scholarly journals Self-Medication for Chronic Pain Using Classic Psychedelics: A Qualitative Investigation to Inform Future Research

2021 ◽  
Vol 12 ◽  
Author(s):  
Julia Bornemann ◽  
James B. Close ◽  
Meg J. Spriggs ◽  
Robin Carhart-Harris ◽  
Leor Roseman
Keyword(s):  
Chronic Pain ◽  
Lived Experience ◽  
Controlled Trial ◽  
Mental Wellbeing ◽  
Future Research ◽  
Health Issues ◽  
Self Medication ◽  
Positive Reframing ◽  
Psychedelic Drugs ◽  
Study Participants

Background: Chronic Pain is among the leading causes of disability worldwide with up to 60% of patients suffering from comorbid depression. Psychedelic-assisted therapy has recently been found effective in treating a host of mental health issues including depression and has historically been found to be useful in treating pain. Reports of self-medication for chronic pain using psychedelic drugs have been widely documented, with anecdotal evidence indicating widespread success in a range of pathologies.Aims: In preparation for an upcoming trial, to better understand how those with lived experience of chronic pain self-medicate with psychedelic drugs, and to establish, in detail, their therapeutic protocols and practices for success.Methods: As part of patient-involvement (PI) for an upcoming trial in this population, 11 individuals who reported self-medicating with psychedelic drugs took part in a 1-h semi-structured discussion, which was then transcribed and thematically analyzed.Results: Across a range of psychedelic substances and doses, reported pain scores improved substantially during and after psychedelic experiences. Two processes, Positive Reframing and Somatic Presence, were reliably identified as playing a role in improvements in mental wellbeing, relationship with pain, and physical (dis)comfort. Inclusion of other strategies such as mindfulness, breathwork, and movement were also widely reported. Due to the data's subjective nature, this paper is vulnerable to bias and makes no claims on causality or generalisability. Together, these results have been used to inform study design for a forthcoming trial.Conclusion: This pre-trial PI work gives us confidence to test psychedelic therapy for chronic pain in a forthcoming controlled trial. The results presented here will be instrumental in improving our ability to meet the needs of future study participants.

Occupational Stress in U.S. Audiologists

2021 ◽  
pp. 1-13
Author(s):  
Diana C. Emanuel
Keyword(s):  
Personality Traits ◽  
Lived Experience ◽  
Occupational Stress ◽  
The United States ◽  
Interview Data ◽  
Future Research ◽  
Work Setting ◽  
Years Of Experience ◽  
Workplace Stressors ◽  
Study Participants

Purpose The goal of this study was to explore interview data related to occupational stress in U.S. audiologists. This study is part of a larger project: The Lived Experience of the Audiologist, which seeks to develop a richer understanding of audiologists' lived experience via interview and survey research. Method Demographic and interview data related to occupational stress were examined from 28 virtual interviews of clinical audiologists in the United States. Qualitative data relative to workplace stressors were subjected to thematic analysis. Stress ratings were examined via descriptive statistics, correlation, and comparison with demographics. Results Self-ratings of average-day and worst-day stress were not related to work setting, years of experience, or U.S. region. Participant descriptions of workplace stressors yielded seven main themes: time, patients, administration, financial, lack of support, colleagues, and work–life balance. Some participants attributed stress response to personality traits. Conclusions Audiologists' quotes illustrate the human impact of stressors in the workplace. The most commonly reported workplace stressors were lack of time, patient-related issues, administration, and financial issues. Time and administration as common causes of stress were consistent with prior studies conducted in other countries; however, patient-related and financial stressors were more prominent stressors for U.S. audiologists. Stress ratings were not related to work setting, location, or years of experience in the current study. Participants often linked their perception of stress to personality traits, a phenomenon that has been explored as a factor in the exploration of occupational stress in other fields, but not in audiology. Future research in stress and burnout should examine personality traits in addition to extensive demographics.

scholarly journals Prevalence of self-medication practices in urban area of Kanchipuram district, Tamil Nadu

2020 ◽  
Vol 7 (3) ◽  
pp. 1089
Author(s):  
A. Abdul Azeez Thoufiq ◽  
Aljin Vijayan
Keyword(s):  
Tamil Nadu ◽  
Age Groups ◽  
P Value ◽  
Health Issues ◽  
Self Medication ◽  
Cross Sectional ◽  
Face To Face ◽  
Medical College ◽  
Important Health ◽  
Study Participants

Background: Self-medication is the selection and use of medicines by individuals to treat self-recognized illnesses or symptoms. Self-medication is one element of self-care. The World Self-medication Industry defines self-medication as the treatment of common health problems with medicines especially designed, labelled and approved for use without medical supervision. It is also defined as the use of drugs to treat self-diagnosed disorders or symptoms, or the intermittent or continued use of a prescribed drug for chronic or recurrent disease or symptoms. This study was carried out to investigate the problem and factors responsible for self medication.Methods: A community based cross sectional descriptive study was conducted in Anakaputhur, an urban field practice area of Sree Balaji Medical College. A pre-tested structured questionnaire was used as a study tool to interview the study participants, conducted by face to face interview.Results: There is an association present between age groups and self-medication were the p value was 0.035. There is an association present between occupation and subjects on self-medication p=0.001. An association present between education and self-medication, per capita income and self-medication and marital status and self-medication with a p=0.000. No statistically significant association was found between other factors like tobacco use and alcohol use with self-medication.Conclusions: Self-medication is an important health issues in India. Health education of the public and regulation of pharmacies may help in limiting the self-medication practices.

