scholarly journals A preliminary analysis of the association between perceived stigma and HIV-related pain

2017 ◽  
Author(s):  
Antonia L Wadley ◽  
Tamar Pincus ◽  
Michael Evangeli

AbstractObjectiveHIV stigma remains common and has been associated with severity of HIV-related symptoms. Associations between HIV stigma and HIV-related pain, one of the most common symptoms in HIV, have not been investigated however. Data from low back pain populations suggest that stigma associates with worse pain intensity and so we hypothesised that the same would be the case in HIV. In a small pilot study we assessed the association between HIV stigma and pain intensity in PLWH with chronic pain while controlling for depression, a well-established correlate of pain.MethodsMediation analysis was used to assess the effect of depression on the relationship between stigma and pain intensity in a cross-sectional cohort of 50 PLWH and chronic pain (pain most days of the week for > 3 months) recruited in Johannesburg, South Africa. All participants were assessed using: HIV/AIDS stigma instrument – PLWA (HASI-P), 11-point numerical pain rating scale, and the Beck Depression Inventory II.Results88% (44/50) of participants reported experiencing some form of HIV stigma (HIV stigma scale score ≥ 1). Worst pain intensity and depressive symptoms individually correlated with total stigma score (Spearman’s r = 0.33, p = 0.02 for both). The mediation analysis highlighted that mediation of the relationship by depression was equivocal (b = −0.002, bootstrapped CI −0.02 to 0.00).ConclusionsWhilst these preliminary data are marginal, they do suggest that associations between HIV stigma and HIV-related pain warrant further investigation. Future study should also include potential mechanisms, which may include mediation through depression.

Author(s):  
Antonia L. Wadley ◽  
Tamar Pincus ◽  
Michael Evangeli

Background: Stigma related to the human immunodeficiency virus (HIV) remains common and has been associated with severity of HIV-related symptoms. Associations between HIV stigma and HIV-related pain, one of the most common symptoms in HIV, have however not been investigated. Data from low back pain populations suggest that stigma is associated with worse pain intensity and so we hypothesised that the same would be the case in HIV.Aim: The goal of this study was to assess the association between HIV stigma and pain intensity in people living with HIV (PLWH) with chronic pain whilst controlling for depression, a well-established correlate of pain.Setting: The study took place at an HIV clinic in Johannesburg, South Africa.Methods: Mediation analysis was used to assess the effect of depression on the relationship between stigma and pain intensity in a cross-sectional cohort of 50 PLWH and chronic pain (pain most days of the week for > 3 months). All participants were assessed using the HIV/AIDS Stigma Instrument – PLWA, an 11-point numerical pain rating scale and the Beck Depression Inventory II.Results: In all, 88% (44/50) of participants reported experiencing some form of HIV stigma (HIV stigma scale score ≥ 1). Worst pain intensity and depressive symptoms individually correlated with total stigma score (Spearman’s r = 0.33, p = 0.02 for both). The mediation analysis highlighted that mediation of the relationship by depression was equivocal (b = -0.002, bootstrapped confidence interval -0.02 to 0.00).Conclusion: Whilst these preliminary data are marginal, they do suggest that associations between HIV stigma and HIV-related pain warrant further investigation. Future study should also include potential mechanisms, which may include mediation through depression.


2021 ◽  
Vol 11 (4) ◽  
pp. 357-368
Author(s):  
Akiko Okifuji ◽  
Reiko Mitsunaga ◽  
Yuri Kida ◽  
Gary W Donaldson

Aim: We conducted a preliminary evaluation of a newly developed, time-based visual time analog (VITA) scale for measuring pain in chronic pain patients. Materials & methods: 40 patients with chronic back pain rated their pain over four visits using numerical (pain) rating scale (NRS) and VITA assessing pain intensity by distributing the amount of time spent on ‘not aware of pain’ (blue), ‘aware of nothing but pain’ (red) and time in between (yellow). Results: The NRS scores were correlated with the VITA Red but not with VITA Blue. The psychometric analyses revealed that VITA achieved greater reliability and sensitivity than did NRS. Conclusion: The results provide preliminary support for VITA scale for assessing pain intensity in patients with chronic pain.


