Pain assessment tools for chronic lower limb wounds: A scoping review

2019 ◽  
pp. 27-35 ◽  
Author(s):  
Nicoletta Frescos

Background Pain in chronic lower limb wounds has been identified as one of the most painful wounds and negatively impacts health-related quality of life and wound healing. In order to optimise pain management, it is necessary to accurately assess wound pain, however there is no identified reliable and valid assessment specifically for wound-related pain in the lower extremities. Objective The objective of this review was to identify how wound-related pain is assessed in people with chronic lower limb wounds. Design A scoping review of the literature was conducted. Methods A search of MEDLINE, EMBASE, CINAHL and PsycINFO was undertaken of eligible studies that reported on assessment tools for pain in chronic lower limb wounds from inception 1946 to current June 2018. Systematic reviews, meta-analyses, randomised controlled trials, observational and qualitative studies were included. Discussion This study investigated the current assessment tools being utilised for pain in chronic lower limb wounds. Conclusion There is no validated pain assessment tool for patients with chronic lower limb wounds.

2017 ◽  
Vol 107 (5) ◽  
pp. 399-412 ◽  
Author(s):  
Antoni Fellas ◽  
Andrea Coda ◽  
Fiona Hawke

Background: Juvenile idiopathic arthritis (JIA), a chronic, autoimmune, inflammatory joint disease, is the most common arthritis affecting children younger than 16 years. Children with JIA commonly experience lower-limb dysfunction and disability. We systematically reviewed the effectiveness of physical and mechanical therapies for lower-limb problems in JIA. Methods: Randomized controlled trials of physical and mechanical interventions for lower-limb problems in children with JIA were included. Primary outcome was pain. Secondary outcomes included disability, functional ability, and health-related quality of life. Several databases were searched for eligible studies. Authors of included studies and researchers in the field were contacted to identify additional studies. Results: Two studies evaluating the effectiveness of customized/custom foot orthoses in treating foot and ankle pain in children with JIA (N = 100) were included. One study also evaluated simple cushioned inserts. Meta-analyses for comparisons between custom/customized foot orthoses and a control intervention after 3 months were not significant for the outcomes of pain (mean difference, –8.97; 95% confidence interval [CI], –18.01 to 0.07), child-rated health-related quality of life (mean difference, 4.38; 95% CI, –3.68 to 12.44), and parent-rated health-related quality of life (mean difference, 1.77; 95% CI, –6.35 to 9.90). Meta-analyses were supported by sensitivity analyses. Conclusions: There is a paucity of research evaluating physical and mechanical therapies for lower-limb problems in JIA. No physical therapy has been evaluated in randomized controlled trials, and mechanical therapy evaluation is limited to foot orthoses and shoe inserts for foot and ankle pain. The existing research is hampered by small sample sizes. Until further research is conducted, the effectiveness of mechanical and physical therapies for lower-limb problems in JIA remains unclear.


2021 ◽  
Vol 7 (1) ◽  
pp. e000920
Author(s):  
Dimitris Challoumas ◽  
Neal L Millar

ObjectiveTo critically appraise the quality of published systematic reviews (SRs) of randomised controlled trials (RCTs) in tendinopathy with regard to handling and reporting of results with special emphasis on strength of evidence assessment.Data sourcesMedline from inception to June 2020.Study eligibilityAll SRs of RCTs assessing the effectiveness of any intervention(s) on any location of tendinopathy.Data extraction and synthesisIncluded SRs were appraised with the use of a 12-item tool devised by the authors arising from the Preferred Reporting Items in Systematic Reviews and Meta-Analyses statement and other relevant guidance. Subgroup analyses were performed based on impact factor (IF) of publishing journals and date of publication.ResultsA total of 57 SRs were included published in 38 journals between 2006 and 2020. The most commonly used risk-of-bias (RoB) assessment tool and strength of evidence assessment tool were the Cochrane Collaboration RoB tool and the Cochrane Collaboration Back Review Group tool, respectively. The mean score on the appraisal tool was 46.5% (range 0%–100%). SRs published in higher IF journals (>4.7) were associated with a higher mean score than those in lower IF journals (mean difference 26.4%±8.8%, p=0.004). The mean score of the 10 most recently published SRs was similar to that of the first 10 published SRs (mean difference 8.3%±13.7%, p=0.54). Only 23 SRs (40%) used the results of their RoB assessment in data synthesis and more than half (n=30; 50%) did not assess the strength of evidence of their results. Only 12 SRs (21%) assessed their strength of evidence appropriately.ConclusionsIn light of the poor presentation of evidence identified by our review, we provide recommendations to increase transparency and reproducibility in future SRs.


2021 ◽  
pp. 205715852110134
Author(s):  
Bente Dale Malones ◽  
Sindre Sylte Kallmyr ◽  
Vera Hage ◽  
Trude Fløystad Eines

Pain assessment tools are often used by patients to report their pain and by health professionals to assess patients’ reported pain. Although valid and reliable assessment of pain is essential for high-quality clinical care, there are still many patients who experience inappropriate pain management. The aim of this scoping review is to examine an overview of how hospitalized patients evaluate and report their pain in collaboration with nurses. Systematic searches were conducted, and ten research articles were included using the PRISMA guidelines for scoping reviews. Content analysis revealed four main themes: 1) the relationship between the patient and nurse is an important factor of how hospitalized patients evaluate and report their post-surgery pain, 2) the patient’s feelings of inconsistency in how pain assessments are administered by nurses, 3) the challenge of hospitalized patients reporting post-surgery pain numerically, and 4) previous experiences and attitudes affect how hospitalized patients report their pain. Pain assessment tools are suitable for nurses to observe and assess pain in patients. Nevertheless, just using pain assessment tools is not sufficient for nurses to obtain a comprehensive clinical picture of each individual patient with pain.


