Interprofessional care improves health-related well-being and reduces medical costs for chronic pain patients

2019 ◽  
Vol 83 (2) ◽  
pp. 105-127 ◽  
Author(s):  
Tamara Seitz ◽  
Kurt Stastka ◽  
Michael Schiffinger ◽  
Bela Rui Turk ◽  
Henriette Löffler-Stastka
Keyword(s):  
Chronic Pain ◽  
Medical Condition ◽  
Group Analysis ◽  
Well Being ◽  
Integrated Treatment ◽  
Psychiatric Ward ◽  
Health Related ◽  
Hospital Stays ◽  
Medical Examinations

This study evaluated whether patients with somatic symptom disorder, expressing chronic pain that could not be attributed to a medical condition, would benefit from an 8-week inpatient residence at a psychiatric ward. In the 1-year follow-up after termination the authors examined the extent to which the integrated treatment decreased patient costs. A total of 106 patients participated in the follow-up and reported a significant improvement in their general health (Cohen's d = 1.5–2.21), a decrease in impairment due to pain (d = 2.24), and a decrease in symptom severity (d = 1.29). They took fewer medications and sick days, reported fewer hospital stays and medical examinations, and consulted and changed physicians and outpatient clinics less often (d = 0.55–1.1). The average cost per patient was cut in half, down to є 80,000/$96,000 per year. From a clinical standpoint, group analysis that focused on aggression was the most effective intervention.

Group Therapy within the NHS V: Patients' Views on the Benefit of Group Therapy for Women Survivors of Child Sexual Abuse

1997 ◽  
Vol 30 (3) ◽  
pp. 409-427 ◽  
Author(s):  
Zaida Hall ◽  
Elizabeth King
Keyword(s):  
Sexual Abuse ◽  
Group Therapy ◽  
Women Survivors ◽  
Group Analysis ◽  
Well Being ◽  
Normal Range ◽  
Analytic Group ◽  
Descriptive Account ◽  
Insight Into

This article reports on a study of how members of a slow-open analytic group for women survivors of childhood sexual abuse felt about the helpfulness of the group. The respondents' views and comments are analysed and related to their age, their termination of the group, length of follow-up, number of sessions, final stage of depression and overall change in depression since before the group. The proportion of patients who found the group helpful (46 percent) was significantly higher than those who found it unhelpful (19 percent). The length of time since the group made no difference to satisfaction with the group. Satisfied patients tended not to lapse but to plan their departure from the group. They were more likely than dissatisfied patients to have depressive ratings which had improved considerably since before the group and were now within the normal range. A descriptive account is presented of patients' comments, giving an insight into their views on the group and on the therapists, and their thoughts about themselves in the years afterwards. Their views were, on the whole, positive, though negative views were also clearly stated. A quarter of those responding felt they needed further help. Group analysis appeared to be an effective method of treating women survivors who benefited from their acceptance by the group and the mirroring back to them of their worth. Group therapy diminished their sense of isolation, guilt and shame. It increased their well-being and confidence, enabling them to make positive changes in their lives.

scholarly journals Multiple Sclerosis Adult Day Programs and Health-Related Quality of Life of Persons with Multiple Sclerosis and Informal Caregivers

2020 ◽  
Vol 22 (4) ◽  
pp. 187-192
Author(s):  
Joseph M. Gasper ◽  
Megan Lewis ◽  
Anne Kroeger ◽  
Ben Muz ◽  
Nicholas LaRocca ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Informal Caregivers ◽  
Well Being ◽  
Care Utilization ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
Mental Hrqol

Abstract Background: Multiple sclerosis adult day programs (MSADPs) offer life-enhancing services for individuals and informal caregivers affected by multiple sclerosis (MS), including medical care, rehabilitation therapies, nutrition therapy, cognitive training, tailored education, exercise programs, and social interaction. The purpose of this study was to examine the effects of MSADPs on health-related quality of life (HRQOL) and health care utilization of persons with MS and HRQOL and well-being of informal caregivers. Methods: Using a quasi-experimental design, outcomes between baseline and 1-year follow-up in persons with MS and informal caregivers who used MSADP services and a comparison group of similar persons with MS and caregivers who did not use MSADP services were compared. For persons with MS, outcomes included standardized measures of physical and mental HRQOL and health care utilization. For caregivers, outcomes included physical and mental HRQOL and well-being. Changes in outcomes between baseline and follow-up were examined using propensity score–weighted difference-in-differences regression analysis. Results: For persons with MS, MSADP use had a significant positive effect on 12-Item Short Form Health Survey physical component scores, although the difference was not clinically meaningful. Use of MSADPs did not have effects on any other outcomes for persons with MS or caregivers. Conclusions: Use of MSADPs did not show a clinically meaningful effect on HRQOL for persons with MS or informal caregivers. The MSADPs do not seem to offer sustained benefits to persons with MS or caregivers, but the possibility of initial short-term benefits cannot be ruled out.