Pain ◽  
2001 ◽  
Vol 94 (2) ◽  
pp. 149-158 ◽  
Author(s):  
John T. Farrar ◽  
James P. Young ◽  
Linda LaMoreaux ◽  
John L. Werth ◽  
Michael R. Poole

Author(s):  
Andry Andry ◽  
Muhammad Akbar ◽  
Hasmawati Basir

  THE CORRELATION BETWEEN THE BODY MASS INDEX AND THE SEVERITY OF MIGRAINE ATTACK WITHOUT AURAABSTRACTIntroduction: In Indonesia, there has been only a few studies that correlate Body Mass Index (BMI) to severity of migraine.Aim: To identify the correlation between the body mass index and the severity of migraine attack  without aura.Methods:  The research used the cross sectional design method. The subjects’ age was 18 years or above, and they were treated at the neurology outpatient clinic of Dr. Wahidin Sudirohusodo Hospital and its networking hospitals from June through September 2018. The measurement of Body Mass Index (BMI) of the subjects was conducted, and the level of migraine severity was determined using the numeric pain rating scale (NPRS), while the frequency of migraine attacks was determined in 1 month during the last 3 months  of the study.Results: The research results revealed that 45 samples met the inclusion criteria, consisting of 86.7% women and 13.3% men. By using Spearman’s test, it was found that there was a correlation between the BMI and the pain intensity, and between the BMI and the frequency of the migraine attacks.Discussion: There were correlations between BMI and pain intensity which confounded by sleep disorder and mi- graine prophylaxis, and between BMI and the frequency of migraine attacks which confounded by prophylaxis of migraine without aura.Keywords: BMI, migraine rant, obesity, severityABSTRAK Pendahuluan: Penelitian yang menghubungkan indeks massa tubuh (IMT) dengan derajat keparahan migren masih sedikit di Indonesia.Tujuan: Mengetahui hubungan IMT dengan derajat keparahan serangan migren tanpa aura.Metode: Penelitian ini menggunakan metode potong lintang. Subjek berumur 18 tahun atau lebih dan berobat ke Poliklinik Neurologi RSUP Dr. Wahidin Sudirohusodo dan rumah sakit jejaring antara Juni hingga September 2018. Terhadap subjek dilakukan pengukuran IMT. Derajat keparahan migren ditentukan secara kuantitatif melalui penggunaan numeric pain rating scale (NPRS) dan ditentukan frekuensi serangan migren dalam satu bulan pada interval tiga bulan terakhir saat dilakukan penelitian.Hasil: Didapatkan 45 sampel yang memenuhi kriteria inklusi yang terdiri dari 86,7% perempuan dan 13,3% laki-la- ki. Dengan menggunakan uji Spearman, didapatkan korelasi antara IMT dan tingkat nyeri dan frekuensi serangan migren.Diskusi: Terdapat korelasi antara IMT, dengan tingkat nyeri yang dirancu dengan gangguan tidur, dan pengobatan preventif, dan antara IMT dengan frekuensi serangan yang dirancu dengan pengobatan preventif  pada penderita migren tanpa aura.Kata kunci: Derajat keparahan, IMT, migren, obesitas  


2021 ◽  
Author(s):  
Keiko Yamada ◽  
Tomoko Fujii ◽  
Yasuhiko Kubota ◽  
Kenta Wakaizumi ◽  
Hiroyuki Oka ◽  
...  

