分娩疼痛感知量表的汉化及信效度研究

目的 汉化分娩疼痛感知量表,并对其进行信效度检验.方法 严格遵循Brislin汉化原则,对分娩疼痛感知量表进行翻译、回译和文化调适,形成中文版量表.采用便利抽样法选取440例经阴道自然分娩的初产妇为研究对象,对其产后2h内的疼痛感知进行调查,通过相关分析法和临界比值法进行项目分析,通过召开专家讨论会评定内容效度,采用探...     

The nature of suffering and its relief in the terminally ill: a qualitative study

The essential mandate of medicine is the relief of suffering. However, the quest for an integrated model towards a conceptualization of suffering is still ongoing and empirical studies are few. Qualitative inquiry using 31 in-depth interviews and content analysis was carried out between 1999 and 2001 in 26 patients diagnosed with terminal cancer. The suffering experience was described through a multiplicity of heterogenous elements from the physical, psychological, and social spheres. Systematic synthesis of interview material yielded three apparently irreducible core dimensions. Respondents defined their suffering in terms of 1) being subjected to violence, 2) being deprived and/or overwhelmed, and 3) living in apprehension. Cassell wrote, in 1991, that to know the suffering of others demands an exhaustive understanding of what makes them the individuals they are (1). Our model can be of use in structuring and eliciting this necessary information. Understanding how a particular patient feels harmed, deprived or overburdened, and overtaken by fear, provides a lever for action tailored to the specifics of that person's experience.     

New Migraine and Pain Research

An understanding of the pathophysiology and pharmacology of migraine has been driven by astute clinical observations, elegant experimental medicine studies and importantly by the introduction of highly effective selective anti-migraine agents such as the Triptan 5-HT_1B/1D agonists. New investigational migraine therapies such CGRP antagonists target key components of the trigeminal sensory neuroinflammatory response and show promise for the future. Cutting edge molecular profiling studies looking at gene expression during chronic pain are now being used to reveal the cell biology of pain and new potential therapeutic targets. Translational neuroimaging research can link the laboratory and the clinic and is now being used to help understand the neural systems biology of migraine. Research into migraine has generated sophisticated hypotheses that encompass primary CNS dysfunction, trigeminovascular activation, pain perception and activation of associated neural circuits involved in affective functions providing a rich framework within which to design and test future migraine treatment strategies.     

意识实质的新理解

目的：意识是一个十分重要而复杂的问题，近10年来意识科学和意识心理学取得了许多重要的实质性研究成果。意识本质问题涌现出了一些新学说，意识研究取得了新成就。资料来源：应用计算机检索Psyclnfo1990-01／2004-12与意识实质问题相关的文章，检索词“consciousness”，并限定语言种类为英文，同时检索万方数据库1995-01／2004-12与意识实质问题有关的相关文章，检索词为“意识学说”，限定语言为中文。并手工查阅相关内容的书籍。资料选择：对资料进行初审，选择与意识实质问题相关的文章，排除重复性研究。资料提炼：共收集72篇相关文章，参阅相关书籍8本。与本文密切相关的22篇，选择其中5篇对意识实质进行同顾性综述。资料综合：在意识的研究热潮中，涌现出许多解释人的意识本质的理论假设和模型，包括意识状态说、功能说、突现说和统一场说。基本上代表了对意识实质研究方面所取得的新成就和新水平。意识状态说认为一般说来，把意识设想为大脑警觉现象似乎更为合理、对于意识状态也可以作各种不同的分析，在正常条件下，意识具有4种不同的状态：①可控制的意识状态。②自动化的意识状态．③模糊状态。④睡眠状态。功能说认为意识始终处于一种社会环境之中。突现说强调人的意识、心理活动依赖于复杂的大脑，但不能还原为大脑活动本身。统一场说假设大脑需要有某种“综合空间”一信息交换台可以使神经系统中专门化了的无意识处理器彼此相互作用一这与剧场舞台很相似。结论：当前国际自然科学和心理学出现了一场意识研究的复兴运动，对于人的意识本质的理解和前理论模型的建构出现了不断递进的趋势。     

