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  • 1.
    Stanley, Anitha
    et al.
    College of Nursing, CMC, Vellore, India.
    Chacko, Ranjitha
    College of Nursing, CMC, Vellore, India.
    Widar, Marita
    Örebro University, Department of Health Sciences.
    Caregivers' perception of their problems and needs in palliative care settings: a literature review2008In: Indian Journal of Continuing Nursing Education, ISSN 2230-7354, Vol. 9, no 2, p. 19-29Article in journal (Refereed)
    Abstract [en]

    Joint disease necessitates surgical interventions to relieve pain, improve stability and improve the function. Hip replacement is one of the most reliable operations in orthopaedic surgery and consistently decreases or eliminates the pain and stiffness, thereby improving quality of life. It is therefore essential for nurses to expand their understanding and ability to provide quality health care for these patients undergoing surgery. This article will sensitize the nurses to be basically prepared, update their knowledge and develop competence in providing quality care based on nursing care protocol.

  • 2.
    Varghese, Jessa
    et al.
    Örebro University, School of Health and Medical Sciences.
    Changoor, Rekha
    Örebro University, School of Health and Medical Sciences.
    Widar, Marita
    Örebro University, School of Health and Medical Sciences.
    Nurses' role in the comprehensive care of clients with brain tumour: a literature review2010In: Indian Journal of Continuing Nursing Education, Vol. 11, no 1, p. 14-24Article in journal (Refereed)
  • 3.
    Widar, Marita
    Örebro University, Department of Health Sciences.
    Att leva med långvarig smärta efter stroke2007In: Långvarig smärta / [ed] Ulf Jakobsson, Lund: Studentlitteratur , 2007, p. 167-180Chapter in book (Other academic)
  • 4.
    Widar, Marita
    Örebro University, School of Health and Medical Sciences.
    Omvårdnad vid stroke: state of the art2005In: Omvårdnad vid stroke: state of the art, Stockholm: Gothia , 2005, p. 43-45Chapter in book (Other (popular science, discussion, etc.))
  • 5.
    Widar, Marita
    et al.
    Örebro University, School of Health and Medical Sciences.
    Ahlström, Gerd
    Disability after a stroke and the influence of long-term pain on everyday life2002In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 16, no 3, p. 302-310Article in journal (Refereed)
    Abstract [en]

    Pain after a stroke is a symptom often forgotten, unnoticed although it is reported to be a great problem in care. The aim of this study was to describe disability after a stroke and how long-term pain influences everyday life according to the Multidimensional Pain Inventory - Swedish language version (MPI-S) and to test the reliability of this instrument. Forty-three persons were investigated 2 years after the stroke incident: 15 with central post-stroke pain (CPSP), 18 with nociceptive pain mainly in the shoulder and 10 with tension-type headache. Data collection was performed through the MPI-S and a questionnaire regarding assistive devices, also structured interviews based on the Activities of Daily Living (ADL) staircase and the Self-report impairment questionnaire. The results show that the persons suffered moderate to severe pain. Almost half were dependent in ADL. The most often reported impairments and use of assistive devices concerned mobility and/or motion. This was most frequent in persons with nociceptive pain. There were significant differences in persons with central pain and nociceptive pain compared with tension-type headache with regard to mobility- and/or motion-related activities. No statistical differences emerged between age, gender, different types of pain and the MPI-S scales, nor any significant differences in degree of pain as between different types of pain according to the Self-report impairment questionnaire. The reliability analysis of the MPI-S shows good homogeneity in all scales except Interference, Life Control and Affective Distress. This is the first study with MPI-S on mainly older persons and on stroke patients, thus further research is needed on this instrument as well as on which specific activities evoke the pain. This is in order to offer adequate treatment, care and support to persons with pain after a stroke.

  • 6.
    Widar, Marita
    et al.
    Örebro University, School of Health and Medical Sciences.
    Ahlström, Gerd
    Experiences and consequences of pain in persons with post-polio syndrome1998In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 28, no 3, p. 606-613Article in journal (Refereed)
    Abstract [en]

    This study describes the meaning of pain and its implications for everyday life in 35 persons with symptoms of post-polio syndrome. The mean age of the study group is 65 years and the sex ratio of men to women is 1.5:1. The study persons were interviewed on two occasions in their homes and answered a pain questionnaire. The result shows that everyday vocabulary is used to express pain experiences. The study persons normally answered that it hurt, although the interviewers used pain in their questions. The results show that the lower back is the most common location of pain. Joint pains are most common in the upper extremities. The pain is worst in the evening and at night, and tangibly affects the daily rhythm. Physical strain and climatic factors commonly provoke pain, whereas rest and heat give relief. The study show that interviews and pain questionnaire should be supplemented with questions on activities so as to gain a comprehensive view of the difficulties experienced in everyday life.

