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Objectives: Lasting, unexplained and high levels of pain may cause anxiety in patients with chronic fatigue syndrome. The objectives of the current study were to test assumptions of the association between pain and anxiety in patients diagnosed with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and to clarify the role of depression in this relationship. Methods: Data were collected from 664 participants (age 18-65 years) with 133 ME/CFS patients and 201 healthy controls from Norway and 330 CFS patients from Spain. Binary logistic regression model was applied to test relationships between the included variables in the samples. Results: Both pain and depression made significant direct contributions to the level of anxiety. The strongest risk for higher levels of anxiety was the combination of high levels of depression and high levels of pain in the overall sample (OR = 49.70; P Conclusions: It was the combination of high pain levels and high levels of depression that to the greatest extent increased the risk of anxiety in patients with CFS/ME. Whatever diagnostic criterion that is applied, anxiety and depression should be mandatory to assess in the clinical assessments performed for diagnosing the ME/CFS. Approaches addressing anxiety-related pain and treatment of depression should be warranted.

Background Pain problems are a rapidly growing health problem found among both children and adolescent, and about 15–30% have reported chronic pain problems. School nurses in Norway meet adolescents with various ailments, including pain. Yet research on how school nurses perceive the pain experienced by adolescents is limited. The aim of the present study was to explore how school nurses explain and experience the everyday pain of adolescents. Method A qualitative study with an explorative design comprising five focus group interviews. Each group consisted of three to five school nurses. Seventeen female school nurses in five junior high schools in Norway, age range 29–65 years participated. To cover the issues a semi structured interview guide was used. The transcribed text was analysed with qualitative content analysis. Results The experience of school nurses with adolescents’ pain in everyday life is mainly that pain is a social, physical, and psychological phenomenon. School nurses experienced that everyday pain is reflecting: 1) high expectations, 2) difficult relationships and traumatic experiences and 3) an unhealthy lifestyle. School nurses have ambivalent attitudes to medicalisation of pain. Conclusion Despite of a biopsychosocial understanding of pain, the school nurses maintained referral practice of medical examinations, with the results that many adolescents became shuttlecocks in the health system. Although the school nurses´ were sceptical of the tendency towards medicalization in society, it appears that they actually help maintain this tendency.

Bakgrunn: Ulike faktorer hos helsepersonell, pasienten selv eller i rammefaktorene kan forklare mangelfull smertelindring hos kreftpasienter. Hos pasientene kan barrierer for optimal smertebehandling være tilbakeholdenhet med å rapportere smerte og å følge anbefalte smerteregimer. Dette kan forklares med feiloppfatninger, misforståelser eller manglende kunnskap om smerte og smertebehandling. For eksempel redsel for avhengighet, toleranse og bivirkninger eller at smerte er en uunngåelig del av sykdommen. Hensikt: Å beskrive pasientrelaterte barrierer i forhold til smerte og smertebehandling i et utvalg av norske kreftpasienter. Og undersøke om barrierer for smertebehandling påvirker pasientenes smerteintensitet og smertens påvirkning på funksjon. Metode: Studien er en beskrivende tverrsnittsundersøkelse med 217 polikliniske kreftpasienter som har smerter og/eller bruker smertestillende medikamenter hvor barriere mot smerte og smertebehandling undersøkes ved hjelp av barriereskjema (NBQ–II). Hovedresultat: De spørsmål som reflekterer de høyeste barrierene for smertebehandling er spørsmål om avhengighet, toleranse, monitorere symptomer i forhold til egen helsetilstand, nye smerter og redsel for enkelte bivirkninger som døsighet. Konklusjon: Polikliniske kreftpasienter rapporterer en del barrierer for smertebehandling og må kanskje få en mer individualisert informasjon om smerte og smertebehandling for å bedre smertebehandlingen.

Udgivelsesdato: 2008-Jul-15 OBJECTIVES: To investigate self-reported chronic pain and other sequelae in a nationally representative sample of long-term breast cancer survivors (BCS). DESIGN: Age-stratified random sample of 2,000 female BCS 5 years after primary surgery without recurrence drawn from the Danish Breast Cancer Cooperative Group register, which is representative regarding long-term BCS in Denmark. ASSESSMENT: Self-administered questionnaire including questions on sociodemography, chronic pain (6 months), health-related quality of life (HRQOL) and other sequelae related to breast cancer. Associations with treatment were investigated. Report of chronic pain was compared to normative data. RESULTS: The response rate was 79%. Chronic pain prevalence of 42% was significantly higher in BCS compared to general population women (SRR: 1.32; 95% CI: 1.23-1.42). Sequelae related to breast cancer were paraesthesia 47%, chronic pain 29%, arm/shoulder swelling 25%, phantom sensations 19%, and allodynia 15%. Chronic pain related to breast cancer was significantly associated with poorer HRQOL and higher medicine consumption, and, in multiple logistic regression analysis, with age (

