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Fang Y, Liu M, Wu M, Zhang J, Liu M, Niu T, Zhang X. Path Analysis Between Family Functioning and Mental Health in People With Neuropathic Pain: Roles of Pain Intensity, Self-Perceived Burden, Pain Catastrophizing, and Functional Status. Pain Manag Nurs 2024; 25:e287-e294. [PMID: 38664088 DOI: 10.1016/j.pmn.2024.03.014] [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: 10/03/2023] [Revised: 03/16/2024] [Accepted: 03/17/2024] [Indexed: 08/16/2024]
Abstract
PURPOSE This study aimed to explore the pathways between family functioning and mental health in people with neuropathic pain, as well as to discuss the mediating role of pain intensity, self-perceived burden, pain catastrophizing, and functional status. DESIGN Cross-sectional design reported using the STROBE guidelines. METHODS A total of 277 people with neuropathic pain completed face-to-face questionnaires to evaluate family functioning, pain intensity, pain catastrophizing, self-perceived burden, functional status, and mental health. Structural equation modeling (SEM) was constructed to analyze the pathways between these variables. RESULTS The positive total effect between family functioning and mental health was significant and partially mediated by self-perceived burden, pain catastrophizing, and functional status. In addition, better family functioning was associated with higher pain intensity, which worsens self-perceived burden, pain catastrophizing, and functional status, masking 23.68% of the positive effects between family functioning and mental health. CONCLUSIONS Better family functioning was associated with better mental health, as explained by reduced self-perceived burden, reduced pain catastrophizing, and improved functional status. However, this benefit may be partially masked by the relationship that better family functioning explains higher pain intensity. CLINICAL IMPLICATIONS Nurses' comprehensive assessment and management of neuropathic pain from both the family and individual levels, such as family functioning, pain intensity, self-perceived burden, pain catastrophizing, and functional status, may be beneficial in promoting patients' mental health. In addition, it is necessary to identify why good family functioning is associated with higher pain intensity and intervene in this regard.
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Affiliation(s)
- Yu Fang
- Graduate Student, School of Nursing, Xuzhou Medical University, Xuzhou, China
| | - Mengjie Liu
- Graduate Student, School of Nursing, Xuzhou Medical University, Xuzhou, China
| | - Min Wu
- Graduate Student, School of Nursing, Xuzhou Medical University, Xuzhou, China
| | - Jingshuo Zhang
- Graduate Student, School of Nursing, Xuzhou Medical University, Xuzhou, China
| | - Mengshi Liu
- Graduate Student, School of Nursing, Xuzhou Medical University, Xuzhou, China
| | - Tianchen Niu
- Graduate Student, School of Nursing, Xuzhou Medical University, Xuzhou, China
| | - Xiaoman Zhang
- Master's Degree, School of Nursing, Xuzhou Medical University, Xuzhou, China.
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Blake H, Chaplin WJ, Gupta A. The effectiveness of digital interventions for self-management of chronic pain in employment settings: a systematic review. Br Med Bull 2024:ldae007. [PMID: 38972661 DOI: 10.1093/bmb/ldae007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 05/29/2024] [Accepted: 06/19/2024] [Indexed: 07/09/2024]
Abstract
INTRODUCTION Chronic pain affects over a quarter of the workforce with high economic burden for individuals, employers and healthcare services. Access to work-related advice for people with chronic pain is variable. This systematic review aims to explore the effectiveness of workplace-delivered digital interventions for the self-management of chronic pain. SOURCE OF DATA MEDLINE, EMBASE, CINAHL, PsycINFO, the Cochrane Library, JBI, Open Science Framework, Epistemonikos and Google Scholar. Articles published between January 2001 and December 2023 were included. Searches were conducted between October 2023 and December 2023. AREAS OF AGREEMENT Workplace-delivered digital interventions to support self-management of chronic pain at work may improve pain and health-related quality of life in vocationally active adults. Delivering interventions outside of clinical services, through the workplace setting, may help to reduce inequity in access to work-related advice for people with chronic pain, and ultimately reduce the burden on individuals, employers and healthcare services. Interventions include mobile apps and web-based programmes. AREAS OF CONTROVERSY Studies were moderate-to-low quality. Most studies focused on exercise, few considered other aspects of pain self-management. Given the limited evidence in the current literature, consensus on best intervention format and delivery is lacking. GROWING POINTS More high-quality studies are needed given the heterogeneity in study design, interventions and outcome measures. AREAS TIMELY FOR DEVELOPING RESEARCH No interventions included advice on work-related adjustments or support. Few studies included work-related outcomes, despite the known impact of pain on work and work on health.