2021 ◽  
Author(s):  
Gabriel Camillo Fezza ◽  
Stephanie Sansone ◽  
Robert Nolan

BACKGROUND Task force statements support the use of cognitive behavioral therapy (CBT) and motivational interviewing (MI) to promote self-care in patients with chronic heart failure (CHF). Digital counseling interventions have the potential to complement conventional programs. However, therapeutic components of digital programs that are associated with improved outcomes are not clearly established. OBJECTIVE Identify therapeutic components of the Canadian e-Platform to Promote Behavioral Self-Management in Chronic Heart Failure (CHF-CePPORT) protocol that were associated with improved health-related quality of life (HRQL). METHODS Ordinal logistic regression was used to identify the therapeutic components of the CHF-CePPORT protocol. The primary outcome was the 12-month Kansas City Cardiomyopathy Questionnaire: Overall Summary (KCCQ-OS) tertile. Logistic regressions determined the association between 12-month KCCQ-OS tertile, using logon hours for key segments of the protocol, modality of content delivery, and clinical themes. RESULTS Patients (n = 117) in this study were enrolled in the e-Counseling arm of the CHF-CePPORT trial. Median age was 60 years (IQR 52-69). Total logon hours in the initial 4-month segment of CHF-CePPORT (Sessions 1-16) was associated with increased 12-month KCCQ-OS tertile (Odds Ratio, OR = 1.31, 95% CI, 1.1-1.5, P = 0.001). Within sessions 1-16, improved KCCQ-OS was associated with logon hours for self-assessment tools/trackers (OR = 1.49, 95% CI, 1.1-2.0, P = 0.007), and videos (OR = 1.57, 95% CI, 1.03-2.4, P = 0.04), but not for CHF information pages. CONCLUSIONS This study highlights the importance of using evidence-based guidelines from CBT and MI as core components of digital counseling, delivered through videos and interactive tools/trackers, to improve HRQL with CHF. CLINICALTRIAL CHF-CePPORT Trial ClinicalTrials.gov NCT01864369


Author(s):  
Joanna Dymecka ◽  
Mariola Bidzan

The aim of this research was to assess the level of adaptation to multiple sclerosis (Sclerosis multiplex; MS) and health-related quality of life (HRQoL) of the study population as well as to determine the relationship between biomedical factors related to the course of multiple sclerosis, adaptation to the disease, and HRQoL. Analysis of medical records, clinical and psychological interviews, the Extended Disability Status Scale (EDSS), Guy’s Neurological Disability Scale (GNDS), the Acceptance of Illness Scale (AIS), and the Multiple Sclerosis Impact Scale 29 (MSIS-29) were collected from 137 patients with MS. It was found that there was a relation between motor impairment, neurological disability, adaptation to illness, and HRQoL; it was also found that there were negative correlations between adaptation to illness and the severity of lower-limb disability, fatigue, mood disorders, other problems related to MS, and upper-limb disability. Of all the symptoms, lower-limb disability, fatigue, and mood disorders had the strongest relation with adaptation. All of the analysed symptoms were found to correlate with HRQoL. Of all the symptoms, HRQoL was most affected by lower- and upper-limb disability, fatigue, other MS problems, and mood disorders.


2018 ◽  
Vol 32 (4) ◽  
pp. 744-756 ◽  
Author(s):  
Marc Sampedro Pilegaard ◽  
Karen la Cour ◽  
Lisa Gregersen Oestergaard ◽  
Anna Thit Johnsen ◽  
Line Lindahl-Jacobsen ◽  
...  

Background: People with advanced cancer face difficulties with their everyday activities at home that may reduce their health-related quality of life. To address these difficulties, we developed the ‘Cancer Home-Life Intervention’. Aim: To evaluate the efficacy of the ‘Cancer Home Life-Intervention’ compared with usual care with regard to patients’ performance of, and participation in, everyday activities, and their health-related quality of life. Design and intervention: A randomised controlled trial ( ClinicalTrials.gov NCT02356627). The ‘Cancer Home-Life Intervention’ is a brief, tailored, occupational therapy–based and adaptive programme for people with advanced cancer targeting the performance of their prioritised everyday activities. Setting/participants: Home-living adults diagnosed with advanced cancer experiencing functional limitations were recruited from two Danish hospitals. They were assessed at baseline, and at 6 and 12 weeks of follow-up. The primary outcome was activities of daily living motor ability. Secondary outcomes were activities of daily living process ability, difficulty performing prioritised everyday activities, participation restrictions and health-related quality of life. Results: A total of 242 participants were randomised either to the intervention group ( n = 121) or the control group ( n = 121). No effect was found on the primary outcome (between-group mean change: −0.04 logits (95% confidence interval: −0.23 to 0.15); p = 0.69). Nor was any effect on the secondary outcomes observed. Conclusion: In most cases, the ‘Cancer Home-Life Intervention’ was delivered through only one home visit and one follow-up telephone contact, which not was effective in maintaining or improving participants’ everyday activities and health-related quality of life. Future research should pay even more attention to intervention development and feasibility testing.


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