism scores also correlate with increased pain levels among individuals in hospital or rehab settings (Ashgari & Nicholas, 2006; Nitch & Boon, 2004). In contrast to these prior studies, this study identifies correlates in a relatively high-functioning population (college students) to further elucidate the connection between chronic pain and personality. This study compares scores on the NEO-FFI (Costa & McCrae, 1992), the West Haven-Yale Multidimensional Pain Inventory (WHYMPI, Kerns, Turk, & Rudy, 1985), and the Pain Catastrophizing Scale (PCS, American Academy of Orthopaedic Manual Physical Therapists, 2010). Significant correlations were found between Neuroticism, Extraversion, and Agreeableness and select subscales of both the WHYMPI and the PCS. A linear regression of scores showed that Neuroticism was very strongly related to WHYMPI scores. In fact, the WHYMPI scores accounted for 67.9% of variance in Neuroticism. Scores on the WHYMPI also correlated with PCS scores. Helplessness and Overall scores significantly correlated to Life Control and certain positive social support scores. The findings of this study emphasize the need for pain clinicians to incorporate psychological assessments, especially concerning Neuroticism, into their evaluations of chronic pain patients.
Show less - Date Issued
- 2011
- Identifier
- CFH0004121, ucf:44863
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFH0004121
- Title
- COHORT STUDY OF PAIN BEHAVIORS IN THE ELDERLY RESIDING IN SKILLED NURSING CARE.
- Creator
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Burfield, Allison, Sole, Mary Lou, University of Central Florida
- Abstract / Description
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An integral concern across care settings is the prompt intervention for patients suffering with pain. Long-term care (LTC) settings present with unique challenges to assess and manage pain in resident populations. Pain assessment is especially challenging, because residents have varying degrees of cognition to communicate their pain, and clinician/staff knowledge of pain symptoms may be lacking. The purpose of this research was to improve the measurement of pain and outcomes of care for the...
Show moreAn integral concern across care settings is the prompt intervention for patients suffering with pain. Long-term care (LTC) settings present with unique challenges to assess and manage pain in resident populations. Pain assessment is especially challenging, because residents have varying degrees of cognition to communicate their pain, and clinician/staff knowledge of pain symptoms may be lacking. The purpose of this research was to improve the measurement of pain and outcomes of care for the elderly residing in skilled nursing care, especially those with cognitive-impairment. The specific aims of this study were to: 1) Determine the magnitude of the relationship between pain behaviors and a measurement model hypothesized for pain; 2) Test the construct validity of a pain measurement model; 3) Examine the concomitance of pain and cognition in a three-year longitudinal analysis. The research questions answered: 1) Is there a difference in the prevalence of pain in cognitively intact versus cognitively-impaired residents; 2) Can a theoretically derived model of pain aid in detecting pain across all cognitive levels; and 3) Do pain and cognitive status concomitantly correlate? The goal was to examine the covariance model of concomitance of pain and cognition to more accurately construct theoretical models of pain to then include additional resident care factors in future research. Traditional self-reports of pain are often under-assessed and under-treated in the cognitively-impaired (CI) elderly resident. Having additional measures to detect pain beyond self-reports of pain intensity and frequency increases the likelihood of detecting pain in populations with complex symptom presentation. Data collected from skilled nursing facilities offer exceptional opportunities to study resident demographics, characteristics, symptoms, medication use, quality indicators, and care outcomes. The Minimum Data Set-Resident Assessment Instrument (MDS-RAI) 2.0, a nationally required resident assessment tool, must be completed on every resident in a Medicare LTC facility within 14 days of admission, quarterly, annually and with significant changes in resident status. Because the MDS is widely used and recognized in LTC settings, core items from MDS [i.e., pain frequency (J2a) and pain intensity (J2b)] along with additional MDS items hypothesized to signify pain were analyzed in the pilot measurement model. Ten core items from MDS were used: 1) Inappropriate behavior frequency (E4da); 2) Repetitive physical movements; 3) Repetitive verbalizations (E1c); 4) Sad facial expressions (E1l); 5) Crying (E1m); 6) Change in mood (E3); 7) Negative statements (E1a); 8) Pain frequency (J2a); 9) Pain intensity (J2b); and 10) Cumulative pain sites scores. All indicators of pain were significant at the p<.01 level. A longitudinal cohort design was used to answer if a concomitance exists between pain and cognition. Data were collected from MDS annual assessments from 2001, 2002 and 2003 for