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Affiliation(s)
- Holly Blake
- School of Health Sciences, Faculty of Medicine and Health Sciences, University of Nottingham, Queen's Medical Centre, Derby Road, Nottingham, NG7 2HA, UK
- NIHR Nottingham Biomedical Research Centre, Medical School, Queen's Medical Centre, Derby Road, Nottingham, NG7 2UH, UK
| | - Wendy J Chaplin
- School of Health Sciences, Faculty of Medicine and Health Sciences, University of Nottingham, Queen's Medical Centre, Derby Road, Nottingham, NG7 2HA, UK
- NIHR Nottingham Biomedical Research Centre, Medical School, Queen's Medical Centre, Derby Road, Nottingham, NG7 2UH, UK
| | - Alisha Gupta
- Population Health Sciences Institute, Baddiley-Clark Building, Newcastle University, Newcastleupon-Tyne, NE1 7RU, UK
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Kuharic M, Mulhern B, Sharp LK, Turpin RS, Pickard AS. Understanding caregiver burden from multiple perspectives: dyadic agreement between caregiver and care recipient. Qual Life Res 2024; 33:1719-1734. [PMID: 38632146 DOI: 10.1007/s11136-024-03643-x] [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] [Accepted: 03/01/2024] [Indexed: 04/19/2024]
Abstract
PURPOSE Caregiver burden (CB) is typically self-assessed by caregivers. However, an emerging concept is assessment of CB by the recipients of care, i.e., the patient. The specific objectives are (1) to assess the level of agreement between care recipients' and caregivers' view on CB, across financial, physical, emotional, and social domains; (2) to explore two care recipient perspectives: their self-perceived burden (CR-SPB), and their interpretation of the caregiver's view (Proxy-CB). METHODS Data were collected from 504 caregiver-care recipient dyads in the U.S. using an online Qualtrics panel. The survey assessed caregiver burden using CarerQol and newly developed items. The level of agreement between responses was quantified using weighted kappa (κ) coefficients for individual items and intraclass correlation coefficients (ICC) for index/summary scores. RESULTS The average age of caregivers was 49.2 years, and 62.7 years for care recipients. Dyads most commonly consisted of spouses/partners (34.5%); 68.3% lived together. Proxy-CB aligned more closely with caregiver's view, with moderate to substantial agreement across CB domains (from κ = 0.48 for emotional to κ = 0.66 for financial). In the same perspective, the CarerQol-7D Index showed moderate agreement (ICC = 0.58) and the summary score of CB items substantial agreement (ICC = 0.76). Care recipients generally overestimated CB in the Proxy-CB perspective, while they underestimated it in the CR-SPB perspective. CONCLUSION Results demonstrate there is a difference between perspectives. Strong agreement in Proxy-CB perspective suggests that care recipients can potentially substitute for caregivers depending on the domain. CR-SPB agrees less with caregivers and may provide complementary information.
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Affiliation(s)
- Maja Kuharic
- Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois, Chicago, IL, USA.
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N Michigan Ave, Chicago, IL, 60611, USA.