scholarly journals Baseline Psychological Inflexibility Moderates the Outcome Pain Interference in a Randomized Controlled Trial on Internet-based Acceptance and Commitment Therapy for Chronic Pain

2018 ◽  
Vol 8 (1) ◽  
pp. 24 ◽  
Author(s):  
Thomas Probst ◽  
Harald Baumeister ◽  
Lance McCracken ◽  
Jiaxi Lin
Keyword(s):  
Chronic Pain ◽  
Randomized Controlled Trial ◽  
Acceptance And Commitment Therapy ◽  
Controlled Trial ◽  
Pain Interference ◽  
Future Research ◽  
Psychological Inflexibility ◽  
Randomized Controlled ◽  
Commitment Therapy ◽  
Acceptance And Commitment

This study re-investigated data of a randomized controlled trial on Internet-based Acceptance and Commitment Therapy for chronic pain (ACTonPain). Baseline psychological inflexibility was examined as a moderator of the outcome pain interference. In the ACTonPain trial, participants with chronic pain were randomized to one of three conditions: guided Internet-based ACT (n = 100), unguided Internet-based ACT (n = 101), and waitlist (n = 101). Moderation analyses were performed with the SPSS macro PROCESS. Pain interference according to the Multidimensional Pain Inventory (MPI) was the primary outcome in this trial, and the potential moderator psychological inflexibility was measured with the Acceptance and Action Questionnaire (AAQ-II). Psychological inflexibility at baseline moderated the outcome between guided Internet-based ACT and waitlist 9-weeks as well as 6-months after randomization. (both p < 0.05). Between unguided Internet-based ACT and waitlist, psychological inflexibility moderated the outcome 6-months after randomization (p < 0.05). Internet-based ACT was superior to waitlist for participants with less psychological inflexibility at baseline, but Internet-based ACT became increasingly comparable to waitlist at higher AAQ-II baseline values. Future research should investigate whether the results can be replicated in more individualized and tailored face-to-face settings.

An Experimental Study of a Peer-Facilitated Violence Prevention Program for Women in Prison

2021 ◽  
pp. 088626052110220
Author(s):  
Nena P. Messina ◽  
Stacy Calhoun
Keyword(s):  
Violence Prevention ◽  
Controlled Trial ◽  
Emotional Dysregulation ◽  
Treatment Programs ◽  
Future Research ◽  
Group Assignment ◽  
Women In Prison ◽  
Women's Prison ◽  
Violence Prevention Program ◽  
Study Participants

The literature has shown a strong correlation between victimization and violence. As the majority of treatment programs for violence and the associated research have been focused on men, it is vital that services are also oriented to the needs of women who perpetrate violence. Beyond Violence ( BV) was developed to fill the gap in violence prevention programming for justice-involved women with histories of violence victimization and perpetration. This randomized controlled trial reports the results of a peer-facilitated model of the BV program implemented in a women’s prison. Women volunteered for the intervention and the study. Participants were randomized to either the 20-session BV condition or to a waitlist control (WC) condition. All 145 participants were asked to complete a preintervention (Time 1) and postintervention (Time 2) survey that included validated measures to assess for depression, anxiety, PTSD, anger/aggression, and emotional dysregulation. Preliminary analyses of the background characteristics and preintervention outcome scores showed no significant differences between the groups at Time 1, indicating that randomization was successful. Separate ANCOVAs were run for 13 outcomes measured using the pretest scores from study participants as the covariate and group assignment as the independent variable. Hypotheses were predominantly supported, and findings showed that the BV participants had significant reductions in the majority of the outcome measures at the postintervention assessment when compared to the WC participants. Future research should continue to explore the advantages of peer-facilitated program models and should incorporate postrelease outcomes to assess change over time.

Speech-Language Pathologists' Comfort Level With Use of Term “Stuttering” During Evaluations

2020 ◽  
Vol 29 (2) ◽  
pp. 841-850 ◽  
Author(s):  
Courtney T. Byrd ◽  
Danielle Werle ◽  
Kenneth O. St. Louis
Keyword(s):  
Communication Disorders ◽  
Academic Experiences ◽  
Comfort Level ◽  
Future Research ◽  
Clinical Experiences ◽  
Speech Language Pathologists ◽  
Comfort Levels ◽  
Parents And Children ◽  
Evaluation Feedback ◽  
Study Participants

