Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2016

Open Access 01-12-2016 | Research article

Pain management among Dominican patients with advanced osteoarthritis: a qualitative study

Authors: Amy Yu, Christopher A. Devine, Rachel G. Kasdin, Mónica Orizondo, Wendy Perdomo, Aileen M. Davis, Laura M. Bogart, Jeffrey N. Katz

Published in: BMC Musculoskeletal Disorders | Issue 1/2016

Login to get access

Abstract

Background

Advanced osteoarthritis and total joint replacement (TJR) recovery are painful experiences and often prompt opioid use in developed countries. Physicians participating in the philanthropic medical mission Operation Walk Boston (OpWalk) to the Dominican Republic have observed that Dominican patients require substantially less opioid medication following TJR than US patients. We conducted a qualitative study to investigate approaches to pain management and expectations for postoperative recovery in patients with advanced arthritis undergoing TJR in the Dominican Republic.

Methods

We interviewed 20 patients before TJR about their pain coping mechanisms and expectations for postoperative pain management and recovery. Interviews were conducted in Spanish, translated, and analyzed in English using content analysis.

Results

Patients reported modest use of pain medications and limited knowledge of opioids, and many relied on non-pharmacologic therapies and family support to cope with pain. They held strong religious beliefs that offered them strength to cope with chronic arthritis pain and prepare for acute pain following surgery. Patients exhibited a great deal of trust in powerful others, expecting God and doctors to cure their pain through surgery.