| | - Brendan Mulhern
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Sydney, NSW, Australia
| | - Lisa K Sharp
- Department of Biobehavioral Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, IL, USA
| | | | - A Simon Pickard
- Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois, Chicago, IL, USA
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Fang Y, Liu M, Wu M, Liu M, Niu T, Zhang X. Pain intensity and self-perceived burden mediate the relationship between family functioning and pain catastrophizing in patients with neuropathic pain. Nurs Health Sci 2024; 26:e13097. [PMID: 38369318 DOI: 10.1111/nhs.13097] [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: 08/08/2023] [Revised: 12/18/2023] [Accepted: 01/25/2024] [Indexed: 02/20/2024]
Abstract
This cross-sectional study aimed to investigate the relationship between family functioning, pain intensity, self-perceived burden, and pain catastrophizing. Moreover, we also wanted to explore the multiple mediating roles of pain intensity and self-perceived burden. From October 2022 to March 2023, 252 Chinese people with neuropathic pain completed face-to-face questionnaires to assess family functioning, pain intensity, self-perceived burden, and pain catastrophizing. Data analysis was done using descriptive statistics and a structural equation model. The results showed better family functioning was significantly associated with more intense pain, less self-perceived burden, and less pain catastrophizing. Mediation analysis showed that family functioning could indirectly affect pain catastrophizing through pain intensity and self-perceived burden in addition to a direct effect on pain catastrophizing. Moreover, the mediating variable of pain intensity played a masking role. These findings suggest that good family functioning can effectively reduce the self-perceived burden and pain catastrophizing in patients with neuropathic pain. However, family functioning cannot show its maximum effectiveness, and it may be necessary to construct a model of family functioning suitable for patients with neuropathic pain in the future.
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Affiliation(s)
- Yu Fang
- School of Nursing, Xuzhou Medical University, Xuzhou, China
| | - Mengjie Liu
- School of Nursing, Xuzhou Medical University, Xuzhou, China
| | - Min Wu
- School of Nursing, Xuzhou Medical University, Xuzhou, China
| | - Mengshi Liu
- School of Nursing, Xuzhou Medical University, Xuzhou, China
| | - Tianchen Niu
- School of Nursing, Xuzhou Medical University, Xuzhou, China
| | - Xiaoman Zhang
- School of Nursing, Xuzhou Medical University, Xuzhou, China
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Chen X, Wang Z, Zhou J, Loke AY, Li Q. A scoping literature review of factors influencing cancer patients' self-perceived burden. Eur J Oncol Nurs 2024; 68:102462. [PMID: 37995428 DOI: 10.1016/j.ejon.2023.102462] [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: 07/09/2022] [Revised: 10/19/2023] [Accepted: 10/30/2023] [Indexed: 11/25/2023]
Abstract
PURPOSE A cancer diagnosis disrupts the peaceful lives and plans of patients and even their caregivers, and patients can easily feel burdened when they are being cared for by others. However, the influencing factors of self-perceived burden (SPB) have not been summarized, and related research is still in its infancy. This review explores factors related to the SPB of cancer patients and identifies future research directions. METHOD A systematic search, including trolling through six electronic databases, was conducted to identity articles published in English and Chinese from January 2003 to April 2022, using key terms related to cancer patients' burden on others; a manual search was also performed on the articles' reference lists. RESULTS Thirty-three articles were identified. The content was described into three groups: patient-related factors, caregiver-related factors, and family-related (financial) factors. Despite the heterogeneity, patients' physical/disease factors, psychological factors, social factors, caregiver type, quality of care provided, caregiver physical and psychological status, and financial factors were all correlated with SPB. CONCLUSIONS This literature review shows that SPB imposes a huge burden on cancer patients, and that SPB in cancer patients is influenced by patient-related factors, caregiver-related factors, and family factors. These influencing factors directly or indirectly affect SPB. In addition, SPB is complex and studies related to its factors deserve a further detailed analysis based on the actual situation of the patients in order to make the results more accurate and relevant.
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Affiliation(s)
- Xuan Chen
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Zhiming Wang
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Junrui Zhou
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China
| | - Alice Yuen Loke
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon Hong Kong, China
| | - Qiuping Li
- Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu Province, China; Affiliated Hospital of Jiangnan University, Wuxi, China.
