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Background: Chronic pain is highly prevalent, economically burdensome, and one of the most common reasons for seeking medical care in the United States (U.S.). Empathic communication is an understudied phenomena in pain management with potential to alleviate the psychological and affective burdens associated with chronic pain and improve pain outcomes. Methods: This dissertation consists of three studies investigating empathic communication in physical therapy pain management care. Study 1 conducted a qualitative meta-synthesis of physical therapist preferred communication behaviors in pain rehabilitation. Study 2 used conversation analysis to investigate how empathic communication was enacted by physical therapists. Study 3 calculated the frequency of empathic communication in the study sample and used repeated-measures, conditional linear mixed-effects models to determine if physical therapist empathic communication was associated with changes in pain intensity and interference across time. Studies 2 and 3 collected original data using a longitudinal observational study design of up to 4 audio recorded physical therapy visits and 4 repeated measures for patients with chronic musculoskeletal pain over 6 weeks of routine care in an outpatient private practice. Results: Study 1 found empathic communication to be one of eight preferred communication behaviors for physical therapists. Study 2 revealed three patterns physical therapists use to provide empathic support to patients expressing emotion. Study 3 found that across 99 recorded visits, physical therapists responded empathically 67% of the time. A significant interaction between empathic communication and time indicated that more frequent empathic communication was associated with a greater reduction in pain intensity across time. Conclusion: Physical therapists were found to be empathic when managing patients with chronic pain and enacted empathic support in ways that met goals for physical therapy care. More frequent empathic communication by physical therapists was associated with lower ratings of pain intensity and interference by patients. Higher empathy was also associated with larger and more rapid decreases in pain intensity over time. These findings provide rationale for future clinical trials to investigate the efficacy of empathic communication training for physical therapists who manage patients with chronic pain, an innovative approach to improving conservative pain management.
This definitive clinical reference comprehensively reviews the most advanced methods for assessing the person in pain. The field's leading authorities present essential information and tools for evaluating psychosocial, behavioral, situational, and medical factors in patients' subjective experience, functional impairment, and response to treatment. Empirically supported instruments and procedures are detailed, including self-report measures, observational techniques, psychophysiological measures, and more. Best-practice recommendations are provided for assessing the most prevalent pain syndromes and for working with children, older adults, and people with communication difficulties. The book also weighs in on the limitations of existing methods and identifies key directions for future research.
The goal of a high quality, cost-effective and accessible health care for patients is achieved through constructing a team-based and patient-centered health care delivery system. The expanded role of pharmacists uplifts them to patient care from dispensing and manufacturing or marketing of drugs. Along with doctors and allied health professionals, pharmacists are increasingly recognized as an integral part of the patient care team. Furthermore, colleges of pharmacy need to revise and up-date their curricula to accommodate the progressively increasing development in the pharmaceutical education and the evolving new roles of practicing pharmacists in patient care settings. This book focuses on the expanded role of the pharmacists in total patient care including prescribing, dispensing, compounding, administering and monitoring of drugs at home, hospital, community, hospice, critical care, changeover and other care settings. The sector is emerging in both developed and under-developed countries. Overburdened by patient loads and the explosion of new drugs physicians turned to pharmacists more and more for drug information especially within institutional settings. And today’s patient care pharmacists are taking more interests in medication review and reconciliation, patient education and counseling, creating drug therapy regimen and monitoring compliance. The purpose of this book is to guide the pharmacists in their daily interactions with patients and to ensure collaboration with other health professionals. The contents are mostly based on recently published articles related to patient care, with most recent ideas and activities followed by the patient care pharmacists around the globe. However, a pharmacist implements the care plan in collaboration with other health care professionals and the patient or caregiver. Along with professional guidelines, the book discusses the concepts and best practices of patient interaction, patient rights, and ethical decision-making for the professional pharmacist, apprentice and student. In every chapter, the role of pharmacists in that chapter specific issues are detailed explicitly so that a professional pharmacist or a student can figure out his or her do’s and don’ts in that specific situation. Moreover, further reading references are listed as future recommendations. So, the book is an archive of potential references too. Among so many books about patient care, either doctors’ or nurses’ roles are highlighted. The proposed book highlights the pharmacists’ roles and responsibilities to the most, separated from those of doctors and nurses, with the most recent information obtained from most publications in several journals, books, bulletins, newsletter, magazines etc.
