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Dueñas M, De Sola H, Salazar A, Esquivia A, Rubio S, Failde I. Prevalence and epidemiological characteristics of chronic pain in the Spanish population. Results from the pain barometer. Eur J Pain 2024. [PMID: 39046161 DOI: 10.1002/ejp.4705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Revised: 07/09/2024] [Accepted: 07/10/2024] [Indexed: 07/25/2024]
Abstract
BACKGROUND Chronic pain (CP) is a public health problem worldwide. AIM To update the prevalence of CP and compare the clinical and social characteristics of people with CP with those with non-chronic continuous pain and a group without pain. METHODS An observational cross-sectional study was carried out in a representative sample of 7058 adults from the Spanish population. Sociodemographic data, the presence of CP and non-chronic continuous pain, characteristics of pain, limitations on activities of daily living (ADL), the presence and level of anxiety and depression (HADS), quality of life (SF-12v2) and social support (DUKE) were collected. Descriptive and bivariate analyses were performed. RESULTS The prevalence of CP was 25.9% (95% CI;24.8-26.9) and that of non-chronic continuous pain was 7.7% (95% CI;7.1-8.3). Women presented a higher prevalence of both CP (30.5% vs. 21.3%) and non-chronic continuous pain (8.8% vs. 6.6%). CP was more common in the group between 55 and 75 years old (30.6%, 95% CI = 28.6-32.6%), non-chronic continuous pain affected most the population between 18 and 34 years old (11.2%, 95% CI = 9.6-12.7%). The median duration of CP was 4 years. The lumbar was the most frequent pain site (58.1%), and 27.1% did not know the cause. A greater frequency of limitations on ADL, more anxiety and depression, and worse quality of life were shown among the subjects with CP. CONCLUSION CP affects one in four Spanish people and impairs the mental, physical and social health. Differences exist by sex and age in its frequency. Identifying subjects with non-chronic continuous pain is fundamental to prevent their pain from becoming chronic. SIGNIFICANCE STATEMENT Indicating the main aspects where this work adds significantly to existing knowledge in the field, and if appropriate to clinical practice. Due to its high prevalence and impact on quality of life, chronic pain has become one of the main health problems nowadays. Attention must be paid to it both from a clinical and social perspective, trying to raise awareness among the population of its possible causes and consequences. In routine clinical practice, greater consideration is given to groups of people with a higher prevalence of chronic pain, such as women and people with middle age, and with no chronic pain to prevent the appearance of chronic pain.
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Affiliation(s)
- M Dueñas
- Observatory of Pain, Grünenthal Foundation-University of Cadiz, Cádiz, Spain
- Biomedical Research and Innovation Institute of Cadiz (INiBICA), Cádiz, Spain
- Department of Statistics and Operational Research, University of Cádiz, Puerto Real, Spain
| | - H De Sola
- Observatory of Pain, Grünenthal Foundation-University of Cadiz, Cádiz, Spain
- Biomedical Research and Innovation Institute of Cadiz (INiBICA), Cádiz, Spain
- Department of General Economics, Area of Sociology, University of Cádiz, Jerez de la Frontera, Spain
| | - A Salazar
- Observatory of Pain, Grünenthal Foundation-University of Cadiz, Cádiz, Spain
- Biomedical Research and Innovation Institute of Cadiz (INiBICA), Cádiz, Spain
- Department of Statistics and Operational Research, University of Cádiz, Puerto Real, Spain
| | - A Esquivia
- Medical Department, Grünenthal Pharma, S.A, San Blas-Canillejas, Spain
| | - S Rubio
- Market Access Department, Grünenthal Pharma, S.A, San Blas-Canillejas, Spain
| | - I Failde
- Observatory of Pain, Grünenthal Foundation-University of Cadiz, Cádiz, Spain
- Biomedical Research and Innovation Institute of Cadiz (INiBICA), Cádiz, Spain
- Preventive Medicine and Public Health Area, University of Cádiz, Cádiz, Spain
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Wild MG, Ehde DM, Reyes MR, Fann JR, Bombardier CH. Disparities Based on Demographic Features in the Intensity and Treatment of Chronic Pain in US Patients With Spinal Cord Injury. Arch Phys Med Rehabil 2024:S0003-9993(24)01072-4. [PMID: 38964636 DOI: 10.1016/j.apmr.2024.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 05/28/2024] [Accepted: 06/16/2024] [Indexed: 07/06/2024]
Abstract
OBJECTIVE Informed by Minority Stress Theory, to investigate disparities in pain intensity, interference, and care in patients with spinal cord injuries (SCI) based on demographic features. DESIGN Cross-sectional survey. SETTING Outpatient SCI clinics in 2 academic medical centers in the northwestern United States. PARTICIPANTS Sample of 242 SCI clinic patients who endorsed SCI-related pain, were ≥18-years-of-age, English-fluent, not diagnosed with bipolar or psychotic disorders, and able to make their own medical decisions. Participants were 74.8% men, an average of 48.5 years (range 18.1-89.8 years), 76.2% White, 31.9% privately insured, and 64.7% making <$50,000 per year. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Exploratory analyses of screening data from a randomized controlled trial for pain treatment. Primary outcomes included pain intensity, pain interference, and the patient report of recommended pain treatments by a medical provider, tried by the patient, or that the patient would be willing to try. RESULTS More treatments recommended was associated with younger age (ρ=-0.14, 95% confidence interval [CI]: -0.01 to -0.27, P=.03) and private insurance (ρ=-0.15, 95% CI: 0.02-0.27, P=.03), whereas more treatments tried was associated with private insurance alone (ρ=0.20, 95% CI: 0.07-0.32, P=.003). Number of treatments willing to be tried was associated with lower income (ρ=-0.15, 95% CI: -0.02 to -0.28, P=.03). SCI patients of color (PoC) reported higher pain intensity (Cohen's d=0.41, 95% CI: 0.11-0.71) and greater odds of receiving psychotherapy for pain (odds ratio: 7.12, 95% CI: 1.25-40.46) than their White peers. CONCLUSIONS These exploratory findings indicate differences in SCI-related pain intensity based on identifying as PoC, and differences in SCI-related pain treatment modalities based on identifying as PoC, age, insurance type, and income. Further work exploring differences in SCI-related pain care based on patient social identities is warranted.
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Affiliation(s)
- Marcus G Wild
- VISN 17 Center of Excellence for Research on Returning War Veterans, Waco, TX.
| | - Dawn M Ehde
- Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA
| | - Maria R Reyes
- Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA
| | - Jesse R Fann
- Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA; Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA
| | - Charles H Bombardier
- Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA
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Wong J, Su H, Kudla A, Munsell EGS, Ezeife N, Crown D, Trierweiler R, Capraro P, Tomazin S, Park M, Heinemann AW. Facilitators and barriers to employment for people with physical disabilities: A cross-sectional study. Work 2024:WOR220721. [PMID: 38905070 DOI: 10.3233/wor-220721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/23/2024] Open
Abstract
BACKGROUND There is increasing evidence that employment, or the lack thereof, affects an individual's health. Consequently, employment provides people with physical disabilities (PWPD) with financial independence, enhances their well-being and self-worth, and facilitates a sense of purpose. People with physical disabilities often retain job skills and motivation to return to work after acquiring a disability. Their vocational rehabilitation and job accommodation needs likely differ from people with disabilities resulting from developmental, sensory, cognitive, and mental health conditions. To better target the needs of PWPD and improve vocational rehabilitation services, it is crucial to identify the modifiable factors that influence their employment outcomes. OBJECTIVE This research aimed to examine systematically the client-, employer-, and context-related facilitators and barriers to employment experienced by PWPD. METHODS We recruited to this cross-sectional study, PWPD from the Midwestern United States who returned to work after injury or illness. An online survey collected data on demographic characteristics and educational history; disability and functional status; supports, facilitators and barriers to employment; and job information and accommodations. RESULTS 347 working-age PWPD completed the survey; at the time of survey completion, 270 were working and 77 were not. People with physical disabilities who reported social support and encouragement at work were more likely to be working than respondents who did not. Negative attitudes of supervisors and colleagues, inaccessible work environments, and inflexible work schedules were barriers to employment. Important reasons for working included financial needs, a sense of purpose, and self-worth. CONCLUSIONS Results provide insights into the importance of social supports in the work environment. Novel approaches are needed to develop supportive relationships with supervisors and coworkers.
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Affiliation(s)
- Jasin Wong
- Department of Special Education, National Tsing Hua University, Hsinchu City, Taiwan
| | - Han Su
- School of Nursing, Vanderbilt University, Nashville, TN, USA
| | - Angelika Kudla
- Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL, USA
| | | | - Nnaemezie Ezeife
- Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL, USA
| | - Deborah Crown
- Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL, USA
| | - Robert Trierweiler
- Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL, USA
| | - Pamela Capraro
- Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL, USA
| | | | - Mirang Park
- Rehabilitation Counseling Department, Kosin University, Busan, Republic of Korea
| | - Allen W Heinemann
- Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL, USA
- Department of Physical Medicine & Rehabilitation, Feinberg School of Medicine at Northwestern University, Chicago, IL, USA
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Sullivan MD, Wilson L, Amick M, Miller-Matero LR, Chrusciel T, Salas J, Zabel C, Lustman PJ, Ahmedani B, Carpenter RW, Scherrer JF. Social support and the association between post-traumatic stress disorder and risk for long-term prescription opioid use. Pain 2024:00006396-990000000-00617. [PMID: 38833573 DOI: 10.1097/j.pain.0000000000003286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 03/15/2024] [Indexed: 06/06/2024]
Abstract
ABSTRACT Post-traumatic stress disorder (PTSD) is common in patients with chronic pain, adversely affects chronic pain outcomes, and is associated with opioid use and adverse opioid outcomes. Social support is a robust predictor of PTSD incidence and course as well as chronic pain outcome. We determined whether the association between PTSD and persistent opioid use was modified by emotional support in a cohort of patients receiving opioids for noncancer pain. Eligible participants were ≥18 years and had completed a new period of prescription opioid use lasting 30 to 90 days. Bivariate associations between cohort characteristics and each key variable was assessed using χ2 tests for categorical variables and t-tests for continuous variables. Interaction between PTSD and emotional support was assessed by a priori stratification on low vs high emotional support. Participants (n = 808) were 53.6 (SD ± 11.6) years of age, 69.8% female, 69.6% White, and 26.4% African American. Overall, 17.2% had probable PTSD. High emotional support was significantly (P < 0.0001) more common among those without probable PTSD. Prescription opioid use at 6-month follow-up was significantly (P = 0.0368) more common among patients with vs without probable PTSD. In fully adjusted models, PTSD was no longer associated with opioid use at 6-month follow-up among participants with high emotional support. Among those with lower emotional support, PTSD was significantly associated with opioid use at 6-month follow-up in unadjusted (odds ratio = 2.40; 95% confidence interval: 1.24-4.64) and adjusted models (odds ratio = 2.39; 95% confidence interval: 1.14-4.99). Results point to the hypothesis that improvement of emotional support in vulnerable patients with chronic pain and PTSD may help reduce sustained opioid use.
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Affiliation(s)
- Mark D Sullivan
- Department of Psychiatry and Behavioral Science, University of Washington School of Medicine, Seattle, WA, United States
| | - Lauren Wilson
- Department of Family and Community Medicine, Saint Louis University School of Medicine, St. Louis, MO, United States
| | - Matthew Amick
- Department of Family and Community Medicine, Saint Louis University School of Medicine, St. Louis, MO, United States
| | - Lisa R Miller-Matero
- Center for Health Policy and Health Services Research and Behavioral Health Services, Henry Ford Health, One Ford Place, Detroit, MI, United States
| | - Timothy Chrusciel
- Department of Family and Community Medicine, Saint Louis University School of Medicine, St. Louis, MO, United States
- Advanced HEAlth Data (AHEAD) Research Institute, Saint Louis University School of Medicine, St. Louis, MO, United States
- Department of Health and Clinical Outcomes Research, Saint Louis University School of Medicine, St. Louis, MO, United States
| | - Joanne Salas
- Department of Family and Community Medicine, Saint Louis University School of Medicine, St. Louis, MO, United States
- Advanced HEAlth Data (AHEAD) Research Institute, Saint Louis University School of Medicine, St. Louis, MO, United States
| | - Celeste Zabel
- Center for Health Policy and Health Services Research and Behavioral Health Services, Henry Ford Health, One Ford Place, Detroit, MI, United States
| | - Patrick J Lustman
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States
| | - Brian Ahmedani
- Center for Health Policy and Health Services Research and Behavioral Health Services, Henry Ford Health, One Ford Place, Detroit, MI, United States
| | - Ryan W Carpenter
- Department of Psychological Sciences, University of Missouri-St. Louis, St. Louis, MO, United States
| | - Jeffrey F Scherrer
- Department of Family and Community Medicine, Saint Louis University School of Medicine, St. Louis, MO, United States
- Advanced HEAlth Data (AHEAD) Research Institute, Saint Louis University School of Medicine, St. Louis, MO, United States
- Department of Psychiatry and Behavioral Neuroscience, Saint Louis University School of Medicine, St. Louis, MO, United States
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Pak R, Mahmoud Alilou M, Bakhshipour Roudsari A, Yousefpour F. Experiential Avoidance as a Factor in Generalized Psychological Vulnerability: In the Relationship Between Chronic Pain and Pain Anxiety With Pain Disability. Pain Manag Nurs 2024; 25:e256-e264. [PMID: 38418316 DOI: 10.1016/j.pmn.2024.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 01/04/2024] [Accepted: 01/28/2024] [Indexed: 03/01/2024]
Abstract
BACKGROUND Pain is a major socio-psychological problem worldwide. Chronic pain has a negative effect on areas of psychological functioning such as depression, anxiety, and perceived stress. AIM The present study investigated the mediating role of experiential avoidance in the relationship between chronic pain and pain anxiety with pain disability. METHODS Participants were treatment-seeking patients (N = 361) at an outpatient pain clinic in Shiraz (Fars, Iran). The Multidimensional Pain Inventory (MPI), Pain Anxiety Symptom Scale (PASS-20), Pain Disability Questionnaire (PDQ), and Acceptance and Action Questionnaire-II (AAQ-II) were used to measure multidimensional pain, anxiety, pain disability, experiential avoidance, and pain severity. RESULTS The results of the correlation revealed that a significant relationship exists between multidimensional pain and pain anxiety, pain disability, and experiential avoidance. Experiential avoidance mediated the associations from multidimensional pain and pain disability significantly. Also, experiential avoidance moderated associations between pain anxiety and pain disability significantly. In general, Structural Equation Modeling (SEM) showed that experiential avoidance mediated the relationship between multidimensional pain and pain anxiety with pain disability. CONCLUSION In general, the results revealed that experiential avoidance can mediate the relationship among pain, pain anxiety, and pain disability as a maladaptive regulation strategy. The results obtained from this study seem to introduce experiential avoidance as a vulnerability factor effectively.