意识实质的新理解

目的:意识是一个十分重要而复杂的问题,近10年来意识科学和意识心理学取得了许多重要的实质性研究成果。意识本质问题涌现出了一些新学说,意识研究取得了新成就。资料来源:应用计算机检索PsycInfo1990-01/2004-12与意识实质问题相关的文章,检索词“consciousness”,并限定语言种类为英文,同时检索万方数据库1995-01/2004-12与意识实质问题有关的相关文章,检索词为“意识学说”,限定语言为中文。并手工查阅相关内容的书籍。资料选择:对资料进行初审,选择与意识实质问题相关的文章,排除重复性研究。资料提炼:共收集72篇相关文章,参阅相关书籍8本。与本文密切相关的22篇,选择其中5篇对意识实质进行回顾性综述。资料综合:在意识的研究热潮中,涌现出许多解释人的意识本质的理论假设和模型,包括意识状态说、功能说、突现说和统一场说。基本上代表了对意识实质研究方面所取得的新成就和新水平。意识状态说认为一般说来,把意识设想为大脑警觉现象似乎更为合理。对于意识状态也可以作各种不同的分析,在正常条件下,意识具有4种不同的状态:①可控制的意识状态。②自动化的意识状态。③模糊状态。④睡眠状态。功能说认为意识始终处于一种社会环境之中。突现说强调人的意识、心理活动依赖于复杂的大脑,但不能还原为大脑活动本身。统一场说假设大脑需要有某种“综合空间”-信息交换台可以使神经系统中专门化了的无意识处理器彼此相互作用-这与剧场舞台很相似。结论:当前国际自然科学和心理学出现了一场意识研究的复兴运动,对于人的意识本质的理解和前理论模型的建构出现了不断递进的趋势。     

手术病人疼痛认知及其与术后疼痛的相关性

目的描述手术病人术前对手术疼痛认知的状况,探讨术前疼痛认知与术后疼痛程度的关系。方法对符合调查标准的282位手术病人进行了调查,问卷由自制调查表、手术疼痛认知量表和休斯敦疼痛量表3个部分组成。结果病人术前疼痛认知总分的平均评分为37．63,术后疼痛程度达到了中重度,术前疼痛认知与术后疼痛呈负相关（p〈0．05）。结论建议加强对手术病人的术前疼痛教育,促进病人对疼痛的正向认知,降低其术后疼痛程度。     

Towards the Development of New Pain Treatments

The neurobiology of pain and analgesia exhibits plasticity in different pain states. Animal models allow the study of the pathways, neuronal plasticity, and pharmacology that reflect the pains many patients have. Inherited pain disorders may also indicate the pain-related roles of gene products. Mixed pain states are more difficult to model and research in this area is ongoing. Pain remains a subjective experience, and the search for objective measures or biomarkers of pain has so far not yielded definitive results. However, rational, mechanistic explanations for pain states are emerging, and a number of potential treatment targets that have recently been revealed by animal models of clinical pain conditions are beginning to be translated to the patient. This article outlines some of the major recent developments in preclinical and clinical pain science that have the potential to shape the development of new treatments for pain.

This report is adapted from paineurope 2014; Issue 3, ©Haymarket Medical Publications Ltd, and is presented with permission. paineurope is provided as a service to pain management by Mundipharma International, LTD and is distributed free of charge to healthcare professionals in Europe. Archival issues can be accessed via the website: http://www.paineurope.com at which European health professionals can register online to receive copies of the quarterly publication.     

New Legislation on Palliative Care and Pain in Mexico

ABSTRACT.?

International policy initiatives have called for recognition of pain management and palliative care as basic humans rights. This paper describes the rationale for and realization of major changes in Mexican health law to help assure availability of such services to the citizenry of that nation. The necessity for appropriate symptom control and safeguards against inappropriate initiation or cessation of care are defined.     