scholarly journals Influence of malocclusion on oral health-related quality of life in children: a seven-year cohort study

2021 ◽  
Vol 26 (2) ◽  
Author(s):  
Jocelito TONDOLO JUNIOR ◽  
Jessica Klöckner KNORST ◽  
Gabriele Rissotto MENEGAZZO ◽  
Bruno EMMANUELLI ◽  
Thiago Machado ARDENGHI
Keyword(s):  
Quality Of Life ◽  
Early Childhood ◽  
Cohort Study ◽  
Oral Health ◽  
Well Being ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

ABSTRACT Objective: To assess the influence of early childhood malocclusion on oral health-related quality of life (OHRQoL). Methods: 7-year cohort study involving 639 preschoolers (1 to 5 years) who had been evaluated initially with a survey conduced in 2010. Children completed the Brazilian version of the Child Perception Questionnaire (CPQ8-10) to assess OHRQoL during the follow-up period. Exploratory variables were collected at baseline, including the presence and severity of malocclusion (overjet and lip coverage). Socioeconomic characteristics, oral health behavior, and patterns of dental attendance were also investigated. A multilevel Poisson regression model was used to fit the association between malocclusion and OHRQoL. With this approach, incidence rate ratio (IRR) and 95% confidence intervals (95% CI) were calculated. Results: A total of 449 children were re-evaluated (follow-up rate, 70.3%). The prevalence of accentuated overjet and inadequate lip coverage was 13.5% and 11.9%, respectively. The mean (±SD) CPQ8-10 score was 10.57±10.32. The presence of inadequate lip coverage was associated with higher overall mean CPQ8-10 scores (IRR 1.51; 95% CI 1.29-1.77), and social well-being, emotional well-being, and functional limitation domains. Children with accentuated overjet (>3mm) also demonstrated higher overall scores on the CPQ8-10 than their normal counterparts. The presence of this condition also influenced the oral symptom (IRR 1.29; 95% CI 1.08-1.53) and emotional well-being (IRR 1.30; 95% CI 1.02-1.66) domains. Conclusion: Results of the present study suggest that early childhood malocclusion is a risk factor for low OHRQoL in future.

scholarly journals Pain, Sleep, and Health-Related Quality of Life after Multidisciplinary Intervention for Chronic Pain

2021 ◽  
Vol 18 (19) ◽  
pp. 10233
Author(s):  
Hafdís Skúladóttir ◽  
Herdis Sveinsdottir ◽  
Janean E. Holden ◽  
Thóra Jenný Gunnarsdóttir ◽  
Sigridur Halldorsdottir ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Sleep Problems ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
Pre Treatment ◽  
One Year

Multidisciplinary pain-management programs have the potential to decrease pain intensity, improve health-related quality of life (HRQOL), and increase sleep quality. In this longitudinal prospective cohort study, the aim was to investigate the long-term effects of multidisciplinary pain rehabilitation interventions in Iceland. More precisely, we (a) explored and described how individuals with chronic pain evaluated their pain severity, sleep, and HRQOL at pre-treatment and at one-year follow-up and (b) examined what predicted the participants’ one-year follow-up HRQOL. Seventy-nine patients aged 20–68 years, most of whom were women (85%), responded. The participants scored their pain lower at one-year follow-up (p < 0.001). According to their response, most of them had disrupted sleep, mainly because of pain. One year after the treatment, more participants slept through the night (p = 0.004), and their HRQOL increased. Higher pre-treatment mental component summary (MCS) scores and having pursued higher education predicted higher MCS scores at one-year follow-up, and higher pre-treatment physical component summary (PCS) scores predicted higher PCS scores at one-year follow-up. Sleep problems, being a woman, and having children younger than 18 years of age predicted lower MCS scores at one-year follow-up. These findings are suggestive that patients should be examined with respect to their mental status, and it could be beneficial if they received some professional support after completing the intervention.

scholarly journals The effects of recombinant human erythropoietin on functional health and well-being in chronic dialysis patients.

