Pressure Ulcers from a Psychological Perspective

Chapter

Abstract

Injury may occur with a disorganized surgical tray in which sharps are covered with gauze or wrappers, needles are left loose on the tray, and when an unstable stand is used. Injury from hand-to-hand passing of sharps is common. Establish a sharps-free neutral zone on the tray to obviate hand-to-hand instrument transfer. Proper setup is facilitated by pre-arranged equipment sets for common procedures. Verify that instruments are sterile before unpacking them. Position the tray close to the field. Have all anticipated instruments on hand to prevent the temptation of improvising. Track sutures via sponge, magnet, or suture box. Use forceps to sift through the tray, especially during clean-up. One person should be assigned to clean up so sharps are traced appropriately. Keep sharps disposal containers close to the tray, and replace them before they are overfilled.

Keywords

Surgical tray Sharps Needles Injury Neutral zone Sterile Sponge Magnet Suture box Forceps Clean-up Sharps disposal container Punch biopsy Excision Shave removal Surgical instruments Sterility Skin hook Needle stick Sharp Gauze Hitchhike Needle driver Sponge Suture needle counter box Safety Scalpel Safety device Blade Laceration Hemostat Recapping Sharps container 

References

  1. 1.
    American Psychiatric Association (2000) Diagnostic and statistical manual of mental disorders: DSM-IV-TR, 4th edn, text revision ed. American Psychiatric Association, Washington, DCGoogle Scholar
  2. 2.
    Widiger TA, Trull TJ (2007) Plate tectonics in the classification of personality disorder: shifting to a dimensional model. Am Psychol 62(2):71–83PubMedGoogle Scholar
  3. 3.
    Mineka S, Watson D, Clark LA (1998) Comorbidity of anxiety and unipolar mood disorders. Annu Rev Psychol 49:377–412PubMedGoogle Scholar
  4. 4.
    Blashfield RK, Intoccia V (2000) Growth of the literature on the topic of personality disorders. Am J Psychiatry 157(3):472PubMedGoogle Scholar
  5. 5.
    O’Connor BP, Dyce JA, Hersen M, Van Hasselt VB (2001) Personality disorders. Advanced abnormal psychology, 2nd edn. Kluwer Academic Publishers, Dordrecht, pp 399–417Google Scholar
  6. 6.
    Torgersen S, Battaglia M (1999) Genetics of personality disorders. In: Derksen J, Maffei C, Groen H (eds) Treatment of personality disorders. Kluwer Academic Publishers, Dordrecht, pp 1–15Google Scholar
  7. 7.
    Dersh J, Gatchel RJ, Mayer T, Polatin P, Temple OR (2006) Prevalence of psychiatric disorders in patients with chronic disabling occupational spinal disorders. Spine 31(10):1156–1162PubMedGoogle Scholar
  8. 8.
    Temple RO, Elliott TR (2000) Personality disorder characteristics and adjustment following spinal cord injury. Top Spinal Cord Inj Rehabil 6(1):54–65Google Scholar
  9. 9.
    Correa GI, Fuentes M, Gonzalez X, Cumsille F, Pineros JL, Finkelstein J (2006) Predictive factors for pressure ulcers in the ambulatory stage of spinal cord injury patients. Spinal Cord 44(12):734–739PubMedGoogle Scholar
  10. 10.
    Bockian NR, Lee A, Fidanque CS (2003) Personality disorders and spinal cord injury: a pilot study. J Clin Psychol Med Settings 10(4):307–313Google Scholar
  11. 11.
    Zuckerman M (2007) Sensation seeking and risky behavior. American Psychological Association, Washington, DCGoogle Scholar
  12. 12.
    Zuckerman M (1979) Sensation seeking: beyond the optimal level of arousal. L Erlbaum Associates, HillsdaleGoogle Scholar
  13. 13.
    Zuckerman M, Kolin EA, Price L, Zoob I (1964) Development of a sensation-seeking scale. J Consult Psychol 28(6):477–482Google Scholar
  14. 14.
