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Biomedical subjects

S H Sanders

Publications and source records attributed to S H Sanders.

At least 19 recordsLinked to original sources
PubMed1992

Chronic low back pain patients around the world: cross-cultural similarities and differences.

OBJECTIVE: The current study sought to determine whether there were any significant cross-cultural differences in medical-physical findings, or in psychosocial, behavioral, vocational, and avocational functioning, for chronic low back pain patients. DESIGN: Partially double-blind controlled comparison of six different culture groups. SETTING: Subjects were selected from primarily ambulatory care facilities specializing in treating chronic pain patients. PATIENTS-SUBJECTS: Subjects consisted of 63 chronic low back pain patients and 63 healthy controls. Low back pain patients were randomly selected from six different culture groups (American, Japanese, Mexican, Colombian, Italian, and New Zealander). Ten to 11 were gathered per culture from a pool of patients treated at various pain treatment programs. Likewise, 10 or 11 control group subjects were obtained from each culture from a pool of healthy support staff. MAIN OUTCOME MEASURES: The Sickness Impact Profile and the Medical Examination and Diagnostic Information Coding System were used as primary outcome measures. RESULTS: Findings showed that (a) low back pain subjects across all cultures had significantly more medical-physical findings and more impairment on psychosocial, behavioral, vocational, and avocational measures than controls did; (b) Mexican and New Zealander low back pain subjects had significantly fewer physical findings than other low back pain groups did; (c) the American, New Zealander, and Italian low back pain patients reported significantly more impairment in psychosocial, recreational, and/or work areas, with the Americans the most dysfunctional; and (d) findings were not a function of working class, age, sex, pain intensity, pain duration, previous surgeries, or differences in medical-physical findings. CONCLUSIONS: It was concluded that there were important cross-cultural differences in chronic low back pain patients' self-perceived level of dysfunction, with the American patients clearly the most dysfunctional. Possible explanations included cross-cultural differences in social expectation; attention; legal-administrative requirements; financial gains; attitudes-expectations about usage, type, and availability of health care; and self-perceived ability and willingness to cope.

Adult↗
PubMed1990

American and Japanese chronic low back pain patients: cross-cultural similarities and differences.

The study compared and contrasted medical, psychological, social and general behavioral functioning of American and Japanese low back pain patients and normal controls. The Sickness Impact Profile and a standardized Medical Examination Protocol for Pain instrument were used to assess all subjects. Findings showed that the American and Japanese low back pain patients had similar and significantly higher medical-physical findings than their respective controls. Likewise, the American and Japanese low back pain patients showed significantly greater psychological, social, and general behavioral dysfunction compared to control subjects. Finally, despite similar medical and physical findings, the Japanese low back pain patients were significantly less impaired in psychological, social, vocational, and avocational functioning than the American low back pain patients. It was concluded that there were significant cross-cultural differences between the American and Japanese low back pain patients, primarily in the psychosocial and behavioral areas. However, given the small sample size, any conclusion should be considered with caution; replication is needed before more definite conclusions are possible.

Adult↗
PubMed1986

The influence on patients' pain intensity ratings of antecedent reinforcement of pain talk or well talk.

This study sought to determine whether positive verbal reinforcement for pain talk or well talk could effectively influence chronic pain patients' subsequent ratings of pain intensity. Four female chronic pain inpatients were each exposed over seven consecutive days to two conditions within an alternating treatments design. Inter-rater reliability analysis from the audiotapes on occurrences of pain and well talk, verbal reinforcement and appropriate reinforcement of verbal behavior across conditions resulted in agreement values from 91 to 100%. Findings revealed that subjects' pain intensity ratings were consistently and significantly lower after verbally reinforcing well talk compared with verbally reinforcing pain talk.

Adult↗
PubMed1985

Chronic pain: a multiple-setting comparison of patient characteristics.

Chronic pain patients attending four different pain management programs (N = 160) were compared on multiple variables encompassing demographics, the nature of the pain problem, and treatment history. Programs were selected because they differed on several dimensions (e.g., geographic location, general hospitals vs those serving veterans of Armed Services, university affiliated vs nonaffiliated) believed potentially to interact with treatment outcome. Results indicated differences between hospital programs serving veterans and general hospital programs (serving nonveterans) in terms of patients' age, percentage married, disability compensation, duration of pain symptoms, and treatment history. In addition, findings indicated that covariance among pain variables was dissimilar across the four types of pain programs, making it difficult to generalize from one type of setting to another regarding issues such as choice of optimal treatment.

Adult↗
PubMed1985

Adjunctive antianxiety agents in the management of chronic pain.

We examined the relative clinical efficacy of three commonly used antianxiety medications and a placebo as adjuncts to analgesic treatment of chronic cancer and arthritic pain. Nine patients with chronic pain, including six with malignancy and three with rheumatic diseases, were each exposed to three treatment phases with antianxiety drugs (hydroxyzine, prochlorperazine, and chlordiazepoxide) and one placebo phase in a double-blind, counter-balanced design. Each phase lasted 2 weeks, with analgesic medication given throughout. Pre- and post-phase measures of anxiety, depression, and hostility were taken, together with daily reports by the patients on pain, mood, and medication intake. None of the antianxiety drugs were significantly more effective than the placebo in reducing pain levels, daily medication usage or hostility. Chlordiazepoxide significantly reduced anxiety and depression compared with the placebo, but also produced the most side effects (e.g., drowsiness). The preliminary findings failed to support the efficacy of the three antianxiety medications as analgesic adjuncts.