residents across the United States. The sample consisted of 56,494 residents age 65 years and older with an average age of 83 ±8.2 years. Descriptive statistics, ANOVA and a covariance model were used to evaluate cognition and pain at the three time intervals. ANOVA indicated a significant effect (p<.01) for pain and cognition with protected t-tests indicating scores decreased significantly over time with resident measures of pain and cognition. Results from this study suggest that: 1) Using only pain intensity and frequency, pain prevalence was found in 30% of the pilot population, while 47.7% of cognitively intact residents had documented pain and only 18.2% of the severely CI had documented pain, supporting previous research that pain is potentially under-reported in the CI; 2) Parsimonious measurements models of pain should include dimensions beyond self-reports of pain (i.e., cognitive, affective, behavioral and inferred pain indicators); 3) Model fit was improved by using specific MDS items in the pain construct; 4) Longitudinal analysis revealed relative stability for pain and cognition measures over time (e.g., larger stability or consistency was found in cognitive measures than the measures of pain over the three-year period); 5) Crossed-legged effects between pain and cognition were not consistent; 6) A concomitant relationship was not found between pain and cognition. The relationship was significant (p<.01), but associations were weak (r=0.03 to 0. 08). Pain or cognition should not be used as a predictor of the other in theoretical models for similar populations. The MDS is a reliable instrument to follow resident attributes, quality of care, and patient outcomes over time. The development of more accurate assessments of pain may improve resident care outcomes. Ineffectively intervening on the pain cycle is posited to cause secondary unmet needs that affect the resident's quality of life. Findings support the importance of improving clinical outcomes in the management of pain in the elderly residing in long-term care. Deficits in the treatment of pain highlight the impetus to support health policy change that includes pain treatment as a top health priority and a quality indicator for federally funded programs supporting eldercare.
Show less - Date Issued
- 2009
- Identifier
- CFE0002533, ucf:47660
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFE0002533
- Title
- INJECTION TECHNIQUES OF SUBCUTANEOUS ANTICOAGULANT THERAPIES.
- Creator
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Morissette, Leah, Desmarais, Paul, University of Central Florida
- Abstract / Description
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Subcutaneous anticoagulant medications like Heparin and Low-Molecular Weight Heparin are injections that readily cause bruising, pain, induration, and hematoma formation at the injection site. It is known that these adverse reactions can be correlated to the technique used to administer these medications; however, there is no established technique that reduces bruising, pain, induration, and hematoma formation at the site. Currently, the only protocol for subcutaneous Heparin and Low...
Show moreSubcutaneous anticoagulant medications like Heparin and Low-Molecular Weight Heparin are injections that readily cause bruising, pain, induration, and hematoma formation at the injection site. It is known that these adverse reactions can be correlated to the technique used to administer these medications; however, there is no established technique that reduces bruising, pain, induration, and hematoma formation at the site. Currently, the only protocol for subcutaneous Heparin and Low-Molecular Weight Heparin is that it is to be administered subcutaneously in the abdomen and when using a prefilled syringe, the air bubble should not be removed. The purpose of this study was to identify current nursing practice for the administration of these medications and to compare the results to researched techniques that resulted in less adverse site reactions. A total of 33 participants were recruited. The survey targeted six researched techniques found, after a comprehensive literature review, to have reduced site adverse effects associated with subcutaneous Heparin and Low-Molecular Weight Heparin. After completing the survey, it was found that current practice does not reflect techniques researched to reduce bruising, pain, induration, and hematoma formation at the site. In fact, very few completed one of the six research techniques that were questioned, which included: a two minute application of a cold compress/pack before and/or after the injection, an injection duration lasting 30 seconds, slow removal of the needle over five seconds, application of pressure after the injection for a minimum of 30 seconds, use of a hot pack/compress after the injection, and the use of a3 mL syringe. It was also found that there were inconsistencies in techniques that have been previously established as current protocol for these medications.
Show less - Date Issued
- 2015
- Identifier
- CFH0004733, ucf:45390
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFH0004733
- Title
- Dissecting the Components of Neuropathic Pain.