    Gray JR, Burgess GC (2004) Personality differences in cognitive control? BAS, processing efficiency, and the prefrontal cortex. J Res Pers 38(1):35–36Google Scholar
  15. 15.
    Uzieblo K, Verschuere B, Crombez G (2007) The psychopathic personality inventory: construct validity of the two-factor structure. Pers Individual Differences 43(4):657–667Google Scholar
  16. 16.
    Alston RJ (1994) Sensation seeking as a psychological trait of drug abuse among persons with spinal cord injury. Rehabil Couns Bull 38(2):154–163Google Scholar
  17. 17.
    Bardo MT, Williams Y, Dwoskin LP, Moynahan SE, Perry IB, Martin CA (2007) The sensation seeking trait and substance use: research findings and clinical implications. Curr Psychiatry Rev 3(1):3–13Google Scholar
  18. 18.
    Benning SD, Patrick CJ, Hicks BM, Blonigen DM, Krueger RF (2003) Factor structure of the psychopathic personality inventory: validity and implications for clinical assessment. Psychol Assess 15(3):340–350PubMedGoogle Scholar
  19. 19.
    Flory K, Lynam D, Milich R, Leukefeld C, Clayton R (2002) The relations among personality, symptoms of alcohol and marijuana abuse, and symptoms of comorbid psychopathology: results from a community sample. Exp Clin Psychopharmacol 10(4):425–434PubMedGoogle Scholar
  20. 20.
    Rohe DE, Basford JR (1989) Traumatic spinal cord injury, alcohol, and the Minnesota Multiphasic Personality Inventory. Rehabil Psychol 34(1):25–32Google Scholar
  21. 21.
    Pires M (1989) Substance abuse. The silent saboteur in rehabilitation. Nurs Clin North Am 24(1):291–296PubMedGoogle Scholar
  22. 22.
    Hawkins DA, Heinemann AW (1998) Substance abuse and medical complications following spinal cord injury. Rehabil Psychol 43(3):219–231Google Scholar
  23. 23.
    Tate DG, Forchheimer MB, Krause JS, Meade MA, Bombardier CH (2004) Patterns of alcohol and substance use and abuse in persons with spinal cord injury: risk factors and correlates. Arch Phys Med Rehabil 85(11):1837–1847PubMedGoogle Scholar
  24. 24.
    Waters RL, Adkins RH, Sie I, Cressy J (1998) Postrehabilitation outcomes after spinal cord injury caused by firearms and motor vehicle crash among ethnically diverse groups. Arch Phys Med Rehabil 79(10):1237–1243PubMedGoogle Scholar
  25. 25.
    Elliot TR, Kurylo M, Chen Y, Hicken B (2002) Alcohol abuse history and adjustment following spinal cord injury. Rehabil Psychol 47(3):278–290Google Scholar
  26. 26.
    Jones ML, Marini I, Slate JR (2005) Prevention practice differences among persons with spinal cord injuries who rarely versus frequently sustain pressure ulcers. Rehabil Couns Bull 48(3):139–145Google Scholar
  27. 27.
    Schryvers OI, Stranc MF, Nance PW (2000) Surgical treatment of pressure ulcers: 20-year experience. Arch Phys Med Rehabil 81(12):1556–1562PubMedGoogle Scholar
  28. 28.
    Kennedy P, Lowe R, Grey N, Short E (1995) Traumatic spinal cord injury and psychological impact: a cross-sectional analysis of coping strategies. Br J Clin Psychol 34(4):627–639PubMedGoogle Scholar
  29. 29.
    Young ME, Rintala DH, Rossi CD, Hart KA, Fuhrer MJ (1995) Alcohol and marijuana use in a community-based sample of persons with spinal cord injury. Arch Phys Med Rehabil 76(6):525–532PubMedGoogle Scholar
  30. 30.
    Krause JS, Vines CL, Farley TL, Sniezek J, Coker J (2001) An exploratory study of pressure ulcers after spinal cord injury: relationship to protective behaviors and risk factors. Arch Phys Med Rehabil 82(1):107–113PubMedGoogle Scholar
  31. 31.
