Pain and disability : clinical, behavioral, and public policy perspectives /

Evaluating claims based on pain poses problems for the Social Security Administration (SSA) and other disability insurers. This volume covers the epidemiology and physiology of pain; psychosocial contributions to pain and illness behavior; promising ways of assessing and measuring chronic pain and d...

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Detalhes bibliográficos
Autor Corporativo: Institute of Medicine (U.S.). Committee on Pain, Disability, and Chronic Illness Behavior
Outros Autores: Osterweis, Marian, Kleinman, Arthur, Mechanic, David, 1936-
Formato: Licensed eBooks
Idioma:inglês
Publicado em: Washington, D.C. : National Academy Press, 1987.
Acesso em linha:https://search.ebscohost.com/login.aspx?direct=true&scope=site&db=nlebk&AN=14531
Sumário:
  • Pain and Disability
  • Copyright
  • PREFACE AND ACKNOWLEDGMENTS
  • Contents
  • SUMMARY
  • CHRONIC PAIN
  • SOCIAL SECURITY ADMINISTRATION DISABILITY PROGRAMS
  • Problems in the System
  • CRITICAL GAPS IN KNOWLEDGE
  • RECOMMENDATIONS
  • 1 Introduction
  • Overview of the Report
  • A Note about Definitions
  • References
  • PART I THE PROBLEM OF PAIN FOR THE SOCIAL SECURITY ADMINISTRATION
  • 2 The Sociopolitical Background of the Pain Issue
  • THE LEGISLATIVE BACKGROUND OF THE PAIN PROBLEM IN DISABILITY INSURANCE
  • Early History of Social Security Disability
  • Physicians' Concerns About Medically Determined Disability
  • The Concept of Impairment
  • Disability and the Labor Market
  • The 1984 Amendments
  • DISABILITY, PAIN, AND DISTRIBUTIVE JUSTICE
  • References
  • 3 Disability Determination and the Role Of Pain
  • OVERVIEW OF THE SOCIAL SECURITY DISABILITY SYSTEM
  • The Programs
  • Program Definitions
  • The Application and Evaluation Process
  • The Appeals Process
  • Program Benefits
  • Incentives for Rehabilitation and Return to Work
  • PAIN'S ROLE IN THE DETERMINATION OF DISABILITY
  • Pain in Social Security Law and Regulation
  • Pain and the Application Process
  • Pain and the Sequential Evaluation Process
  • Pain and the Courts
  • COMPARISON WITH OTHER DISABILITY COMPENSATION PROGRAMS
  • Veterans Administration
  • The Role of Pain
  • Workers' Compensation
  • The Role of Pain
  • Private Disability Insurance
  • The Role of Pain
  • Disability Compensation Programs in Western Europe
  • References
  • 4 Conflicts And Contradictions In The Disability Program
  • CONGRESS AND THE SOCIAL SECURITY ADMINISTRATION
  • TENSIONS WITHIN THE PROGRAM
  • Medical Definitions Versus Functional Concept
  • Income Support Versus Rehabilitation
  • Physicians, Claimants, and Administrators
  • Administrative Law Judges Versus Program Administrators.
  • THE FEDERAL COURTS AND CHRONIC DISABLING PAIN
  • COMPENSATION AND INCENTIVES
  • Importance of Job Satisfaction
  • Program Rules as an Explanation of Labor Supply
  • Employment Opportunity as a Determinant of Labor Supply
  • CONCLUSIONS
  • References
  • PART II THE EXTENT AND COST OF THE PROBLEM
  • 5 Economic Issues and the Cost of Disability
  • DISABILITY EXPENDITURES
  • Cash Transfers
  • Medical Care
  • Direct Services
  • TRENDS IN EXPENDITURES
  • Disabled Persons
  • A Note About Measurement
  • Number and Characteristics of the Disabled
  • Benefit Levels and Beneficiaries
  • Program Influences
  • Program Efficiency
  • PREVENTING DISABILITY BY REALLOCATING FUNDS
  • THE ECONOMICS OF PAIN: GAPS IN THE LITERATURE
  • CONCLUSIONS
  • References
  • 6 The Epidemiology of Chronic Pain and Work Disability
  • METHODOLOGICAL ISSUES
  • Definitions and Measures of Chronic Pain
  • Study Samples
  • Methods of Data Collection
  • PAIN AND ITS CONSEQUENCES
  • What Kinds of Chronic Pain Do People Have?