  • 7.
    Widar, Marita
    et al.
    Örebro University, Department of Nursing and Caring Sciences.
    Ahlström, Gerd
    Pain in persons with post-polio: the Swedish version of the Multidimensional Pain Inventory (MPI)1999In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 13, no 1, p. 33-40Article in journal (Refereed)
    Abstract [en]

    Increasing muscular atrophy and joint instability in the post-polio syndrome (PPS) leads to muscle and joint pain. The aim of this study was to describe how persons with post-polio syndrome (PPS) perceive their pain and how the pain affects their everyday lives. The Multidimensional Pain Inventory (MPI-S) was used together with supplementary questions concerning location and verbal description of the pain. The study group comprised 37 persons with PPS who had had pain for an average of 19 years. Most commonly reported was pain from the joints of the extremities, followed by pain from the lower back. The verbal description suggests that pain is a palpable health problem for this study group. The results of the MPI-S show that women had the most pain and that the younger the persons are, the more the pain involves negative stress experiences. Activities such as outdoor work, social and other activities away from home involve difficulties, according to the results. The study group could manage their pain, experienced social support, and especially women managed to carry out household chores despite their pain. The MPI-S demonstrates acceptable reliability for this study group.

  • 8.
    Widar, Marita
    et al.
    Örebro University, Department of Nursing and Caring Sciences.
    Ahlström, Gerd
    Ek, Anna-Christina
    Health-related quality of life in persons with long-term pain after a stroke2004In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 13, no 4, p. 497-505Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    No study has, to our knowledge, previously been published on health-related quality of life (HRQoL) in a group suffering from long-term pain after a stroke.

    AIM:

    The aim of the present study was to describe HRQoL in persons with long-term pain after a stroke, and to compare this with different types of pain conditions, age, gender and household status.

    DESIGN:

    This study has a design combining qualitative and quantitative methods.

    METHODS:

    Forty three participants suffering from long-term pain after a stroke were included. A qualitative interview was performed and then analysed by means of latent content analysis. In addition, two self-report questionnaires, SF-36 and the Hospital Anxiety and Depression Scale (HAD Scale), were used.

    RESULTS:

    The qualitative data revealed that physical and cognitive functioning, economic security and good relationships, support and having the ability to be together with family and friends were important factors with regard to experienced HRQoL. No significant differences were found in SF-36 and the HAD Scale with regard to the different types of pain. The older age group had decreased physical functioning in SF-36. The men had more decreased vitality than the women.

    CONCLUSION:

    The results show, that the participants in this study have a lower HRQoL due to their long-term pain than those in previous studies on stroke survivors. It is evident that further research is needed with longitudinal studies and larger populations to gain more knowledge and thereby provide better supportive care.

    RELEVANCE TO CLINICAL PRACTICE:

    Awareness and understanding of the patients' perceptions and transitions with regard to their life situation and suffering from long-term pain after a stroke is important in order to support a maintained or increased HRQoL. This is also important after the acute stage and rehabilitation, including quality of life of the relatives, especially to older and dependent persons.

  • 9.
    Widar, Marita
    et al.
    Örebro University, School of Health and Medical Sciences.
    Ahlström, Gerd
    Hälsohögskolan, Jönköping.
    Ek, Anna-Christina
    Inst Medicin och Vård, Hälsouniversitetet, Linköping.
    Pain conditions after a stroke2009Conference paper (Refereed)
  • 10.
    Widar, Marita
    et al.
    Örebro University, Department of Health Sciences.
    Ek, A.-C.
    Ahlström, Gerd
    Living with long-term pain after stroke2007Conference paper (Other academic)
    Abstract [en]

    Objectives

    The general aim of this thesis was to classify and describe long-term pain two years after a stroke and to describe the experiences of pain, and the consequences it has on the persons’ lives.

    Material and methods

    The studies comprised 43 persons, 13 women and 30 men, aged 33-82 years, with pain after stroke and no other major pain conditions and able to participate in an interview and independently answer questionnaires.

    The studies were conducted from a multidimensional perspective on pain, combining quantitative and qualitative methods. Clinical examinations were somatic, neurological and Quantitative Sensory Testing (QST). The Pain-O-Meter, ADL staircase, Self-reported impairment, SF-36 and Hospital Anxiety and Depression Scale were used. Qualitative interviews were performed and analyzed with content analysis.