    White JM, Hay JL, Miller PM, Kavanagh D (2007) Opioids, pain and addiction: cause and consequence. In: Miller PM, Kavanagh D (eds) Translation of addictions science into practice. Elsevier Science, New York, pp 39–55Google Scholar
  32. 32.
    Ziegler PP (2005) Addiction and the treatment of pain. Subst Use Misuse 40(13):1945–1954PubMedGoogle Scholar
  33. 33.
    Turner JA, Cardenas DD (1999) Chronic pain problems in individuals with spinal cord injuries. Semin Clin Neuropsychiatry 4(3):186–194PubMedGoogle Scholar
  34. 34.
    Widerström-Noga EG, Felipe-Cuervo E, Yezierski RP (2001) Relationships among clinical characteristics of chronic pain after spinal cord injury. Arch Phys Med Rehabil 82(9):1191–1197PubMedGoogle Scholar
  35. 35.
    Hopkins A, Dealey C, Bale S, Defloor T, Worboys F (2006) Patient stories of living with a pressure ulcer. J Adv Nurs 56(4):345–353PubMedGoogle Scholar
  36. 36.
    Günes UY (2008) A descriptive study of pressure ulcer pain. Ostomy Wound Manage 54(2):56–61PubMedGoogle Scholar
  37. 37.
    Manfredi PL, Breuer B, Meier DE, Libow L (2003) Pain assessment in elderly patients with severe dementia. J Pain Symptom Manage 25(1):48PubMedGoogle Scholar
  38. 38.
    Aminoff BZ, Adunsky A (2005) Dying dementia patients: too much suffering, too little palliation. Am J Hosp Palliat Med 22(5):344–348Google Scholar
  39. 39.
    Siddall PJ, Loeser JD (2001) Pain following spinal cord injury. Spinal Cord 39(2):63PubMedGoogle Scholar
  40. 40.
    Westgren N, Levi R (1998) Quality of life and traumatic spinal cord injury. Arch Phys Med Rehabil 79(11):1433–1439PubMedGoogle Scholar
  41. 41.
    Middleton J, Tran Y, Craig A (2007) Relationship between quality of life and self-efficacy in persons with spinal cord injuries. Arch Phys Med Rehabil 88(12):1643–1648PubMedGoogle Scholar
  42. 42.
    Chiodo AE, Scelza WM, Kirshblum SC, Wuermser L-A, Ho CH, Priebe MM (2007) Spinal cord injury medicine. 5. Long-term medical issues and health maintenance. Arch Phys Med Rehabil 88(3 Suppl 1):S76–S83PubMedGoogle Scholar
  43. 43.
    Drahovzal DN, Stewart SH, Sullivan MJL (2006) Tendency to catastrophize somatic sensations: pain catastrophizing and anxiety sensitivity in predicting headache. Cogn Behav Ther 35(4):226–235PubMedGoogle Scholar
  44. 44.
    Wollaars MM, Post MWM, van Asbeck FWA, Brand N (2007) Spinal cord injury pain: the influence of psychologic factors and impact on quality of life. Clin J Pain 23(5):383–391PubMedGoogle Scholar
  45. 45.
    Roth RS, Lowery JC, Hamill JB (2004) Assessing persistent pain and its relation to affective distress, depressive symptoms, and pain catastrophizing in patients with chronic wounds: a pilot study. Am J Phys Med Rehabil 83(11):827–834PubMedGoogle Scholar
  46. 46.
    Budh CN, Österåker A-L (2007) Life satisfaction in individuals with a spinal cord injury and pain. Clin Rehabil 21(1):89–96PubMedGoogle Scholar
  47. 47.
    Mathew KM, Ravichandran G, May K, Morsley K (2001) The biopsychosocial model and spinal cord injury. Spinal Cord 39(12):644PubMedGoogle Scholar
  48. 48.