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Li K, Zhu L, Zhang LY. Correlations between activation, family adaptation, and self-perceived burden in breast cancer patients with an implanted venous access port: A cross-sectional study. Medicine (Baltimore) 2023; 102:e36443. [PMID: 38115378 PMCID: PMC10727680 DOI: 10.1097/md.0000000000036443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 11/05/2023] [Accepted: 11/10/2023] [Indexed: 12/21/2023] Open
Abstract
We found that activation and family adaptation on the self-perceived burden of breast cancer patients with an implanted venous access port (IVAP), and to analyze the correlations among these scores. A total of 256 patients completed a general data questionnaire, the Patient Activation Measure (PAM), the Family adaptation and Cohesion Scale II-Chinese version (FACES-II-CV), and the Self-perceived Burden Scale (SPBS). The total scores for activation, family adaptation, and self-perceived burden were 63.31 ± 18.92, 42.72 ± 7.937, and 28.55 ± 7.89, respectively. We analyzed activation and family adaptation were associated with self-perceived burden (P < .05) the patients' self-perceived burden main factors is included Main caregiver, disease stage, complications, Type of health insurance, activation, and family adaptation. The activation, family adaptation, and self-perceived burden of breast cancer patients with an IVAP are closely related, which suggests that clinical workers should consider the patient family to formulate an intervention plan to improve patient activation, and thus reduce the self-perceived burden. For example, hospitals regularly conduct breast cancer health education activities, or invite psychological counselors to provide services to patients.
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Affiliation(s)
- Kun Li
- Department of Neurology, The Third Hospital of Nanchang, Nanchang People's Hospital, Nanchang, Jiangxi Province, China
| | - Lan Zhu
- Department of Nursing, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China
| | - Liu-Yi Zhang
- Department of The Medical College, School of Hunan Normal University, Changsha, Hunan Province, China
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Liu S, Zhang Y, Miao Q, Zhang X, Jiang X, Chang T, Li X. The Mediating Role of Self-Perceived Burden Between Social Support and Fear of Progression in Renal Transplant Recipients: A Multicenter Cross-Sectional Study. Psychol Res Behav Manag 2023; 16:3623-3633. [PMID: 37693331 PMCID: PMC10488562 DOI: 10.2147/prbm.s424844] [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: 06/23/2023] [Accepted: 08/17/2023] [Indexed: 09/12/2023] Open
Abstract
Purpose To explore the mechanism of social support and fear of progression (FoP) in renal transplant recipients (RTRs) and the self-perceived burden that acts as a mediator between social support and FoP. Patients and Methods Sociodemographic and clinical characteristics, the Social Support Rating Scale (SSRS), the Self-Perceived Burden Scale (SPBS), and the Fear of Progression-Questionnaire-Short Form (FoP-Q-SF) were used. Structural equation modeling (SEM) was used to examine the mediating role of self-perceived burden. Results Our results showed that social support was negatively related to the self-perceived burden (r = -0.28, p < 0.001) and FoP (r = -0.37, p < 0.001). Moreover, we determined that self-perceived burden was positively related to FoP (r = 0.58, p < 0.001) and that the indirect effect of social support on FoP via self-perceived burden was significant (β = -0.172, 95% CI: -0.253, -0.097), and with a mediating effect value of 36.9%. Conclusion The FoP in RTRs is a concern. Higher social support and lower self-perceived burden can reduce the risk of FoP. Healthcare professionals (HCPs) should assist RTRs in correctly evaluating an individual's social support system, helping them optimize social support to reduce the self-perceived burden and the development of FoP.
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Affiliation(s)
- Sainan Liu
- The First Affiliated Hospital of China Medical University, Shenyang, 110000, People’s Republic of China
| | - Ying Zhang
- The First Affiliated Hospital of China Medical University, Shenyang, 110000, People’s Republic of China
| | - Qi Miao
- The First Affiliated Hospital of China Medical University, Shenyang, 110000, People’s Republic of China
| | - Xu Zhang
- The First Affiliated Hospital of China Medical University, Shenyang, 110000, People’s Republic of China
| | - Xiaoyu Jiang
- The First Affiliated Hospital of China Medical University, Shenyang, 110000, People’s Republic of China
| | - Tiantian Chang
- The First Affiliated Hospital of China Medical University, Shenyang, 110000, People’s Republic of China
| | - Xiaofei Li
- Transplantation and Hepatobiliary Department, The First Affiliated Hospital of China Medical University, Shenyang, 110000, People’s Republic of China
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Junghaenel DU, Schneider S, Lucas G, Boberg J, Weinstein FM, Richeimer SH, Stone AA, Lumley MA. Virtual Human-Delivered Interviews for Patients With Chronic Pain: Feasibility, Acceptability, and a Pilot Randomized Trial of Standard Medical, Psychosocial, and Educational Interviews. Psychosom Med 2023; 85:627-638. [PMID: 37363989 PMCID: PMC10527278 DOI: 10.1097/psy.0000000000001228] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/28/2023]
Abstract