Conclusion

We note the importance of understanding a patient’s individual pain coping mechanisms and identifying strategies to support these coping behaviors in pain management. Such an approach has the potential to reduce the burden of chronic arthritis pain while limiting reliance on opioids, particularly for patients who do not traditionally utilize powerful analgesics.
Literature
1.
2.
3.
Moskowitz RW. The burden of osteoarthritis: clinical and quality-of-life issues. Am J Manag Care. 2009;15:S223–9.PubMed
4.
Hunter DJ, Guermazi A, Roemer F, Zhang Y, Neogi T. Structural correlates of pain in joints with osteoarthritis. Osteoarthr Cartil. 2013;21:1170–8.CrossRefPubMed
5.
Lingard EA, Katz JN, Wright EA, Sledge CB. Predicting the outcome of total knee arthroplasty. J Bone Joint Surg Am. 2004;86A:2179–86.
6.
Zhang W, Moskowitz RW, Nuki G, Abramson S, Altman RD, Arden N, et al. OARSI recommendations for the management of hip and knee osteoarthritis, part I: critical appraisal of existing treatment guidelines and systematic review of current research evidence. Osteoarthr Cartil. 2007;15:981–1000.CrossRefPubMed
7.
Bono JV, Robbins CE, Mehio AK, Aghazadeh M, Talmo CT. Pharmacologic pain management before and after total joint replacement of the hip and knee. Clin Geriatr Med. 2012;28:459–70.CrossRefPubMed
8.
Parvizi J, Miller AG, Gandhi K. Multimodal pain management after total joint arthroplasty. J Bone Joint Surg Am. 2011;93:1075–84.CrossRefPubMed
9.
Joranson DE, Ryan KM, Gilson AM, Dahl JL. Trends in medical use and abuse of opioid analgesics. JAMA. 2000;283:1710–4.CrossRefPubMed
10.
Davis WR, Johnson BD. Prescription opioid use, misuse, and diversion among street drug users in New York City. Drug Alcohol Depend. 2008;92:267–76.CrossRefPubMed
11.
Centers for Disease Control and Prevention (CDC). CDC grand rounds: prescription drug overdoses - a U.S. epidemic. MMWR Morb Mortal Wkly Rep. 2012;61:10–3.
12.
Zywiel MG, Stroh DA, Lee SY, Bonutti PM, Mont MA. Chronic opioid use prior to total knee arthroplasty. J Bone Joint Surg Am. 2011;93:1988–93.CrossRefPubMed
13.
Size M, Soyannwo OA, Justins DM. Pain management in developing countries. Anaesthesia. 2007;62:38–43.CrossRefPubMed
14.
15.
Niu NN, Collins JE, Thornhill TS, Alcantara Abreu L, Ghazinouri R, Okike K, et al. Pre-operative status and quality of life following total joint replacement in a developing country: a prospective pilot study. Open Orthop J. 2011;5:307–14.CrossRefPubMedPubMedCentral
16.
Steultjens MP, Dekker J, Bijlsma JW. Coping, pain, and disability in osteoarthritis: a longitudinal study. J Rheumatol. 2001;28:1068–72.PubMed
17.
Hawker GA, Stewart L, French MR, Cibere J, Jordan JM, March L, et al. Understanding the pain experience in hip and knee osteoarthritis--an OARSI/OMERACT initiative. Osteoarthr Cartil. 2008;16:415–22.CrossRefPubMed
18.
19.
20.
Fylan F. Semi-structured interviewing. In: Miles J, Gilbert P, editors. A handbook of research methods for clinical and health psychology. New York: Oxford University Press; 2005. p. 65–78.
21.
Weber R. Basic content analysis. 2nd ed. Newbury Park: Sage Publications; 1990.
22.
Fleiss JL, Levin B, Paik MC. Statistical methods for rates and proportions. 3rd ed. New York: Wiley; 2003.CrossRef
23.
Lazarus RS, Cohen JB. Environmental stress. In: Altman I, Wohlwill JF, editors. Human behavior and environment. New York: Springer US; 1977. p. 89–127.CrossRef
24.
Lazarus R, Folkman S. Stress, appraisal, and coping. 1st ed. New York: Springer Publishing Company; 1984.
25.
Hampson SE, Glasgow RE, Zeiss AM. Coping with osteoarthritis by older adults. Arthritis Care Res. 1996;9:133–41.CrossRefPubMed
26.
Sinclair VG. Predictors of pain catastrophizing in women with rheumatoid arthritis. Arch Psychiatr Nurs. 2001;15:279–88.CrossRefPubMed
27.
Sullivan MJ, Thorn B, Haythornthwaite JA, Keefe F, Martin M, Bradley LA, et al. Theoretical perspectives on the relation between catastrophizing and pain. Clin J Pain. 2001;17:52–64.CrossRefPubMed
28.
Dysvik E, Natvig GK, Eikeland OJ, Lindstrøm TC. Coping with chronic pain. Int J Nurs Stud. 2005;42:297–305.CrossRefPubMed
29.
Wallston KA, Wallston BS, DeVellis R. Development of the multidimensional health locus of control (MHLC) scales. Health Educ Monogr. 1978;6:160–70.CrossRefPubMed
30.
Juarez G, Ferrell B, Borneman T. Influence of culture on cancer pain management in Hispanic patients. Cancer Pract. 1998;6:262–9.CrossRefPubMed
31.
Brown GK, Nicassio PM. Development of a questionnaire for the assessment of active and passive coping strategies in chronic pain patients. Pain. 1987;31:53–64.CrossRefPubMed
32.
Hsieh JB, Dominick KL. Use of non-pharmacological therapies among patients with osteoarthritis. Aging Clin Exp Res. 2003;15:419–25.CrossRefPubMed
33.
McKinlay JB, Trachtenberg F, Marceau LD, Katz JN, Fischer MA. Effects of patient medication requests on physician prescribing behavior: results of a factorial experiment. Med Care. 2014;52:294–99.CrossRefPubMedPubMedCentral
Metadata
Title
Pain management among Dominican patients with advanced osteoarthritis: a qualitative study
Authors
Amy Yu
Christopher A. Devine
Rachel G. Kasdin
Mónica Orizondo
Wendy Perdomo
Aileen M. Davis
Laura M. Bogart
Jeffrey N. Katz
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2016
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-016-1075-y

Other articles of this Issue 1/2016

BMC Musculoskeletal Disorders 1/2016 Go to the issue

Study protocol

The osteoporotic fracture prevention program in rural areas (OFRA): a protocol for a cluster-randomized health care fund driven intervention in a routine health care setting

Research article

Does knee awareness differ between different knee arthroplasty prostheses? A matched, case-control, cross-sectional study

Study protocol

The clinical and cost effectiveness of steroid injection compared with night splints for carpal tunnel syndrome: the INSTINCTS randomised clinical trial study protocol

Research article

Spinal sagittal imbalance in patients with lumbar disc herniation: its spinopelvic characteristics, strength changes of the spinal musculature and natural history after lumbar discectomy

Research article

A joint effort over a period of time: factors affecting use of urate-lowering therapy for long-term treatment of gout

Research article

Ncf1 affects osteoclast formation but is not critical for postmenopausal bone loss