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Affiliation(s)
- Razieh Pak
- Faculty of Education and Psychology, University of Tabriz, Tabriz, Iran.
| | - Majid Mahmoud Alilou
- Department of Psychology, Faculty of Psychology and Educational Sciences, University of Tabriz, Tabriz, Iran
| | - Abass Bakhshipour Roudsari
- Department of Psychology, Faculty of Psychology and Educational Sciences, University of Tabriz, Tabriz, Iran
| | - Fatemeh Yousefpour
- Faculty of Education and Psychology, Persian Gulf University, Bandar Bushehr, Iran
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Rutter-Locher Z, Esterine T, Williams R, Taams LS, Bannister K, Kirkham BW, Lempp H. Comparative analysis of centrally mediated and inflammatory pain experiences amongst patients diagnosed with rheumatoid arthritis: A multimethods study. Health Expect 2024; 27:e14090. [PMID: 38838095 DOI: 10.1111/hex.14090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 05/09/2024] [Accepted: 05/11/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND The identification of pain originating from distinct biological processes may lead to individualised pain treatment. In this study, we aimed to explore the pain experiences of patients with rheumatoid arthritis (RA), differentiating between those predominantly exhibiting features of peripheral inflammatory versus centrally mediated pain. METHODS Through a multimethods approach we (i) quantitatively analysed the differences in pain descriptors between patients diagnosed with RA experiencing peripheral inflammatory and centrally mediated pain, utilising the Short Form-McGill Pain Questionnaire which includes the pain visual analogue scale (VAS) and (ii) qualitatively explored their subjective pain experiences grounded in the biopsychosocial model, commonly applied in chronic pain. RESULTS Participants with centrally mediated pain reported higher pain scores on the VAS, used a wider range of pain descriptors, and a higher proportion selected each descriptor compared to those with inflammatory pain (p < .001). The qualitative analysis revealed the centrally mediated pain group's experiences were overwhelming and relentless, struggling to precisely articulate the nature of their pain. In contrast, individuals with inflammatory pain expressed their pain in more tangible terms and shared their adaptive and coping strategies. Importantly, both groups revealed the substantial psychological, functional and social impacts of their pain, highlighting the often 'invisible' and misunderstood nature of their symptoms. CONCLUSION This study has gained a deeper insight into the pain experiences of patients living with RA, particularly in differentiating between centrally mediated and inflammatory types of pain, potentially facilitating a more individualised approach to pain treatment. PATIENT CONTRIBUTION Patients actively participated in the study conception and design. This engagement includes collaboration with key stakeholders, such as members of the National Rheumatoid Arthritis Society and Patient Research Partners (PRPs), who provided continuous feedback and guidance throughout the research process. Specifically, the qualitative element was coproduced with two PRPs, who were involved in co-leading the focus groups and data analysis.
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Affiliation(s)
- Zoe Rutter-Locher
- Rheumatology Department, Guy's and St Thomas' NHS Trust, London, UK
- Department of Inflammation Biology, Centre for Inflammation Biology and Cancer Immunology, Faculty of Life Sciences and Medicine, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Tom Esterine
- Department of Inflammation Biology, Centre for Rheumatic Diseases, Faculty of Life Sciences and Medicine, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Ruth Williams
- Department of Inflammation Biology, Centre for Rheumatic Diseases, Faculty of Life Sciences and Medicine, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Leonie S Taams
- Department of Inflammation Biology, Centre for Inflammation Biology and Cancer Immunology, Faculty of Life Sciences and Medicine, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Kirsty Bannister
- Central modulation of pain group, Wolfson Centre for Age-Related Diseases, Guy's Campus, King's College London, London, UK
| | - Bruce W Kirkham
- Rheumatology Department, Guy's and St Thomas' NHS Trust, London, UK
| | - Heidi Lempp
- Department of Inflammation Biology, Centre for Rheumatic Diseases, Faculty of Life Sciences and Medicine, School of Immunology and Microbial Sciences, King's College London, London, UK
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Weiß M, Gründahl M, Jachnik A, Lampe EC, Malik I, Rittner HL, Sommer C, Hein G. The Effect of Everyday-Life Social Contact on Pain. J Med Internet Res 2024; 26:e53830. [PMID: 38687594 PMCID: PMC11094601 DOI: 10.2196/53830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 02/01/2024] [Accepted: 03/13/2024] [Indexed: 05/02/2024] Open
Abstract
Pain is a biopsychosocial phenomenon, resulting from the interplay between physiological and psychological processes and social factors. Given that humans constantly interact with others, the effect of social factors is particularly relevant. Documenting the significance of the social modulation of pain, an increasing number of studies have investigated the effect of social contact on subjective pain intensity and pain-related physiological changes. While evidence suggests that social contact can alleviate pain, contradictory findings indicate an increase in pain intensity and a deterioration of pain coping strategies. This evidence primarily stems from studies examining the effect of social contact on pain within highly controlled laboratory conditions. Moreover, pain assessments often rely on one-time subjective reports of average pain intensity across a predefined period. Ecological momentary assessments (EMAs) can circumvent these problems, as they can capture diverse aspects of behavior and experiences multiple times a day, in real time, with high resolution, and within naturalistic and ecologically valid settings. These multiple measures allow for the examination of fluctuations of pain symptoms throughout the day in relation to affective, cognitive, behavioral, and social factors. In this opinion paper, we review the current state and future relevance of EMA-based social pain research in daily life. Specifically, we examine whether everyday-life social support reduces or enhances pain. The first part of the paper provides a comprehensive overview of the use of EMA in pain research and summarizes the main findings. The review of the relatively limited number of existing EMA studies shows that the association between pain and social contact in everyday life depends on numerous factors, including pain syndromes, temporal dynamics, the nature of social interactions, and characteristics of the interaction partners. In line with laboratory research, there is evidence that everyday-life social contact can alleviate, but also intensify pain, depending on the type of social support. Everyday-life emotional support seems to reduce pain, while extensive solicitous support was found to have opposite effects. Moreover, positive short-term effects of social support can be overshadowed by other symptoms such as fatigue. Overall, gathering and integrating experiences from a patient's social environment can offer valuable insights. These insights can help interpret dynamics in pain intensity and accompanying symptoms such as depression or fatigue. We conclude that factors determining the reducing versus enhancing effects of social contact on pain need to be investigated more thoroughly. We advocate EMA as the assessment method of the future and highlight open questions that should be addressed in future EMA studies on pain and the potential of ecological momentary interventions for pain treatment.
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Affiliation(s)
- Martin Weiß
- University Hospital Würzburg, Center of Mental Health, Department of Psychiatry, Psychosomatic and Psychotherapy, Translational Social Neuroscience Unit, Würzburg, Germany
| | - Marthe Gründahl
- University Hospital Würzburg, Center of Mental Health, Department of Psychiatry, Psychosomatic and Psychotherapy, Translational Social Neuroscience Unit, Würzburg, Germany
| | - Annalena Jachnik
- University Hospital Würzburg, Center of Mental Health, Department of Psychiatry, Psychosomatic and Psychotherapy, Translational Social Neuroscience Unit, Würzburg, Germany
| | - Emilia Caya Lampe
- University Hospital Würzburg, Center of Mental Health, Department of Psychiatry, Psychosomatic and Psychotherapy, Translational Social Neuroscience Unit, Würzburg, Germany
| | - Ishitaa Malik
- University Hospital Würzburg, Center of Mental Health, Department of Psychiatry, Psychosomatic and Psychotherapy, Translational Social Neuroscience Unit, Würzburg, Germany
| | - Heike Lydia Rittner
- University Hospital Würzburg, Center for Interdisciplinary Medicine, Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, Würzburg, Germany
| | - Claudia Sommer
- University Hospital Würzburg, Department of Neurology, Würzburg, Germany
| | - Grit Hein
- University Hospital Würzburg, Center of Mental Health, Department of Psychiatry, Psychosomatic and Psychotherapy, Translational Social Neuroscience Unit, Würzburg, Germany
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Allen NE, Romaliiska O, Naisby J. Pain and the Non-Pharmacological Management of Pain in People with Parkinson's Disease. JOURNAL OF PARKINSON'S DISEASE 2024:JPD230227. [PMID: 38457146 DOI: 10.3233/jpd-230227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
Pain is a distressing and universal experience, yet everyone's pain experience is influenced by a complex array of biological, psychological, and social factors. For people with Parkinson's disease (PwP), these biopsychosocial factors include neurodegeneration and the psychological and social factors that accompany living with a chronic, neurodegenerative condition in addition to the factors experienced by those in the general population (e.g., living with co-morbidities such as osteoarthritis). The way these factors influence each individual is likely to determine which pain management strategies are optimal for them. This review first describes pain and the biopsychosocial model of pain. It explores how pain is classified in Parkinson's disease (PD) and describes the three main types of pain: nociceptive, neuropathic, and nociplastic pain. This background provides context for a discussion of non-pharmacological pain management strategies that may aid in the management of pain in PwP; exercise, psychological strategies, acupuncture and massage. While there is little PD-specific research to inform the non-pharmacological management of pain, findings from current PD research are combined with that from chronic pain research to present recommendations for clinical practice. Recommendations include assessment that incorporates potential biopsychosocial contributors to pain that will then guide a holistic, multi-modal approach to management. As exercise provides overall benefits for PwP, those with chronic pain should be carefully monitored with exercise prescribed and adjusted accordingly. Research is needed to develop and evaluate multi-modal approaches to pain management that are delivered in a biopsychosocial framework.
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Affiliation(s)
- Natalie Elizabeth Allen
- Discipline of Physiotherapy, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Oksana Romaliiska
- Department of Neurology, Center of Expertise for Parkinson & Movement Disorders, Radboud University Medical Center, Nijmegen, Netherlands
| | - Jenni Naisby
- Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Sciences, Northumbria University, Newcastle Upon Tyne, United Kingdom
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Ljungvall H, Ekselius L, Åsenlöf P. Reliability, construct validity, and factorial structure of a Swedish version of the medical outcomes study social support survey (MOS-SSS) in patients with chronic pain. Scand J Pain 2024; 24:sjpain-2023-0002. [PMID: 37712773 DOI: 10.1515/sjpain-2023-0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 06/21/2023] [Indexed: 09/16/2023]
Abstract
OBJECTIVES This study aimed to examine the psychometric properties of a Swedish version of the Medical Outcomes Study Social Support Survey (MOS-SSS). METHODS Standard forward-backward translation was used. A cross-sectional survey was conducted among treatment seeking individuals with chronic pain included in a clinical cohort. Internal consistency was measured with Cronbach's α, test-retest reliability was examined with intraclass correlation, confirmatory factor analyses was used for examining factor structure, and correlations between the MOS-SSS and selected health validity measures were used for testing concurrent validity hypotheses. RESULTS 182 participants were included in the study. Internal consistency measured with Cronbach's alpha was acceptable for all subscales and for the total support index of the MOS-SSS. Test-retest reliability was moderate - good for the different subscales, and was good for the overall support index. The original four factor model of the MOS-SSS was confirmed, and the concurrent validity hypotheses were also confirmed; however, the associations were weaker than expected. CONCLUSIONS The Swedish version of the MOS-SSS was found psychometrically sound and offers a systematic assessment of social support in specialized pain care.
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Affiliation(s)
- Hanna Ljungvall
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
- Department of Social Work, Uppsala University, Uppsala, Sweden
| | - Lisa Ekselius
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Pernilla Åsenlöf
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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Stubbs C, McAuliffe S, Chimenti RL, Coombes BK, Haines T, Heales L, de Vos RJ, Lehman G, Mallows A, Michner LA, Millar NL, O'Neill S, O'Sullivan K, Plinsinga M, Rathleff M, Rio E, Ross M, Roy JS, Silbernagel KG, Thomson A, Trevail T, van den Akker-Scheek I, Vicenzino B, Vlaeyen JWS, Pinto RZ, Malliaras P. Which Psychological and Psychosocial Constructs Are Important to Measure in Future Tendinopathy Clinical Trials? A Modified International Delphi Study With Expert Clinician/Researchers and People With Tendinopathy. J Orthop Sports Phys Ther 2024; 54:14-25. [PMID: 37729020 DOI: 10.2519/jospt.2023.11903] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
OBJECTIVE: To identify which psychological and psychosocial constructs to include in a core outcome set to guide future clinical trials in the tendinopathy field. DESIGN: Modified International Delphi study. METHODS: In 3 online Delphi rounds, we presented 35 psychological and psychosocial constructs to an international panel of 38 clinician/researchers and people with tendinopathy. Using a 9-point Likert scale (1 = not important to include, 9 = critical to include), consensus for construct inclusion required ≥70% of respondents rating "extremely critical to include" (score ≥7) and ≤15% rating "not important to include" (score ≤3). Consensus for exclusion required ≥70% of respondents rating "not important to include" (score ≤3) and ≤15% of rating "critical to include" (score ≥7). RESULTS: Thirty-six participants (95% of 38) completed round 1, 90% (n = 34) completed round 2, and 87% (n = 33) completed round 3. Four constructs were deemed important to include as part of a core outcome set: kinesiophobia (82%, median: 8, interquartile range [IQR]: 1.0), pain beliefs (76%, median: -7, IQR: 1.0), pain-related self-efficacy (71%, median: 7, IQR: 2.0), and fear-avoidance beliefs (73%, median: -7, IQR: 1.0). Six constructs were deemed not important to include: perceived injustice (82%), individual attitudes of family members (74%), social isolation and loneliness (73%), job satisfaction (73%), coping (70%), and educational attainment (70%). Clinician/researchers and people with tendinopathy reached consensus that kinesiophobia, pain beliefs, pain self-efficacy, and fear-avoidance beliefs were important psychological constructs to measure in tendinopathy clinical trials. J Orthop Sports Phys Ther 2024;54(1):1-12. Epub 20 September 2023. doi:10.2519/jospt.2023.11903.
