Thesis (M Nursing)--Montana State University--Bozeman, 2008. / Typescript. Chairperson, Graduate Committee: Elizabeth G. Nichols. Includes bibliographical references (leaves 36-38).

No description available.

Typescript (photocopy) Includes bibliographical references (leaves: 260-304)

The purpose of this study is to evaluate the association between sustained-release morphine (Avinza®), and performance on neuropsychological tests assessing short term memory, information processing, and motor skills in chronic pain patients, while controlling for stages of pain model variables and the effects of benzodiazepines. A convenience sampling procedure was utilized to enroll a sample of patients who had a trial of short-acting narcotic analgesics for their chronic non-malignant pain. Enrolled patients were treated with long-acting morphine Avinza.® Patient interviews were conducted at enrollment and one-month follow-up. A total of 129 patients were enrolled in the study. Mean pain intensity ratings at the highest, lowest, and average levels in the previous week were lower at follow-up (10.90, 4.56. 7.64) than at baseline (12.71, 6.76, 10.01) respectively. Reduction in pain levels was associated with a corresponding reduction in levels of pain unpleasantness, pain suffering, and pain behaviors. The models evaluating the associations between the stages of pain model variables, morphine dose, benzodiazepine dose, and digit span test (chi square = 147.79, p = 0.76), digit symbol test (chi square = 128.06, p = 0.5), and paced auditory serial attention test fit the data well (chi square = 160.39, p = 0.85). There was a statistically significant inverse association between frequency of pain behaviors and digit span test scores at baseline (-0.49, p = 0.01). Although the association between pain behaviors and digit symbol test scores (- 17. 0 %, p = 0.09) and paced auditory serial addition test scores (-4.0%, p = .28) at baseline were not statistically significant, a large negative effect was found. At follow-up, the association between pain behaviors and digit span test was positive and not significant. The negative association between frequency of pain behaviors and digit symbol test scores (-4.4%, p = 0.67 ) and paced auditory serial addition test scores (-2.8%, p = 0.21) at follow-up were considerably weaker. There were no significant association between opioid dose and cognitive function test scores. Opioid therapy, particularly, sustained release morphine therapy (Avinza) does not contribute to cognitive impairment in chronic pain patients. / text

Sleep, emotions and pain are intimately connected, physiologically, by their location and utilization of the same brain centers and neurotransmitters. Sleep disturbances have been clinically observed in chronic pain populations; yet, no treatment program has formally addressed this aspect of patient care. It is hypothesized that a pain population (PN) will differ significantly from a non-injured workforce (WF) when reviewing quantitative and qualitative sleep data. This study strongly supports that sleep disturbances and socioeconomic decrements exist in chronic pain patients. Forty-seven variables were surveyed and 13 were found to show significant differences between the groups and seven were found to discriminate between the PN and WF groups at less than the .0001 level. A discriminant analysis was performed to determine the smallest model which could efficiently classify cases, according to successive root variables. The major discriminators are pain levels, medication, amount of sleep obtained and number of awakenings.

This study assessed the influence of massage therapy on the psychobiology of chronic pain patients. A pre- and posttest design measured the effects of a one-month treatment program Twenty outpatients and twenty inpatients of two chronic pain treatment programs, were administered several psychological and physiological tests before and after the study. Experimental subjects received massage therapy twice a week for one month in addition to their other therapies. Control subjects continued with their regular treatment modalities for one month. Results showed statistically significant differences (p < .05) on 5 of the 17 psychological variables and on the electromyograph levels. Analysis of Holmes-Rahe scores suggested that these differences were not attributable to the artifact effect of differential life stress.

No description available.

The purpose of the present study was to determine the extent of emotional alienation consistent with ecological and chronic pain patients and to assess differences on this dimension between these two patient populations. Ecological group included 100 ecological inpatients, chronic pain group, 30 spinal pain clinic patients. Tests administered were the Sixteen Personality Factor (16 PF) and the Minnesota Multiphasic Personality Inventory (MMPI) including Harris and Lingoes subscales. The ecological group was significantly higher on measures of alienation than the pain group or the standardization population. Results also indicated that the ecological group demonstrated more psychopathology. Emotional alienation appeared to be a consistent stressor in ecological and chronic pain patients. Treatment of these patients should include the reduction of this emotional correlate.

No description available.