    Rudy TE, Lieber SJ, Boston JR, Gourley LM, Baysal E (2003) Psychosocial predictors of physical performance in disabled individuals with chronic pain. Clin J Pain 19(1):18–30PubMedGoogle Scholar
  49. 49.
    Martz E, Livneh H (2003) Death anxiety as a predictor of future time orientation among individuals with spinal cord injuries. Disabil Rehabil 25(18):1024–1032PubMedGoogle Scholar
  50. 50.
    Buchanan KM, Elias LJ (2001) Psychological distress and family burden following spinal cord injury: concurrent traumatic brain injury cannot be overlooked. Axone 22(3):16–17PubMedGoogle Scholar
  51. 51.
    Povolny MA, Kaplan SP (1993) Traumatic brain injury occurring with spinal cord injury: significance for rehabilitation. J Rehabil 59(2):23Google Scholar
  52. 52.
    Richards JS, Brown L, Hagglund K, Bua G, Reeder K (1988) Spinal cord injury and concomitant traumatic brain injury. Results of a longitudinal investigation. Am J Phys Med Rehabil 67(5):211–216PubMedGoogle Scholar
  53. 53.
    Richards JS, Osuna FJ, Jaworski TM, Novack TA, Leli DA, Boll TJ (1991) The effectiveness of different methods of defining traumatic brain injury in predicting postdischarge adjustment in a spinal cord injury population. Arch Phys Med Rehabil 72(5):275–279PubMedGoogle Scholar
  54. 54.
    Davidoff G, Doljanac R, Berent S et al (1988) Galveston Orientation and Amnesia Test: its utility in the determination of closed head injury in acute spinal cord injury patients. Arch Phys Med Rehabil 69(6):432–434PubMedGoogle Scholar
  55. 55.
    Roth E, Davidoff G, Thomas P et al (1989) A controlled study of neuropsychological deficits in acute spinal cord injury patients. Paraplegia 27(6):480–489PubMedGoogle Scholar
  56. 56.
    Hess DW, Marwitz JH, Kreutzer JS (2003) Neuropsychological impairments after spinal cord injury: a comparative study with mild traumatic brain injury. Rehabil Psychol 48(3):151–156Google Scholar
  57. 57.
    Elliott TR, Bush BA, Chen Y (2006) Social problem-solving abilities predict pressure sore occurrence in the first 3 years of spinal cord injury. Rehabil Psychol 51(1):69–77Google Scholar
  58. 58.
    Fowler JS, Volkow ND, Kassed CA, Chang L (2007) Imaging the addicted human brain. Sci Pract Perspect 3(2):4–16PubMedCentralPubMedGoogle Scholar
  59. 59.
    Herrick SM, Elliott TR, Crow F (1994) Social support and the prediction of health complications among persons with spinal cord injuries. Rehabil Psychol 39(4):231–250Google Scholar
  60. 60.
    Dryden DM, Saunders LD, Rowe BH et al (2004) Utilization of health services following spinal cord injury: a 6-year follow-up study. Spinal Cord 42(9):513–525PubMedGoogle Scholar
  61. 61.
    Shnek ZM, Foley FW, LaRocca NG et al (1997) Helplessness, self-efficacy, cognitive distortions, and depression in multiple sclerosis and spinal cord injury. Ann Behav Med 19(3):287–294PubMedGoogle Scholar
  62. 62.
    Johnson MF, Kramer AM, Lin MK, Kowalsky JC, Steiner JF (2000) Outcomes of older persons receiving rehabilitation for medical and surgical conditions compared with hip fracture and stroke. J Am Geriatr Soc 48(11):1389–1397PubMedGoogle Scholar
  63. 63.
    Chen M-L, Chang H-K (2004) Physical symptom profiles of depressed and nondepressed patients with cancer. Palliat Med 18(8):712–718PubMedGoogle Scholar
  64. 64.
    Charlifue SW, Gerhart KA (1991) Behavioral and demographic predictors of suicide after traumatic spinal cord injury. Arch Phys Med Rehabil 72(7):488–492PubMedGoogle Scholar
  65. 65.
