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Adaptive Yoga for a Multidisciplinary Pain Treatment Program
No full textAmple research has demonstrated the impact of yoga on chronic pain, as well as its psychological correlates (e.g., mood, catastrophizing). The current study evaluated the integration of adaptive yoga into a multidisciplinary pain treatment program, utilizing previously gathered qualitative and quantitative data. Results indicate that awareness of the adaptive yoga group (i.e., structure, logistics, referral route, introducing it to patients) and its potential benefits for patients was somewhat limited across providers. Patients reported that yoga led to noticeable physical improvements (e.g., range of motion, flexibility, stamina), while facilitating a wellness-oriented mindset that allowed for relief from the psychological impacts of chronic pain. Preliminary recommendations based on qualitative feedback include increased promotion within the clinic, additional class times to accommodate for a range of patient work schedules, and developing a more clearly delineated referral process. Quantitative data was exploratory in nature, gathered through previously administered pain and health-related measures (i.e., pain catastrophizing, pain acceptance, mood) within the adaptive yoga group (n = 11) and an acceptance and commitment therapy group (n = 14). In sum, the results from the current study reflect yoga’s potential impact on complex medical patients, while illuminating provider perceptions of mind-body practices. This data will be used to inform culturally-relevant recommendations made to the clinic to more effectively integrate and utilize the adaptive yoga group, in conjunction with traditional treatments that are already offered
Effect of Health Messaging on the Delivery of Culturally Appropriate Food Suggestions for Asian Indian Patients With Type 2 Diabetes
No full textCulturally appropriate recommendations for East Indian patients with diabetes are not readily available. This study presents an initial attempt to determine traditional food preferences, diabetes knowledge, attitudes about the standard American diet, and interactions with health care providers regarding their medical condition in East Indian adults (Mean age = 67.5) with type 2 diabetes mellitus (n=55). Respondents were shown a diabetes health message that was either positive in emphasis or culturally sensitive in emphasis. Positive messaging was hypothesized as less relevant than culturally sensitive messaging. URICA change scores, perceived relevance of health messaging, a food frequency assessment, and the Asian Indian Dietary Acculturation Measure were also administered to better understand the sample. Results indicated an overall lower level of acculturation of study participants, and that individuals preferring mostly traditional foods perceived healthcare providers’ dietary recommendations as irrelevant. Furthermore, there was a positive correlation between URICA and DKT2 scores suggesting that individuals who are not ready to change are less likely to be receptive to recommendations, which provides even greater support for the use of culturally tailored recommendations. It is noteworthy that participants reporting good care from their diabetes providers were no more knowledgeable about their diabetes than those who reported inadequate care provision. This may reflect a cultural value for showing respect for and deference to medical providers in combination with a health literacy issue in this sample. Implications for the use of these tools with East Indian patients with type 2 diabetes are discussed as well broad considerations of culturally relevant health messaging for individuals unlikely to be able to implement dietary recommendations that reference the standard American diet
Does Exposure to Nature in a Pain Clinic Waiting Room Influence Patient’s Anxiety, Pain Ratings, or Perception of Their Healthcare Experience?
No full textChronic Pain
More than one hundred million Americans suffer from chronic pain – pain characterized as lasting over 6 months (Boyles, 2011). It is estimated by the Institute of Medicine that the cost of chronic pain across the categories of productivity loss and medical treatment is around 600 billion dollars every year (Steglitz, Buscemi, & Ferguson, 2012). Although our understanding of pain and how it should be treated by specialists is still developing, there has been a shift towards treating pain in a more holistic and interdisciplinary manner (Boyles, 2011). For example, other alternative treatments for chronic pain that are commonly explored are acupuncture, massage, herbal supplements, exercise, chiropractic manipulation, supplements and vitamins, therapy, stress-reduction techniques, yoga, hypnosis, biofeedback, and music therapy among others (Volkow & McLellan, 2016). Analgesics, otherwise known throughout the literature as painkillers, do not treat pain effectively by themselves, and more comprehensive treatments have begun to include pain management, coping strategies, and preventative measures (Narita et al., 2006). One experience that patients with pain often experience is comorbid anxiety. Managing stress and anxiety levels in patients with chronic pain can bolster a patient’s ability to function in their day to day lives.
Pain is a complex phenomenon that most everyone experiences, humans and animals alike. Pain is an attention-demanding sensory process (Rochais, Fureix, Lesimple, & Hausberger, 2016). When we are in pain, our attention gravitates towards the pain, the cause of pain, and what to do to reduce or expel the pain. Pain pulls us inwards, away from our external environment and can make it challenging to nearly impossible to maintain awareness of any other type of information. The increased focus on pain can result in catastrophizing and in higher levels of anxiety and depression, thus deteriorating one’s quality of life (Asmundson & Norton, 1995). In a study of patients suffering from chronic pain by Kremer et al. (2013), catastrophizing pain was associated with pain intensity, distress, and functional disability. The experience of stress can influence pain through the activation of the sympathetic nervous system, which in turn can exacerbate underlying pain, eventually forming a repetitive cycle. Patients with chronic pain have been linked with increased significant psychiatric morbidities, specifically to mood and anxiety disorders (Knaster, Karlsson, Estlander, & Kalso, 2012), and an increasing body of literature has demonstrated the strong relationship between stress, anxiety, and pain.