OBJECTIVE Seminal advances in virtual human (VH) technology have introduced highly interactive, computer-animated VH interviewers. Their utility for aiding in chronic pain care is unknown. We developed three interactive telehealth VH interviews-a standard pain-focused, a psychosocial risk factor, and a pain psychology and neuroscience educational interview. We then conducted a preliminary investigation of their feasibility, acceptability, and efficacy. We also experimentally compared a human and a computer-generated VH voice. METHODS Patients ( N = 94, age = 22-78 years) with chronic musculoskeletal pain were randomly assigned to the standard ( n = 31), psychosocial ( n = 34), or educational ( n = 29) VH interview and one of the two VH voices. Acceptability ratings included patient satisfaction and expectations/evaluations of the VH interview. Outcomes assessed at baseline and about 1-month postinterview were pain intensity, interference, emotional distress, pain catastrophizing, and readiness for pain self-management. Linear mixed-effects models were used to test between- and within-condition effects. RESULTS Acceptability ratings showed that satisfaction with the VH and telehealth format was generally high, with no condition differences. Study attrition was low ( n = 5). Intent-to-treat-analyses showed that, compared with the standard interview, the psychosocial interview yielded a significantly greater reduction in pain interference ( p = .049, d = 0.43) and a marginally greater reduction in pain intensity ( p = .054, d = 0.36), whereas the educational interview led to a marginally greater yet nonsignificant increase in readiness for change ( p = .095, d = 0.24), as well as several significant improvements within-condition. Results did not differ by VH voice. CONCLUSIONS Interactive VH interviewers hold promise for improving chronic pain care, including probing for psychosocial risk factors and providing pain-related education.
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Affiliation(s)
- Doerte U. Junghaenel
- Dornsife Center for Self-Report Science and Center for Economic & Social Research, University of Southern California, CA, USA
- Department of Psychology, University of Southern California, CA, USA
- Leonard Davis School of Gerontology, University of Southern California, CA, USA
| | - Stefan Schneider
- Dornsife Center for Self-Report Science and Center for Economic & Social Research, University of Southern California, CA, USA
- Department of Psychology, University of Southern California, CA, USA
- Leonard Davis School of Gerontology, University of Southern California, CA, USA
| | - Gale Lucas
- Institute for Creative Technologies, University of Southern California, CA, USA
- Viterbi School of Engineering, University of Southern California, CA, USA
| | - Jill Boberg
- Institute for Creative Technologies, University of Southern California, CA, USA
| | - Faye M. Weinstein
- Department of Anesthesiology, Keck School of Medicine, University of Southern California, CA, USA
| | - Steven H. Richeimer
- Department of Anesthesiology, Keck School of Medicine, University of Southern California, CA, USA
| | - Arthur A. Stone
- Dornsife Center for Self-Report Science and Center for Economic & Social Research, University of Southern California, CA, USA
- Department of Psychology, University of Southern California, CA, USA
| | - Mark A. Lumley
- Department of Psychology, Wayne State University, MI, USA
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Zhang Y, Li X, Bi Y, Kan Y, Liu H, Liu L, Zou Y, Zhang N, Fang L, Gong W. Effects of family function, depression, and self-perceived burden on loneliness in patients with type 2 diabetes mellitus: a serial multiple mediation model. BMC Psychiatry 2023; 23:636. [PMID: 37648996 PMCID: PMC10466700 DOI: 10.1186/s12888-023-05122-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 08/19/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND Type 2 Diabetes mellitus (T2DM) has become a major lifestyle disease endangering human health worldwide. Patients with T2DM face varying degrees of loneliness, which adversely affects their family and the larger society. This study investigates the serial multiple mediating roles of depression and self-perceived burden between family function and loneliness in the T2DM population of China. METHODS In total, 260 T2DM patients were included. They rated themselves based on UCLA Loneliness Scale, Self-Rating Depression Scale, Self-Rating Anxiety Scale, Family Care Index, and Self-Perceived Burden Scale. Pearson and Spearman correlation analyses were conducted to clarify the association among variables. The SPSS macro-PROCESS program was used for a series of multiple mediation analyses. RESULTS Family function, depression, self-perceived burden, and loneliness were significantly correlated (P < 0.01). Family function not only has a direct negative impact (effect = -2.809; SE = 0.213; 95%CI: LL = -3.228, UL = -2.390) on loneliness, but also has an indirect impact on loneliness through the independent mediating role of depression (effect = -0.862; SE = 0.165; 95%CI: LL = -1.202, UL = -0.567) and self-perceived burden (effect = -0.288; SE = 0.107; 95%CI: LL = -0.525, UL = -0.114) and the chain mediating role of depression and self-perceived burden (effect = -0.202; SE = 0.066; 95%CI: LL = -0.342, UL = -0.088). CONCLUSIONS Diversified interventions aimed at improving family function of T2DM patients would help in reducing the level of depression and self-perceived burden, and ultimately reducing loneliness.