    Results

    Three types of pain were classified: Neuropathic (central post-stroke pain) (n=15), nociceptive/mainly shoulder pain (n=18) and tension-type headache (n=10). Pain onset, within one to six months in most of the cases was after discharge from the hospital. Continuous pain or pain almost every day was reported by nearly two-thirds. The pain was mostly described as troublesome, annoying and tiring in all groups. The rating of pain intensity revealed individual differences among the participants within the pain groups. In addition to long-term pain, the participants suffered several impairments and nearly half of them were dependent on others, and two-thirds on assistive devices. Several coping strategies were described, most often problem-focused. Their health-related quality of life was decreased, mostly related to their long-term pain and physical impairments. Their experiences of caring revealed the need of improvements in knowledge about long-term pain, attention and understanding among the professionals, and continuity in the contacts.

    Conclusion

    All professionals need knowledge about pain conditions after stroke. Pain assessment and classification, regular follow-up and documentation are required in order to prevent unnecessary suffering. Patients need attention, understanding and continuity in contacts with professionals. Further, information and education about pain and treatment/caring interventions are required in the case of both the sufferer and next of kin.

  • 11.
    Widar, Marita
    et al.
    Örebro University, Department of Health Sciences.
    Ek, Anna-Christina
    Ahlström, Gerd
    Caring and uncaring experiences as narrated by persons with long-term pain after a stroke2007In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 21, no 1, p. 41-47Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to describe how persons with long-term pain after a stroke experience their care. The study is part of a larger research project concerning a group persons suffering from long-term pain after a stroke. Qualitative interviews were performed with 43 persons suffering from central poststroke pain, nociceptive pain or tension-type headache after their stroke incident. Content congruence emerged among the narratives (n = 43), and therefore the most information-rich ones (n = 23) were selected for deeper investigation by means of qualitative content analysis. The results reveal the patients’ need for being respected, understood and supported, also for being given adequate time and information. Accessibility and continuity in the professional contacts and with regard to medical and physical treatment was emphasized. The participants’ narratives highlight the importance of the professionals having knowledge of pain and pain management.

  • 12.
    Widar, Marita
    et al.
    Örebro University, Department of Nursing and Caring Sciences.
    Ek, Anna-Christina
    Ahlström, Gerd
    Coping with long-term pain after a stroke2004In: Journal of Pain and Symptom Management, ISSN 0885-3924, Vol. 27, no 3, p. 215-225Article in journal (Refereed)
    Abstract [en]

    The aim of this qualitative study was to describe pain, coping strategies, and experienced outcome of coping with long-term pain conditions after a stroke. Forty-three participants were interviewed: 15 with central post-stroke pain (CPSP), 18 with nociceptive pain, and 10 with tension-type headache. Analysis of the data was by content analysis. Pain-related problems described were incomprehensibility regarding the pain, disturbed sleep, fatigue, diminished capacity, mood changes, and stress in relationships. Different coping strategies were used; the most common were making the pain comprehensible, planning of activities, taking medications, communicating, and distractions. Changing body position, making comparison, and enduring the pain were common in central or nociceptive pain, rest and relaxation in tension-type headache. Communicating their pain gave a feeling of perplexity and resignation. Satisfaction was reported in the cases of consideration shown by others. Pain after a stroke requires specialized knowledge in order to understand the patient's experiences and to enhance coping.

  • 13.
    Widar, Marita
    et al.
    Örebro University, School of Health and Medical Sciences.
    Samuelsson, Lars
    Karlsson-Tivenius, Susanne
    Ahlström, Gerd
    Long-term pain conditions after a stroke2002In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 34, no 4, p. 165-170Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to classify and describe the characteristics of different long-term pain conditions after a stroke by clinical examination and pain assessment using the Pain-O-Meter and a Pain questionnaire. Pain was classified as central post-stroke pain (n = 15), nociceptive pain (n = 18), and tension-type headache (n = 10). In 65%, pain onset was within 1-6 months and the pain intensity revealed individual differences. Many pain descriptors was common, some were discriminating as burning in central and cramping in nociceptive pain, and pressing and worrying in headache. More than half with central or nociceptive pain had continuous or almost continuous pain. Cold was the factor mostly increasing the pain in central, physical movements in nociceptive pain, and stress and anxiety in headache. More than one-third had no pain treatment and two-thirds of those with central pain had no or inadequate prescribed pain treatment. The clinical findings support the classification of pain and describe discriminating and common pain characteristics in pain conditions after a stroke.

1 - 13 of 13
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