Purpose Speech-language pathologists (SLPs) anecdotally report concern that their interactions with a child who stutters, including even the use of the term “stuttering,” might contribute to negative affective, behavioral, and cognitive consequences. This study investigated SLPs' comfort in providing a diagnosis of “stuttering” to children's parents/caregivers, as compared to other commonly diagnosed developmental communication disorders. Method One hundred forty-one school-based SLPs participated in this study. Participants were randomly assigned to one of two vignettes detailing an evaluation feedback session. Then, participants rated their level of comfort disclosing diagnostic terms to parents/caregivers. Participants provided rationale for their ratings and answered various questions regarding academic and clinical experiences to identify factors that may have influenced ratings. Results SLPs were significantly less likely to feel comfortable using the term “stuttering” compared to other communication disorders. Thematic responses revealed increased experience with a specific speech-language population was related to higher comfort levels with using its diagnostic term. Additionally, knowing a person who stutters predicted greater comfort levels as compared to other clinical and academic experiences. Conclusions SLPs were significantly less comfortable relaying the diagnosis “stuttering” to families compared to other speech-language diagnoses. Given the potential deleterious effects of avoidance of this term for both parents and children who stutter, future research should explore whether increased exposure to persons who stutter of all ages systematically improves comfort level with the use of this term.

The impact of patient narratives on medical students’ perceptions of shared decision making: A randomized controlled trial

2020 ◽  
Author(s):  
Martina Bientzle ◽  
Marie Eggeling ◽  
Simone Korger ◽  
Joachim Kimmerle
Keyword(s):  
Decision Making ◽  
Medical Students ◽  
Shared Decision Making ◽  
Medical Training ◽  
Controlled Trial ◽  
Future Research ◽  
Shared Decision ◽  
Randomized Controlled ◽  
Information Text ◽  
The Impact

BACKGROUND: Successful shared decision making (SDM) in clinical practice requires that future clinicians learn to appreciate the value of patient participation as early as in their medical training. Narratives, such as patient testimonials, have been successfully used to support patients’ decision-making process. Previous research suggests that narratives may also be used for increasing clinicians’ empathy and responsiveness in medical consultations. However, so far, no studies have investigated the benefits of narratives for conveying the relevance of SDM to medical students.METHODS: In this randomized controlled experiment, N = 167 medical students were put into a scenario where they prepared for medical consultation with a patient having Parkinson disease. After receiving general information, participants read either a narrative patient testimonial or a fact-based information text. We measured their perceptions of SDM, their control preferences (i.e., their priorities as to who should make the decision), and the time they intended to spend for the consultation.RESULTS: Participants in the narrative patient testimonial condition referred more strongly to the patient as the one who should make decisions than participants who read the information text. Participants who read the patient narrative also considered SDM in situations with more than one treatment option to be more important than participants in the information text condition. There were no group differences regarding their control preferences. Participants who read the patient testimonial indicated that they would schedule more time for the consultation.CONCLUSIONS: These findings show that narratives can potentially be useful for imparting the relevance of SDM and patient-centered values to medical students. We discuss possible causes of this effect and implications for training and future research.

scholarly journals Intrauterine lidocaine and naproxen for analgesia during intrauterine device insertion: randomized controlled trial

2019 ◽  
Vol 4 (1) ◽  
Author(s):  
Shana M. Miles ◽  
Katerina Shvartsman ◽  
Susan Dunlow
Keyword(s):  
Pain Assessment ◽  
Controlled Trial ◽  
Intrauterine Device ◽  
Self Medication ◽  
Double Blind ◽  
Clinical Trial Registration ◽  
Treatment Groups ◽  
Pain Scores ◽  
Post Procedure ◽  
Treatment Medication

Abstract Background This study evaluates oral naproxen and intrauterine instillation of lidocaine for analgesia with intrauterine device (IUD) placement as compared to placebo. Methods This was a randomized, double-blind, placebo-controlled trial. Patients desiring levonorgestrel 52 mg IUD or Copper T380A IUD were randomized into treatment groups. Patients received either oral naproxen 375 mg or placebo approximately 1 h prior to procedure in conjunction with 5 mL of 2% lidocaine or 5 mL of intrauterine saline. The primary outcome was pain with IUD insertion measured on a visual analog scale immediately following the procedure. Prespecified secondary outcomes included physician pain assessment, post procedure analgesia, satisfaction with procedure, satisfaction with IUD, and pain assessment related to IUD type. Results From June 4, 2014 to October 28, 2016 a total of 160 women desiring Copper T380A or levonorgestrel 52 mg intrauterine device insertion and meeting study criteria were enrolled and randomized in the study. Of these, 157 (78 in the Copper T380A arm, 79 in the levonorgestrel 52 mg) received study treatment medication. There were 39 in naproxen/lidocaine arm, 39 in placebo/lidocaine arm, 40 in naproxen/placebo arm, and 39 in placebo/placebo arm. There were no differences in the mean pain scores for IUD placement between treatment groups (naproxen/lidocaine 3.38 ± 2.49; lidocaine only 2.87 ± 2.13; naproxen only 3.09 ± 2.18; placebo 3.62 ± 2.45). There was no difference in self-medication post procedure or in satisfaction with the procedure and IUD among women in the treatment arms or by type of IUD. Conclusion Naproxen with or without intrauterine lidocaine does not reduce pain with IUD placement. Clinical trial registration Clinicaltrials.gov, NCT02769247. Registered May 11, 2016, Retrospectively registered

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