    DeVivo MJ, Kartus PL, Stover SL, Rutt RD, Fine PR (1989) Cause of death for patients with spinal cord injuries. Arch Intern Med 149(8):1761–1766PubMedGoogle Scholar
  66. 66.
    DeVivo MJ, Black KJ, Richards JS, Stover SL (1991) Suicide following spinal cord injury. Paraplegia 29(9):620–627PubMedGoogle Scholar
  67. 67.
    Kennedy P, Marsh N, Lowe R, Grey N, Short E, Rogers B (2000) A longitudinal analysis of psychological impact and coping strategies following spinal cord injury. Br J Health Psychol 5(Part 2):157–172 [serial online]Google Scholar
  68. 68.
    Heinemann AW, Hawkins D (1995) Substance abuse and medical complications following spinal cord injury. Rehabil Psychol 40(2):125–140Google Scholar
  69. 69.
    Eachempati SR, Hydo LJ, Barie PS (2001) Factors influencing the development of decubitus ulcers in critically ill surgical patients. Crit Care Med 29(9):1678–1682PubMedGoogle Scholar
  70. 70.
    Kennedy GJ (1995) The geriatric syndrome of late-life depression. Psychiatr Serv 46(1):43–48PubMedGoogle Scholar
  71. 71.
    Gerhart KA, Weitzenkamp DA, Kennedy P, Glass CA, Charlifue SW (1999) Correlates of stress in long-term spinal cord injury. Spinal Cord 37(3):183PubMedGoogle Scholar
  72. 72.
    Braden BJ (1998) The relationship between stress and pressure sore formation. Ostomy Wound Manage 44(3A Suppl):26S–36SPubMedGoogle Scholar
  73. 73.
    Kennedy P, Duff J (2001) Post traumatic stress disorder and spinal cord injuries. Spinal Cord 39(1):1PubMedGoogle Scholar
  74. 74.
    Anderson TP, Andberg MM (1979) Psychosocial factors associated with pressure sores. Arch Phys Med Rehabil 60(8):341–346PubMedGoogle Scholar
  75. 75.
    Crewe NM, Athelstan GT, Krumberger J (1979) Spinal cord injury: a comparison of preinjury and postinjury marriages. Arch Phys Med Rehabil 60(6):​252–256PubMedGoogle Scholar
  76. 76.
    Elliott TR, Shewchuk RM, Richards JS (1999) Caregiver social problem-solving abilities and family member adjustment to recent-onset physical disability. Rehabil Psychol 44(1):104–123Google Scholar
  77. 77.
    Cooper C, Katona C, Finne-Soveri H, Topinkova E, Carpenter GI, Livingston G (2006) Indicators of elder abuse: a crossnational comparison of psychiatric morbidity and other determinants in the Ad-HOC study. Am J Geriatr Psychiatry 14(6):489–497PubMedGoogle Scholar
  78. 78.
    Guihan M, Goldstein B, Smith BM, Schwartz A, Manheim LM (2003) SCI health care provider attitudes about pressure ulcer management. J Spinal Cord Med 26(2):129–134PubMedGoogle Scholar
  79. 79.
    Anson CA, Stanwyck DJ, Krause JS (1993) Social support and health status in spinal cord injury. Paraplegia 31(10):632–638PubMedGoogle Scholar
  80. 80.
    Norton L, Sibbald RG (2004) Is bed rest an effective treatment modality for pressure ulcers? Ostomy Wound Manage 50(10):40PubMedGoogle Scholar
  81. 81.
    Antonovsky A (1979) Health, stress, and coping. Jossey-Bass, San FranciscoGoogle Scholar
  82. 82.
    Antonovsky A (1987) Unraveling the mystery of health: how people manage stress and stay well. Jossey-Bass, San FranciscoGoogle Scholar
  83. 83.
    Antonovsky A, Ornstein RE, Swencionis C (1990) The salutogenic model of health. The healing brain: a scientific reader. Guilford Press, New York, pp 231–243Google Scholar
  84. 84.