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Krohner S, Town J, Cannoy CN, Schubiner H, Rapport LJ, Grekin E, Lumley MA. Emotion-Focused Psychodynamic Interview for People with Chronic Musculoskeletal Pain and Childhood Adversity: A Randomized Controlled Trial. THE JOURNAL OF PAIN 2024; 25:39-52. [PMID: 37479050 DOI: 10.1016/j.jpain.2023.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 06/25/2023] [Accepted: 07/14/2023] [Indexed: 07/23/2023]
Abstract
Childhood adversity and emotional conflicts are associated with the presence and severity of chronic musculoskeletal pain (CMP), yet common treatments for CMP do not address such risk factors. We developed a single session, emotion-focused psychodynamic interview, based on Emotional Awareness and Expression Therapy and Intensive Short-term Psychodynamic Therapy, and we tested the interview's effects on pain-related outcomes and potential psychological mediators in a randomized, controlled trial. Adults (N = 91; ages 21-70, M = 44.64; 87.9% women) reporting CMP and at least 3 adverse childhood experiences completed measures at baseline and 6-week follow-up. Participants were randomized to immediate interview or waitlist control conditions. The 90-minute interview was conducted via videoconference, and the interviewer elicited disclosure of adversities and conflicts, linked these with pain, and encouraged the experience and expression of adaptive emotions. Analyses indicated that conditions did not differ significantly on change in pain severity; however, compared to control, the interview led to a significantly greater reduction in pain interference (P = .016, ηp2 = .05) and a similar trend for anxiety (P = .058, ηp2 = .04). The interview also significantly changed several potential mediators: pain-related anxiety (P = .008, ηp2 = .06), pain controllability (P = .016, ηp2 = .06), and psychological (P < .001, ηp2 = .15) and brain attributions (P = .022, ηp2 = .05) for pain. Participants viewed the interview as very valuable. We conclude that addressing childhood adversities and conflicts in a psychodynamic interview is beneficial for people with CMP. PERSPECTIVE: This study found that, compared to waitlist control, a 90-minute, remotely-administered, emotion-focused, psychodynamic interview improved pain interference, and anxiety among adults with chronic musculoskeletal pain and childhood adversity. Intensive emotional work can be done in a single session to the benefit of patients with chronic musculoskeletal pain.
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Affiliation(s)
- Shoshana Krohner
- Department of Psychology, Wayne State University, Detroit, Michigan
| | - Joel Town
- Centre for Emotions & Health, Department of Psychiatry, Dalhousie University, Halifax, Canada
| | - Ciara N Cannoy
- Department of Psychology, Wayne State University, Detroit, Michigan
| | - Howard Schubiner
- Department of Internal Medicine, Ascension Health / Providence Park Hospital, Michigan State University, Southfield, Michigan
| | - Lisa J Rapport
- Department of Psychology, Wayne State University, Detroit, Michigan
| | - Emily Grekin
- Department of Psychology, Wayne State University, Detroit, Michigan
| | - Mark A Lumley
- Department of Psychology, Wayne State University, Detroit, Michigan
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Castarlenas E, Galán S, Solé E, Roy R, Sánchez-Rodríguez E, Jensen MP, Miró J. Perceived Stress, Perceived Social Support, and Global Health in Adults with Chronic Pain. Int J Behav Med 2023:10.1007/s12529-023-10250-6. [PMID: 38129718 DOI: 10.1007/s12529-023-10250-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Chronic pain is a common problem in adults that can have a significant impact on individuals' quality of life and on society. The complex pain experience emerges from a dynamic combination of biological, psychological, and social factors. Previous research has shown that social support has positive effects on health-related outcomes through two mechanisms: direct-effects and stress-buffering effects. The aim of this study was to investigate the role that perceived stress, perceived social support, and their interaction play as predictors of global physical health and global mental health in adults with chronic pain. METHOD One hundred sixty-five adults with chronic pain completed measures of pain, perceived stress, perceived social support, global physical health, and global mental health. RESULTS Perceived stress but not perceived social support made a significant and independent contribution to the prediction of global physical health; both perceived stress and perceived social support made independent contributions to the prediction of global mental health. The perceived stress × perceived social support interaction did not make a significant contribution to the prediction of either criterion variable. The results suggested that perceived stress has an impact on both global physical and mental health, whereas perceived social support associated mostly with global mental health. In addition, perceived social support does not appear to moderate the impact of stress on global physical and mental health. CONCLUSION The findings are more consistent with a direct-effects model than a stress-buffering model of social support.
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Affiliation(s)
- Elena Castarlenas
- Unit for the Study and Treatment of Pain - ALGOS, Research Center for Behavior Assessment, Department of Psychology, Universitat Rovira I Virgili, Catalonia, Spain
- Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Catalonia, Spain
| | - Santiago Galán
- Unit for the Study and Treatment of Pain - ALGOS, Research Center for Behavior Assessment, Department of Psychology, Universitat Rovira I Virgili, Catalonia, Spain
- Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Catalonia, Spain
| | - Ester Solé
- Unit for the Study and Treatment of Pain - ALGOS, Research Center for Behavior Assessment, Department of Psychology, Universitat Rovira I Virgili, Catalonia, Spain
- Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Catalonia, Spain
| | - Rubén Roy
- Unit for the Study and Treatment of Pain - ALGOS, Research Center for Behavior Assessment, Department of Psychology, Universitat Rovira I Virgili, Catalonia, Spain
- Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Catalonia, Spain
| | - Elisabet Sánchez-Rodríguez
- Unit for the Study and Treatment of Pain - ALGOS, Research Center for Behavior Assessment, Department of Psychology, Universitat Rovira I Virgili, Catalonia, Spain
- Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Catalonia, Spain
| | - Mark P Jensen
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| | - Jordi Miró
- Unit for the Study and Treatment of Pain - ALGOS, Research Center for Behavior Assessment, Department of Psychology, Universitat Rovira I Virgili, Catalonia, Spain.
- Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Catalonia, Spain.
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Canfora F, Ottaviani G, Calabria E, Pecoraro G, Leuci S, Coppola N, Sansone M, Rupel K, Biasotto M, Di Lenarda R, Mignogna MD, Adamo D. Advancements in Understanding and Classifying Chronic Orofacial Pain: Key Insights from Biopsychosocial Models and International Classifications (ICHD-3, ICD-11, ICOP). Biomedicines 2023; 11:3266. [PMID: 38137487 PMCID: PMC10741077 DOI: 10.3390/biomedicines11123266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/04/2023] [Accepted: 12/08/2023] [Indexed: 12/24/2023] Open
Abstract
In exploring chronic orofacial pain (COFP), this review highlights its global impact on life quality and critiques current diagnostic systems, including the ICD-11, ICOP, and ICHD-3, for their limitations in addressing COFP's complexity. Firstly, this study outlines the global burden of chronic pain and the importance of distinguishing between different pain types for effective treatment. It then delves into the specific challenges of diagnosing COFP, emphasizing the need for a more nuanced approach that incorporates the biopsychosocial model. This review critically examines existing classification systems, highlighting their limitations in fully capturing COFP's multifaceted nature. It advocates for the integration of these systems with the DSM-5's Somatic Symptom Disorder code, proposing a unified, multidisciplinary diagnostic approach. This recommendation aims to improve chronic pain coding standardization and acknowledge the complex interplay of biological, psychological, and social factors in COFP. In conclusion, here, we highlight the need for a comprehensive, universally applicable classification system for COFP. Such a system would enable accurate diagnosis, streamline treatment strategies, and enhance communication among healthcare professionals. This advancement holds potential for significant contributions to research and patient care in this challenging field, offering a broader perspective for scientists across disciplines.
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Affiliation(s)
- Federica Canfora
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, 5 Via Pansini, 80131 Naples, Italy; (F.C.); (D.A.)
| | - Giulia Ottaviani
- Department of Surgical, Medical and Health Sciences, University of Trieste, 447 Strada di Fiume, 34149 Trieste, Italy
| | - Elena Calabria
- Dentistry Unit, Department of Health Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy
| | - Giuseppe Pecoraro
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, 5 Via Pansini, 80131 Naples, Italy; (F.C.); (D.A.)
| | - Stefania Leuci
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, 5 Via Pansini, 80131 Naples, Italy; (F.C.); (D.A.)
| | - Noemi Coppola
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, 5 Via Pansini, 80131 Naples, Italy; (F.C.); (D.A.)
| | - Mattia Sansone
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, 5 Via Pansini, 80131 Naples, Italy; (F.C.); (D.A.)
| | - Katia Rupel
- Department of Surgical, Medical and Health Sciences, University of Trieste, 447 Strada di Fiume, 34149 Trieste, Italy
| | - Matteo Biasotto
- Department of Surgical, Medical and Health Sciences, University of Trieste, 447 Strada di Fiume, 34149 Trieste, Italy
| | - Roberto Di Lenarda
- Department of Surgical, Medical and Health Sciences, University of Trieste, 447 Strada di Fiume, 34149 Trieste, Italy
| | - Michele Davide Mignogna
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, 5 Via Pansini, 80131 Naples, Italy; (F.C.); (D.A.)
| | - Daniela Adamo
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, 5 Via Pansini, 80131 Naples, Italy; (F.C.); (D.A.)
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Kviatkovsky SA, Hickner RC, Cabre HE, Small SD, Ormsbee MJ. Collagen peptides supplementation improves function, pain, and physical and mental outcomes in active adults. J Int Soc Sports Nutr 2023; 20:2243252. [PMID: 37551682 PMCID: PMC10411303 DOI: 10.1080/15502783.2023.2243252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 07/25/2023] [Indexed: 08/09/2023] Open
Abstract
INTRODUCTION Chronic pain affects 19% of adults in the United States, with increasing prevalence in active and aging populations. Pain can limit physical activity and activities of daily living (ADLs), resulting in declined mental and social health. Nutritional interventions for pain currently target inflammation or joint health, but few influence both. Collagen, the most abundant protein in the human body and constituent of the extra cellular matrix, is such a nutraceutical. While there have been reports of reductions in pain with short-term collagen peptide (CP) supplementation, there are no long-term studies specifically in healthy middle-aged active adults. PURPOSE To determine the effects of daily CP consumption over 3, 6, and 9 months on survey measures of pain, function, and physical and mental health using The Knee Injury & Osteoarthritis Outcomes Score (KOOS) and Veterans Rand 12 (VR-12) in middle-aged active adults. METHODS This study was a double-blind randomized control trial with three treatment groups (Placebo, 10 g/d CP, and 20 g/d CP). RESULTS Improvements in ADLs (p = .031, ηp2 = .096) and pain (p = .037, ηp2 = .164) were observed with 10 g/d CP over 6 months, although pain only improved in high frequency exercisers (>180 min/week). Additionally, VR-12 mental component scores (MCS) improved with 10 g/d of CP over 3-9 months (p = .017, ηp2 = .309), while physical component scores (PCS) improved with 20 g/d of CP over 3-9 months, but only in females (p = .013, ηp2= .582). CONCLUSION These findings suggest 10 to 20 g/d of CP supplementation over 6 to 9 months may improve ADLs, pain, MCS, and PCS in middle-aged active adults.
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Affiliation(s)
- Shiloah A. Kviatkovsky
- Florida State University, Department of Nutrition and Integrative Physiology, Tallahassee, FL, USA
- Florida State University, Institute of Sports Sciences and Medicine, Tallahassee, FL, USA
- University of Arkansas for Medical Sciences, Center for Aging and Longevity, Geriatrics, Little Rock, AR, USA
| | - Robert C. Hickner
- Florida State University, Department of Nutrition and Integrative Physiology, Tallahassee, FL, USA
- Florida State University, Institute of Sports Sciences and Medicine, Tallahassee, FL, USA
- University of KwaZulu-Natal, School of Health Sciences, Discipline of Biokinetics, Exercise and Leisure Sciences, Durban, South Africa
| | - Hannah E. Cabre
- The University of North Carolina at Chapel Hill, Applied Physiology Lab, Department of Sport Science, Chapel Hill, NC, USA
| | - Stephanie D. Small
- University of Toronto, Faculty of Kinesiology & Physical Education, Toronto, ON, Canada
| | - Michael J. Ormsbee
- Florida State University, Department of Nutrition and Integrative Physiology, Tallahassee, FL, USA
- Florida State University, Institute of Sports Sciences and Medicine, Tallahassee, FL, USA
- University of KwaZulu-Natal, School of Health Sciences, Discipline of Biokinetics, Exercise and Leisure Sciences, Durban, South Africa
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Williamson JN, Grunst MM, Lynn J, Williamson GA, Blanck RV, Wilken JM. Predictors of long-term pain and function in individuals who received a custom dynamic orthosis and device-centric care pathway. Prosthet Orthot Int 2023:00006479-990000000-00194. [PMID: 37934175 DOI: 10.1097/pxr.0000000000000290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 07/20/2023] [Indexed: 11/08/2023]
Abstract
INTRODUCTION Carbon fiber custom dynamic orthoses (CDOs) have been shown to effectively reduce pain and improve function in military service members with lower-limb impairment, but data are limited for civilians. OBJECTIVES To evaluate the long-term outcomes of individuals who completed a CDO-centric care pathway in a civilian clinic by comparing baseline pain, mobility, and function with outcomes at long-term follow-up. To identify baseline characteristics and postintervention outcomes predictive of outcomes at long-term follow-up. METHODS Records of 131 adult patients who received a CDO and CDO-centric training were reviewed. Patient-reported measures of pain and physical function and timed assessment of walking and agility collected during routine clinical care were extracted. These patients were contacted on average 4 (±1) years postintervention to complete a survey including measures of pain and physical function. RESULTS The 63 participants who responded reported improved or greatly improved function, maximum pain, and typical pain on average, irrespective of age or sex (P < 0.001). Change in function from baseline to long-term follow-up was predicted by short-term change in function (35.1% of the variance; P < 0.001). Change in pain from baseline to long-term follow-up was predicted by baseline typical pain and change in four square step test time (63% of variance; P < 0.001). CONCLUSIONS Most survey respondents reported positive outcomes. Long-term pain reduction and improved function were predicted by baseline status and by short-term changes associated with receiving a CDO and completing an intensive training program.