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Affiliation(s)
- Yu Zhang
- School of Nursing, Yangzhou University, 136 Jiangyang middle road, Yangzhou City, Jiangsu Province, 225009, China.
- Jiangsu Key Laboratory of Integrated Traditional Chinese and Western Medicine for Prevention and Treatment of Senile Diseases, Yangzhou, China.
| | - Xiangning Li
- School of Nursing, Yangzhou University, 136 Jiangyang middle road, Yangzhou City, Jiangsu Province, 225009, China
| | - Yaxin Bi
- Northern Jiangsu People's Hospital, Yangzhou, 225009, China
| | - Yinshi Kan
- School of Nursing, Yangzhou University, 136 Jiangyang middle road, Yangzhou City, Jiangsu Province, 225009, China
| | - Hongyuan Liu
- School of Nursing, Yangzhou University, 136 Jiangyang middle road, Yangzhou City, Jiangsu Province, 225009, China
| | - Lin Liu
- School of Nursing, Yangzhou University, 136 Jiangyang middle road, Yangzhou City, Jiangsu Province, 225009, China
| | - Yan Zou
- School of Nursing, Yangzhou University, 136 Jiangyang middle road, Yangzhou City, Jiangsu Province, 225009, China
| | - Ning Zhang
- School of Nursing, Yangzhou University, 136 Jiangyang middle road, Yangzhou City, Jiangsu Province, 225009, China
| | - Li Fang
- Affiliated Hospital of Yangzhou University, Yangzhou, 225009, China
| | - Weijuan Gong
- Department of Basic Medicine, School of Medicine, Yangzhou University, 136 Jiangyang Road, Yangzhou, Jiangsu, 225009, China.
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Fan W, Ma KK, Yang CX, Guo YL. The mediating effect of stigma between self-perceived burden and loneliness in stroke patients. Front Psychiatry 2023; 14:1219805. [PMID: 37575575 PMCID: PMC10412817 DOI: 10.3389/fpsyt.2023.1219805] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 07/12/2023] [Indexed: 08/15/2023] Open
Abstract
Introduction Stroke patients may experience reduced socialization and feelings of isolation due to post-stroke sequelae such as impaired motor function and cognitive deficits. Factors associated with loneliness need to be explored to develop targeted interventions. However, little is known about the impact of self-perceived burden and illness stigma on loneliness in this population.The aim of this study was to explore the mediating effect of stigma on self-perceived burden and loneliness in stroke patients. Methods The cluster random sampling method was adopted to select 1028 stroke patients from the neurology department of third-grade A hospitals and second-grade A hospitals in 5 cities of Henan Province from May 2022 to August 2022. A general data questionnaire, self-perceived burden scale, stroke stigma scale, and loneliness scale were used to investigate. The structural equation model was used to analyze the mediating effect of stigma between self-perceived burden and stigma. Results The loneliness of stroke patients was positively correlated with self-perceived burden and stigma. The results of the mediation analysis showed that stigma played a complete mediating role between self-perceived burden and loneliness. Discussion The results of the study revealed the relationship between self-perceived burden, stigma, and loneliness in stroke patients. Stigma mediated the relationship between self-perceived burden and loneliness in this population.Stigma should be emphasized as an important modifiable psychological factor that affects loneliness of stroke patients.