    Clark FA, Jackson JM, Scott MD et al (2006) Data-based models of how pressure ulcers develop in daily-living contexts of adults with spinal cord injury. Arch Phys Med Rehabil 87(11):1516–1525PubMedGoogle Scholar
  85. 85.
    Alden P (1992) Psychological aspects of spinal cord injury. Educ Child Psychol 9(1):34–48Google Scholar
  86. 86.
    Grzesiak RC (1977) Relaxation techniques in treatment of chronic pain. Arch Phys Med Rehabil 58(6):​270–272PubMedGoogle Scholar
  87. 87.
    Umlauf RL (1992) Psychological interventions for chronic pain following spinal cord injury. Clin J Pain 8(2):111–118PubMedGoogle Scholar
  88. 88.
    Kemp BJ, Kahan JS, Krause JS, Adkins RH, Nava G (2004) Treatment of major depression in individuals with spinal cord injury. J Spinal Cord Med 27(1):​22–28PubMedGoogle Scholar
  89. 89.
    Cole MG, Elie LM, McCusker J, Bellavance F, Mansour A (2001) Feasibility and effectiveness of treatments for post-stroke depression in elderly inpatients: systematic review. J Geriatr Psychiatry Neurol 14(1):37–41PubMedGoogle Scholar
  90. 90.
    Draper BM (2000) The effectiveness of the treatment of depression in the physically ill elderly. Aging Ment Health 4(1):9–20Google Scholar
  91. 91.
    McFarland K (2005) Battling late-life depression: short term psychotherapy for depression in older adults–a review of evidence-based studies since 2000. Ann Am Psychother Assn 8(4):20–27Google Scholar
  92. 92.
    Galea M, Tumminia J, Garback LM (2006) Telerehabilitation in spinal cord injury persons: a novel approach. Telemed J E Health 12(2):160–162PubMedGoogle Scholar
  93. 93.
    Young JM, Lawrence W, Quick P (1999) A unique role: the peer mentor on the spinal cord team at G.F. Strong Rehab Centre. Healthc Manage Forum 12(3):51–53PubMedGoogle Scholar
  94. 94.
    Thompson G, Tanberg BJ, Requejo PS, Scott M (2008) Effects of a structured life coaching program on the quality of life of participants with SCI. Paper presented at: American Spinal Injury Association, San Diego, June 2008Google Scholar
  95. 95.
    Young JM, Fish WW, Browne A, Lawrie RS (2002) Using a harm reduction approach with clients who have alcohol/drug dependencies in a spinal cord rehabilitation program. J Spinal Cord Med 25(2):81–87PubMedGoogle Scholar
  96. 96.
    LaMantia JG, Hirschwald JF, Goodman CL, Wooden VM, Delisser O, Staas WE Jr (1987) A program design to reduce chronic readmissions for pressure sores. Rehabil Nurs 12(1):22PubMedGoogle Scholar
  97. 97.
    Cupples SA, Steslow B (2001) Use of behavioral contingency contracting with heart transplant candidates. Prog Transplant 11(2):137–144PubMedGoogle Scholar
  98. 98.
    Gorski JA, Slifer KJ, Townsend V, Kelly-Suttka J, Amari A (2005) Behavioural treatment of non-compliance in adolescents with newly acquired spinal cord injuries. Pediatr Rehabil 8(3):​187–198PubMedGoogle Scholar
  99. 99.
    Kornbluth ID, Freedman MK, Holding MY, Overton EA, Saulino MF (2008) Interventions in chronic pain management. 4. Monitoring progress and compliance in chronic pain management. Arch Phys Med Rehabil 89(3 Suppl 1):S51–S55PubMedGoogle Scholar
  100. 100.
    Butler SF, Fernandez K, Benoit C, Budman SH, Jamison RN (2008) Validation of the revised Screener and Opioid Assessment for Patients with Pain (SOAPP-R). J Pain 9(4):360–372PubMedCentralPubMedGoogle Scholar
  101. 101.
    Butler SF, Budman SH, Fernandez K, Jamison RN (2004) Validation of a screener and opioid assessment measure for patients with chronic pain. Pain 112(1):65–75PubMedGoogle Scholar
  102. 102.