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Affiliation(s)
- Jared N Williamson
- Health Sciences Program, Rocky Mountain University of Health Professions, Provo, UT
| | - Megan M Grunst
- Department of Physical Therapy and Rehabilitation Science, The University of Iowa, Iowa City, IA
| | - Jeffrey Lynn
- Department of Exercise and Rehabilitative Sciences, Slippery Rock University, Slippery Rock, PA
| | | | | | - Jason M Wilken
- Department of Physical Therapy and Rehabilitation Science, The University of Iowa, Iowa City, IA
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Leech JB, MacPherson KL, Klopper M, Shumway J, Salvatori RT, Rhon DI, Young JL. The relationships between pain-associated psychological distress, pain intensity, patient expectations, and physical function in individuals with musculoskeletal pain: A retrospective cohort study. PM R 2023; 15:1371-1381. [PMID: 37041723 DOI: 10.1002/pmrj.12983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 03/06/2023] [Accepted: 03/15/2023] [Indexed: 04/13/2023]
Abstract
INTRODUCTION The presence of pain-associated psychological distress (PAPD) in musculoskeletal disorders, including negative mood, fear-avoidance, and lack of positive affect/coping, is associated with prolonged disability. The importance of considering psychological influence on pain is well known, but practical ways of addressing it are not as straightforward. Identifying relationships between PAPD and pain intensity, patient expectations, and physical function may guide the development of future studies that assess causality and inform clinical practice. OBJECTIVE To assess the relationship between PAPD measured by the Optimal Screening for Prediction of Referral and Outcome-Yellow Flag tool, and baseline pain intensity, expectations of treatment effectiveness, and self-reported physical function at discharge. DESIGN Retrospective cohort study. SETTING Hospital-based outpatient physical therapy. PARTICIPANTS Patients 18 to 90 years old with spinal pain or lower extremity osteoarthritis. MAIN OUTCOME MEASURES Pain intensity and patient expectations of treatment effectiveness at intake, and self-reported physical function at discharge. RESULTS A total of 534 patients, 56.2% female, median (interquartile range [IQR]) age 61 (21) years with an episode of care between November 2019 and January 2021 were included. A multiple linear regression showed a significant association between PAPD and pain intensity with 6.4% (p < .001) of the variance explained. PAPD explained 3.3% (p < .001) of the variance in patient expectations. One additional yellow flag present resulted in a 0.17-point increase in pain intensity and 1.3% decrease in patient expectations. PAPD was also associated with physical function with 3.2% (p < .001) of the variance explained. PAPD explained 9.1% (p < .001) of the variance in physical function at discharge in the low back pain cohort only when assessed independently by body region. CONCLUSION These findings support the theory that the pain experience is complex and multiple factors should be considered when evaluating a patient with musculoskeletal pain. Clinicians who have identified PAPD may consider these relationships when planning or modifying interventions and pursuing multidisciplinary collaboration.
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Affiliation(s)
- Joseph B Leech
- Bellin College, Department of Physical Therapy, Doctor of Science in Physical Therapy Program, Green Bay, Wisconsin, USA
- The University of St. Augustine for Health Sciences, College of Rehabilitative Sciences, Doctor of Physical Therapy Program, Austin, Texas, USA
| | - Kevin L MacPherson
- Bellin College, Department of Physical Therapy, Doctor of Science in Physical Therapy Program, Green Bay, Wisconsin, USA
- South College, School of Physical Therapy, Doctor of Physical Therapy Program, Atlanta, Georgia, USA
| | - Mareli Klopper
- Bellin College, Department of Physical Therapy, Doctor of Science in Physical Therapy Program, Green Bay, Wisconsin, USA
| | - Joshua Shumway
- Bellin College, Department of Physical Therapy, Doctor of Science in Physical Therapy Program, Green Bay, Wisconsin, USA
| | - Robert T Salvatori
- Bellin College, Department of Physical Therapy, Doctor of Science in Physical Therapy Program, Green Bay, Wisconsin, USA
- The University of St. Augustine for Health Sciences, College of Rehabilitative Sciences, Doctor of Physical Therapy Program, Austin, Texas, USA
| | - Daniel I Rhon
- Bellin College, Department of Physical Therapy, Doctor of Science in Physical Therapy Program, Green Bay, Wisconsin, USA
| | - Jodi L Young
- Bellin College, Department of Physical Therapy, Doctor of Science in Physical Therapy Program, Green Bay, Wisconsin, USA
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Franqueiro AR, Yoon J, Crago MA, Curiel M, Wilson JM. The Interconnection Between Social Support and Emotional Distress Among Individuals with Chronic Pain: A Narrative Review. Psychol Res Behav Manag 2023; 16:4389-4399. [PMID: 37915959 PMCID: PMC10617401 DOI: 10.2147/prbm.s410606] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 10/21/2023] [Indexed: 11/03/2023] Open
Abstract
Chronic pain is a public health concern affecting over 100 million U.S. adults. Because chronic pain is multifactorial, it requires a biopsychosocial approach to understand how biological, psychological, and social factors contribute to both the development and maintenance of pain. On average, individuals with chronic pain report higher levels of emotional distress compared to pain-free individuals. Research has demonstrated that social support is associated with better pain outcomes and less emotional distress. It has been proposed that social support may improve pain outcomes by reducing the influence of stressors. However, the majority of research exploring the relationships between social support and pain-related outcomes has focused on the direct relationship between these variables, largely overlooking the process by which social support has a positive influence on pain. This narrative review synthesizes research on how chronic pain, emotional distress, and social support are highly interconnected, yet research investigating chronic pain and emotional distress within a social context is limited. We then highlight disparities in chronic pain, such that the burden of chronic pain is unequal between demographic groups. Next, we discuss existing evidence for the use of group-based interventions to address pain-related outcomes. Lastly, we summarize limitations of prior research studies and highlight gaps in the current literature. Overall, longitudinal research comprehensively investigating the distinct nuances in the measurement of social support and how these nuances relate to emotional distress and pain outcomes is needed and may provide insight into the unique needs of individuals or subgroups. Further, demographically diverse randomized controlled trials are needed to identify the process by which group-based interventions improve pain outcomes and whether these interventions are more effective for particular groups in order to personalize treatment approaches and address inequities in pain care.
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Affiliation(s)
- Angelina R Franqueiro
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Boston, MA, 02115, USA
| | - JiHee Yoon
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Boston, MA, 02115, USA
| | - Madelyn A Crago
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Boston, MA, 02115, USA
| | - Marie Curiel
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Boston, MA, 02115, USA
| | - Jenna M Wilson
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Boston, MA, 02115, USA
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Brennan PL. Stressors and Pain across the Late-Life Span: Findings from Two Parent Longitudinal Studies of Aging and Health. J Aging Health 2023; 35:677-687. [PMID: 35658697 PMCID: PMC10478334 DOI: 10.1177/08982643221104369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The objective is to determine associations between stressors and pain across the late-life span. METHOD Multilevel linear modeling was applied separately to harmonized repeated measures data from the Longitudinal Late-Life Health study (LLLH; n = 342; 13-year interval) and the Health and Retirement Study (HRS; n = 2959; 8-year interval). RESULTS In both the LLLH and HRS samples, independent of age, gender, and race, participants with higher average stressor levels experienced more numerous painful conditions and higher pain severity over the study intervals. In the HRS sample, they also experienced higher levels of pain interference. In general, participants' stressor levels did not influence rates of increase in their pain. Gender and race had few moderating effects on associations between stressors and pain. DISCUSSION Stressors and pain are associated across the late-life span. Future research should focus on the mediating mechanisms that account for this association and the moderating factors that affect its strength.
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Affiliation(s)
- Penny L. Brennan
- Institute for Health & Aging, University of California San Francisco, San Francisco, CA, USA
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Bernardes SF, Almeida I, Forgeron P. Friend or Foe? A Thematic Analysis of Adult Friendships and Chronic Pain Adjustment. Pain Manag Nurs 2023:S1524-9042(23)00060-7. [PMID: 37037702 DOI: 10.1016/j.pmn.2023.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 03/06/2023] [Accepted: 03/09/2023] [Indexed: 04/12/2023]
Abstract
BACKGROUND Chronic pain is a worldwide public health challenge. Despite chronic pain having biopsychosocial dimensions, its social contexts are less investigated. Although current evidence shows that chronic pain shapes and is shaped by interactions with romantic partners, research about friendships and chronic pain is scarce, and mostly focused on adolescents. AIM Drawing upon theories on friendship and social support, this study aimed to investigate the role of adult friendships on chronic pain adjustment and, the effect of chronic pain on adult friendships. METHODS This study drew upon a qualitative descriptive methodology. Sixteen adults with primary or secondary (non-cancer) chronic pain participated in individual semi-structured interviews, conducted using voice over internet protocol applications. Data analysis was guided by Clarke and Brown's guidelines for thematic analysis. RESULTS The analysis of participants' (87.5% women; Mage = 43 years) stories revealed two themes. The first captured how friends promote/hinder adjustment to chronic pain by being: (1) (un)available and providing (un)needed support; and (2) (not)accepting and (not)accommodating to support life engagement. The second captured the negative effect of chronic pain on both parties' attitudes and behaviors towards the relationship, leading to smaller and more homogeneous friendship networks. CONCLUSIONS This study stresses the relevance of including adult friends in interventions to reduce the negative effect of chronic pain on friendships, harnessing their power to promote chronic pain adjustment. The findings bring new insights on a topic that has rarely been investigated in the pain field, hence pointing out innovative directions for future research and practice.
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Affiliation(s)
- Sónia F Bernardes
- From the Iscte-University Institute of Lisbon, Centre for Social Research and Intervention (Cis-iscte), Portugal.
| | - Inês Almeida
- From the Iscte-University Institute of Lisbon, Centre for Social Research and Intervention (Cis-iscte), Portugal
| | - Paula Forgeron
- Faculty of Health Sciences, University of Ottawa, Canada
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Murphy SL, Chen YT, Lee YC, Carns M, Aren K, Korman B, Hinchcliff M, Varga J. Differences in symptom experience among patients with systemic sclerosis: a cluster analytic approach to identifying subgroups. Rheumatology (Oxford) 2023; 62:SI64-SI73. [PMID: 35920770 PMCID: PMC9910572 DOI: 10.1093/rheumatology/keac444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 06/22/2022] [Accepted: 07/27/2022] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES Symptoms of people who have SSc are heterogeneous and difficult to address clinically. Because diverse symptoms often co-occur and may share common underlying mechanisms, identifying symptoms that cluster together may better target treatment approaches. We sought to identify and characterize patient subgroups based on symptom experience. METHODS An exploratory hierarchical agglomerative cluster analysis was conducted to identify subgroups from a large SSc cohort from a single US academic medical centre. Patient-reported symptoms of pain interference, fatigue, sleep disturbance, dyspnoea, depression and anxiety were used for clustering. A multivariate analysis of variance (MANOVA) was used to examine the relative contribution of each variable across subgroups. Analyses of variance were performed to determine participant characteristics based on subgroup assignment. Presence of symptom clusters were tallied within subgroup. RESULTS Participants (n = 587; 84% female, 41% diffuse cutaneous subtype, 59% early disease) divided into three subgroups via cluster analysis based on symptom severity: (i) no/minimal, (ii) mild, and (iii) moderate. Participants in mild and moderate symptoms subgroups had similar disease severity, but different symptom presentation. In the mild symptoms subgroup, pain, fatigue and sleep disturbance was the main symptom cluster. Participants in the moderate symptoms subgroup were characterized by co-occurring pain, fatigue, sleep disturbance, depression and anxiety. CONCLUSION Identification of distinct symptom clusters, particularly among SSc patients who experience mild and moderate symptoms, suggests potential differences in treatment approach and in mechanisms underlying symptom experience that require further study.
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Affiliation(s)
- Susan L Murphy
- Correspondence to: Susan L. Murphy, Department of Physical Medicine and Rehabilitation, University of Michigan, ScD OTR/L, 24 Frank Lloyd Wright Drive, Lobby M Suite 3100, Ann Arbor, MI 48105, USA. E-mail:
| | - Yen T Chen
- Department of Physical Medicine and Rehabilitation
- Michigan Medicine Scleroderma Program, University of Michigan, Ann Arbor, MI
| | | | - Mary Carns
- Division of Rheumatology
- Divisions of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Kathleen Aren
- Division of Rheumatology
- Divisions of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Benjamin Korman
- Division of Allergy-Immunology, and Rheumatology, University of Rochester Medical Center, Rochester, NY
| | - Monique Hinchcliff
- Section of Rheumatology, Allergy and Immunology, Yale School of Medicine, Yale University, New Haven, CT, USA
| | - John Varga
- Division of Rheumatology
- Michigan Medicine Scleroderma Program, University of Michigan, Ann Arbor, MI
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21
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Picariello F, Chilcot J, Chalder T, Herdman D, Moss-Morris R. The Cognitive and Behavioural Responses to Symptoms Questionnaire (CBRQ): Development, reliability and validity across several long-term conditions. Br J Health Psychol 2023; 28:619-638. [PMID: 36690909 DOI: 10.1111/bjhp.12644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 12/07/2022] [Accepted: 01/06/2023] [Indexed: 01/25/2023]
Abstract
OBJECTIVES Cognitive and behavioural responses to symptoms can worsen or maintain the severity of symptoms across long-term conditions (LTCs). Although the Cognitive and Behavioural Responses Questionnaire (CBRQ) has been used in research, its original development and psychometric properties as a transdiagnostic measure have not been reported. Our aim was to evaluate the psychometric properties of the CBRQ and a recently proposed short version, across different LTCs. DESIGN Psychometric validation study. METHODS Confirmatory factor analysis (CFA) tested the factor structure of the CBRQ in two datasets from the CBRQ's original development; (chronic fatigue syndrome, N = 230; and multiple sclerosis, N = 221) and in additional groups: haemodialysis (N = 174), inflammatory bowel disease (N = 182) and chronic dizziness (N = 185). Scale reliability and construct validity were assessed. The factor structure of the shortened CBRQ (CBRQ-SF) was also assessed. RESULTS CFA revealed that a 7-or 8-factor structure had generally appropriate fit supporting the originally proposed 7 factors (Fear avoidance, Damage beliefs, Catastrophising, Embarrassment avoidance, Symptom focusing, All-or-nothing behaviour and Avoidance/Resting behaviour). Omega coefficients indicated satisfactory internal reliability. Correlations with related constructs suggested construct validity. The scale appeared sensitive to change. The CBRQ-SF also displayed good psychometric quality, with a better model fit than the CBRQ. CONCLUSIONS The CBRQ and the shortened version were shown to be reliable and valid at assessing a range of cognitive and behavioural responses to symptoms, highlighting the multi-symptom, transdiagnostic properties of this questionnaire. Further research is necessary to determine the test-retest reliability and sensitivity to change of the CBRQ and CBRQ-SF and a thorough evaluation of the content validity of the items.