慢性疼痛患者的生活质量及其与抑郁、疼痛的关系

目的 探讨慢性疼痛患者的生活质量及其与抑郁、疼痛的关系.方法 采用一般调查问卷、简明MiGill疼痛量表、BECK抑郁自评问卷、SF-12生活质量量表对115例健康人和139例慢性疼痛患者进行调查,对结果进行相关分析和多元线性回归分析.结果 慢性疼痛患者的生活质量总分及各维度得分均低于健康人组(p<0.001),其抑郁得分高于健康人组(p<0.001).慢性疼痛患者的生活质量总分及身体健康、心理健康维度的得分与抑郁得分、疼痛得分均呈正相关,抑郁、疼痛强度进入回归方程(F＝46.864,p<0.001),方程可以解释慢性疼痛患者生活质量变化的40.8%.结论 慢性疼痛患者的生活质量较健康人群低.抑郁与疼痛均对患者的生活质量有影响,提示临床护士应采用干预措施,减轻患者的抑郁和疼痛程度,从而提高其生活质量.     

瞬时波强（WI）曲线的方法学研究及其意义

目的重点研究WI的方法学问题，期望对WI的临床推广应用有所帮助。方法查阅文献，结合临床的应用体会，从ET与WI技术的关系、多普勒取样门大小、多普勒流速曲线的奈奎斯特现象、时间分辨力、呼吸、血压、心律不齐、心率等9个因素对WI的影响进行方法学研究。结果上述9种因素对wI均有影响：结论WI有两个主要变量，即动脉管壁的波动和管腔内血流流动，在为临床提供大量有用诊断信息的同时，也出现了一些干扰因素，后者可以通过方法学研究加以控制     

New Pain Management Options for the Surgical Patient on Methadone and Buprenorphine

Perioperative management of patients receiving opioid addiction therapy presents a unique challenge for the anesthesiologist. The goal of pain management in this patient population is to effectively manage postoperative pain, to improve patient satisfaction and outcomes, and to reduce the cost of health care. Multimodal analgesics, including nonsteroid anti-inflammatory drugs, intravenous acetaminophen, gabapentanoid agents, and low-dose ketamine infusions, have been used to improve postoperative pain and to reduce postoperative opioid use. Patients on long-term opioid management therapy with methadone and buprenorphine require special considerations. Recommendations and options for treating postoperative pain in patients on methadone and buprenorphine are outlined below. Other postoperative pain management options include patient-controlled analgesia, intravenous, and transdermal, in addition to neuraxial and regional anesthesia techniques. Special patient populations include the parturient on long-term opioid therapy. Recommendations for use of opioids in these patients during labor and delivery and in the postpartum period are discussed.     

Pain and Aging: The Emergence of a New Subfield of Pain Research

The pain and aging subfield has grown dramatically, including a 6-fold increase in publications over the last 2 decades. This subfield is based on the assumption that pain in older and younger adults differs in clinically and theoretically significant ways. If this were not the case, data from younger groups could be generalized to older persons, and the subfield would not be needed. This article considers the evidence for this assumption. Possible interpretations of the discrepant findings of age-related increases, decreases and stability in pain, including methodological limitations, challenges of gerontological research, and the possibility of nonuniform age-related variation, are discussed. Evidence is presented for several unique characteristics of geriatric pain: difficulty using Visual Analog Scales, increased vulnerability to neuropathic pain, decreased vulnerability to acute pain related to visceral pathology, prolonged recovery from tissue and nerve injury, including prolonged hyperalgesia, and differences in the relationships among psychosocial factors important in adjustment to chronic pain. However, without a theoretical framework, it is difficult to integrate these results in a heuristic manner. Further research is needed to elucidate the characteristics of geriatric pain, to examine the mechanisms for age-related patterns, and to develop and test the efficacy of age-tailored interventions.PerspectiveThis article reviews the emerging subfield of pain and aging, discusses the interpretation of age-related patterns in pain, and presents several avenues for future research and subfield development. This could contribute to the continued growth of this subfield.