Studiens bakgrunn: Pasienter rapporterer smerte som det hyppigst forekommende symptomet etter hjertekirurgi. Studier viser at sykepleiere mangler kunnskaper om smerte og smertelindring. Hensikt med studien: å kartlegge hvilke kunnskaper sykepleiere selv mener de trenger for å hjelpe pasienter til å håndtere smerter etter gjennomgått hjertekirurgi og hvilke oppfatninger sykepleiere har om smerter og smertelindring generelt. Metode: Fokusgruppeintervjuer og spørreskjema ble brukt for å samle inn data fra 21 sykepleiere ved en hjertekirurgisk post i Oslo. Tematisk innholdsanalyse av transkribert tekst fra fokusgruppene, supplert med data fra spørreskjema, identifiserte hvilke områder sykepleiere trengte undervisning i. Hovedresultat: Sentrale undervisningsområder var ulike utfordringer med smertelindring: pasientenes individuelle forskjeller og uenighet med kirurgene om smertebehandlingen. Alder og kultur var også utfordrende. Bruk av smertekartlegging sammen med pasientene var også et aktuelt område for undervisning. Sykepleierne hadde gode kunnskaper om vurdering av smerte og kommunikasjon med pasientene, men de trenger mer kunnskap om medikamenter og virkningsmekanismer. Konklusjon: Funnene vil bli brukt til å utvikle et skreddersydd undervisningsprogram for sykepleiere som jobber med hjertekirurgiske pasienter. Det endelige målet er å gjennomføre en randomisert pasientstudie med preoperativ informasjon, og kunne bedre praksis innen postoperativ smertelindring av hjertekirurgiske pasienter.

Objectives The aims of this study were 2-fold: (1) to investigate the consequences of opioid use in individuals with chronic pain in the Danish population, and (2) to investigate the development of and recovery from chronic pain from 2000 to 2005. Methods Data derived from the Danish Health Interview Survey in 2000, which were linked on the individual level with register-based follow-up data. The survey was based on a county-stratified random sample of 16,684 individuals, out of which 10,434 individuals (62.5%) completed a face-to-face interview and returned a self-administered questionnaire. In addition, a subsample of the sample in 2000 was reinvited to a follow-up survey in 2005. In total, 3649 individuals (61.7%) of this subsample completed the interview and returned the questionnaire at baseline in 2000. At follow-up, 2354 of these participants completed the interview and returned the self-administered questionnaire. Respondents with cancer diagnosis were excluded from all analyses. Respondents with chronic pain were identified as having chronic/long-lasting pain more than 6 months. Results and discussion The annual incidence for the development of and the recovery from chronic pain was 2.7% and 9.4%, respectively. Increasing age up to 64 years, short education, poor self-rated health, high body mass index, and physical strain at work were predictors of chronic pain. The odds of recovery from chronic pain were almost 4 times higher among individuals not using opioids compared with individuals using opioids. In addition, use of strong opioids was associated with poor health-related quality of life. Furthermore, the results indicated that individuals with chronic pain using strong opioids pain had a higher risk of death than individuals without chronic pain (HR: 1.67; 95% CI: 1.03-2.70). However, this study cannot exclude disease severity as the primary cause of increased mortality.

Udgivelsesdato: 2009-Mar The most recent Danish health survey of 2005 is based on a region-stratified random sample of 10.916 individuals. Data were collected via personal interviews and self-administrated questionnaires. Respondents suffering from chronic pain were identified through the question 'Do you have chronic/long-lasting pain lasting 6 months or more?' The prevalence of chronic pain among individuals with a present or earlier cancer diagnosis was also assessed. In all, 7275 individuals (66.6%) completed a personal interview and 5552 individuals (50.9% of the original sample) completed and returned the self-administrated questionnaire. The same questions were included in the survey in 2000 and, hence, it was possible to evaluate the trends in the past five years. In all, 20.2% of the adult Danish population has chronic pain. From year 2000-2005 the prevalence of chronic pain has remained stable. Generally, chronic pain was associated with female gender and increasing age. Higher prevalence of chronic pain were associated with being divorced, separated or widowed, having less than 10 years of education and high BMI. Musculoskeletal diseases (66.8%) were the most common cause for chronic pain and most persons with chronic pain rated their health and quality of life as poor. Persons with earlier or present cancer diagnosis were more likely to report chronic pain. A substantial part of persons with chronic pain were not satisfied with the examinations and treatments offered. In conclusion, over a five-year period the prevalence of chronic pain in Denmark has remained stable, but high.

Udgivelsesdato: July The primary aim of this epidemiological study was to investigate associations between chronic non-cancer pain with or without opioid treatment and the alcohol and smoking behavior. The secondary aims were to investigate self-reported quality of life, sleeping problems, oral health and the use of different health care providers. The Danish health survey of 2005 was based on a region-stratified random sample of 10.916 individuals. Data were collected via personal interviews and self-administrated questionnaires. Respondents suffering from chronic pain were identified through the question 'Do you have chronic/long-lasting pain lasting 6 months or more?' The question concerning alcohol intake assessed the frequency of alcohol intake and binge drinking. Smoking behavior assessed the daily number of cigarettes. Individuals reporting chronic pain were stratified into two groups (opioid users and non-opioid users). In all, 7275 individuals completed a personal interview and 5552 individuals completed and returned the self-administrated questionnaire. Responders with a self-reported earlier or present cancer diagnosis were excluded from the study. Hence, the final study population consisted of 5292 individuals. We found, that individuals suffering from chronic pain were less likely to drink alcohol. In opioid users alcohol consumption was further reduced. Cigarette smoking was significantly increased in individuals suffering from chronic pain and in opioid users smoking was further increased. Poor oral health, quality of life and sleep were markedly associated with chronic pain and opioid use. The use of opioids was associated with significantly more contacts to healthcare care providers.