"Nurses play a vital role in improving the safety and quality of patient car -- not only in the hospital or ambulatory treatment facility, but also of community-based care and the care performed by family members. Nurses need know what proven techniques and interventions they can use to enhance patient outcomes. To address this need, the Agency for Healthcare Research and Quality (AHRQ), with additional funding from the Robert Wood Johnson Foundation, has prepared this comprehensive, 1,400-page, handbook for nurses on patient safety and quality -- Patient Safety and Quality: An Evidence-Based Handbook for Nurses. (AHRQ Publication No. 08-0043)." - online AHRQ blurb, http://www.ahrq.gov/qual/nurseshdbk/
Drug overdose, driven largely by overdose related to the use of opioids, is now the leading cause of unintentional injury death in the United States. The ongoing opioid crisis lies at the intersection of two public health challenges: reducing the burden of suffering from pain and containing the rising toll of the harms that can arise from the use of opioid medications. Chronic pain and opioid use disorder both represent complex human conditions affecting millions of Americans and causing untold disability and loss of function. In the context of the growing opioid problem, the U.S. Food and Drug Administration (FDA) launched an Opioids Action Plan in early 2016. As part of this plan, the FDA asked the National Academies of Sciences, Engineering, and Medicine to convene a committee to update the state of the science on pain research, care, and education and to identify actions the FDA and others can take to respond to the opioid epidemic, with a particular focus on informing FDA's development of a formal method for incorporating individual and societal considerations into its risk-benefit framework for opioid approval and monitoring.
Painâ€"it is the most common complaint presented to physicians. Yet pain is subjectiveâ€"it cannot be measured directly and is difficult to validate. Evaluating claims based on pain poses major problems for the Social Security Administration (SSA) and other disability insurers. This volume covers the epidemiology and physiology of pain; psychosocial contributions to pain and illness behavior; promising ways of assessing and measuring chronic pain and dysfunction; clinical aspects of prevention, diagnosis, treatment, and rehabilitation; and how the SSA's benefit structure and administrative procedures may affect pain complaints.
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Despite medical technological advances, the major killers with which we must currently contend have remained essentially the same for the past few decades. Stroke, cancer, and heart disease together account for the vast majority of deaths in the United States. In addition, due to improved medical care, many Americans who would previously have died now survive these disorders, necessitating that they receive appropriate rehabilitation efforts. One result of our own medical advances is that we must now accept the high costs associated with providing quality care to individuals who develop one of these problems, and we must avail ourselves to assist of afflicted individuals. families Despite the relative stability of causes of death and disability, the health-care field is currently experiencing tremendous pressures, both from professionals with in the field, who desire more and better technology than is currently available, and from the public and other payers of health care (e.g., insurance companies), who seek an end to increasing health-care costs. These pressures, along with an increased emphasis on providing evidence of cost-effectiveness and quality assurance, are substantially changing the way that health-care professionals perform their jobs.
Chronic back and neck pain. Whiplash. Fibromyalgia. Carpal tunnel syndrome. Intractable headaches. Depression. Anxiety and posttraumatic stress. Concussion. More than ever, the term workplace disabilities is synonymous with greater clinical and case management complexity and escalating personal, social, occupational and economic cost. Complex illnesses and injuries that defy a traditional medical management model continue to baffle medical, mental health, rehabilitation, compensation, corporate, and legal professionals despite new advances in diagnosis, prevention, and rehabilitation. The Handbook of Complex Occupational Disability Claims: Early Risk Identification, Intervention and Prevention cuts through the confusion by integrating current theories and findings into a state-of-the-art tool for critical thinking, decision making, and effective practice. A book that synthesizes so many diverse viewpoints has the potential to influence both policy and practice across disciplines and cut through politicization of these still poorly understood conditions with evidence. The Handbook is important reading for all clinicians, professionals, and members of rehabilitation and disability management teams, across healthcare, occupational and compensation settings.
Presents state-of-the-art manual therapy research from the last 10 years Multidisciplinary authorship presents the viewpoints of different professions crucial to the ongoing back pain management debate Highly illustrated and fully referenced