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Affiliation(s)
- Federica Picariello
- Health Psychology Section, Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience King's College London, London, UK
| | - Joseph Chilcot
- Health Psychology Section, Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience King's College London, London, UK
| | - Trudie Chalder
- Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience King's College London, London, UK
| | - David Herdman
- Health Psychology Section, Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience King's College London, London, UK.,St George's University Hospitals NHS Foundation Trust, London, UK
| | - Rona Moss-Morris
- Health Psychology Section, Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience King's College London, London, UK
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22
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Posa S, Wasilewski MB, Mercer SW, Simpson S, Robinson LR, Simpson R. Conceptualization, use, and outcomes associated with empathy and compassion in physical medicine and rehabilitation: a scoping review. Int J Rehabil Res 2022; 45:291-301. [PMID: 35837691 DOI: 10.1097/mrr.0000000000000542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The purpose of this review is to scope the literature on the conceptualization, use, and outcomes associated with empathy and compassion in physical medicine and rehabilitation. Eligible studies included quantitative, qualitative, or mixed-methods research that presented primary data on the conceptualization, use, and outcomes associated with empathy and compassion in physical medicine and rehabilitation. Relevant studies were identified through CINAHL, Cochrane Library, EMBASE, MEDLINE, and PEDRO. Twenty-four studies were included (participant n = 3715): 13 quantitative, six mixed-methods, and five qualitative. In qualitative analysis, empathy and compassion were conceptualized as both intrinsic and exhibitory. Where self-compassion was examined as an intervention for patients, improvements in anxiety, depression, and quality of life were reported. Survey data suggested that when rehabilitation health care providers were perceived to be more empathic, patients reported greater treatment satisfaction, acceptance, adherence, and goal attainment. Individuals receiving and health care providers who deliver rehabilitative care conceptualize empathy and compassion as valuable in physical medicine and rehabilitation settings, with cognitive and behavioural elements described. Health care provider empathy and compassion-based interventions may influence outcomes positively in this context. More research is needed to understand the mechanisms of action of empathy and compassion and effectiveness in physical medicine and rehabilitation settings.
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Affiliation(s)
- Stephanie Posa
- St. John's Rehab Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Marina B Wasilewski
- St. John's Rehab Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Stewart W Mercer
- Usher Institute, Edinburgh Medical School, University of Edinburgh, Edinburgh, UK
| | - Sharon Simpson
- Institute of Health and Wellbeing, University of Glasgow, Glasgow,UK
| | - Lawrence R Robinson
- St. John's Rehab Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Division of Physical Medicine & Rehabilitation, Department of Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Robert Simpson
- Institute of Health and Wellbeing, University of Glasgow, Glasgow,UK
- Division of Physical Medicine and Rehabilitation, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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23
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Bernardes SF, Rei A, Carvalho H. Assessing family social support for functional autonomy and dependence in pain: A psychometric study. THE JOURNAL OF PAIN 2022; 24:582-592. [PMID: 36372361 DOI: 10.1016/j.jpain.2022.10.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 09/29/2022] [Accepted: 10/28/2022] [Indexed: 11/11/2022]
Abstract
Assessing family supportive responses to pain behaviors is paramount, as these may help or hinder chronic pain (CP) adjustment. Current self-report measures of pain-specific family supportive dynamics are scarce, covering a limited range of responses. To address this gap, this paper aimed at the psychometric validation of a (revised) novel measure - the Informal Social Support for Autonomy and Dependence in Pain Inventory (ISSADI-PAIN). Three-hundred and three adults participated in this study (53.3% women; Mage = 49.31), 53.5% with current CP, 20.1% with acute pain (AP) in the previous week and 26.4% with no current pain. All participants completed the revised ISSADI-PAIN. Participants reporting AP/CP in the previous week also filled out measures of pain coping/outcomes. Exploratory and confirmatory factor analyzes supported a 3-factor structure: Perceived Promotion of Dependence (PPD; 5 items; α = .82), Perceived Promotion of Autonomy-Emotional (PPA-Emot; 3 items; α = .78), PPA-instrumental (PPA-Inst; 3 items; α = .82). Higher PPD was associated with higher AP disability and less wellness-focused coping; higher PPA-Emot was associated with more wellness-focused CP coping; PPA-Inst was associated with better/worse AP/CP outcomes and more frequent use of wellness-focused CP coping. Men with AP reported more PPD than women. The revised ISSADI-PAIN is an innovative, valid, and reliable measure of relevant functions of pain-related social support, which may influence pain persistence and adaptation. PERSPECTIVE: This article presents a novel self-report measure (ISSADI-PAIN) that assesses family support for functional autonomy and dependence in pain contexts. This measure may contribute to further research on the complexities of family supportive dynamics surrounding individuals with AP/CP, clarifying their role on pain persistence and adaptation processes.
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24
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Fehrmann E, Fischer-Grote L, Kienbacher T, Tuechler K, Mair P, Ebenbichler G. Perceived psychosocial stressors and coping resources in chronic low back pain patients as classified by the avoidance-endurance model. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:996945. [DOI: 10.3389/fresc.2022.996945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 10/07/2022] [Indexed: 11/07/2022]
Abstract
ObjectivesThe Avoidance-Endurance Model distinguishes between subgroups of low back pain (LBP) patients with three maladaptive styles of coping with pain: fear-avoidance (FAR), distress-endurance (DER), eustress-endurance (EER), and one adaptive coping style (AR). This study aimed to compare the quantity of patients' perceived psychosocial stressors and coping resources across these subgroups.Materials and methodsThis cross-sectional study was conducted at an outpatient rehabilitation center for patients with chronic musculoskeletal pain. One hundred and thirty-seven patients (69 women/68 men) with chronic LBP were assessed using the following: a demographic checklist, the visual analogue scale, Avoidance-Endurance Questionnaire, Roland-Morris Disability Questionnaire, Pain Disability Index, and 36-Item Short Form. Subsequently, patients participated in semi-structured interviews led by clinical psychologists, which were intended to identify their perception of stressors and coping resources. The quantity of psychosocial stressors and coping resources were analyzed using deductive and inductive content analyses and then compared between subgroups using chi-square-tests.ResultsFARs experienced significantly higher levels of “mental suffering” (p = <0.001) and “other workplace problems” compared to ARs and EERs (p = <0.001). DERs reported significantly higher levels of “mental suffering” (p = <0.001), “job stress” (p = 0.022), and “familial losses” (p = 0.029) compared to ARs, whereas the AR group demonstrated significantly more “coping resources” (p = 0.001) compared to FARs.ConclusionAEM-subgroups differed in the quantity of perceived psychosocial stressors and coping resources with AR, who demonstrated a lower risk for pain chronicity and reported the highest quantity of resources. The variability across subgroups may imply differences in patientś needs regarding therapeutic interventions and suggests that a resource-centered approach to cope with stress and pain may be beneficial.
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25
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Andersen I, Rossi R, Kahorha Mukubirho C, Ragazzoni L, Hubloue I. Mental health and psychosocial support during physical rehabilitation in Eastern Democratic Republic of Congo: a retrospective cohort study. Disabil Rehabil 2022:1-10. [PMID: 36000719 DOI: 10.1080/09638288.2022.2107093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE This study explores the relevance of integrating mental health and psychosocial support (MHPSS) into physical rehabilitation services in conflict settings. MATERIAL AND METHODS Symptoms of psychological distress and daily functioning of 132 physical rehabilitation service users in Eastern Democratic Republic of Congo were assessed before and after MHPSS. Logistical regression models were used to identify factors associated with these symptoms. RESULTS Prior to receiving MHPSS, "extreme" symptoms of depression were reported by 64% of the service users. Amputation predicted high levels of depression (aOR 5.12, p = 0.021), anxiety (aOR 7.09, p = 0.004) and stress (aOR 3.37, p = 0.035), while having witnessed violence predicted high symptoms of stress (aOR 3.65, p = 0.014). Lack of social support was associated with high symptoms of stress prior to MHPSS (aOR 3.17, p = 0.046) as well as a large reduction in symptoms of depression following MHPSS (aOR 3.91, p = 0.019). Most physical rehabilitation service users reported a reduction in symptoms of depression (100.00%), anxiety (98.03%) and stress (100.00%) along with improved functioning (81.13%) after MHPSS. CONCLUSION MHPSS needs of physical rehabilitation service users in conflict settings stem from the combined impact of disability and exposure to violence. MHPSS care, particularly the mobilization of peer support, appears necessary and relevant.Implications for rehabilitationIn conflict settings, mental health and psychosocial support (MHPSS) needs of physical rehabilitation service users must address the combined impact of physical disability and exposure to violence.Physical rehabilitation service users who lacked social support prior to receiving MHPSS were more likely to report a large reduction in symptoms of depression following MHPSS.The study underlines the importance of social support, particularly peer support, in addressing MHPSS needs.
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Affiliation(s)
- Ida Andersen
- Health Unit, International Committee of the Red Cross, Geneva, Switzerland.,Research Group on Emergency and Disaster Medicine, Vrije Universiteit Brussel, Brussels, Belgium
| | - Rodolfo Rossi
- Health Unit, International Committee of the Red Cross, Geneva, Switzerland
| | | | - Luca Ragazzoni
- Center for Research and Training in Disaster Medicine, Humanitarian Aid and Global Health, Università del Piemonte Orientale, Novara, Italy
| | - Ives Hubloue
- Research Group on Emergency and Disaster Medicine, Vrije Universiteit Brussel, Brussels, Belgium
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26
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Siu AMH, Chan SCC, Cheung MKT, Shek DTL. Predictors of Psychosocial Adaptation and Mental Well-Being Among People With Chronic Illnesses and Disabilities in Hong Kong. REHABILITATION COUNSELING BULLETIN 2022. [DOI: 10.1177/00343552221115864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Psychosocial adaptation to chronic illness and disability (CID) involves a complex interplay of the client’s background factors with resilience and coping. To date, there have been few studies on psychosocial adaptation to CID in the Chinese context. To examine the predictors of psychosocial adaptation, we surveyed people with CID from community-rehabilitation settings and self-help groups ( N = 224). The research questionnaire collected information on demographics, health-related factors, social support, resilience, coping strategies, psychosocial adaptation, and mental well-being. Resilience, coping strategies, health-related factors, and sex were found to be important predictors of psychosocial adaptation. Using structural equation modeling (SEM), we tested a conceptual model on how social support and health-related factors predict adjustment variables (resilience and coping strategies), which further affect psychosocial adaptation and mental well-being. All the variables are closely linked and the path coefficients are all significant. An overall fair model fit (comparative fit index [CFI] = 0.89; root mean square error of approximation [RMSEA] = 0.089) was obtained. The results provide support for the conceptual model we proposed based on health-related coping and the phase model of psychosocial adaptation. The key predictors of psychosocial adaptation and mental well-being in Chinese people with CID in Hong Kong are similar to those identified in non-Chinese studies.
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Affiliation(s)
| | - Sam C. C. Chan
- The Hong Kong Polytechnic University, Hung Hom, Hong Kong
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27
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Hobson JM, Moody MD, Sorge RE, Goodin BR. The neurobiology of social stress resulting from Racism: Implications for pain disparities among racialized minorities. NEUROBIOLOGY OF PAIN (CAMBRIDGE, MASS.) 2022; 12:100101. [PMID: 36092741 PMCID: PMC9449662 DOI: 10.1016/j.ynpai.2022.100101] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 08/17/2022] [Accepted: 08/17/2022] [Indexed: 11/02/2022]
Abstract
Extant literature posits that humans experience two types of threat: physical threat and social threat. While describing pain as "physical" or "social" can be helpful for understanding pain origins (i.e., broken bone versus lost relationship), this dichotomy is largely artificial and not particularly helpful for understanding how the human brain experiences pain. One real world example of social exclusion and rejection that is threatening and likely to bring about significant stress is racism. Racism is a system of beliefs, practices, and policies that operates to disadvantage racialized minorities while providing advantage to those with historical power, particularly White people in the United States and most other Western nations. The objective of this Mini-Review is to present evidence in support of the argument that racism promotes physical pain in racialized minorities, which in turn promotes chronic pain disparities. First, we provide a theoretical framework describing how racism is a potent stressor that affects the health and well-being of racialized minorities. We will then address the neurobiological underpinnings linking racism to social threat, as well as that linking social threats and physical pain. Finally, we will discuss how the perception of social threat brought about by racism may undermine pain management efforts.
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Affiliation(s)
- Joanna M. Hobson
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, U.S.A
| | - Myles D. Moody
- Department of Sociology, University of Alabama at Birmingham, Birmingham, Alabama, U.S.A
| | - Robert E. Sorge
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, U.S.A
- Center for Addiction & Pain Prevention & Intervention (CAPPI), University of Alabama at Birmingham, Birmingham, AL, U.S.A
| | - Burel R. Goodin
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, U.S.A
- Center for Addiction & Pain Prevention & Intervention (CAPPI), University of Alabama at Birmingham, Birmingham, AL, U.S.A
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28
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Lee J, Green BM, Palmarella G, McNamara K, Wachholtz A. Negative impact of chronic pain: The role of locus of control and perceived family validation of chronic pain. Health Psychol Open 2022; 9:20551029221125170. [PMID: 36091332 PMCID: PMC9449507 DOI: 10.1177/20551029221125170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The present study investigates how participants' locus of control and their family and friends' validation of their pain influences participants' chronic pain experiences. Four thousand, 25 adults were recruited through the Chronic Pain In America survey. Results show that individuals who endorse an internal locus of control and experience family and friends' validation of their chronic pain reported better chronic pain outcomes and less negative life impact due to chronic pain. The current results indicate the locus of control and family and friends' validation of chronic pain experience plays an important role in chronic pain and the impact of chronic pain across the life course.
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Affiliation(s)
- Jieun Lee
- Department of Psychology, Chung-Ang University, Seoul, South Korea
| | | | | | | | - Amy Wachholtz
- Department of Psychology, University of Colorado Denver, Denver, CO, USA.,Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, USA
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29
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Wilson JM, Colebaugh CA, Flowers KM, Edwards RR, Schreiber KL. Profiles of Risk and Resilience in Chronic Pain: Loneliness, Social Support, Mindfulness, and Optimism Coming out of the First Pandemic Year. PAIN MEDICINE 2022; 23:2010-2021. [PMID: 35587150 PMCID: PMC9384018 DOI: 10.1093/pm/pnac079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 04/03/2022] [Accepted: 05/10/2022] [Indexed: 11/17/2022]
Abstract
Objective Individuals experience chronic pain differently, not only because of different clinical diagnoses, but also because of differing degrees of influence from biopsychosocial pain modulators. We aimed to cluster patients with chronic pain into distinct subgroups based on psychosocial characteristics and pain intensity, and we subsequently examined group differences in pain-related interference approximately 1 year later. Methods In this observational, longitudinal study, patients with chronic pain (n = 94) completed validated assessments of psychosocial characteristics and pain intensity at the beginning of COVID-19–related social distancing (April to June 2020). One year later (May to June 2021), patients completed a follow-up survey with assessments of pain interference, loneliness, social support, mindfulness, and optimism. Results A cluster analysis, using psychosocial factors and pain intensity, empirically produced three patient groups: 1) psychosocial predominant (PSP), characterized by high psychosocial distress and average pain intensity; 2) pain intensity predominant (PIP), characterized by average psychosocial distress and high pain intensity; and 3) less elevated symptoms (LES), characterized by low psychosocial distress and low pain intensity. At the 1-year follow-up, patients in the PSP and PIP clusters suffered greater pain interference than patients in the LES cluster, while patients in the PSP cluster also reported greater loneliness and lower mindfulness and optimism. Conclusions An empirical psychosocial-based clustering of patients identified three distinct groups that differed in pain interference. Patients with high psychosocial modulation of pain at the onset of social distancing (the PSP cluster) suffered not only greater pain interference but also greater loneliness and lower levels of mindfulness and optimism, which suggests some potential behavioral targets for this group in the future.