1996 ◽  
Vol 7 (5) ◽  
pp. 763-773 ◽  
Author(s):  
K M Beusterien ◽  
A R Nissenson ◽  
F K Port ◽  
M Kelly ◽  
B Steinwald ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Well Being ◽  
Health Related Quality ◽  
Dialysis Patients ◽  
Human Erythropoietin ◽  
Sf 36 ◽  
Related Quality ◽  
Health Related

As a component of the open-label, multicenter National Cooperative Recombinant Human Erythropoietin (Epo) Study, the health-related quality-of-life effects of Epo therapy were assessed in 484 dialysis patients who had not previously been treated with Epo therapy (New-to-Epo) and 520 dialysis patients who were already receiving Epo therapy at the time of study enrollment (Old-to-Epo). Using scales from the Medical Outcomes Study 36-item Short Form Health Survey (SF-36), health-related quality of life was assessed on study enrollment (baseline) and at an average of 99 days follow-up. At baseline, SF-36 scores for Old- and New-to-Epo patients were well below those observed in the general population, reflecting substantial impairments in functional status and well-being among patients with chronic renal failure. Significant improvements from baseline to follow-up were observed among New-to-Epo patients in vitality, physical functioning, social functioning, mental health, looking after the home, social life, hobbies, and satisfaction with sexual activity (P < 0.05 for each). The mean improvements in hematocrit values among New-to-Epo and Old-to Epo patients were 4.6 and 0.3, respectively. At the time of follow-up, SF-36 scores for New-to-Epo patients were comparable with those observed among Old-to-Epo patients, whose scores did not change significantly from baseline to follow-up. Analysis of the relationship between Epo therapy, hematocrit values, and health-related quality of life suggest that some of the beneficial quality-of-life effects of Epo are mediated through a change in hematocrit level.

Assessment and treatment at a pain clinic: A one-year follow-up of patients with chronic pain

2017 ◽  
Vol 17 (1) ◽  
pp. 233-242 ◽  
Author(s):  
Andrea Hållstam ◽  
Monika Löfgren ◽  
Lina Benson ◽  
Christer Svensén ◽  
Britt-Marie Stålnacke
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Pain Clinic ◽  
Health Related Quality ◽  
Pain Clinics ◽  
Related Quality ◽  
Health Related ◽  
One Year

AbstractBackground and aimsPain is one of the most common reasons for patients to seek primary health care. Pain relief is likely to be achieved for patients suffering from acute pain, but for individuals with chronic pain it is more likely that the condition will persist. These patients have the option of being referred to specialised pain clinics. However, the complexity surrounding chronic pain patients is not well studied in these settings. This study aimed to describe patients with chronic pain referred to a pain clinic by using the information submitted during their first visit and one year later and also to identify associations between baseline characteristics and improvements in health-related quality of life in the follow-up.MethodsThis was a longitudinal observational study of a sample consisting of 318 patients referred to a pain clinic. One group of patients containing 271 individuals (median age 48, 64% females) was assessed and received conventional pain treatment (CPT group) and a second group of 47 patients (median age 53, 64% females) was assessed by a pain specialist and referred back to their physician with a treatment recommendation (assessment only, AO group). Patient-reported outcome measures in health-related quality of life (EQ-5D), pain intensity (VAS), mental health (HADS), insomnia (ISI), pain-related disability (PDI), kinesiophobia (TSK) and sense of coherence (SOC) were collected at the first visit and one year later.ResultsAt baseline, the CPT group reported a low EQ-5D Index (median (md) 0.157) and EQVAS (md 40) as well as considerable high, current pain intensity VAS (md 58), HADS anxiety (md 8), ISI (md 17), PDI (md 36) and TSK (md 39). The AO group showed similar problems (no significant differences compared to the CPT group), except for ISI, where the AO group reported less severe problems. At the one-year follow-up, the CPT group had a statistically significant improvement in EQ-5D, VAS, ISI, PDI and TSK. In the AO group no significant changes were observed. In the CPT group there was an association between a high ISI level at baseline and an improved EQ-5D Index in the follow-up.ConclusionsThe study describes rarely explored groups of patients with chronic pain at a pain clinic. Severe pain problems were present in both groups at their first visit. A statistically significant improvement could be seen in the group that was conventionally treated while this was not the case among those subjects who were assessed and referred. The results imply, that relatively limited treatment strategies were helpful for the patients’ health-related quality of life. Despite these improvements, the patients were not fully recovered, pointing to the chronicity of pain conditions and the need of support for many patients.ImplicationsIncreased knowledge about assessment, selection and treatment at pain clinics is important to improve the quality of the work performed at these clinics. Despite limited resources, further efforts should be made to collect comparable, valid data on a regular base from pain clinics in order to develop recommendation models.

