12 research outputs found

    By accident: the prevention of chronic neck pain after a motor vehicle accident

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    Chronic neck pain is often the result of motor vehicle accidents, rear-end collisions in particular. A striking pattern of complaints often occurs after the accident. It is estimated that ca. 20% of patients with an acute neck pain episode develop chronic neck pain, also called 'chronic whiplash syndrome'. So far, studies focusing on medical predictors have not found conclusive evidence that biomedical factors contribute to the development and persistence of complaints. Bio-psychosocial models such as the Fear-Avoidance model and the Post-Traumatic Stress model seem more promising in explaining chronic complaints. The prevention of both acute and chronic pain and complaints after a motor vehicle accident is complex. Primary prevention is mostly focused on biomechanics, such as headrests and seatbelts. However, these type of studies are confronted with ethical boundaries and challenges in research. Secondary prevention seems to give promising results for two factors, being education and activation. Both factors are linked to catastrophic beliefs of patients about their pain and the possible harmfulness of being active. These catastrophic beliefs appear to be even more important when it comes to tertiary prevention, the treatment of chronic complaints after a motor vehicle accident. Catastrophic beliefs are elevated in people with chronic pain and need to be the primary target within interventions. However, research on the prevention of complaints lacks a sound theoretical framework and strong recommendations about the implementation of strategies cannot be made

    Походження права законодавчої ініціативи Державної ради Російської імперії 1906-1916 років

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    Демократизація державного та громадського життя в Україні висуває вимоги вивчення історичного досвіду цього процесу, перш за все, в умовах переходу від авторитарного управління до парламентаризму, а також гальмуючої ролі пережитків минулого. Це зачіпає і питання про впливи, які визначили сутність права законодавчої ініціативи Державної ради Російської імперії 1906 – 1916 рр. Воно не знайшло висвітлення, за одиночним винятком – статті російського правознавця Б.Е.Нольде (3) ні в дорадянській, ні в радянській історіографії. Мету нашого дослідження складає спроба встановити і охарактеризувати джерело виникнення права законодавчої ініціативи Державної ради Російської імперії 1906 – 1916 рр. шляхом аналізу відповідних законодавчих актів. Головним завданням дослідження є аналіз Основних державних законів 23 квітня 1906 р., Запровадження Державної ради 24 квітня 1906 р., Запроваджень Державної думи 6 серпня 1905 та 20 лютого 1906 рр., а також підготовчих матеріалів щодо цих актів

    The effect of validating and invalidating communication on satisfaction, pain and affect in nurses suffering from low back pain during a semi-structured interview

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    When physicians interview patients with ambiguous or nonspecific symptoms, they often try to reassure them with the purpose of explaining that no dangerous illness or disease is causing the symptoms. Unfortunately the evidence suggests that patients with benign (back) pain instead feel misunderstood, frustrated and unsatisfied with the consultation. Validation is a communication method that focuses on understanding and empathy as a platform for problem solving and it may be applicable for interviews in medical settings. The aim of this study was to examine the effects of validation on patient satisfaction, pain and affect. To this end 28 nurses with (re) current back pain were recruited and randomly assigned to be interviewed in a validating or invalidating condition. Patient satisfaction, affect, pain, disability, pain catastrophizing, and fear of movement were assessed immediately after the interview. The results show that the participants in the validated group were more satisfied with the interview than participants in the invalidating condition. Moreover, they showed a significant decrease on all measures of negative affect as well as for pain. For example, there was a significant between group difference in frustration where frustration decreased in the validation group, while it increased in the invalidation condition. A validating communication style seems to be beneficial for enhancing patient satisfaction, as well as diminishing negative affect and pain intensity ratings. Our results suggest that validation might be a viable technique to use in clinical examinations of patients suffering pain

    Painfully reassuring? The effects of validation on emotions and adherence in a pain test

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    Communicating reassurance to patients with musculoskeletal pain complaints, but no red flags, presents a dilemma of dampening worry while refraining from reinforcing undue pain behaviors. Previous research shows that reassurance does not decrease negative affect and may be perceived as not taking the symptoms seriously. Validation offers an alternative where the patient's experiences and feelings are acknowledged and has demonstrated, for other problems, a decrease in arousal which may set the stage for behavioral change. The purpose of this study was to investigate experimentally whether validation, as compared to invalidation, impacts on emotions and adherence during repeated pain tests. To this end, 50 participants were randomized to either a validation or invalidation condition. Each participant was told they would undergo four pain trials involving holding a bucket at arm's length to tolerance. During the inter-trial interval, the experimenter provided validating or invalidating responses according to the randomization. As a proxy measure of adherence subjects were asked to engage in an additional pain test. Results indicated that validation relative to invalidation resulted in significantly more positive affect and significantly less worry. Both groups had reductions in negative affect over the trials, but there were no difference between the groups on negative affect or pain. However, adherence was more than twice as high in the validation group as compared to invalidation. These results show that a relatively simple validation procedure had significant and positive effects on emotion and increased adherence. Further research should extend these findings and explore their clinical application

    Social modulation of facial pain display in high-catastrophizing children: An observational study in schoolchildren and their parents

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    The present study examined existing communal and operant accounts of children's pain behavior by looking at the impact of parental presence and parental attention upon children's pain expression as a function of child pain catastrophizing. Participants were 38 school children and 1 of their parents. Children completed a cold pressor pain task (CPT) twice, first when told that no one was observing (alone condition) and subsequently when told that they were being observed by their parent (parent-present condition). A 3-minute parent-child interaction occurred between the 2 CPT immersions, allowing measurement of parental attention to their child's pain (ie, parental pain-attending talk vs non-pain-attending talk). Findings showed that child pain catastrophizing moderated the impact of parental presence upon facial displays of pain. Specifically, low-catastrophizing children expressed more pain in the presence of their parent, whereas high-catastrophizing children showed equally pronounced pain expression when alone or in the presence of a parent. Furthermore, children's catastrophizing moderated the impact of parental attention upon facial displays and self-reports of pain; higher levels of parental nonpain talk were associated with increased facial expression and self-reports of pain among high-catastrophizing children; for low-catastrophizing children, facial and self-report of pain was independent of parental attention to pain. The findings are discussed in terms of possible mechanisms that may drive and maintain pain expression in high-catastrophizing children, as well as potential limitations of traditional theories in explaining pediatric pain expression. The impact of parental presence and parental attention to the child's pain upon the child's pain expression is moderated by the child's catastrophizing about pain. © 2011 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved
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