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Affiliation(s)
- Wenfeng Fan
- Nursing and Health School, Zhengzhou University, Zhengzhou, China
| | - Ke ke Ma
- Neurology of the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Cai xia Yang
- Neurology of the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yuan li Guo
- Neurology of the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Filipponi C, Chichua M, Masiero M, Mazzoni D, Pravettoni G. Cancer Pain Experience Through the Lens of Patients and Caregivers: Mixed Methods Social Media Study. JMIR Cancer 2023; 9:e41594. [PMID: 37399067 PMCID: PMC10365594 DOI: 10.2196/41594] [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: 08/01/2022] [Revised: 05/12/2023] [Accepted: 06/05/2023] [Indexed: 07/04/2023] Open
Abstract
BACKGROUND Cancer pain represents a challenge for cancer patients and their family members. Despite progression in pain management, pain is still underreported and undertreated, and there is limited information on the related needs that patients and caregivers may have. Online platforms represent a fundamental tool for research to reveal the unmet needs of these users and their emotions outside the medical setting. OBJECTIVE This study aimed to (1) reveal the unmet needs of both patients and caregivers and (2) detect the emotional activation associated with cancer pain by analyzing the textual patterns of both users. METHODS A descriptive and quantitative analysis of qualitative data was performed in RStudio v.2022.02.3 (RStudio Team). We analyzed 679 posts (161 from caregivers and 518 from patients) published over 10 years on the "cancer" subreddit of Reddit to identify unmet needs and emotions related to cancer pain. Hierarchical clustering, and emotion and sentiment analysis were conducted. RESULTS The language used for describing experiences related to cancer pain and expressed needs differed between patients and caregivers. For patients (agglomerative coefficient=0.72), the large cluster labeled unmet needs included the following clusters: (1A) reported experiences, with the subclusters (a) relationship with doctors/spouse and (b) reflections on physical features; and (1B) changes observed over time, with the subclusters (a) regret and (b) progress. For caregivers (agglomerative coefficient=0.80), the main clusters were as follows: (1A) social support and (1B) reported experiences, with the subclusters (a) psychosocial challenges and (b) grief. Moreover, comparison between the 2 groups (entanglement coefficient=0.28) showed that they shared a common cluster labeled uncertainty. Regarding emotion and sentiment analysis, patients expressed a significantly higher negative sentiment than caregivers (z=-2.14; P<.001). On the contrary, caregivers expressed a higher positive sentiment compared with patients (z=-2.26; P<.001), with trust (z=-4.12; P<.001) and joy (z=-2.03; P<.001) being the most prevalent positive emotions. CONCLUSIONS Our study emphasized different perceptions of cancer pain in patients and caregivers. We revealed different needs and emotional activations in the 2 groups. Moreover, our study findings highlight the importance of considering caregivers in medical care. Overall, this study increases knowledge about the unmet needs and emotions of patients and caregivers, which may have important clinical implications in pain management.
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Affiliation(s)
- Chiara Filipponi
- Applied Research Division for Cognitive and Psychological Science, IEO European Institute of Oncology IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Mariam Chichua
- Applied Research Division for Cognitive and Psychological Science, IEO European Institute of Oncology IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Marianna Masiero
- Applied Research Division for Cognitive and Psychological Science, IEO European Institute of Oncology IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Davide Mazzoni
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - Gabriella Pravettoni
- Applied Research Division for Cognitive and Psychological Science, IEO European Institute of Oncology IRCCS, Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
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12
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Shannonhouse L, Hong J, Fullen M, Westcott J, Mingo CA, Mize MC, Love SF. Racial Differences in the Relationship Between Pain and Suicide Desire in Older Adults. J Appl Gerontol 2022; 42:972-980. [PMID: 36540033 DOI: 10.1177/07334648221145854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Older adults are reported to die by suicide at higher rates than the general population. Suicide desire among older adults is associated with pain, and pain experiences have been found to differ based on race. To investigate the relationship between pain and suicidal desire, 437 racially diverse older adults who receive home-based services (home-delivered meals) in the Southeastern region of the United States completed standardized measures of psychological pain, chronic physical pain, and suicidal desire. Results identified race moderated the relationship between pain and suicidal desire, indicating a stronger relationship between pain and suicidal desire among Black older adults than White older adults. Chronic physical pain (i.e., emotional burden) interacted with race to predict Perceived Burdensomeness ( p = .011) and Thwarted Belongingness ( p = .032). Greater attention to pain experiences among Black older adults is warranted, considering the impact of COVID-19 on racial/ethnic minorities’ mental health.