Patients with chronic pain: One-year follow-up of a multimodal rehabilitation programme at a pain clinic

2016 ◽  
Vol 10 (1) ◽  
pp. 36-42 ◽  
Author(s):  
Andrea Hållstam ◽  
Monika Löfgren ◽  
Christer Svensén ◽  
Britt-Marie Stålnacke
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Pain Clinic ◽  
Pain Clinics ◽  
Related Quality ◽  
Health Related ◽  
One Year ◽  
Eq Vas

AbstractBackground and aimsMultimodal rehabilitation (MMR) programmes, including, physical training, educational and psychological interventions by an interdisciplinary team are found to be more successful for patients with disabling chronic pain compared with less comprehensive treatments. MMR programmes are based on the biopsychosocial model and the goal is usually to improve function, quality of life and facilitate and enable return to work. As pain clinics traditionally offer conventional medical pain treatment, there is limited knowledge about MMR given in this context. The aim of our study was to describe characteristics of patients with chronic pain, treated with a MMR programme at a conventional pain clinic, to evaluate patient-reported outcome measures (PROM) from start to one year after, and to study possibly associated factors for the improvement of health-related quality of life after one year.MethodsA prospective, observational study with a one-year follow-up was performed.SubjectsA total of 42 individuals (38 females, age 44.0 ± 12.3 years and 4 men age 40 ± 8.5 years) with different pain diagnoses were included. After a team assessment, the patients began a programme that lasted about three months. The MMR programme contained coordinated, individually adapted treatments administered individually or in groups, and was based on cognitive behavioural principles. Questionnaires regarding health-related quality of life (HRQoL) (EQ-5D), insomnia (ISI), mental health (HADS), painrelated disability (PDI), kinesiophobia (TSK), current pain intensity (VAS) and sense of coherence (SOC) were used at the start of the MMR and at follow-up. Demographic data were collected from the patient records.ResultsThe PROM at baseline showed substantial pain problems with low HRQoL (EQ-5D index of 0.1 ± 0.282, and EQ VAS of 32.67 ± 20.1), moderate insomnia (ISI 18.95 ± 6.7), doubtful cases of depression and anxiety (HADS-depression 9.35 ± 4.1 and HADS-anxiety 9.78 ± 3.95), presence of pain-related disability (PDI 39.48 ±12.64), kinesiophobia (TSK 40.8 ± 9.8), as well as moderate current pain (VAS 61.31 ± 20.4). The sense of coherence was weak (SOC of 51.37 ± 14). At one-year follow-up, significant (p ≥ 0.05) improvement occurred on the EQ-5D index, EQ VAS, ISI, PDI and TSK. In the logistic regression analysis, no significant associations could be identified.ConclusionsMMR for patients with complex pain problems can be a successful treatment alternative at conventional pain clinics.ImplicationsSince access to rehabilitation clinics in Sweden may be limited, the availability of MMR can increase by providing this type of intervention in pain clinics. Increased knowledge of MMR in different settings can also contribute to increased understanding and collaboration between pain clinics and rehabilitation units.

scholarly journals Impact of cataract surgery in quality of life of patients

2021 ◽  
Vol 9 (2) ◽  
pp. 386
Author(s):  
Surbhi Gupta ◽  
Riya Gupta ◽  
Rajiv K Gupta
Keyword(s):  
Quality Of Life ◽  
Visual Acuity ◽  
Cataract Surgery ◽  
Well Being ◽  
Substantial Improvement ◽  
Department Of Ophthalmology ◽  
Related Quality ◽  
Health Related