  • Incidence and Prevalence of Relevant Outcomes
  • Back Pain and Medical Care
  • Descriptive Epidemiology of Chronic Pain and Disability
  • Trends in Time
  • Demographic Factors, Pain, and Work Disability
  • Physical Factors
  • Socioeconomic Status
  • Psychosocial Factors
  • Research Agenda
  • Epidemiological Studies
  • Methodological Research
  • References
  • PART III INFLUENCES ON PAIN AND PAIN BEHAVIOR
  • 7 The Anatomy and Physiology of Pain
  • PAIN PROCESSES
  • Transduction
  • Transmission
  • Peripheral Nervous System
  • Pain Pathways In the Central Nervous System
  • Sensory Versus Affective Aspects of Pain
  • Modulation
  • PHYSIOLOGICAL PROCESSES THAT ENHANCE PAIN AND MAY LEAD TO CHRONICITY
  • Sensitization
  • Hyperactivity of the Sympathetic Nervous System: Reflex Sympathetic Dystrophy
  • Muscle Contraction.
  • Self-Sustaining Painful Processes: Livingston's ''Vicious Circle''
  • Neuropathic Pain
  • Acute Versus Chronic Pain
  • POTENTIAL METHODS OF PHYSIOLOGICAL MONITORING
  • References
  • 8 Illness Behavior and the Experience of Pain
  • ILLNESS BEHAVIOR: AN INTEGRATING CONCEPT
  • THE PROCESS OF ILLNESS BEHAVIOR
  • Symptom Perception
  • Meaning Attribution
  • Expression and Communication
  • Help-Seeking Behavior and Other Coping Responses
  • THE INFLUENCE OF PERSONALITY, FAMILIAL, AND SOCIOCULTURAL FACTORS ON ILLNESS BEHAVIOR
  • Personality and Illness Behavior
  • Family Influences
  • Cultural Influences
  • CONCLUSIONS
  • References
  • 9 Psychiatric Aspects of Chronic Pain
  • EPIDEMIOLOGY OF CERTAIN PSYCHIATRIC DISORDERS
  • CHRONIC PAIN, DEPRESSION, AND ANXIETY
  • Chronic Pain, Depression, and Somatoform Disorders
  • A Neurobiological View of Chronic Pain and Depression
  • Depression as a Consequence of Chronic Pain
  • Depressive Symptoms as a Consequence of Drug Therapy
  • TREATMENT OF DEPRESSIVE DISORDERS IN THE CHRONIC PAIN PATIENT
  • Psychotherapeutic Treatment
  • Psychopharmacological Treatment of Pain
  • ADDICTION AND ALCOHOLISM
  • PERSONALITY FACTORS AND CHRONIC PAIN
  • RESEARCH ON PSYCHIATRIC ASPECTS OF CHRONIC PAIN
  • References
  • PART IV ASSESSING AND TREATING PAIN AND DYSFUNCTION
  • 10 Chronic Pain in Medical Practice
  • CLINICAL DECISION MAKING
  • The Diagnostic Process
  • Treatment of the Pain and the Disorder: The Medical Model
  • DIAGNOSING AND MANAGING THE PATIENT WITH PAIN: AN EXPANDED MODEL
  • WHY IS THE DIAGNOSIS OF CHRONIC PAIN SO ELUSIVE?
  • Unknown Disease Processes
  • Overlooked Diagnoses
  • Controversial Diagnoses
  • Myofascial Trigger Point Syndromes
  • Fibrositis or Fibromyalgia
  • Articular Dysfunction
  • IMPROVING DIAGNOSIS, TREATMENT, AND PREVENTION
  • Diagnosis
  • Treatment Of Chronic Pain
  • Bed Rest And Restricted Activity.
