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      Terapias no farmacológicas para el dolor crónico no oncológico: percepciones de los pacientes Translated title: Non-drug treatments for chronic non-malignant pain: patients’ perceptions

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          Abstract

          Resumen Fundamento La prevalencia de dolor crónico en España es del 17%. Es conveniente recopilar evidencia científica acerca de las terapias no farmacológicas que sean efectivas para el tratamiento del dolor crónico. El objetivo fue analizar las percepciones sobre las terapias no farmacológicas de los pacientes con dolor crónico no oncológico. Método Estudio mixto, descriptivo y fenomenológico. Se realizó un taller de control del dolor mediante terapias no farmacológicas de cuatro sesiones (una a la semana), de cuatro horas de duración cada una, en el que participaron 19 pacientes. Se analizó la escritura reflexiva sobre las vivencias personales de cada uno de los participantes. Se utilizó el software Atlas Ti 8 para analizar los datos cualitativos. Resultados Dieciséis participantes habían probado alguna terapia alternativa y catorce valoraban sus beneficios. Las expectativas de los participantes se clasificaron en tres grupos de similar tamaño: alivio del dolor físico, manejo del dolor emocional, y herramientas aplicables en su vida cotidiana. Todos los participantes estuvieron satisfechos con el taller. Los beneficios personales percibidos fueron mejor manejo del dolor y del sueño; disminución de la fatiga; reducción del consumo de medicamentos; mejora de la actitud ante la vida, del estado emocional, mayor energía positiva y motivación, y mejor afrontamiento. Conclusiones Los participantes afirmaron que el taller les había ayudado a disminuir el dolor y el consumo de analgésicos, así como otros síntomas asociados a la enfermedad crónica, mejorando por tanto su salud percibida. Además, manifestaron gran satisfacción con la organización y las docentes.

          Translated abstract

          Abstract Background The prevalence of chronic pain in Spain is 17%. There is a need for more scientific data on non-drug treatments that can be effectively used to treat chronic pain. The aim of this study is to analyze how patients with chronic non-malignant pain perceive non-drug approaches. Method Mixed, descriptive and phenomenological study. Nineteen patients enrolled in a workshop on pain management and non-drug treatments that consisted of four sessions (one session a week). Each session lasted four hours. The patients then participated in a reflective writing activity about their personal experiences. Data from this activity was then analyzed. Atlas.ti 8 software was used for the qualitative data analysis. Results Sixteen participants tried an alternative therapy and fourteen assessed its benefits. The participants’ expectations were divided into three groups of similar size: relief from physical pain, emotional pain management and tools for use in daily life. All the participants were satisfied with the workshop. Perceived personal benefits were better pain and sleep management, reduced fatigue, reduced drug consumption; a more positive approach to life, better mood, more positive energy, more motivation and improved capacity to cope. Conclusions The participants commented that the workshop had helped them to reduce pain levels and consume to fewer analgesics, and had reduced other symptoms associated with chronic disease, thus improving their perceived health. They also expressed great satisfaction with the organization and teachers.

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          Nonpharmacologic Therapies for Low Back Pain: A Systematic Review for an American College of Physicians Clinical Practice Guideline

          A 2007 American College of Physicians guideline addressed nonpharmacologic treatment options for low back pain. New evidence is now available.
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            Acceptance- and mindfulness-based interventions for the treatment of chronic pain: a meta-analytic review.

            The number of acceptance- and mindfulness-based interventions for chronic pain, such as acceptance and commitment therapy (ACT), mindfulness-based stress reduction (MBSR), and mindfulness-based cognitive therapy (MBCT), increased in recent years. Therefore an update is warranted of our former systematic review and meta-analysis of studies that reported effects on the mental and physical health of chronic pain patients. Pubmed, EMBASE, PsycInfo and Cochrane were searched for eligible studies. Current meta-analysis only included randomized controlled trials (RCTs). Studies were rated for quality. Mean quality did not improve in recent years. Pooled standardized mean differences using the random-effect model were calculated to represent the average intervention effect and, to perform subgroup analyses. Outcome measures were pain intensity, depression, anxiety, pain interference, disability and quality of life. Included were twenty-five RCTs totaling 1285 patients with chronic pain, in which we compared acceptance- and mindfulness-based interventions to the waitlist, (medical) treatment-as-usual, and education or support control groups. Effect sizes ranged from small (on all outcome measures except anxiety and pain interference) to moderate (on anxiety and pain interference) at post-treatment and from small (on pain intensity and disability) to large (on pain interference) at follow-up. ACT showed significantly higher effects on depression and anxiety than MBSR and MBCT. Studies' quality, attrition rate, type of pain and control group, did not moderate the effects of acceptance- and mindfulness-based interventions. Current acceptance- and mindfulness-based interventions, while not superior to traditional cognitive behavioral treatments, can be good alternatives.
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              Effect of Mindfulness-Based Stress Reduction vs Cognitive Behavioral Therapy or Usual Care on Back Pain and Functional Limitations in Adults With Chronic Low Back Pain: A Randomized Clinical Trial.

              Mindfulness-based stress reduction (MBSR) has not been rigorously evaluated for young and middle-aged adults with chronic low back pain.
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                Author and article information

                Journal
                asisna
                Anales del Sistema Sanitario de Navarra
                Anales Sis San Navarra
                Gobierno de Navarra. Departamento de Salud (Pamplona, Navarra, Spain )
                1137-6627
                April 2021
                : 44
                : 1
                : 61-69
                Affiliations
                [4] Bormujos. Sevilla Andalucía orgnameUniversidad de Sevilla orgdiv1Centro Universitario de Enfermería San Juan de Dios Spain
                [2] Sevilla Andalucía orgnameUniversidad de Sevilla orgdiv1Facultad de Enfermería, Fisioterapia y Podología Spain
                [3] Bormujos. Sevilla orgnameHospital San Juan de Dios del Aljarafe orgdiv1Servicio de Rehabilitación
                [5] Bormujos. Sevilla orgnameHospital San Juan de Dios del Aljarafe orgdiv1Servicio de Anestesiología y Reanimación
                [1] Bormujos. Sevilla orgnameHospital San Juan de Dios del Aljarafe orgdiv1Unidad de Calidad e Investigación
                Article
                S1137-66272021000100006 S1137-6627(21)04400100006
                10.23938/assn.0927
                33853226
                5b0bf25f-8167-4bd8-897c-0e4bac6c0f36

                This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 International License.

                History
                : 24 July 2020
                : 30 October 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 31, Pages: 9
                Product

                SciELO Spain

                Categories
                Artículos Originales

                Complementary therapies,Calidad de vida,Atención plena,Terapias complementarias,Patient reported outcome measures,Chronic pain,Quality of life,Mindfulness,Dolor crónico,Resultados percibidos por el paciente

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