Biomedical subjects

Helen Poole

Publications and source records attributed to Helen Poole.

5 recordsLinked to original sources

PubMed2006

Psychological approaches to chronic pain management: part 1.

AIMS AND OBJECTIVES: The aim of this paper is to provide an overview of the theoretical basis and application of psychological interventions used in the management of chronic pain. In doing this, psychological factors mediating pain and disability will also be reviewed. BACKGROUND: A biopsychosocial model of chronic pain is widely purported and pain management is often based upon cognitive-behavioural principles as psychological factors meditating pain and disability have been found to include emotional, cognitive and behavioural components. CONCLUSIONS: This paper provides support for a biopsychosocial model of and for the effectiveness and efficacy of psychological interventions for the management of chronic pain conditions. RELEVANCE TO CLINICAL PRACTICE: The application of psychological approaches to chronic pain management is reviewed and discussed. The way in which psychological approaches may be integrated specifically into nursing management of chronic pain is discussed in a later paper.

Adaptation, Psychological↗

PubMed2006

Psychological approaches for the nursing management of chronic pain: part 2.

AIMS AND OBJECTIVES: The aim of this article was to present the ways that nurses can integrate psychological approaches into their management of chronic pain conditions using a biopsychosocial framework. Communication, the importance of the patient-practitioner interaction, the role of education and provision of information, reassurance and reduction of anxiety and the use of coping strategies training in the management of chronic pain are reviewed alongside the key skills of nursing. BACKGROUND: This is the second part of a two-part article. Part 1 was a discussion of psychosocial factors associated with chronic pain conditions and the psychological approaches used in the management of these conditions. CONCLUSIONS: It is identified that key nursing skills often equate to the requirements of the psychological approaches, therefore specific techniques from a cognitive-behavioural framework can be readily applied, integrated and used by nurses in the management of chronic pain conditions. RELEVANCE TO CLINICAL PRACTICE: Commonly utilized nursing skills are similar to those required for cognitive-behavioural therapy. It is reasonable to assume therefore that nurses can and should be involved in effectively managing the psychological aspects associated with chronic pain conditions.

Activities of Daily Living↗

PubMed2006

Women's views of being screened for postnatal depression.

Routine use of the Edinburgh Postnatal Depression Scale (EPDS) as part of the assessment process for postnatal depression (PND) has been widely implemented in England. However, the views of the women being assessed are only now becoming known. The paper reports on a study aimed at exploring women's views of being screened for PND. Interviews were undertaken with 15 recent mothers who had been screened for PND. Participants included those with both high and low scores on the EPDS. Although mothers were generally positive about screening there were a number of issues which caused some concern. These related to the process of screening, the instrument itself and the lack of information provided to the women. A major concern related to being identified as having PND and the consequences. A number of simple measures were identified around the provision of information which, if implemented in current practice, could improve the acceptability of screening for PND. We believe that, by ensuring these simple provisos are met, screening for PND using the EPDS could be seen as beneficial to a large proportion of women and acceptable even to those who are not troubled by symptoms.

Adult↗

PubMed2004

Using a reflective diary to develop bracketing skills during a phenomenological investigation.

In this article, I have attempted to show how a reflective diary can be an effective tool for developing bracketing skills. A framework is necessary to guide reflective thought and encourage deep and critical thinking. My framework was influenced by the work of Schön (1987) and Johns (1984), and related to the concepts of reflecting 'on' and 'in' action, and identified specific learning that had taken place. Bracketing is an important part of the Husserlian approach to descriptive phenomenology. It is a continuous process that can be used in a number of ways. Within my study I used bracketing 'pre', 'in', and 'on' actions. In addition to using bracketing to facilitate the clear emergence of the phenomenon under investigation, it can also be used to help review the methodology of a study. Examples have been given within the article to highlight different situations where bracketing took place.

Attitude of Health Personnel↗

PubMedDate not supplied

Factor Structure of the Beck Depression Inventory-II in patients With chronic pain.

OBJECTIVES: To examine the factor structure of the Beck Depression Inventory version II (BDI-II) in patients seeking treatment for chronic pain, using exploratory and confirmatory factor analysis and provide comparative data for use with similar patient populations. In addition, to consider the utility of using BDI-II subscale scores to further inform the management of patients with chronic pain. METHODS: Phase I involved analysis of responses to the BDI-II by 1227 patients assessed for a pain management program. The sample data was split into 2 halves. A series of exploratory factor analyses on the first half suggested 2 factors. Confirmatory factor analysis was then used on the second half to confirm goodness-of-fit for this 2-factor solution and compare with a 1-factor solution and factor models presented in the BDI-II handbook derived on student and psychiatric outpatient populations. Comparison was also made of derived factor scores between this pain clinic sample and the normative psychiatric outpatient and student samples. In the second phase, longitudinal data on a further 269 patients who had completed the pain management program was used to examine the amount of variance in pain and disability outcomes accounted for by total BDI-II and 2-factor subscale scores at assessment. RESULTS: Two correlated factors incorporating 18 items from the BDI-II gave good goodness-of-fit (0.916). Factor 1 loaded heavily onto negative cognitions about the self plus mood symptoms, factor 2 onto changes in behavior and activity plus low mood. Summed scores on factor 1 from pain clinic patients were very significantly lower than for psychiatric outpatients, indicating less negative cognitions about the self, and very significantly higher than for a student sample. Pain clinic patient scores on factor 2 were very significantly higher than those for both psychiatric outpatients and students, indicating more reporting of behavior change and affective symptoms. Subscale scores accounted for a small but significant amount of variance in both pain and disability at follow-up, with each scale predicting in opposite directions. Total BDI-II scores predicted similar amounts of variance in disability at follow-up, but were not significantly associated with pain at follow-up. DISCUSSION: Results are consistent with studies using previous versions of the BDI in suggesting that 2-factor scores may be more clinically useful in the assessment of patients referred with chronic pain.

Comorbidity↗