Assessment and treatment of pain associated with combat-related polytrauma.

Due to the high rates of blast injuries sustained during operations in Iraq and Afghanistan, the number of soldiers returning with massive and multiple wounds is unprecedented. While casualty survival rates have improved dramatically, the extent and impact of these wounds on soldiers' functioning pose unique challenges for their rehabilitation. Pain is highly prevalent in these individuals with polytrauma injuries and is a source of suffering, as well as an impediment to rehabilitation.

Comparison of pain and emotional symptoms in soldiers with polytrauma: unique aspects of blast exposure.

Objectives: To compare the physical and emotional presentation and pain treatment outcomes of service members who sustained polytrauma secondary to blast with those of soldiers injured by other means.

Design: Retrospective medical record review.

Setting And Patients: One of four Veterans Affairs multidisciplinary inpatient Polytrauma Rehabilitation Centers.

Preliminary evaluation of reliability and criterion validity of Actiwatch-Score.

The restoration of normal physical activity is a primary objective of most chronic pain rehabilitative interventions, yet few clinically practical objective measures of activation exist. Actigraphy is one technology that promises to fill this void in the field of pain outcomes assessment. This study evaluates the measurement properties of one of several commercially available actigraphs: the Actiwatch-Score (AW-S).

Pain and combat injuries in soldiers returning from Operations Enduring Freedom and Iraqi Freedom: implications for research and practice.

Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) have resulted in a growing number of seriously injured soldiers who are evacuated to the United States for comprehensive medical care. Trauma-related pain is an almost universal problem among these war-injured soldiers, and several military and Department of Veterans Affairs initiatives have been implemented to enhance pain care across the continuum of medical services. This article describes several innovative approaches for improving the pain care provided to OEF and OIF military personnel during acute stabilization, transport, medical-surgical treatment, and rehabilitation and presents summary data characterizing the soldiers, pain management services provided, and associated outcomes.

Anxiety and marital adjustment in patients with implantable cardioverter defibrillator and their spouses.

Purpose: Device-related fears are a pervasive psychosocial difficulty that patients with implantable cardioverter defibrillators (ICDs) experience. Spouses also encounter anxieties that may influence patient and spouse adjustment. This study examined anxiety and marital adjustment among ICD patients and spouses, as well as intersex differences between female and male patients.

Measurement of patient fears about implantable cardioverter defibrillator shock: an initial evaluation of the Florida Shock Anxiety Scale.

Background: Psychological distress is both a precipitant and a consequence of ICD shock. Therefore, the assessment of patient anxiety and concerns related to receiving an ICD shock may prompt appropriate psychological referrals and treatment.

Methods: The purpose of this study is to assess the initial validity and clinical utility of the Florida Shock Anxiety Scale (FSAS).

Do positive health expectations and optimism relate to quality-of-life outcomes for the patient with an implantable cardioverter defibrillator?

Purpose: Clinical trials with the implantable cardioverter defibrillator (ICD) have demonstrated desirable outcomes in terms of mortality and morbidity among patients with potentially lethal arrhythmias. This study examined the "resilience factors" of positive health expectations and global optimism prospectively using the general quality-of-life (QOL) scores of newly implanted ICD patients.

Methods: The study enrolled 88 newly implanted ICD patients (mean age, 65.

Women and the implantable cardioverter defibrillator: a lifespan perspective on key psychosocial issues.

The clinical success of the implantable cardioverter defibrillator (ICD) in reducing mortality suggests that more women will be receiving ICDs in the future. The impact of ICD therapy in women is unique in western societies; the ICDs scar and lump in the pectoral area can lead to body image concerns due to the emphasis on women's physical attractiveness. Social support and roles are challenged because women's reaction to stress has been characterized by a "tend and befriend" response, involving cultivating and utilizing social networks, rather than the "fight or flight" response more typical of men.