Investigating The Effect of Psychological Variables On Postoperative Pain In Children

Background and Purpose: Despite the progress of pain management in children, the prevalence of postoperative pain remains a caring challenge. Given the multidimensional nature of pain and the effect of various factors on pain, the need to identify risk factors in preventing postoperative pain is felt. The purpose of this study was therefore to investigate the effect of psychological variables on postoperative pain in childrenMethods: This study was conducted following a descriptive-correlational study design. The samples of the study were 171 children aged 6-13 years who were conveniently selected from the selected children's hospital in Tehran according to the inclusion criteria. Data were collected using the “demographic questionnaire”, “Child Pain Anxiety Symptoms Scale (CPASS)”, the Spielberger’s State-Trait Anxiety Inventory (STAI), and “Coping Strategies Questionnaire (CSQ)” and analyzed using SPSS21 software.Results: Most of the 171 children participated were boys (65.5%) with a mean age of 9.58 years. The most common type of surgery was abdominal (53.2%), with an average surgery duration of 134.29 minutes. The results of regression analysis showed that postoperative pain was positively affected by child and parent anxiety and negatively affected by coping strategies. The postoperative pain increased 0.31 and 0.30 per unit increase in child and parent anxiety, respectively, and decreased 0.14 per unit increase in coping strategies.Conclusion: Based on the confirmation of the relationship between child and parent psychological variables on postoperative pain, identifying children at risk and presenting psychological interventions can be an effective step for managing postoperative pain and improving child and family comfort.

Chronic pain management a fundamental human right: adaptation and examination of psychometric properties of pain anxiety symptoms scale among osteoporosis sample from Pakistan

Purpose Chronic pain is a global community health and human rights issue. Proper health care is an important necessity for every human being and access for treatment is every human’s right. Likewise, it is significant that proper instruments should be administered to assess these clinical issues. It is equally necessary to reassess these tools accordingly to diverse cultures, especially subjective tools to check their validity and cultural specification. The purpose of this study is to adapt and examine the factorial structure of 20 items and three-factor structure, pain anxiety symptoms scale (McCracken and Dhingra, 2002). As literature evidence suggested of a three-factor structure (Cho, 2010). Design/methodology/approach Primarily, the scale was translated into Urdu language using the forward-backward method. Afterward, a reliability assessment and a confirmatory factor analysis (CFA) for construct validity, on an osteoporosis patients’ sample (N = 250) was performed. Subsequently, an Obliman method exploratory factor analysis (EFA) was conducted on an osteoporosis sample (N = 500) for factor structuring followed by validity and reliability analysis. Findings The initial findings demonstrated a high internal consistency of the translated version of the scale (α = 0.85) and an acceptable test-retest reliability (r = 0.69). CFA displayed a high inter-correlation between scale and its subscales. However, CFA suggested a three-factor model. Consequently, EFA proposed a three-factor, 19 item scale, namely, behavioral; cognitive; and physical subscale, which demonstrated high alpha reliability (α.= 0.86). Other results indicated the scale to have a significant predictive and convergent validity for depression and positive and negative affect. Originality/value The present study is novel in its approach as the present study not only tried to adapt the original Pain Anxiety Symptom Scale to Pakistani culture but has also checked the factorial structure of the original scale. The results achieved in the process suggested a three-factor structure scale with 19 items in opposition to the original four structured, 20 items scale.

Headache Perception in an Epilepsy Patient with Neuromodulation by Anterior Thalamic Nuclei Deep Brain Stimulation: A Case Report

Objective Headache disorders are frequently associated with epilepsy. Some neuromodulation techniques for refractory epilepsy have been reported to positively influence the associated chronic headache. However, the exact mechanism of action of vagus nerve stimulation (VNS) and anterior thalamic nuclei-deep brain stimulation (ANT-DBS) on pain perception is unclear. Method We report a structured assessment of pain perception in a patient who experienced headache relief after ANT-DBS for refractory focal epilepsy and compare it with pain perception of epilepsy patients with chronic headache who were treated with and without VNS. Results The pain-associated symptoms in the ANT-DBS case were on the Pain Anxiety Symptoms Scale (PASS-40) subscore “physiological anxiety” closer to the control collective, whereas in patients with VNS, this was more likely for the PASS-40 subscores “cognitive anxiety” or “escape and avoidance.” Conclusion ANT-DBS and VNS may influence epilepsy-associated chronic headache in different ways.