  • Drug Therapy
  • Surgical Treatment
  • RECOMMENDATIONS FOR CLINICAL RESEARCH
  • References
  • 11 Measuring Pain And Dysfunction
  • BASIC CONCEPTS OF MEASUREMENT
  • MEASUREMENT TOOLS
  • Measurement Of Subjective Pain States
  • Self-Report: Data From Introspection
  • Self-Report Methods Using A Single Dimension
  • Self-Report Of Pain In Several Dimensions
  • Pain As Behavior: Observational Data
  • Pain Judgments By Health Care Providers
  • Measurement Of Pain Behavior
  • Mixed Methods: Self-Reports Of Pain Behaviors
  • RELATED MEASURES OF DISABILITY
  • Pain And Functional Status
  • Disability Assessment
  • Sickness Impact
  • Assessment of Work Performance
  • Severity of Pain and Dysfunction
  • FACTORS BIASING PAIN MEASUREMENT
  • Personal Meaning
  • Coping
  • Memory for Pain
  • Attributional Factors
  • Medication Toxicity
  • SUMMARY
  • IMPLICATIONS FOR SSA DISABILITY ASSESSMENT
  • MEASUREMENT PANELISTS
  • References
  • 12 Rehabilitation Approaches And Issues In Chronic Pain
  • THE REHABILITATION APPROACH
  • PAIN MANAGEMENT PROGRAMS: AN OVERVIEW
  • The Need for Standards
  • REHABILITATION TECHNIQUES FOR PATIENTS WITH CHRONIC PAIN
  • Physical Modalities
  • Behavior Modification
  • Patient Education
  • Psychosocial Rehabilitation
  • Stress Management
  • Medical Interventions for Pain Control
  • Attention to Myofascial Trigger Points
  • Use of Drugs
  • Nerve Blocks and Epidural Steroid Injections
  • Vocational Rehabilitation
  • OUTCOMES OF PAIN MANAGEMENT PROGRAMS
  • EMPLOYMENT AND COMPENSATION AS INCENTIVES OR DISINCENTIVES IN OUTCOMES OF PAIN MANAGEMENT PROGRAMS
  • Employment as A Factor in Treatment Outcome
  • Compensation Status as A Factor in Treatment Outcome
  • Studies Suggesting a Negative Effect of Compensation on Outcome
  • Studies Suggesting Little or No Negative Effect of Compensation
  • REHABILITATION ISSUES IMPORTANT TO THE SSA.
  • The Ssa and Vocational Rehabilitation
  • Measurement and Evaluation of Pain
  • The Question of Mandatory Rehabilitation
  • Research and Demonstration Projects
  • References
  • PART V CONCLUSIONS AND RECOMMENDATIONS
  • 13 Conclusions and Recommendations
  • RECOMMENDATION 1 DATA COLLECTION AT THE SSA
  • RECOMMENDATION 2 NO NEW LISTINGS FOR PAIN OR ILLNESS BEHAVIOR
  • RECOMMENDATION 3 SIGNIFICANT PAIN' SHOULD TRIGGER AN ASSESSMENT
  • RECOMMENDATION 4 DEMONSTRATION PROJECTS
  • Demonstration: The Feasibility and Consequences of Early Assessment
  • Simple Assessment Tool
  • Early Face-to-Face Hearing
  • Integrated Functional Assessment
  • Demonstration Project: Does Early Rehabilitation Work?
  • Incentives and Disincentives for Rehabilitation
  • The HHS Pain Commission's Proposal
  • Demonstration Project for Early Rehabilitation
  • Evaluation of the Demonstrations
  • A Note About Research with Human Subjects
  • RECOMMENDATION 5 RESEARCH AGENDA
  • Epidemiological Initiatives
  • Clinical Research
  • Health Services Research
  • Improved Methodology and Multidisciplinary Research
  • RECOMMENDATION 6 EDUCATION TO IMPROVE THE CLINICAL CARE AND TREATMENT OF CHRONIC PAIN PATIENTS
  • APPENDIX
  • MYOFASCIAL PAIN SYNDROMES DUE TO TRIGGER POINTS
  • MYOFASCIAL PAIN SYNDROMES: HOW COMMON ARE THEY?
  • Why Are Myofascial Pain Syndromes So Common?
  • HISTORICAL BACKGROUND
  • NATURAL HISTORY
  • DIAGNOSIS
  • PERPETUATING FACTORS
  • TREATMENT
  • REFERENCES
  • INDEX.

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