Background: Loss of vision invariably leads to loss of quality of life (QOL), which represents the general well-being of individuals and societies. Researchers have tended to indicate that visual acuity (VA) alone is an inadequate measure of visual impairment. Studies on QOL after cataract surgery are scarce in this part of India and there our present study holds potential to be really useful.Methods: This study was a prospective study consisting of 300 patients aged 50 years and above, who were operated for cataract in the Department of ophthalmology, GMC Jammu from May 2017-February 2018, a period of 10 months. Visual acuity was measured by logMaR method and generic health related quality of life (HRQoL) was measured using EuroQol (EQ-5D).Results: Only 182 turned up for the follow up after six months, mainly belonging to the age group: 60 to 70. 66.48% of the people studied upon belong to the lower strata of the society. Substantial improvement in visual acuity was observed with only 3.84% of patients showing less than 6/60 visual acuity during follow up after 6 months. All domains related to the generic health related QOL showed improvement. There was clear and marked improvement for performance of usual activities by the patients after surgery.Conclusions: In conclusion this study has provided valuable information about the change in vision related quality of life after cataract surgery there is statistically significant improvement in QOL of all patients enrolled in our study after the cataract surgery.

scholarly journals 1153Marital dissolution in later life: Change in health behaviours and outcomes following divorce and widowhood

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Melody Ding ◽  
Jo-Anne Gale ◽  
Adrian Bauman ◽  
Philayrath Phongsavan ◽  
Binh Nguyen
Keyword(s):  
Quality Of Life ◽  
Psychological Health ◽  
Marital Dissolution ◽  
Later Life ◽  
Well Being ◽  
Psychological Outcomes ◽  
Anxiety And Depression ◽  
Health Related

Abstract Background Marital dissolution, such as divorce and widowhood, are common life events with potentially important implications on health. Previous research has found that those who have divorced or widowed tended to have a higher risk of mortality, however, the mechanisms for the observed associations are not well understood. We aimed to examine the association of divorce and widowhood with subsequent changes in health-related lifestyles, psychological outcomes, and overall health and wellbeing within both immediate and longer terms. Methods We used data from the 45 and Up study collected at baseline (T1, 2006-09), first (T2, 2010) and second follow-up (T3, 2012-16). Martial status and health-related outcomes were self-reported at all three time-points using validated questionnaires. Nine outcomes were examined, including lifestyles (smoking, drinking, diet and physical activity), psychological outcomes (distress, anxiety and depression) and overall health/well-being (self-rated health and quality of life). Logistic regression and generalised estimating equations were conducted adjusted for sociodemographic characteristics. Results Of the 33184 participants who were married/co-habiting at T1, after 3.4 years, 2.9% became divorced and 2.4% widowed. Those who divorced had much higher odds of smoking, having poor quality of life, high psychological distress, anxiety and depression at T2. Similar but weaker associations were observed for those who became widowed. After another 5 years of follow-up, however, the associations were much attenuated towards the null. Conclusions We found strong adverse short-term effects of marital dissolution on health outcomes, particularly within the psychological health domain. The effects, however, seemed to attenuate in the longer terms.

scholarly journals Killing two birds with one stone: how intervening when witnessing bullying at the workplace may help both target and the acting observer

2020 ◽  
Author(s):  
Morten Birkeland Nielsen ◽  
Michael Rosander ◽  
Stefan Blomberg ◽  
Ståle Valvatne Einarsen
Keyword(s):  
Mental Health ◽  
Mental Health Problems ◽  
Time Lag ◽  
Well Being ◽  
Health Problems ◽  
Social Situations ◽  
Health Related ◽  
The Relationship ◽  
Health And Well Being

Abstract Objective This study examines under which conditions being an observer of bullying can be detrimental to health and well-being. It was hypothesized that health-related problems following observations of bullying are determined by (1) whether the observer has been exposed to bullying her/himself and (2) whether the observer have tried to intervene in the bullying situation that they witnessed. Methods The study was based on a longitudinal probability survey of the Swedish workforce, with an 18-month time lag between assessment points (N = 1096). Results Witnessing bullying at work were associated with an increase in subsequent levels of mental distress among the observers, although this association became insignificant when adjusting for the observers’ own exposure to bullying. Intervening against bullying moderated the relationship between observations of bullying and mental health problems. Observers who did not try to intervene reported a significant increase in mental health problems at follow-up, whereas there were no significant changes in levels of mental health problems among those who did intervene. Conclusions the findings suggest that observer interventions against bullying may be highly beneficial for both the targets and observers of bullying. Organizations should therefore invest in ways to increase constructive bystander behavior in negative social situations at the workplace.

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