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Affiliation(s)
- Jenna M Wilson
- Correspondence to: Jenna M. Wilson, PhD, Department of Anesthesiology, Perioperative, and Pain Medicine,Brigham and Women’s Hospital, 45 Francis St, Boston, MA 02115, USA. Tel: 7813673972; E-mail:
| | - Carin A Colebaugh
- Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham & Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - K Mikayla Flowers
- Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham & Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Robert R Edwards
- Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham & Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Kristin L Schreiber
- Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham & Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
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30
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Sagar I, Popok PJ, Reichman M, Lester EG, Doorley J, Bakhshaie J, Vranceanu AM. Orthopedic Providers’ Preferences for Education and Training on Psychosocial Clinical Research Initiatives: A Qualitative Investigation. J Patient Exp 2022; 9:23743735221092570. [PMID: 35450087 PMCID: PMC9016593 DOI: 10.1177/23743735221092570] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Introduction: Psychosocial factors (e.g., depression, anxiety) increase risk for
chronic pain, disability, and other health complications following acute
orthopedic traumatic injury. Orthopedic providers lack skills to address these
factors. Education around psychosocial factors of recovery and psychosocial
clinical and research initiatives could address this gap. The purpose of this
study was to understand orthopedic trauma providers’ preferences for the design
and distribution of educational materials to facilitate psychosocial initiative
implementation. Methods: We conducted live-video, semi-structured focus groups with outpatient
orthopedic trauma providers across three Level 1 Trauma Centers, using a hybrid
inductive-deductive approach to analyze qualitative data and extract themes and
subthemes characterizing providers’ recommendations for appropriate psychosocial
education. Results: Four themes described providers’ recommendations for receiving
educational materials: (1) provide foundational knowledge and tools about
psychosocial factors; (2) provide information regarding a psychosocial
initiative's purpose and procedures; (3) leverage educational materials to
maximize buy-in to psychosocial clinical research initiatives; and (4) deliver
information concisely, clearly, and electronically. Conclusion: Orthopedic providers recommended ways to optimize design and
dissemination of education on psychosocial care. Optimizing knowledge of
psychosocial factors and clinical and research initiatives facilitates
providers’ ability to appropriately target the often-underdressed psychosocial
component of recovery in orthopedics.
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Affiliation(s)
- Isabell Sagar
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Paula J. Popok
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Mira Reichman
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Ethan G. Lester
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - James Doorley
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Jafar Bakhshaie
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Ana Maria Vranceanu
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
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31
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Braunwalder C, Ehrmann C, Hodel J, Müller R, von Matt D, Fekete C. Pain trajectories during initial rehabilitation after spinal cord injury: Do psychosocial resources and mental health predict trajectories? Arch Phys Med Rehabil 2022; 103:1294-1302. [DOI: 10.1016/j.apmr.2022.01.149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 01/04/2022] [Accepted: 01/14/2022] [Indexed: 11/02/2022]
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32
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Luo H, Cai Z, Huang Y, Song J, Ma Q, Yang X, Song Y. Study on Pain Catastrophizing From 2010 to 2020: A Bibliometric Analysis via CiteSpace. Front Psychol 2022; 12:759347. [PMID: 34975649 PMCID: PMC8718514 DOI: 10.3389/fpsyg.2021.759347] [Citation(s) in RCA: 51] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 11/29/2021] [Indexed: 12/14/2022] Open
Abstract
Purpose: This study aimed to evaluate the global scientific output of research on pain catastrophizing and explore the hotspots and frontiers from 2010 to 2020 using bibliometric methods. Methods: Publications regarding pain catastrophizing published from 2010 to 2020 were extracted from the Web of Science Core Collection. CiteSpace was used to analyze the number of publications, countries, institutions, journals, authors, cited references, and keywords using standard bibliometric indicators. Results: A total of 1,576 publications on pain catastrophizing were retrieved from 2010 to December 31, 2020. The number and rate of the annual publications gradually increased totally. Pain (130) was the most productive journal. Meanwhile, Pain ranked first in the frequency (1,432) and centrality (0.31) of the cited journals. The most productive country and institution in this frequency field were the United States (642) and the University of Washington (73), respectively. Jensen MP (34) was the most prolific author, and Sullivan MJL (1,196) ranked first among the cited authors. In the ranking of frequency in the cited references, the first article was a critical review about pain catastrophizing published by Quartana (100). The keyword “Low back pain” had the highest frequency (556). “Total hip” was identified as a frontier research item for 2016–2020. Conclusion: The findings of this bibliometric study provide the current status and trends in the clinical research of pain catastrophizing and may help researchers to identify hot topics and explore new research directions in this field.
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Affiliation(s)
- Huifang Luo
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zongliao Cai
- Physical and Mental Medicine, Guangzhou Brain Hospital, Guangzhou, China
| | - Yanyi Huang
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jiating Song
- Second Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Qing Ma
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiangwei Yang
- Department of Rheumatology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yang Song
- School of Nursing, Guangzhou University of Chinese Medicine, Guangzhou, China
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33
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Zhou WBS, Meng J, Zhang J. Does Low Grade Systemic Inflammation Have a Role in Chronic Pain? Front Mol Neurosci 2021; 14:785214. [PMID: 34858140 PMCID: PMC8631544 DOI: 10.3389/fnmol.2021.785214] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 10/21/2021] [Indexed: 12/17/2022] Open
Abstract
One of the major clinical manifestations of peripheral neuropathy, either resulting from trauma or diseases, is chronic pain. While it significantly impacts patients’ quality of life, the underlying mechanisms remain elusive, and treatment is not satisfactory. Systemic chronic inflammation (SCI) that we are referring to in this perspective is a state of low-grade, persistent, non-infective inflammation, being found in many physiological and pathological conditions. Distinct from acute inflammation, which is a protective process fighting against intruders, SCI might have harmful effects. It has been associated with many chronic non-communicable diseases. We hypothesize that SCI could be a predisposing and/or precipitating factor in the development of chronic pain, as well as associated comorbidities. We reviewed evidence from human clinical studies indicating the coexistence of SCI with various types of chronic pain. We also collated existing data about the sources of SCI and who could have it, showing that those individuals or patients having SCI usually have higher prevalence of chronic pain and psychological comorbidities. We thus elaborate on the need for further research in the connection between SCI and chronic pain. Several hypotheses have been proposed to explain these complex interactions.
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Affiliation(s)
- Wen Bo Sam Zhou
- The Alan Edwards Centre for Research on Pain, McGill University, Montreal, QC, Canada.,Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | - JingWen Meng
- The Alan Edwards Centre for Research on Pain, McGill University, Montreal, QC, Canada.,Faculty of Dentistry, McGill University, Montreal, QC, Canada
| | - Ji Zhang
- The Alan Edwards Centre for Research on Pain, McGill University, Montreal, QC, Canada.,Faculty of Dentistry, McGill University, Montreal, QC, Canada.,Department of Neurology and Neurosurgery, Faculty of Medicine McGill University, Montreal, QC, Canada
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34
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Reif S, Lauer EA, Adams RS, Brucker DL, Ritter GA, Mitra M. Examining differences in prescription opioid use behaviors among U.S. adults with and without disabilities. Prev Med 2021; 153:106754. [PMID: 34348132 DOI: 10.1016/j.ypmed.2021.106754] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 07/21/2021] [Accepted: 07/30/2021] [Indexed: 10/20/2022]
Abstract
We aimed to identify differences in prescription opioid-related behaviors between adults with and without disabilities in the U.S. We analyzed data from the 2015-2017 National Survey on Drug Use and Health (128,740 individuals; weighted N of 244,831,740) to examine disability-based differences in (1) reasons and sources of last prescription opioid misuse and, in multivariate models overall and stratified by disability, the likelihood of (2) prescription opioid use, and if used, (3) misuse and prescription opioid use disorder (OUD), overall and stratified by disability. Adults with disabilities were 11% more likely than adults without disabilities to report any past-year prescription opioid use, adjusted for sociodemographic, health, and behavioral health characteristics. However, among adults with any prescription opioid use, which is more common among people with disabilities, likelihood of prescription OUD did not vary by disability status. Pain relief as the reason for last misuse was associated with 18% increased likelihood of prescription OUD, if any use. To reduce risk of opioid misuse among people with disabilities, accessible and inclusive chronic pain management services are essential. Further, the substance use treatment field should provide accessible and inclusive services, and be aware of the need for pain management by many people with disabilities, which may include the use of prescription opioids. These findings highlight essential opportunities for public health and policies to improve access, accommodations, and quality of health and behavioral health care for people with disabilities, and to encourage a holistic perspective of people with disabilities and their needs.
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Affiliation(s)
- Sharon Reif
- Institute for Behavioral Health, Heller School for Social Policy and Management, Brandeis University, 415 South Street, Waltham, MA 02453, USA.
| | - Eric A Lauer
- Institute on Disability, University of New Hampshire, 10 West Edge Drive, Suite 101, Durham, NH 03824, USA
| | - Rachel Sayko Adams
- Institute for Behavioral Health, Heller School for Social Policy and Management, Brandeis University, 415 South Street, Waltham, MA 02453, USA; Rocky Mountain Mental Illness Research Education and Clinical Center, Veterans Health Administration, Aurora, CO 80045, USA
| | - Debra L Brucker
- Institute on Disability, University of New Hampshire, 10 West Edge Drive, Suite 101, Durham, NH 03824, USA
| | - Grant A Ritter
- Schneider Institutes for Health Policy and Research, Heller School for Social Policy and Management, Brandeis University, 415 South Street, Waltham, MA 02453, USA
| | - Monika Mitra
- Lurie Institute for Disability Policy, Heller School for Social Policy and Management, Brandeis University, 415 South Street, Waltham, MA 02453, USA
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35
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Chadwick A, Frazier A, Khan TW, Young E. Understanding the Psychological, Physiological, and Genetic Factors Affecting Precision Pain Medicine: A Narrative Review. J Pain Res 2021; 14:3145-3161. [PMID: 34675643 PMCID: PMC8517910 DOI: 10.2147/jpr.s320863] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 08/11/2021] [Indexed: 12/11/2022] Open
Abstract
PURPOSE Precision pain medicine focuses on employing methods to assess each patient individually, identify their risk profile for disproportionate pain and/or the development of chronic pain, and optimize therapeutic strategies to target specific pathological processes underlying chronic pain. This review aims to provide a concise summary of the current body of knowledge regarding psychological, physiological, and genetic determinants of chronic pain related to precision pain medicine. METHODS Following the Scale for the Assessment of Narrative Review Articles (SANRA) criteria, we employed PubMed/Medline to identify relevant articles using primary database search terms to query articles such as: precision medicine, non-modifiable factors, pain, anesthesiology, quantitative sensory testing, genetics, pain medicine, and psychological. RESULTS Precision pain medicine provides an opportunity to identify populations at risk, develop personalized treatment strategies, and reduce side effects and cost through elimination of ineffective treatment strategies. As in other complex chronic health conditions, there are two broad categories that contribute to chronic pain risk: modifiable and non-modifiable patient factors. This review focuses on three primary determinants of health, representing both modifiable and non-modifiable factors, that may contribute to a patient's profile for risk of developing pain and most effective management strategies: psychological, physiological, and genetic factors. CONCLUSION Consideration of these three domains is already being integrated into patient care in other specialties, but by understanding the role they play in development and maintenance of chronic pain, we can begin to implement both precision and personalized treatment regimens.
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Affiliation(s)
- Andrea Chadwick
- Department of Anesthesiology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Andrew Frazier
- Department of Anesthesiology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Talal W Khan
- Department of Anesthesiology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Erin Young
- Department of Anesthesiology, University of Kansas Medical Center, Kansas City, KS, USA
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36
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Hruschak VJ, Yuan Y, Ringwald W, Beaugard C, Repine M, Pacella-LaBarbara M, Rosen D, Cochran G. Pain Appraisals in Patients with Physical Injury: Assessing the Role of Distress Tolerance in the Relationship between Depression and Pain Catastrophizing. HEALTH & SOCIAL WORK 2021; 46:187-198. [PMID: 34312666 PMCID: PMC8785948 DOI: 10.1093/hsw/hlab021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/23/2020] [Indexed: 05/04/2023]
Abstract
Pain is a complex construct contributing to significant impairment, particularly among physically injured patients seeking treatment in trauma and orthopedic surgery settings in which social workers are an integral component of care. The biopsychosocial theory, fear-avoidance, and cognitive mediation models of pain suggest that psychological factors (for example, depression) affect one's ability to tolerate distress, leading to negative pain appraisals, such as catastrophizing. This study examined whether distress tolerance serves as a mechanism by which depression is associated with pain catastrophizing. We administered a health survey to outpatient trauma and orthopedic surgery clinic patients who were using opioid medications; 84 patients were included in the final analysis; 39.3 percent screened positive for depression. A multilevel mediation model using structural equation modeling revealed a significant direct effect from depression to pain catastrophizing (ß = .31, z = 3.96, p < .001) and a significant indirect effect by distress tolerance (Δß = .27, z = 3.84, p < .001). These results, which suggest that distress tolerance partially mediated the path from depression to pain catastrophizing, can inform social workers and other members of the multidisciplinary team about both the critical role of psychosocial factors after injury and interventions to improve postinjury recovery.
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Affiliation(s)
- Valerie J Hruschak
- research fellow in anesthesia, Brigham and Women’s Hospital, Harvard Medical, Anesthesiology, Perioperative, and Pain Medicine, 75 Francis Street, Boston, MA 02115
| | - Yan Yuan
- postdoctoral associate, School of Social Work, University of Pittsburgh
| | - Whitney Ringwald
- PhD student, Clinical Psychology Department, University of Pittsburgh
| | | | - Melissa Repine
- clinical research coordinator, Department of Emergency Medicine, University of Pittsburgh
| | | | - Daniel Rosen
- professor, School of Social Work, University of Pittsburgh
| | - Gerald Cochran
- associate professor, Internal Medicine, Epidemiology, University of Utah, Salt Lake City
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37
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Abstract
OBJECTIVES The primary aim of this study was to better understand the role that social factors (ie, social support, satisfaction in participation with social roles, social isolation, and self-perceived ability to perform social roles and activities) play in pain-related interference and depressive symptoms in adults with chronic pain. Moreover, this study also examined if sex exerts a moderating role in these associations. MATERIALS AND METHODS In this cross-sectional study, 364 adults with chronic pain participated: 133 were university students and 231 were individuals from the community. University students completed a paper-and-pencil survey and individuals from the community responded to a web-based survey. Both surveys included the same questions assessing sociodemographic, pain characteristics, pain-related interference, depressive symptoms, and social factors. RESULTS Only satisfaction in participation in usual social roles and self-perceived ability for participating in such social roles contributed independently, significantly, and negatively to the prediction of pain interference, whereas all 4 social factors made independent and significant contributions to the prediction of depressive symptoms. Satisfaction with participation in usual social roles, self-perceived social ability, and social support were negatively related to depressive symptoms, whereas social isolation was positively related. The results also indicated that sex moderated the associations between social factors and depressive symptoms, but not between social factors and pain interference. DISCUSSION The study provides important new findings regarding the associations between social factors and physical and psychological functioning of individuals with chronic pain, supporting biopsychosocial models.