    Webster LR, Webster RM (2005) Predicting aberrant behaviors in opioid-treated patients: preliminary validation of the Opioid Risk Tool. Pain Med 6(6):432–442PubMedGoogle Scholar
  103. 103.
    Butler SF, Budman SH, Fernandez KC et al (2007) Development and validation of the Current Opioid Misuse Measure. Pain 130(1):144–156PubMedCentralPubMedGoogle Scholar
  104. 104.
    Mayfield D, McLeod G, Hall P (1974) The CAGE questionnaire: validation of a new alcoholism screening instrument. Am J Psychiatry 131(10):​1121–1123PubMedGoogle Scholar
  105. 105.
    Selzer ML (1971) The Michigan Alcoholism Screening Test: the quest for a new diagnostic instrument. Am J Psychiatry 127(12):1653–1658PubMedGoogle Scholar
  106. 106.
    Shields AL, Howell RT, Potter JS, Weiss RD (2007) The Michigan Alcoholism Screening Test and its shortened form: a meta-analytic inquiry into score reliability. Subst Use Misuse 42(11):​1783–1800PubMedGoogle Scholar
  107. 107.
    Donovan MI, Evers K, Jacobs P, Mandleblatt S (1999) When there is no benchmark: designing a primary care-based chronic pain management program from the scientific basis up. J Pain Symptom Manage 18(1):38–48PubMedGoogle Scholar
  108. 108.
    Wallace LS, Keenum AJ, Roskos SE, McDaniel KS (2007) Development and validation of a low-literacy opioid contract. J Pain 8(10):759–766PubMedGoogle Scholar
  109. 109.
    Hariharan J, Lamb GC, Neuner JM (2007) Long-term opioid contract use for chronic pain management in primary care practice. A five year experience. J Gen Intern Med 22(4):485–490PubMedCentralPubMedGoogle Scholar
  110. 110.
    Futterman R, Lorente M, Silverman SW (2005) Beyond harm reduction: a new model of substance abuse treatment further integrating psychological techniques. J Psychother Integration 15(1):3–18Google Scholar
  111. 111.
    Little J (2006) Harm reduction therapy groups: engaging drinkers and drug users in a process of change. J Groups Addict Recovery 1(1):69–93Google Scholar
  112. 112.
    MacCoun RJ (1998) Toward a psychology of harm reduction. Am Psychol 53(11):1199PubMedGoogle Scholar
  113. 113.
    MacCoun RJ (1999) What harm reduction is and isn’t. Am Psychol 54(10):843Google Scholar
  114. 114.
    Marlatt GA (1998) Basic principles and strategies of harm reduction. In: Marlatt GA (ed) Harm reduction: pragmatic strategies for managing high-risk behaviors. Guilford Press, New York, pp 49–66Google Scholar
  115. 115.
    Duff E, Redhead A, Paxton R, Iceton J, Rochester J (2006) Challenging behaviour in Mental Health Services: combining psychological perspectives. J Ment Health 15(4):475–490Google Scholar
  116. 116.
    Kindler CH, Szirt L, Sommer D, Häusler R, Langewitz W (2005) A quantitative analysis of anaesthetist-patient communication during the pre-operative visit. Anaesthesia 60(1):53–59PubMedGoogle Scholar
  117. 117.
    Epstein RM, Franks P, Shields CG et al (2005) Patient-centered communication and diagnostic testing. Ann Fam Med 3(5):415–421PubMedCentralPubMedGoogle Scholar
  118. 118.
    Epstein RM, Mauksch L, Carroll J, Jaén CR (2008) Have you really addressed your patient’s concerns? Fam Pract Manag 15(3):35–40PubMedGoogle Scholar
  119. 119.
    Maynard FM (1996) Ethical issues in pressure ulcer management. Top Spinal Cord Inj Rehabil 2(1):57–63Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  1. 1.Rancho Los Amigos, National Rehabilitation CenterDowneyUSA

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