EBP Assignment 1 - Student Sample

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Aspen University *

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MISC

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Psychology

Date

Feb 20, 2024

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1 Pain and Depression After Surgery Student Name Aspen University Evidence-based Practice for Quality Improvement Instructor Name Date

2 Abstract A search was conducted for the purpose of attaining information in the subject matter of post- surgical psychosocial follow up related to pain and depression through telehealth communication. Initially the Medical Subject Heading (MeSH) terms utilized through PubMed were telemedicine and surgical oncology, however these terms did not render results. Multiple combinations of terms were utilized but were not effective in retrieving the appropriate number of peer-reviewed current articles. Ultimately the MeSH terms used were pain and depression. This search returned 6,932 articles, 619 reviewed. When the search was refined to within the last five years, the articles that met the criteria numbered at 1,833 of which 118 were reviewed. The search was then refined further to include references in which the search terms are within the title or abstract. This search indicated an increase to 10,332 articles available, however only 35 were reviewed. The search was then refined to just the title which resulted in 664 articles, yet again 35 were reviewed. Campos, A. C., Antunes, G. F., Matsumoto, M., Pagano, R. L., & Martinez, R. C. (2020). Neuroinflammation, pain, and depression: An overview of the main findings. Frontier in Psychology, 11 (1825). https://pubmed.ncbi.nlm.nih.gov/32849076/ doi: 10.3389/fpsyg.2020.01825 The aim of the paper was to place emphasis on the correlation among chronic pain and depression. Focus was placed on the neuroinflammatory response associated with both chronic pain and severe depression. Through quantitative research it was indicated that improvements can be made by targeting inflammatory mediators, including cytokines. The review of research included as many published articles on pain-depression syndrome and neuroinflammation as possible, therefore there were no publication restrictions placed on the search. A formal

3 systematic-review or meta-analysis was not conducted. Studies that were not included were those that presented repeat information, involved reviews or meta-analysis, and those that were not published in English. This work may hold value as it may assist in formulating pharmacological treatment for pain-depression syndrome. The article noted no ethical issues or conflicts of interest. Authors were well associated in the fields of neuroscience, anesthesiology, and psychology. Dadgostar, A., Bigder, M., Punjani, N., Lozo, S., Chahal, V., & Kavanagh. (2017). Does preoperative depression predict post-operative surgical pain: A systematic review. International Journal of Surgery , 141 , 162-173. https://pubmed.ncbi.nlm.nih.gov/28359955/ doi: 10.1016/j.ijsu.2017.03.061 As much psychosocial research has indicated there is a link among pre-surgical social factors and thoughts and behaviors and their effects on surgical outcome, additional attention on pre- surgical depression and post-surgical pain may lead to better surgical outcomes. In order to assess the relationship between pre-operative depression and post-operative pain a systematic review of randomized control trials and observational studies were conducted. A qualitative approach was utilized. The systematic review identified eight studies in which a significant correlation among pre-surgical depression and post-surgical pain.10 studies indicated no significant statistical correlation among the two topics. For this reason, this study may provide poor data to support the theory and is not indicative to answer additional questions or provide further information. Inclusion and exclusion criteria involved a 10-year span, from published work between the years of 2006-2016. The New Castle Ottawa scale was used to assess quality and to protect against bias. Humo, M., Lu, H. & Yalcin, I. (2019). The molecular neurobiology of chronic pain-induced

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4 depression. Cell and Tissue Research, 377 (1), 21-43. https://pubmed.ncbi.nlm.nih.gov/30778732/ doi: 10.1007/s00441-019-03003-z It is noted that there is a pressing need to address comorbidities such as the treatment of mood disorders and chronic pain. Better management of these co-existing diseases are necessitated as the continued lack of appropriate treatment greatly affects the quality of life. The study focuses on providing a synopsis of pre-clinical and clinical studies that have been conducted over the last two decades. The study emphasizes the molecular attributes of the relationship between depression and chronic pain. Major depressive disorders were a key focus and genetic and non- genetic points of view were considered in the study in relation to the co-morbidities between depression and chronic pain. The most significant ethical concern in regard to this study was its use of animal models to conduct research to better understand the disease processes and their correlation. Michaelidis, A. & Zis,P. (2019). Depression, anxiety and acute pain: Links and management challenges. Postgrad Med, 131 (7), 438-444. https://pubmed.ncbi.nlm.nih.gov/31482756/ doi: 10.1080/00325481.2019.1663705 The literature review and narratives aim were to discuss the correlation among different types of pain and their relation to depression and anxiety. Pain is discussed as a subjective experience that is based on multiple factors such as gender, culture, social, genetic, and other personal aspects, and influences. The study refers to the evidenced information that pain is bi- directional with mood disorder and that both heavily influence one another and are risk factors for each. The study also indicates that less evidence is available on the subject matter of acute pain and anxiety, although what little information that is available shows that acute pain is correlated with increased levels of anxiety. It shares that as anxiety levels increase the ability to

5 tolerate pain decreases. In addition, it is evidence that as anxiety levels increase, perceived pain increases as well. This research may be valuable as many patients struggle and present with depression, anxiety, and pain and are disregarded by their care team. This study indicates and places focus on continued research in this area for the purpose of creating effective treatment and care plans. It was stated in the article that peer reviewers and the authors did not have any financial involvement in the study or any questionable ethical relationships to disclose. The study was not funded, and no conflicts of interest were reported. Sheng, J., Liu,S., Wang, Y., Cui, R. & Zhang, X. (2017). The link between depression and Chronic pain: Neural mechanisms in the brain. Neural Plasticity. https://pubmed.ncbi.nlm.nih.gov/28706741/ doi: 10.1155/2017/9724371 This study focuses on chronic pain and depression and their influence on one another. The detail regarding their association is unclear however it does create significant problems in regard to treatment. In this review the authors explain the role of neuroplasticity in relation to how these two conditions arise and progress. The study also aims at determining the pharmacological effects on the two conditions with the utilization of anti-depressants and analgesics. The review may be valuable as it shares new information in regard to the correlation between chronic pain and depression. It identifies that additional research should be conducted in order to assess shared neuroplasticity changes by both chronic pain and depression for the purpose of identifying drug targets to relieve patients from chronic pain induced depression. It was shared that the work was funded by the Natural Science Foundation of China and that there were no conflicts of interest.

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