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February 2007 - September 2014
- PhD Student
- PhD Classical grounded theory of Living Well with Chronic pain. A theoretical explanation for the process of learning to live well with chronic pain.
January 2002 - present
University of Otago, Christchurch, New Zealand
- Professor (Associate)
- Postgraduate courses in Pain and Pain Management, coordinator for MHealSc (Musculoskeletal Management), MHealSc (Pain and Pain Management). 5th year medical student teaching - pain
How is it that good clinicians so often mistrust people with pain? A brief explanatory paper discussing othering, stigma, stereotyping and people with persistent pain.
A study was conducted to test an online mindfulness and gratitude intervention for self-management of arthritis. It was hypothesized that the intervention would decrease pain anxiety, intensity and interference, fear of movement, and increase pain self-efficacy for a group of self-referred people with arthritis. The intervention consisted of four o...
Background: Osteoarthritis (OA) is a common cause of pain and disability. Currently available analgesics are often insufficiently effective or have unacceptable adverse effects. Tricyclic antidepressants may offer a useful centrally-acting analgesic. Nortriptyline is a readily-available, cheap and comparatively well-tolerated tricyclic antidepress...
In New Zealand, one in six people report chronic pain, but the literature indicates only a 30% pain reduction is typically achieved in about half of treated patients. Most patients expecting a cure of their pain, or even substantial pain reduction, are therefore likely to be disappointed. It is important to align patient expectations with this real...
Chronic pain is a public health problem that is likely to increase as the population ages, and has few effective treatments. Although viewed by many as profoundly distressing and disabling, there are a surprising number of people (approximately 30%) who cope well with their chronic pain and do not continue to seek treatment. There is little theory...
A small group of individuals participate in an extreme form of body modification known as body suspension. This involves being pierced with hooks, and suspended until the entire body weight is taken through the hooks. Despite the pain of this process, participants describe feeling euphoric, relaxed and calm both during and afterwards. What can we l...
Acceptance and Commitment Therapy (ACT) is a third wave cognitive behavioural approach that has been used in chronic pain management. Rather than emphasising the need to change thought contents, ACT emphasises changing an individual's awareness of, and relationship to their thoughts, emotions and behaviours (Steven C. Hayes & Duckworth, 2006). This...
Helping people with chronic pain return to work using Prochaska and DiClemente’s “stages of change” model within a chronic pain management programme is explored in this paper. By discussing motivation as a combination of importance and confidence, participants are encouraged to examine the factors that impede their ability to manage the process of...
Introduction What is a Problem? What Clinician Factors Influence the Process of Clinical Reasoning? Ways Clinicians Reduce the Complexity Assumptions are Invisible What is Abductive Reasoning? What is Clinical Reasoning and Case Formulation? What is Case Formulation? Why Should We Use a Case Formulation Approach? Case Formulation Using Abductive Re...
It's been suggested that this approach is a useful way to validate a questionnaire with two different populations. While I'm confident with single subject design for experiments, I'm not at all familiar with using these strategies for validating a questionnaire - can anyone help?
A discussion I'm having with a colleague raised this question: if a nociceptive stimulus is applied, before the brain determines that it is important enough to be "pain" (the unpleasant sensory and emotional experience etc) can it be perceived?
For example, a person participating in body suspension where the body is suspended from large hooks will say the experience of having hooks inserted ks definitely painful. They later experience the suspension part as perhaps even euphoric. This I can understand in terms of appraisal, hormone release, social context etc
Then a person who gets a shark bite may say "I felt a dull thump at first, but it didn't hurt until I got back on land".
The question is: is the "dull thump" nociception, or is it activation of other receptors and pathways? It's not pain at the time, so what is it?
I've noticed that all of the body diagrams used in pain drawings represent a masculine body shape, and I wondered why this is, and also whether anyone has examined whether this makes a difference in the ways individuals respond to pain drawings?
Given that more women than men develop chronic pain, and in view of a feminist agenda, is there any reason NOT to use either an androgynous body shape, or a female body shape? Just wondering...
This project aims to generate a set of images depicting people engaged in daily occupations (activities). The images will reflect a range of ages, ethnic backgrounds, and be gender and culturally relevant to New Zealand. The images will then be used to generate an assessment tool for indicating disability severity, and also to function as a guide for interventions.