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38
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Jiao J, Tang H, Zhang S, Qu X, Yue B. The relationship between mental health/physical activity and pain/dysfunction in working-age patients with knee osteoarthritis being considered for total knee arthroplasty: a retrospective study. ARTHROPLASTY 2021; 3:22. [PMID: 35236496 PMCID: PMC8796639 DOI: 10.1186/s42836-021-00077-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Accepted: 03/10/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Increasing total knee arthroplasty (TKA) surgeries are being performed on working-age patients with prominent manifestations of pain and dysfunction. But few studies have explored the risk factors for pain and dysfunction in working-age patients with knee osteoarthritis (KOA) being considered for TKA. Therefore, this study sought to explore the relationship between mental health/physical activity and pain/dysfunction in working-age patients with KOA being considered for TKA. METHODS This study was a secondary analysis of data derived from a public database, the Work participation In Patients with Osteoarthritis cohort study, which included 152 working-age patients (65 men and 87 women) with KOA planning for TKA. We analyzed preoperative data comprising age, educational level, body mass index (BMI), mental factors (Patient Health Questionnaire-9 [PHQ-9] and the 36-Item Short Form Survey Instrument [SF-36 mental health]), physical activity level, and clinical outcomes (the Western Ontario and McMaster Universities Osteoarthritis Index and SF-36 sub-item score). Multivariate regression analysis was performed to determine risk factors for pain and dysfunction in working-age patients with KOA being considered for TKA. RESULTS Women had lower pain, worse function, and higher PHQ-9 scores than men (p < 0.001). The depression scores were significantly linearly related to pain and function scores in women after adjusting for age, BMI, educational level, and physical activity (P < 0.05), whereas this relation was not observed in men. After adjusting for age, BMI, educational level, and mental factors, exercise time was found to be positively correlated with pain scores in women (P < 0.05). CONCLUSIONS Depression scores and exercise time were significantly correlated with pain and dysfunction in working-age women with KOA being considered for TKA.
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Affiliation(s)
- Juyang Jiao
- Department of Bone and Joint Surgery, Department of Orthopaedics, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 145, Shandong Road, Shanghai, 200011, China
| | - Haozheng Tang
- Department of Bone and Joint Surgery, Department of Orthopaedics, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 145, Shandong Road, Shanghai, 200011, China
| | - Shutao Zhang
- Department of Bone and Joint Surgery, Department of Orthopaedics, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 145, Shandong Road, Shanghai, 200011, China
| | - Xinhua Qu
- Department of Bone and Joint Surgery, Department of Orthopaedics, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 145, Shandong Road, Shanghai, 200011, China.
| | - Bing Yue
- Department of Bone and Joint Surgery, Department of Orthopaedics, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 145, Shandong Road, Shanghai, 200011, China.
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39
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Gatien C, Too A, Cormier S. Dimensions of relationship adjustment as correlates of depressive and anxiety symptoms among individuals with chronic pain. PSYCHOL HEALTH MED 2021; 27:1748-1759. [PMID: 34126820 DOI: 10.1080/13548506.2021.1936579] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Research suggests that partner relationship quality influences the psychological well-being of individuals with chronic pain, but the specific components of the relationship involved remain understudied. This study examined which dimensions of relationship adjustment influence the depressive and anxiety symptoms reported by the partner with chronic pain. A community sample of 214 adults in a romantic relationship for at least a year were recruited. Participants completed online questionnaires assessing pain characteristics (pain duration, pain intensity), relationship characteristics (marital status, duration of relationship), quality of relationship (dyadic adjustment, conjugal support) and emotional state (symptoms of depression and anxiety). Overall, participants reported well-adjusted relationships with their partners and higher levels of dyadic adjustment and conjugal support were associated with reduced symptoms of depression and anxiety. Most importantly, dyadic consensus, marital status, and pain intensity revealed to be predictive of depressive symptoms, whereas dyadic consensus and pain intensity were predictive of anxiety symptoms. These findings highlight the need to consider the interpersonal functioning of this population to enhance their psychological well-being.
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Affiliation(s)
- Catherine Gatien
- Département De Psychoéducation Et De Psychologie, Université Du Québec En Outaouais, Gatineau, QC, Canada
| | - Andrea Too
- Département De Psychoéducation Et De Psychologie, Université Du Québec En Outaouais, Gatineau, QC, Canada
| | - Stéphanie Cormier
- Département De Psychoéducation Et De Psychologie, Université Du Québec En Outaouais, Gatineau, QC, Canada
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40
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Herbert MS, Wooldridge JS, Paolillo EW, Depp CA, Moore RC. Social Contact Frequency and Pain among Older Adults with HIV: An Ecological Momentary Assessment Study. Ann Behav Med 2021; 56:168-175. [PMID: 34057465 DOI: 10.1093/abm/kaab037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Social relationships are important for pain management among individuals with HIV, but the impact of daily social contact on pain responses in real-time, real-world settings has never been specifically examined. PURPOSE The purpose of the present study was to examine the relationship between social contact frequency and pain, and the role of negative and positive affect in this relationship among older adults with HIV using ecological momentary assessment (EMA). METHODS A total of 66 (Mage = 59.3, SD = 6.3, range: 50-74) older adults with HIV completed EMA surveys that included social contact frequency, pain level, and negative and positive affect four times per day for 2 weeks. Mixed-effects regression models were used to examine concurrent and lagged associations between social contact frequency, pain, and negative and positive affect. RESULTS Greater recent social contact frequency was associated with less severe current pain (unstandardized B = -0.04, 95% CI: -0.08, -0.01, p = .014), while greater current pain was associated with lower subsequent social contact frequency (unstandardized B = -0.07, 95% CI: -0.11, -0.03, p < .001). Further, higher current negative affect was related to greater current pain, and this relationship was dampened by increased recent social contact frequency (unstandardized B = -0.17, 95% CI: -0.26, -0.08, p < .001). Neither negative nor positive affect was significantly associated with the relationship between current pain and subsequent social contact frequency. CONCLUSIONS Social contact frequency and pain are bidirectionally and inversely associated among older adults with HIV. Further, recent social contact influences current pain by attenuating negative affect. Together, these results highlight the need to address social engagement in interventions for pain among older adults with HIV.
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Affiliation(s)
- Matthew S Herbert
- VA San Diego Healthcare System, San Diego, CA, USA.,Department of Psychiatry, University of California, San Diego, San Diego, CA, USA.,VA Center of Excellence for Stress and Mental Health, San Diego, CA, USA
| | - Jennalee S Wooldridge
- VA San Diego Healthcare System, San Diego, CA, USA.,Department of Psychiatry, University of California, San Diego, San Diego, CA, USA.,VA Center of Excellence for Stress and Mental Health, San Diego, CA, USA
| | - Emily W Paolillo
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
| | - Colin A Depp
- VA San Diego Healthcare System, San Diego, CA, USA.,Department of Psychiatry, University of California, San Diego, San Diego, CA, USA
| | - Raeanne C Moore
- Department of Psychiatry, University of California, San Diego, San Diego, CA, USA
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41
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Knowles LM, Phillips KM, Herring TE, Alschuler KN, Jensen MP, Turner AP, Ehde DM. Pain Intensity and Pain Interference in People With Progressive Multiple Sclerosis Compared With People With Relapsing-Remitting Multiple Sclerosis. Arch Phys Med Rehabil 2021; 102:1959-1964. [PMID: 34048792 DOI: 10.1016/j.apmr.2021.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 04/30/2021] [Accepted: 05/10/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To describe pain intensity and interference in people with progressive multiple sclerosis (MS), compare these with people with relapsing-remitting multiple sclerosis (RRMS), and identify common and unique factors associated with pain intensity in people with progressive MS and RRMS. DESIGN Observational, cross-sectional analysis using baseline data from a longitudinal survey on quality of life in participants with MS. SETTING Community. PARTICIPANTS A total of 573 adults with MS (N=573; progressive MS, n=142; RRMS, n=431). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Average pain intensity was measured by an 11-point numeric rating scale, and pain interference was measured by the Patient-Reported Outcomes Measurement Information System Pain Interference Short Form. RESULTS Participants with progressive MS reported moderate average pain intensity (3.22±2.50) and elevated pain interference (T score of 55.55±9.13). They did not differ significantly from those with RRMS in average pain intensity or pain interference. Common factors associated with higher average pain intensity were more severe disability, lower education level, unemployment, and current smoking. In those with progressive MS, older age was associated with lower average pain intensity. CONCLUSIONS Pain intensity and interference are similar across MS types. In addition to assessing and treating pain, it is important to screen for modifiable pain-related factors, such as smoking cessation, in this population.
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Affiliation(s)
- Lindsey M Knowles
- Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA; Multiple Sclerosis Center of Excellence-West, Veterans Administration Puget Sound Health Care System, Seattle Division, Seattle, WA.
| | - Kala M Phillips
- Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA
| | - Tracy E Herring
- Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA
| | - Kevin N Alschuler
- Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA; Department of Neurology, University of Washington School of Medicine, Seattle, WA
| | - Mark P Jensen
- Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA
| | - Aaron P Turner
- Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA; Multiple Sclerosis Center of Excellence-West, Veterans Administration Puget Sound Health Care System, Seattle Division, Seattle, WA
| | - Dawn M Ehde
- Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA
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42
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Sánchez-Rodríguez E, Aragonès E, Jensen MP, Tomé-Pires C, Rambla C, López-Cortacans G, Miró J. The Role of Pain-Related Cognitions in the Relationship Between Pain Severity, Depression, and Pain Interference in a Sample of Primary Care Patients with Both Chronic Pain and Depression. PAIN MEDICINE 2021; 21:2200-2211. [PMID: 32100028 DOI: 10.1093/pm/pnz363] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The aims of this study were twofold: 1) to better understand the associations between pain-related cognitions and pain severity, and psychological and physical function, and 2) to determine the extent to which these cognitions function as mediators in the association between pain severity and depression in a sample of primary care adult patients with chronic pain and depression. DESIGN Cross-sectional design. METHODS Three hundred twenty-eight patients with both depression and chronic pain from primary care centers responded to measures of pain severity, pain interference, depression severity, and pain-related cognitions (including measures of catastrophizing and other pain-related beliefs). We performed three hierarchical regression analyses and two multiple regression analyses. RESULTS The helplessness domain of pain catastrophizing was positively associated with pain severity, depression severity, and pain interference and mediated the relationship between depression and pain severity and vice versa. Beliefs about disability showed a positive association with pain severity, pain interference, and depression severity, and also mediated the relationship between pain severity and depression. Believing in a medical cure was positively associated with pain interference and negatively associated with depression; emotion beliefs were positively associated with pain severity. CONCLUSIONS These findings provide important new information about the associations between several pain-related cognitions and pain severity, depression, and pain interference and the potential mediating roles that these cognitions play in the associations between pain severity and depression in patients with both chronic pain and depression in the primary care setting.
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Affiliation(s)
- Elisabet Sánchez-Rodríguez
- Department of Psychology, Universitat Rovira i Virgili, Unit for the Study and Treatment of Pain - ALGOS, Research Center for Behavior Assessment (CRAMC), Catalonia, Spain.,Institut d'Investigació Sanitària Pere Virgili, Catalonia, Spain
| | - Enric Aragonès
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain.,Atenció Primària Camp de Tarragona, Institut Català de la Salut, Tarragona, Spain
| | - Mark P Jensen
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA
| | - Catarina Tomé-Pires
- Department of Psychology, Universitat Rovira i Virgili, Unit for the Study and Treatment of Pain - ALGOS, Research Center for Behavior Assessment (CRAMC), Catalonia, Spain.,Institut d'Investigació Sanitària Pere Virgili, Catalonia, Spain.,Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain
| | - Concepció Rambla
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain.,Atenció Primària Camp de Tarragona, Institut Català de la Salut, Tarragona, Spain
| | - Germán López-Cortacans
- Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain.,Atenció Primària Camp de Tarragona, Institut Català de la Salut, Tarragona, Spain
| | - Jordi Miró
- Department of Psychology, Universitat Rovira i Virgili, Unit for the Study and Treatment of Pain - ALGOS, Research Center for Behavior Assessment (CRAMC), Catalonia, Spain.,Institut d'Investigació Sanitària Pere Virgili, Catalonia, Spain
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43
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Riquelme I, Escobio-Prieto I, Oliva-Pascual-Vaca Á, Heredia-Rizo AM, Montoya P. Effect of Social Support in Pain Sensitivity in Children with Cerebral Palsy and Typically Developing Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094661. [PMID: 33925690 PMCID: PMC8125433 DOI: 10.3390/ijerph18094661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 04/25/2021] [Indexed: 12/03/2022]
Abstract
Pain and abnormal somatosensory processing are important associated conditions in children and adolescents with cerebral palsy (CP). Perceived social support is highly relevant for pain perception and coping. Aim: The aim of the present study was to assess the influence of social support on pain sensitivity in children and adolescents with cerebral palsy and healthy peers. Design: Cross-sectional study. Methods: Pressure pain thresholds were assessed in 42 children and adolescents with CP and 190 healthy peers during three different conditions: alone, with their mother and with a stranger. Results: Children with CP reported lower pain sensitivity when they were with their mother than being alone or with a stranger, whereas healthy peers did not experience different pain sensitivity related to the social condition. Sex or clinical characteristics did not affect the relationship between pain perception and social support. Conclusion: The present study shows how children with CP are highly affected by social and contextual influences for regulating pain sensitivity. Solicitous parental support may enhance pain perception in children with CP. Further research on the topic is warranted in order to attain well-founded conclusions for clinical practice.