ABSTRACT Objectives To investigate whether mood states other than anger can modify the association between anger and pain intensity in individuals with chronic pain. Methods We analysed 22,059 participants with chronic pain, including 214 participants with rheumatoid arthritis (RA), who completed a questionnaire. The Profile of Mood States short form (POMS-SF) was used to assess six dimensions of mood states (anger-hostility, tension-anxiety, depression-dejection, confusion, fatigue, and vigour). A numerical rating scale (NRS) assessed pain intensity. We examined the association between anger-hostility and the NRS and the relationship between POMS-SF components. Moderation analyses were used to investigate whether the five mood states other than anger-hostility modified the effect of anger-hostility on the NRS. Results Anger-hostility contributed to pain intensity. Although increased mood states other than vigour were associated with increased pain intensity, these increased mood states appeared to suppress the effect of anger-hostility on pain intensity. Increased vigour was associated with decreased pain intensity and increased the effect of anger-hostility on pain intensity. Conclusions Mood states other than anger may influence the association between anger and pain intensity in individuals with chronic pain. It is important to focus on complicated mood states and anger in individuals with chronic pain, including RA.


2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Hayato Shigetoh ◽  
Yoichi Tanaka ◽  
Masayuki Koga ◽  
Michihiro Osumi ◽  
Shu Morioka

Background. Central sensitization (CS) and psychological factors are associated with pain intensity; however, the mediating role of CS on the relation between psychological factors and pain intensity remains unclear. Objectives. We performed mediation analysis to investigate how CS mediates relation between psychological factors and pain intensity. Methods. Twenty patients with musculoskeletal pain were included in this cross-sectional study. Central sensitization inventory (CSI), one pain intensity-related outcome measure (Short-Form McGill Pain Questionnaire 2 (SFMPQ2)), and three psychological outcome measures (Hospital Anxiety and Depression Scale (HADS), Pain Catastrophizing Scale-4 (PCS), and Tampa Scale for Kinesiophobia-11 (TSK)) of all participants were assessed. The mediation analysis with a bootstrap sampling procedure was used to assess the indirect effects. The level of significance was set at 5%. Results. Mediation analysis showed that the HADS-anxiety, HADS-depression, and PCS had significant indirect effects on the pain ratings of CSI. Additionally, the direct effect was significant only for PCS. Conclusions. The relationship among anxiety symptoms, depression symptoms, and pain intensity was completely mediated by CS. Furthermore, the relationship between catastrophic thinking and pain intensity was partially mediated by CS. Our findings suggest that CS mediates relation between psychological factors and pain intensity, and CS-focused intervention may be important.


2020 ◽  
Vol 24 (1) ◽  
pp. 101-104
Author(s):  
Muhammad Rafiq

Recent findings have indicated that hypnotic interventions produce significant decrease in pain intensity. This current case studies are focused to highlight significant impact on pain management including headache. All the patients underwent a complete observation and clinical interview and only patients with psychological pain were included in the study group. For the management of headache, a novel hypnotic intervention - Circle Therapy (CT), was applied on a group of ten patients indicating their pain intensity in the range of 8-10 on subjective pain rating scale. According to rating scale, headache above 8 was considered as severe, 5-8 moderate and < 5 as mild.  CT is a brief hypnotic technique limited to about 10 min. Post hypnosis ratings were also measured. The pre and post hypnosis data were recorded and analyzed by paired samples t test. Use of CT showed significant results between pre and post rating e.g. 9 ± 0.25 vs. 1 ± 0.21 (p < 0.001). This brief CT intervention provided an immediate relief from headache, however, this is limited to few case studies focusing on just headache. So, we recommend large sample studies to document the effects of CT in different types of pain. Citation: Rafiq M. Circle therapy for headache management: case studies. Anaesth pain intensive care 2020;24(1):__ DOI: https://doi.org/10.35975/apic.v24i1. Received – 28 December 2019; Reviewed – 10 January 2020; Accepted - 10 January 2020;


2020 ◽  
Author(s):  
Jessica Robinson-Papp ◽  
Gabriela Cedillo ◽  
Richa Deshpande ◽  
Mary Catherine George ◽  
Qiuchen Yang ◽  
...  