The complexities within the population of those individuals experiencing chronic pain pose a challenge for researchers who aim to discover methods for clinicians to use in their efforts to provide therapeutic relief. Researchers should be mindful of the possibility of participant overstimulation, as many may not be able to tolerate it well. For instance, fast tempo music provided in a waiting room may serve well for the general population, however, this may be for an individual with chronic pain. Similar to the variation in pain sensitivity, Asmundson and Norton (1995) differentiate varying levels of anxiety sensitivity and how this influences perception and management of pain. They found that those with high anxiety sensitivity were more negatively impacted by their experience with pain, exhibited more cognitive disruption, experienced more anxiety in response to pain, had greater fears of their pain, and reported an increased negative affect than did the average and low sensitivity to anxiety groups. Additionally, the high anxiety sensitivity patients reported significantly greater use of analgesic medications to manage their pain. These findings suggest that the chronic pain population may have a lower threshold for feeling overstimulated as compared to the general population; this may result in significantly more negative experiences of both pain and affect. Advancing our understanding of factors that exacerbate or relieve the experience of chronic pain can strengthen our ability to provide appropriate treatment modalities, including preventative care (Asmundson & Norton, 1995). It has been suggested that detection and management of anxiety within pain treatment settings should be mandatory in an effort to provide comprehensive care (McWilliams, Cox, & Enns, 2003). Given the diverse presentation and experience of anxiety, as well as the role it plays in avoidance behaviors, appropriate assessment strategies are required.
Anxiety
Patients often have stressful experiences in hospitals or doctor’s offices (Wilson-Barnett, 1979; Gordon, Sheppard, & Anaf, 2010). This stress is often a result of the patient’s reason for the visit, which may be diagnostic or procedural in nature, depending on whether they feel ill or have an injury. The anxiety a patient might experience, specifically within healthcare settings, can be categorized as short-term state anxiety (unlike longer-term trait anxiety), and is caused by the arousal of the autonomic nervous system (Shuldham, Cunningham, Hiscock, & Luscombe, 1995). Patients can experience fear, uncertainty, and anxiety that can complicate their health and recovery (Beukeboom, Langeveld, & Tanja-Dijkstra, 2012). In addition, patient’s anxieties can have adverse impacts on their cognitive ability, can cause mental and physical discomfort, and can trigger avoidance (Vaughn, Wichowski, & Bosworth, 2007). More importantly, this anxiety has been shown to further complicate the symptoms a patient is already experiencing and has been associated with increased blood pressure, heart rate, and respiratory rate (Haun, Mainous, & Looney, 2001). Possible explanations of patient anxiety experienced prior to reaching the waiting room or while waiting to be seen may include: (a) thoughts about the unfamiliar environment, (b) loss of independence and sense of control, (c) separation from friends and family, (d) lack of information, financial stress, (e) problems with pain and medications, (f) or threat of severe illness or death (Arneill & Devlin, 2002).
Though the most commonly reported psychiatric disorder in chronic pain is depression (Surah, Baranidharan, & Morley, 2014), there is a paucity of research between the relationship of anxiety and chronic pain, warranting further investigation within this arena. When pain is invasive, persistent, and intertwined with stress and anxiety, quality of life and self-efficacy can suffer the effects of pain permeate into the patient’s overall physical health, psychological wellbeing, social relationships, and personal expectations and goals. Pain can also complicate their ability to carry out daily tasks and routines, and can be economically burdensome (Carlson, 2014). It is common among those who suffer from chronic pain conditions to avoid pain-related activities that may induce or exacerbate pain and anxiety associated with their pain (Yamaguchi, Nicholson Perry, & Hines, 2014). This avoidance can lead to a diminished sense of control, increase beliefs that certain activities will cause pain, and result in additional anxiety-related pain. According to the fear-avoidance model of pain, anxiety towards pain and avoidant behaviors are major contributors to the chronic pain experience (Engel, Schwartz, Jensen, & Johnson, 2000; Vlaeyen, & Linton, 2000). The perception of pain seems to play a critical role in reinforcing avoidant behaviors, leading to inactivity, social withdrawal, and the exacerbation of chronic pain.
