Emerging research has indicated that ‘significant others’ (spouses/relatives) may have important influences on continued work participation for individuals with chronic non-specific musculoskeletal pain (CMP). In order to expand on this novel area of research, data from studies conducted in The Netherlands and the UK were assimilated. In both studies, worker and significant other perceptions of pain self-efficacy, perceived partner responses to pain, pain catastrophizing, and contribution to work participation were explored in relation to the worker's CMP. In the Netherlands, questionnaire data were collected from workers with CMP and their significant others (n=103), and in the UK, in-depth semi-structured interviews were conducted (n=10). Appropriate quantitative and qualitative analysis techniques were applied.Background
Method
Individual illness perceptions have been shown to be important influences on both clinical and work outcomes for those with back pain, yet the influence of ‘significant others’ (spouse/partner/close family member) illness perceptions is rarely explored, particularly in relation to work participation. Semi-structured interviews based on the Illness Perceptions Questionnaire were conducted with two purposive samples of chronic back pain patients (working and work disabled), along with their significant others (n=28). Data were analysed using template analysis.Background
Method
Individual illness perceptions have been shown to be important influences on clinical outcomes for low back, yet significant others' illness perceptions are rarely explored, particularly in relation to work disability. Semi-structured interviews based on the Illness Perceptions Questionnaire were conducted with a purposive sample of UK disability benefit claimants, along with their significant others (n=5 dyads). Data were analysed using template analysis.Background
Method
The risk of blood transfusion in spinal fusion surgery is significant and mandates efforts to reduce ABT. This prospective study demonstrated a significant reduction in the rate of allogeneic blood transfusion (ABT) using Cell Saver (CS), Preoperative Autologus Donation (PAD), and Preoperative Erythropoietin Therapy (PET). The ABT was inversely related to the number of modalities used: 74% (n=14/19) with zero modalities; 32% (n=24/74) with one modalities; 17% (n=9/52) with two modalities; and 7% (n=2/28) with three modalities. Due to the potential amount of blood loss during spinal fusions the use of several BC techniques in combination is required to effectively reduce ABT. The purpose of this prospective study is to assess the efficacy of current blood conservation (BC) techniques in reducing the rate of allogeneic blood transfusion (ABT) in spinal fusions. All three current blood conservation techniques, particularly in combination, proved to be very effective in reducing the rate of ABT in elective spinal fusions. Transfusion of allogenic blood despite its improved safety is not without risk. From June 1999 to September 2001, transfusion and related surgical data has been prospectively collected in one hundred and seventy-three patients undergoing elective spinal fusions. The following three BC techniques were utilized: Cell Saver (CS), Preoperative Auto-logus Donation (PAD), and Preoperative Erythropoietin Therapy (PET). The average number of fusion levels was 2.3 (range 1–5). The average estimated blood loss was 1725 milliliters (range 250–10700). Decompression was also preformed in 75% of cases. The overall ABT rate was 28% (n=49/173). The ABT was inversely related to the number of modalities used: 74% (n=14/19) with zero modalities; 32%* (n=24/74) with one modalities; 17%* (n=9/52) with two modalities; and 7%*† (n=2/28) with three modalities respectively (*statistically significant compared to zero modality group; † statistically significant compared to one modality group). The patient demographics and surgical variables were similar between the four groups. The use of CS, PAD, and PET was independently related to ABT. The risk of blood transfusion in spinal fusion surgery is significant and mandates efforts to reduce ABT. Due to the amount of blood loss the use of several BC techniques in combination is required to effectively reduce ABT.
