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

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...

Descripción completa

Detalles Bibliográficos
Autor Corporativo: Institute of Medicine (U.S.). Committee on Pain, Disability, and Chronic Illness Behavior (-)
Otros Autores: Osterweis, Marian (-), Kleinman, Arthur, Mechanic, David, 1936-
Formato: Libro electrónico
Idioma:Inglés
Publicado: Washington, D.C. : National Academy Press 1987.
Edición:1st ed
Materias:
Chronic pain > Social aspects.
Chronic pain > Government policy.
Chronic pain > Economic aspects.
Disability evaluation.
Ver en Biblioteca Universitat Ramon Llull:https://discovery.url.edu/permalink/34CSUC_URL/1im36ta/alma991009622107006719
Tabla de Contenidos:
  • 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.

Ejemplares similares