Waiting Rooms and Anxiety
The physical attributes of waiting rooms may also contribute to stress, as it has been shown to increase patient anxiety (Yu, Chojniak, Borba, Girão, & Lourenço, 2010). The period spent within the waiting room provides patients with ample time to ruminate about a multitude of concerns and worst-case scenarios (Beukeboomet et al., 2012). For those who are faced with medical conditions and additional life stressors, the effects of waiting can be exacerbated. Positive distractions within the waiting environment may have the ability to shift a patient’s focus away from their own status and towards something else, thus improving their affective state (Nanda et al., 2012). The waiting room is the first impression of a healthcare facility that patients receive. It is common for this first impression to be generalized to the way in which the patient perceives the doctors, nurses, and staff (Arneill & Devlin, 2002). If the environment communicates that it was designed with the patient in mind, it is more likely that the patient will have a positive experience with the healthcare process and will maintain an overall increased satisfaction level with their healthcare experience (Arneill & Devlin, 2002; Bournes & Mitchell, 2002).
The time spent in the waiting room is a robust determinant of overall patient satisfaction (Pruyn & Smidts, 1998). The way in which patients perceive situations plays a large role in this. One study found that the physical attractiveness of a waiting room not only decreased patient’s anxiety levels, but also influenced their perception of quality of care to a greater degree than the actual waiting time (Becker & Douglass, 2008). Zakay (1989) also found that elements within the waiting room environment affected the patient’s internal clock by diverting their attention away from the passage of time. The implication of how the wait time corresponds to patient’s overall satisfaction should be considered in healthcare facilities where patients are spending a bulk of their time within the waiting room, which is often more time than they spend with their provider.
Current research suggests that anxiety should be targeted in chronic pain treatment settings; therefore, incorporating nature elements within a chronic pain waiting room may generate positive influences on the overall healthcare experience, in addition to the patient’s perception and experience of their pain. Targeting the treatment of anxiety within the waiting room can be considered part of the comprehensive care of chronic pain. Baldwin (2012) highlights the importance of such research investigating the effects of creating a comfortable and relaxing experience for patients within hospital settings, since such investigations promote cost-effective strategies that can be implemented across a variety of healthcare settings, from large hospitals to smaller clinics. Beukeboom et al. (2012) state that aesthetic enhancements in these settings can provide unobtrusive and inexpensive stress and anxiety management methods for patients and staff alike. It is possible that elements of nature within the waiting room could result in decreased levels of anxiety and may aid patients in mediating their pain experience
Effects of caffeine intake on visual performance of the eye among normal healthy adults
Get PDFPurpose: The purpose of this study is to examine the effects of caffeine on visual performance of the eye among normal healthy adults.
Methods: This two-visit randomized placebo-controlled crossover study included 49 normal healthy adults aged 18 years and above who received either 200mg of caffeine or placebo capsules. Choroidal thickness, tear break-up time, accommodative power, pupil size and reading performance were assessed at baseline, 1 hour and 2 hours.
Results:Consumption of caffeine showed an increased effect on reading rate (p\u3c0.05), average span of recognition and tear break up time (p=0.05) at 1 hour. There was no significant difference seen between the caffeine and placebo group in choroidal thickness (p=0.547), pupil size (p=0.137) and accommodative power (p=0.860). All the aforementioned metrics were not significant at 2 hours. Average span of recognition has a good correlation (r=0.855, p\u3c0.01) with reading rate that was significant at 1 hour among the caffeine group.
Conclusion: Caffeine consumption has some effect on visual performance of the eye by increasing reading rate and tear film quality. This transient effect peaks at the 1 hour mark and can potentially help an individual have better quality of vision to improve their visual performance for near tasks
Interprofessionalism Across Healthcare Services
No full textPresenter will discuss her experiences with interprofessional development in healthcare
Transdisciplinary Services in Early Childhood: Yes, It Can Be Done, and Yes, There’s Evidence Behind It
No full textAshleigh Walters, PT, DPT will cover the ways in which she encounters interprofessionalism throughout her career as a Physical Therapist
A Socio-Technological Design for an Interprofessional Community of Inquiry in Education & Leadership
No full textThis poster introduces a socio-technological design for an interprofessional Community of Inquiry (COI) in Education and Leadership. We present an overview of the technological infrastructure used to support the newly launched PhD in Education & Leadership program as well as some of the lines of research that have been initiated as a result of this collaborative partnership between the College of Education and the College of Health Professions at Pacific University
Delivering Healthcare Educationo to Rural and Underserved Areas
No full textThe prevalence of chronic disease in the US population is increasing. Projections indicate that half the US population will live with at least one chronic disease by the year 2030. Statistics indicate that chronic illnesses account for 70% of all deaths. Developing healthy self-management behaviors can lower the risk of developing chronic disease and also minimize the magnitude of subsequent morbidity and disability. Individuals need access to reliable information in order to learn successful self-management skills. Delivering healthcare information in rural areas is difficult. Geography, distance, inclement weather and/or the lack of financial resources are barriers that can prevent individuals from accessing health care and health education. Likewise, rural health clinics often lack the financial resources to provide the most current patient education materials
History of the PhDEL Program
No full textPresenters will introduce the history of the PhD in Education and Leadership Program