RESUMO
Background: Stroke is prevalent in Iran, and its complications can decline patients' quality of life and psychological state. Objectives: This study aimed to investigate the relationship between pain following stroke (PFS) and disability in stroke patients. Methods: The current case-control study was conducted on 184 stroke patients (92 cases and 92 controls). Data collection tools included a demographic questionnaire, the Visual Analog Scale (VAS), and the Disabilities of the Arm Shoulder and Hand (DASH) questionnaire. Based on the medical files of all patients with stroke, eligible ones were invited to participate in the study via phone calls. The collected data were then analyzed. Results: The disability rate was higher in the case group of patients with a history of hemorrhagic stroke, smoking, stroke, and diabetes (P < 0.05). The mean ± SD age was 72.45 (11.54). Also, the level of disability in patients increased with age (P = 0.000). The mean ± SD disability score was 78.63 (6.92) in patients with PFS and 54.9 (10.87) in patients without PFS. Also, R = 0.795 and R2= 0.631 indicated the significance of disability severity in patients with PFS. Conclusions: The prevalence of disability was higher in patients with higher PFS levels. Hence, drug interventions or rehabilitation programs can be used to reduce the disability of stroke patients.
RESUMO
Context: Hemiplegic shoulder pain (HSP) is one of the complications of a stroke. Objectives: This study aimed to determine shoulder pain prevalence in cerebrovascular accident (CVA) patients. Methods: This meta-analysis study searched English and Persian descriptive or descriptive-analytical full-text studies on CVA patients. The search was carried out in all databases by two researchers using keywords such as stroke, pain, CVA, hemiplegic, and shoulder pain. Data analysis was done with the software CMA3. Results: In the initial search, 109 articles were found, and finally, the data from four articles were analyzed. The prevalence of HSP was 23% (confidence interval (CI) = 10.3% - 43.5%). Conclusions: Considering the HSP prevalence (28.1%) among CVA patients, it is necessary to carry out rehabilitation interventions to prevent such pain in these patients. It is also suggested that rehabilitation interventions be included in the patient education of the healthcare system.
RESUMO
BACKGROUND: Pain in trauma has a role similar to the double-edged sword. On the one hand, pain is a good indicator to determine the severity and type of injury. On the other hand, pain can induce sever complications and it may lead to further deterioration of the patient. Therefore, knowing how to manage pain in trauma patients is an important part of systemic approach in trauma. The aim of this manuscript is to provide information about pain management in trauma in the Emergency Room settings. METHODS: In this review we searched among electronic and manual documents covering a 15-yr period between 2000 and 2016. Our electronic search included Pub Med, Google scholar, Web of Science, and Cochrane databases. We looked for articles in English and in peer-reviewed journals using the following keywords: acute pain management, trauma, emergency room and injury. RESULTS: More than 3200 documents were identified. After screening based on the study inclusion criteria, 560 studies that had direct linkage to the study aim were considered for evaluation based World Health Organization (WHO) pain ladder chart. CONCLUSIONS: To provide adequate pain management in trauma patients require: adequate assessment of age-specific pharmacologic pain management; identification of adequate analgesic to relieve moderate to severe pain; cognizance of serious adverse effects of pain medications and weighting medications against their benefits, and regularly reassessing patients and reevaluating their pain management regimen. Patient-centered trauma care will also require having knowledge of barriers to pain management and discussing them with the patient and his/her family to identify solutions.