- Creator
-
George, Dale, Lambert, Stephen, Kim, Yoon-Seong, Fernandez-Valle, Cristina, Ebert, Steven, University of Central Florida
- Abstract / Description
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Pain is a public health issue affecting the lives of nearly 116 million adults in the US, annually. Understanding the physiological and phenotypic changes that occur in response to painful stimuli is of tremendous clinical interest, but, the complexity of pain and the lack of a representative in vitro model hinders the development of new therapeutics. Pain stimuli are first perceived and transmitted by the neurons within the dorsal root ganglia (DRG) which become hyperexcitable under these...
Show morePain is a public health issue affecting the lives of nearly 116 million adults in the US, annually. Understanding the physiological and phenotypic changes that occur in response to painful stimuli is of tremendous clinical interest, but, the complexity of pain and the lack of a representative in vitro model hinders the development of new therapeutics. Pain stimuli are first perceived and transmitted by the neurons within the dorsal root ganglia (DRG) which become hyperexcitable under these conditions. It has now been established that satellite glial cells (SGCs) that ensheathe the DRG cell body actively contribute to this neuronal dysregulation. To understand the role of SGCs in this pain circuit, first, we looked at the development of SGCs within the DRG of rats, and we showed that SGCs developed postnatally, and appeared morphologically, transcriptionally and functionally similar to Schwann cells precursors (SCs), supporting the idea that these cells may exhibit multipotent behavior. Secondly, we describe here, a three-dimensional in vitro model of the DRG which is functionally characterized on a microelectrode array (MEA). This model can be used to assess the long-term recording of spontaneous activity from bundles of axons while preserving the neuronal-SGC interactions similar to those observed in vivo. Furthermore, using capsaicin, an agonist of the TRPV1 nociceptive receptor, we show that this model can be used as an in vitro assay to acquire evoked responses from nociceptive neurons. Overall, this study advances our knowledge on the development and differentiation of SGCs and establishes a novel functional three-dimensional model for the study of SGCs. This model can now be used as a tool to study the underlying basis of neuronal dysregulation in pain.
Show less - Date Issued
- 2018
- Identifier
- CFE0007002, ucf:52053
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFE0007002
- Title
- The Gasoline Tree.
- Creator
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Manning, Brianne, Thaxton, Terry, Stap, Donald, Milanes, Cecilia, University of Central Florida
- Abstract / Description
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In exploration of Millennial anxieties and the power of dreaming, The Gasoline Tree imagines a soundtrack for the revelations, defeats, and curiosities of leaving childhood behind. This is a collection of 40 poems that examines eating disorders, gender roles, physical abuse, sex, infidelity, loneliness, and the fear of losing one's parents. This collection also contemplates the brutalities and muted delights of what drives us all: love, in all of its forms. (")The Gasoline Tree,(") (")Wolf of...
Show moreIn exploration of Millennial anxieties and the power of dreaming, The Gasoline Tree imagines a soundtrack for the revelations, defeats, and curiosities of leaving childhood behind. This is a collection of 40 poems that examines eating disorders, gender roles, physical abuse, sex, infidelity, loneliness, and the fear of losing one's parents. This collection also contemplates the brutalities and muted delights of what drives us all: love, in all of its forms. (")The Gasoline Tree,(") (")Wolf of Chocorua,(") and many other poems construct New England landscapes that pay homage to the pastoral uniqueness of Maxine Kumin and Galway Kinnell, while poems in the latter half of the collection, such as (")Home Alone(") and (")Little Big Econ,(") rouse depictions of southern environments and intensify the narrator's budding sense of displacement. There are many voices within, but there are three particular voices that can be heard above the rest: the child struggles with the complexities of divorce and identity; the young woman struggles with the complexities of remorse and relationships; the woman struggles with reminiscence and loss. Yet, each voice works toward expressions of awareness and acceptance of the enduring captivation with impermanence and consequence in a disposition influenced by W.S. Merwin, Anne Sexton, Kay Ryan, and Louise Gl(&)#252;ck. Whether driving by a homeless man, staring at the ceiling fan, or lying awake late into the night, this collection examines the transient nature of everyday occurrences and the buried meanings that might govern them all.
Show less - Date Issued
- 2016
- Identifier
- CFE0006139, ucf:51181
- Format
- Document (PDF)
- PURL
- http://purl.flvc.org/ucf/fd/CFE0006139