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Affiliation(s)
- Inmaculada Riquelme
- Institute of Health Sciences Research (IUNICS-IdISBa), University of Balearic Islands, Carretera de Valldemossa km 7.5, 07122 Palma de Mallorca, Spain;
- Department of Nursing and Physiotherapy, University of the Balearic Islands, 07122 Palma de Mallorca, Spain
- Correspondence: ; Tel.: +34-971-171-310; Fax: +34-971-172-309
| | - Isabel Escobio-Prieto
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, 41009 Sevilla, Spain; (I.E.-P.); (Á.O.-P.-V.); (A.M.H.-R.)
| | - Ángel Oliva-Pascual-Vaca
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, 41009 Sevilla, Spain; (I.E.-P.); (Á.O.-P.-V.); (A.M.H.-R.)
| | - Alberto Marcos Heredia-Rizo
- Departamento de Fisioterapia, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, 41009 Sevilla, Spain; (I.E.-P.); (Á.O.-P.-V.); (A.M.H.-R.)
| | - Pedro Montoya
- Institute of Health Sciences Research (IUNICS-IdISBa), University of Balearic Islands, Carretera de Valldemossa km 7.5, 07122 Palma de Mallorca, Spain;
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Benville JR, Compton P, Giordano NA, Cheatle MD. Perceived social support in patients with chronic pain with and without opioid use disorder and role of medication for opioid use disorder. Drug Alcohol Depend 2021; 221:108619. [PMID: 33667781 PMCID: PMC8796693 DOI: 10.1016/j.drugalcdep.2021.108619] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 12/31/2020] [Accepted: 01/26/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND A significant predictor of treatment outcomes for patients with chronic non-cancer pain (CNCP) and opioid use disorder (OUD) is the degree and quality of social support they receive. Specifically, in patients with CNCP and on long-term opioid therapy, the development of OUD tends to be associated with losses in social support, while engagement in treatment for OUD improves support networks. Delivery of the evidence-based OUD treatment medications, methadone and buprenorphine, occurs in clinical environments which patently differ with respect to social support resources. The aims of this study were to describe perceived social support in patients with CNCP without OUD (no-OUD), with OUD and on buprenorphine (OUD-BP), and with OUD and on methadone (OUD-methadone). METHODS Using the Duke Social Support Index (DSSI), perceived social support in a sample of Caucasian patients with CNCP and on opioid therapy was compared between no-OUDs (n = 834), OUD-methadone (n = 83) and OUD-BP (n = 99) therapy. Average DSSI scores were compared across groups and a linear regression model computed to describe association between group and perceived social support. RESULTS No difference was observed in DSSI scores between no-OUDs and OUD-methadone, however scores were lower among OUD-BP participants than those receiving methadone (x = -5.2; 95% CI: -7.5, -2.9) and (x = -6.5, 95% CI: -8.2, -4.9). CONCLUSIONS Patients with CNCP and OUD on methadone therapy endorse levels of social support comparable to those without OUD, however those on buprenorphine therapy report significantly less support, bringing implications for OUD treatment outcomes.
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Affiliation(s)
- Julia R Benville
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Suite 500, Philadelphia, PA, 19104, United States; Department of Psychiatry, NYU School of Medicine, Bellevue Hospital, 462 First Avenue, Room A842, New York, NY 10016, United States.
| | - Peggy Compton
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, 418 Curie Blvd, Claire Fagin Hall, Room 402, Philadelphia, PA, 19104, United States.
| | - Nicholas A Giordano
- Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road, Atlanta, GA, 30322, United States.
| | - Martin D Cheatle
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, 3535 Market Street, Suite 500, Philadelphia, PA, 19104, United States.
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Nanda U, Luo J, Wonders Q, Pangarkar S. Telerehabilitation for Pain Management. Phys Med Rehabil Clin N Am 2021; 32:355-372. [PMID: 33814062 PMCID: PMC9585226 DOI: 10.1016/j.pmr.2021.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Telerehabilitation for pain management uses communication technology to minimize geographic barriers. Access to such technology has proven critically important during the coronavirus disease-2019 pandemic and has been useful for patients with chronic pain disorders unable to travel. The evaluation and treatment of such disorders requires a whole health approach that individualizes treatment options and delivers care through a biopsychosocial approach. The goals of care are unchanged from an in-person patient-provider experience. Telerehabilitation can be successfully implemented in pain management with appropriate consideration for staging an evaluation, a structured approach to the visit, and application of standard clinical metrics.
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Affiliation(s)
- Udai Nanda
- Department of Physical Medicine and Rehabilitation, VA Greater Los Angeles Healthcare System, 11301 Wilshire Boulevard (W117), Los Angeles, CA 90073, USA; Division of Physical Medicine and Rehabilitation, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
| | - Jerry Luo
- Department of Physical Medicine and Rehabilitation, VA Greater Los Angeles Healthcare System, 11301 Wilshire Boulevard (W117), Los Angeles, CA 90073, USA; Division of Physical Medicine and Rehabilitation, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Quinn Wonders
- Department of Physical Medicine and Rehabilitation, VA Greater Los Angeles Healthcare System, 11301 Wilshire Boulevard (W117), Los Angeles, CA 90073, USA; Department of Pharmacy, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - Sanjog Pangarkar
- Department of Physical Medicine and Rehabilitation, VA Greater Los Angeles Healthcare System, 11301 Wilshire Boulevard (W117), Los Angeles, CA 90073, USA; Division of Physical Medicine and Rehabilitation, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
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Silva K, Castro L, Costa-Santos C, Lourenco A, Lima M. More than Ownership: The Importance of Relationships with Companion Dogs for the Psychological Adjustment of Fibromyalgia Patients. PAIN MEDICINE 2021; 22:2987-2997. [PMID: 33594430 DOI: 10.1093/pm/pnaa438] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE This study explored the role of companion dogs for psychological adjustment to pain in patients with fibromyalgia with different levels of social support. It also considered the potential moderating effects of the quality of the owner-dog relationship and the use of interactions with dogs as a coping strategy. SETTING A cross-sectional approach was followed using an online questionnaire. SUBJECTS AND METHODS Linear regression analyses were performed on data obtained from 106 participants (dog owners and non-owners). Sub-analyses were performed on 64 dog owners. RESULTS Complex associations were observed between human social support, dog ownership and anxiety/depression levels. For participants with low levels of social support, owning a dog was associated with higher levels of anxiety and depression. In contrast, for moderate and high levels of social support, owning a dog was associated with lower levels of anxiety and depression. Sub-analyses showed that participants in this study actively used interactions with companion dogs to manage their pain more frequently than other pain coping strategies. Among those interactions, patting and stroking the dog to cope with pain was associated with lower anxiety levels, even after adjusting for social support. Emotional closeness with the dog was associated with lower depression levels. CONCLUSIONS Obtained results highlight the importance to go beyond mere ownership when addressing the effects of companion dogs and suggest that the development of emotional ties with companion dogs and the active use of interactions with these animals to cope with pain may contribute to better psychological adjustment in patients with fibromyalgia, regardless of human social support.
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Affiliation(s)
- Karine Silva
- Department of Behavioral Sciences at the Institute of Biomedical Sciences Abel Salazar, University of Porto, Portugal.,Center for Health Technology and Services Research - CINTESIS, University of Porto, Porto, Portugal
| | - Luísa Castro
- Center for Health Technology and Services Research - CINTESIS, University of Porto, Porto, Portugal.,Institute for Systems and Computer Engineering, Technology and Science - INESC-TEC, Porto, Portugal
| | - Cristina Costa-Santos
- Center for Health Technology and Services Research - CINTESIS, University of Porto, Porto, Portugal.,Health Information and Decision Sciences Department - MEDCIDS, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Antonio Lourenco
- Food Safety Department, Teagasc Food Research Centre, Moorepark, Fermoy, County Cork, Ireland
| | - Mariely Lima
- Center for Health Technology and Services Research - CINTESIS, University of Porto, Porto, Portugal.,Superior School of Education Paula Frassinetti, Porto, Portugal.,Health Sciences School of the University of Aveiro, Aveiro, Portugal
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Giusti EM, Lacerenza M, Manzoni GM, Castelnuovo G. Psychological and psychosocial predictors of chronic postsurgical pain: a systematic review and meta-analysis. Pain 2021; 162:10-30. [PMID: 32694386 DOI: 10.1097/j.pain.0000000000001999] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Knowledge about psychological and psychosocial predictors of chronic postsurgical pain is important to identify patients at risk for poor outcomes. The objective of this systematic review with meta-analysis was to assess the effect of such predictors. A comprehensive search of the available literature on this topic was performed using the electronic databases PubMed, Scopus, Embase, and PsycInfo. Estimates of the effect of each predictor were extracted, and both a narrative synthesis and a quantitative synthesis of these estimates were performed. Multiple imputation was used to take into account the effect of nonsignificant estimates in case they were not reported by original studies. From a sample of 8322 records, 83 articles were included in the narrative synthesis and 41 studies were used to perform the meta-analyses. The narrative synthesis showed that evidence about the effect of psychological predictors is heterogeneous, with few expected predictors, such as optimism, state anxiety and psychological distress, consistently associated with chronic postsurgical pain. By contrast, the meta-analyses showed that state anxiety, trait anxiety, mental health, depression, catastrophizing and, to a lesser extent, kinesiophobia and self-efficacy have a weak but significant association with chronic postsurgical pain. In conclusion, this study showed that psychological predictors have a significant association with chronic postsurgical pain and that state anxiety is the most explicative one.
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Affiliation(s)
- Emanuele M Giusti
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, Ospedale San Giuseppe, Verbania, Italy
- Department of Psychology, Catholic University of Milan, Milan, Italy
| | - Marco Lacerenza
- Neurology Service, and Pain Center, Humanitas San Pio X Clinic, Milan, Italy
| | | | - Gianluca Castelnuovo
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, Ospedale San Giuseppe, Verbania, Italy
- Department of Psychology, Catholic University of Milan, Milan, Italy
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Alphonsus KB, D’Arcy C. Is There an Association Between Social Support and Pain Among Individuals Living With Multiple Sclerosis? J Evid Based Integr Med 2021; 26:2515690X21991995. [PMID: 33535805 PMCID: PMC7868479 DOI: 10.1177/2515690x21991995] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 12/13/2020] [Accepted: 01/09/2021] [Indexed: 12/04/2022] Open
Abstract
CONTEXT Pain is one of the most common symptoms reported by patients living with Multiple Sclerosis (MS). Risk factors associated with pain may include individual's cognitive thinking process, emotional and behavioural response to pain and amount of social support. There is a lack of research on the influence on the amount of social support and its association to pain outcomes. OBJECTIVE The primary objective of this study was to determine the association between amount and of social support and its association with odds of pain among individuals with MS. METHODS The Survey on Living with Neurological Conditions in Canada (SLNCC) 2011-2012 linked to the Canadian Community Health Survey (CCHS) 2010-2011 was used to carry out a logistic regression model for this analysis (N = 78,623). MAIN OUTCOME MEASURES The factors that were assessed were psychological factors, problems with sleeping, self-perceived general health, self-perceived level of stress, number of years living with MS, as well as social factors. The outcome variable was pain. RESULTS The amount of social support was found to be significant in that individuals who had 3 or fewer types of social support were 3.02 times more likely (95% CI 1.06 to 8.59) to report being in pain as opposed to individuals who had 4 types of support. The results indicate the importance of self efficacy in overcoming symptoms of MS and the need for more home care services.
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Affiliation(s)
- Khrisha B. Alphonsus
- School of Public Health, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Carl D’Arcy
- Applied Research, Department of Psychiatry, Royal University Hospital, Saskatoon, Saskatchewan, Canada
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Sahar K, Thomas SA, Clarke SP. Adjustment to fibromyalgia: The role of domain‐specific self‐efficacy and acceptance. AUSTRALIAN JOURNAL OF PSYCHOLOGY 2020. [DOI: 10.1111/ajpy.12089] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Karan Sahar
- Division of Rehabilitation and Ageing, University of Nottingham, Nottingham, UK,
| | - Shirley A. Thomas
- Division of Rehabilitation and Ageing, University of Nottingham, Nottingham, UK,
| | - Simon P. Clarke
- Division of Rehabilitation and Ageing, University of Nottingham, Nottingham, UK,
- Arthritis Research UK Pain Centre, University of Nottingham, Nottingham, UK,
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Braunwalder C, Müller R, Kunz S, Tough H, Landmann G, Fekete C. Psychosocial resources and chronic pain in individuals with spinal cord injury: evidence from the second Swiss national community survey. Spinal Cord 2020; 59:410-418. [PMID: 33214625 DOI: 10.1038/s41393-020-00577-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 09/10/2020] [Accepted: 09/11/2020] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Cross-sectional. OBJECTIVE To investigate the associations of a set of psychosocial resources with pain and pain-related factors in individuals with spinal cord injury (SCI) and chronic pain. SETTING Community, Switzerland. METHODS Data from 1,064 individuals with chronic pain who participated in the second community survey of the Swiss Spinal Cord Injury Cohort Study (Survey 2017) were analyzed. Multiple linear regression modeling was performed to test the hypotheses that higher levels of psychosocial resources (self-efficacy, self-esteem, purpose in life, optimism, hope, social support, sense of belonging) are negatively associated with pain intensity, pain interference and depressive symptoms. RESULTS Higher self-esteem, optimism and hope were related to less pain interference and all psychosocial resources under study were negatively associated with depressive symptoms in final models. However, neither of the psychosocial resources was related to pain intensity when models were adjusted for pain interference and depressive symptoms. CONCLUSIONS These findings strengthen the evidence that psychosocial resources can have an impact on pain interference and depressive symptoms as pain-related factors, and support the notion that psychosocial resources might be promising targets for pain interventions in individuals with SCI.
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Affiliation(s)
- Céline Braunwalder
- Swiss Paraplegic Research, Guido A. Zäch Strasse 4, 6207, Nottwil, Switzerland. .,Department of Health Sciences and Medicine, University of Lucerne, Frohburgstrasse 3, 6002, Lucerne, Switzerland.
| | - Rachel Müller
- Swiss Paraplegic Research, Guido A. Zäch Strasse 4, 6207, Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Lucerne, Frohburgstrasse 3, 6002, Lucerne, Switzerland
| | - Simon Kunz
- Swiss Paraplegic Research, Guido A. Zäch Strasse 4, 6207, Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Lucerne, Frohburgstrasse 3, 6002, Lucerne, Switzerland
| | - Hannah Tough
- Swiss Paraplegic Research, Guido A. Zäch Strasse 4, 6207, Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Lucerne, Frohburgstrasse 3, 6002, Lucerne, Switzerland
| | - Gunther Landmann
- Center for Pain Medicine, Guido A. Zäch Strasse 1, 6207, Nottwil, Switzerland
| | - Christine Fekete
- Swiss Paraplegic Research, Guido A. Zäch Strasse 4, 6207, Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Lucerne, Frohburgstrasse 3, 6002, Lucerne, Switzerland
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