BACKGROUND Collecting patient-reported data needed by clinicians to adhere to opioid prescribing guidelines represents a significant time burden. OBJECTIVE We developed and tested an opioid management app (OM-App) to collect these data directly from patients. METHODS OM-App used a pre-existing digital health platform to deliver daily questions to patients via text-message and organize responses into a dashboard. We pilot tested OM-App over 9 months in 40 diverse participants with HIV who were prescribed opioids for chronic pain. Feasibility outcomes included: ability to export/integrate OM-App data with other research data; patient-reported barriers and adherence to OM-App use; capture of opioid-related harms, risk behaviors and pain intensity/interference; comparison of OM-App data to urine drug testing, prescription drug monitoring program data, and validated questionnaires. RESULTS OM-App data was exported/integrated into the research database after minor modifications. Thirty-nine of 40 participants were able to use OM-App, and over the study duration 70% of all OM-App questions were answered. Although the cross-sectional prevalence of opioid-related harms and risk behaviors reported via OM-App was low, some of these were not obtained via the other measures, and over the study duration all queried harms/risks were reported at least once via OM-App. Clinically meaningful changes in pain intensity/interference were captured. CONCLUSIONS OM-App was used by our diverse patient population to produce clinically relevant opioid- and pain-related data, which was successfully exported and integrated into a research database. These findings suggest that OM-App may be a useful tool for remote monitoring of patients prescribed opioids for chronic pain. CLINICALTRIAL NCT03669939 INTERNATIONAL REGISTERED REPORT RR2-doi:10.1016/j.conctc.2019.100468


Author(s):  
Priti A. Mehendale ◽  
Mayur T. Revadkar

Background: There is evidence regarding beneficial use of Transcutaneous Electrical Nerve Stimulation (TENS) on post Lower Segment Caesarean Section (LSCS) incision pain. However, efficacy of different types of TENS following C section pain has not yet been explored adequately.Methods: 96 women who had recently undergone LSCS were included for the study. The subjects were in the age group of 20 to 40 years (25.84±3.96); having pain intensity 4 or more on Numerical Pain Rating Scale (NPRS). They were divided into three groups by random allocation method; namely Group A: Acupuncture (Low/Motor) TENS, Group B: Conventional (High/Sensory) TENS and Group C: Control group. Group A and B received specific type of TENS twice a day for 15 minutes. Control group C did not receive any TENS intervention. All subjects received standard post-operative medications and physiotherapy. Pain intensity was recorded on NPRS pre and post intervention.Results: Both Acupuncture TENS and Conventional TENS significantly decreased post-operative pain intensity as compared to control group (p value <0.0001).Conclusions: Both, acupuncture and conventional TENS are equally effective in reducing post LSCS incision pain at a strong and non-painful intensity.


2021 ◽  
Vol 7 (4) ◽  
pp. 292-295
Author(s):  
Roland Prethipa P ◽  
Jimsha V K ◽  
Jonathan Daniel M

Pain intensity is a common outcome domain assessed in pain clinical trials. The patient’s self-report is the gold standard and it appears to be embedded in everyday clinical practice. Most often pain assessment is considered to be the cornerstone for ideal treatment.The aim of this study was to assess the dental patients’ level of pain using Full Cup Test (FCT) and Numeric Pain Rating Scale (NPRS), and to compare and validate the Full Cup Test in the assessment of orofacial pain with Numeric Pain Rating Scale.A total of sixty patients presenting with various forms of orofacial pain were included in this cross-sectional study. Data collected include the patient demographic details and the diagnosis of each case was made after proper history taking, clinical examination and radiographic investigation. Pain assessment was done for each patient using both numeric pain rating scale and full cup test.All the data were analysed using inferential statistics Mann Whitney test and the analysis was carried out with SPSS 17.The comparison of mean pain scores using full cup test and numeric pain rating scale shows there was significant differences between acute and chronic pain with P- value of 0.023 and 0.005 respectively. FCT had shown 83 percent sensitivity and 94 percent specificity.Patients who presented with either acute or chronic dental conditions experienced moderate to severe level of pain. FCT is useful for both evaluating and discerning changes in pain and it can be used as a tool in pain assessment.


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