Adult↗
PubMed1984

The physiological effects of cigarette smoking: implications for psychophysiological research.

The present study was designed to determine the specific physiological effects of two experimental conditions, smoking and mock smoking (puffing on an unlit cigarette), with smokers and nonsmokers. Two groups (smokers versus nonsmokers) with nine subjects each (five females, four males) participated in the present study. Physiological measures included alveolar carbon monoxide (COa) levels, skin resistance, heart rate, and finger temperature across a standard session sequence. The results of the COa assessment indicated increments only in the smoking condition. Multivariate analyses of variance (MANOVA) across skin conductance, heart rate, and hand temperature were initially performed, followed by univariate analyses of variance (ANOVA) for each physiological measure. Post hoc analyses were performed using orthogonal polynomial trend analyses. A number of significant differences were found. Discussion focuses on the need for experimental controls related to cigarette smoking in psychophysiological research in general, and in hand temperature biofeedback training in particular.

Adult↗
PubMed1983

Automated versus self-monitoring of 'up-time' in chronic low-back pain patients: a comparative study.

The study compared up-time data gathered with automated and self-monitoring measurement systems. Six chronic low-back pain inpatients, 6 psychiatric inpatients and 6 hospital staff members were used as subjects. Concurrent recordings of up-time were taken over 4 consecutive days with the two measurement systems. Results showed that: (a) subjects across all 3 groups reported significantly less absolute up-time values from self-monitoring than automated monitoring, (b) non-patient staff subjects exhibited greater absolute up-time levels from both measurement methods than those reported by low-back pain or psychiatric inpatients, (c) low-back pain subjects showed a greater discrepancy between absolute up-time measures from the two measurement systems than differences found for psychiatric or staff subjects, and (d) automated and self-monitoring up-time values were positively correlated within each group of subjects. It was concluded that automated and self-monitoring up-time data were not directly comparable. Expanded development and usage of automated measurement systems was recommended.

Adult↗
PubMed1983

The comparative efficacy of relaxation training and masseter EMG feedback in the treatment of TMJ dysfunction.

The present series of single case studies was designed to evaluate the comparative efficacy of masseter EMG feedback with progressive relaxation training in the treatment of TMJ dysfunction. Study 1 employed a multiple baseline design across the symptoms of jaw pain, jaw tension and shoulder pain in a patient with chronic TMJ problems. The results indicated that relaxation training was the treatment responsible for improvements in subjective ratings of jaw pain and tension, whereas masseter EMG feedback provided little additional benefit. Trapezius EMG feedback was necessary to provide improvements in ratings of shoulder pain. Study 2 consisted of four single case designs in which masseter EMG feedback and relaxation training were compared with four TMJ patients. Results indicated that relaxation produced clear improvements in pain and tension ratings for two patients, a combination of EMG feedback and relaxation training resulted in slight improvements in one patient, and neither treatment procedure was effective for the final patient. The possibility of wide-scale application of relaxation training with TMJ patients and the need for further controlled research of masseter EMG feedback were discussed.

Adult↗
PubMed1982

An instrument to measure nurses' knowledge of behavioral methods with chronic pain patients.

A 32-item multiple-choice questionnaire is described to assess nurses' knowledge of behavioral methods with chronic pain patients. The instrument was designed to assess knowledge across four areas: (a) behavioral principles, terms, and facts about pain patients, (b) application of behavioral methods to decrease negative pain behavior, (c) application of behavioral methods to increase positive well behavior, and (d) when, and with which pain patients to apply behavioral methods. Factor analyses identified two basic factors measured by the instrument. These included general knowledge of behavioral methods with chronic pain patients and the ability to differentially apply these methods in various medical circumstances. Further analysis revealed that the instrument contained adequate internal consistency, reliability and validity.

Behavior Therapy↗
PubMed1981

The effect of electrode placement on frontalis EMG measurement in headache patients.

Comparisons were made between frontalis EMG surface recordings concurrently taken from horizontal, right vertical, and left vertical electrode placement configurations. Six migraine and seven tension headache patients were used as subjects. Results showed that, in general, a positive correlation existed between recordings from the three placements for both migraine and tension subjects as a group. However, marked individual differences were noted. It was concluded that electrode placement can be quite important in measuring changes in frontalis muscle tension for headache patients.

Action Potentials↗
PubMed1980

Analysis of nurses' knowledge of behavioral methods applied to chronic and acute pain patients.

Thirty-seven nurses with no formal training in behavioral methods were assessed on their knowledge of basic behavioral principles and terminology, the application of behavioral methods with chronic and acute pain patients to decrease negative and increase positive behaviors, and when and with which patients such methods should be applied. Results showed that nurses failed to exhibit adequate understanding of behavioral methods except for their application to decrease negative behavior. Findings are discussed in terms of documenting the need for formal training in behavioral methods as part of nurses' academic curriculum and targeting specific areas that should be emphasized as part of such training.

Acute Disease↗
PubMed1979

A trimodal behavioral conceptualization of clinical pain.

A trimodal behavioral conceptualization of pain is outlined in the current article. It proposes that pain should be viewed as an interacting cluster of gross motor, cognitive, and physiological responses. Such a conceptual system is thought to contain the basic properties needed to incorporate current divergent views of pain held by medical and behavior science into a common conceptual framework.

Cognition↗