Spirituality Needs in Chronic Pain Patients: A Cross-Sectional Study in a General Hospital in Malaysia.

Evidence-based practices that rely upon pain relieving medications and interventional strategies for symptom alleviation in chronic pain survivors have shown modest benefits. The recent emphasis of spiritual care as a new dimension of treatment strategy incorporated within the biopsychosocial model has inspired new hopes to mediate mental and physical health for illness coping. This study aimed to explore the factors associated with spirituality needs among chronic pain patients in a general hospital in Malaysia. An analytical cross-sectional study was conducted among 117 chronic pain patients in a general hospital in Malaysia. Clinical features and assessments were evaluated by an experienced pain physician and retrieved from patient medical records. An interviewer-administered questionnaire that consisted of items on socio-demographics, the validated 19-items spiritual needs questionnaire and the visual analog scale was utilized. Multivariate linear regression analysis was conducted to identify the factors associated with spiritual needs in chronic pain patients. Patients had higher actively giving score as compared to other spirituality need domains. Central neuropathic pain (ß = 1.691, p = 0.040) predicted existential. Renal problems (ß = 5.061, p = 0.019) highly predicted religiosity; followed by head pain (ß = 3.774, p = 0.036), central neuropathic pain (ß = 2.730, p = 0.022), heart problems (ß = 1.935, p = 0.041), income (ß = 0.001, p = 0.003), living arrangement (ß = - 3.045, p = 0.022), face (ß = - 3.223, p = 0.005) and abdominal (ß = - 4.745, p = 0.0001) pains. Predictors of inner peace include renal problems (ß = 3.752, p = 0.021), shoulder pain (ß = 1.436, p = 0.038) and pain duration (ß = - 0.012, p = 0.027). Predictors of actively giving were renal problems (ß = 3.803, p = 0.001), central neuropathic pain (ß = 1.448, p = 0.017), heart problems (ß = 1.004, p = 0.042), income (ß = 0.001, p = 0.0001), age (ß = - 0.046, p = 0.004) and abdominal pain (ß = - 2.617, p = 0.0001). Chronic pain patients had higher actively giving score compared to other spirituality needs. Their spirituality needs were significantly influenced by pain type, duration and site, co-existing medical conditions and socio-demographics.

Injection speed of spinal anaesthesia for Caesarean delivery in Asian women and the incidence of hypotension: A randomised controlled trial.

STUDY OBJECTIVE: The purpose of this investigation was to determine if a slower speed of spinal anaesthesia injection would reduce the incidence of hypotension. STUDY DESIGN: Randomised controlled trial. SETTING: Tertiary level hospital in Malaysia. PATIENTS: 77 patients undergoing elective Caesarean delivery. INTERVENTION: Differing speeds of spinal injection. MEASUREMENTS: Systolic blood pressure was assessed every minute for the first 10min and incidence of hypotension (reduction in blood pressure of >30% of baseline) was recorded. The use of vasopressor and occurrence of nausea/vomiting were also recorded. MAIN RESULTS: 36 patients in SLOW group and 41 patients in FAST group were recruited into the study. There was no significant difference in blood pressure drop of >30% (p=0.497) between the two groups. There was no difference in the amount of vasopressor used and incidence of nausea/vomiting in both groups. CONCLUSION: In our study population, there was no difference in incidence of hypotension and nausea/vomiting when spinal injection time is prolonged beyond 15s to 60s. TRIAL REGISTRATION: ClinicalTrials.govNCT02275897. Registered on 15 October 2014.