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Affiliation(s)
| | - Jihee Hong
- University of Maryland, College Park, MD, USA
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13
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Tang B, Fu Y, Liu B, Yi Q. Self-perceived burden and associated factors in Chinese adult epilepsy patients: A cross-sectional study. Front Neurol 2022; 13:994664. [PMID: 36176558 PMCID: PMC9513448 DOI: 10.3389/fneur.2022.994664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 08/23/2022] [Indexed: 12/02/2022] Open
Abstract
Objectives Epilepsy requires long-term or lifelong treatment, and patients are prone to financial, emotional and psychological burdens that can cause psychological changes during the treatment process. This study aimed to describe the prevalence and associated factors of Self-Perceived Burden (SPB) in Chinese adult epilepsy patients, informing the treatment and nursing of epilepsy. Methods A total of 143 adult epilepsy patients were included in this study, and the clinical questionnaire survey was conducted at the Third Xiangya Hospital of Central South University in Hunan, China, from March 2022 to June 2022. The sociodemographic and clinical characteristics of adult epilepsy patients were collected using a self-developed questionnaire, and the data on SPB, stigma and quality of life were collected through the Self-Perceived Burden Scale (SPBS), Kilifi Stigma Scale for Epilepsy (KSSE) and Quality of Life in Epilepsy Inventory-31 (QOLIE-31). Multiple linear regression analysis was used to determine the associated factors influencing SPB in adult epilepsy patients. Results The average score of SPBS for the 143 adult epilepsy patients was 30.77 (SD = 9.06), and 89.5% of them had obvious SPB. The results of the univariate analysis showed that residence, monthly household income, duration of epilepsy, type of medication and electroencephalogram finding were associated with SPB (P < 0.05). In Spearman correlation analysis indicated that SPBS score were positively correlated with KSSE score (r = 0.510, P < 0.05) while negatively correlated with QOLIE-31 score (r = −0.506, P < 0.05). Multiple linear regression analysis revealed that factors such as KSSE, type of medication, residence and electroencephalogram finding accounted for 32.8% of the factors influencing SPB in adult epilepsy patients. Conclusion 89.5% of adult epilepsy patients have varying degrees of SPB, which is associated with high stigma and poor quality of life. Therefore, during the treatment and nursing of adult epilepsy patients, clinical staff should pay attention to the psychological status of patients, help them reduce their psychological burden, and guide them to develop a healthy lifestyle.
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Affiliation(s)
- Binmi Tang
- Xiangya Nursing School, Central South University, Changsha, China
| | - Yaqian Fu
- Xiangya Nursing School, Central South University, Changsha, China
| | - Birong Liu
- Xiangya Nursing School, Central South University, Changsha, China
| | - Qifeng Yi
- Department of Nursing, Third Xiangya Hospital, Central South University, Changsha, China
- *Correspondence: Qifeng Yi
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14
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Filipponi C, Masiero M, Pizzoli SFM, Grasso R, Ferrucci R, Pravettoni G. A Comprehensive Analysis of the Cancer Chronic Pain Experience: A Narrative Review. Cancer Manag Res 2022; 14:2173-2184. [PMID: 35855762 PMCID: PMC9288227 DOI: 10.2147/cmar.s355653] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 03/16/2022] [Indexed: 11/29/2022] Open
Abstract
Cancer-related chronic pain (CP) represents a critical clinical issue through the disease, severely compromising the quality of life (QoL) of patients and the family environment. The current review employed a narrative method to synthesize the main results about the impact of cancer-related CP on QoL, adopting a multidimensional and threefold vision: patients, caregivers, and patient–caregiver perspective. Evidence emphasizes the importance of considering a bidirectional perspective (patient–caregiver) to understand better the pain experience throughout the cancer continuum and its consequences on QoL of patients and caregivers. Moreover, a holistic and multidimensional approach to cancer-related CP and its impact on QoL of patients and caregivers is still needed, in which the interconnection between physical, psychological, and social factors should be analyzed. Theoretical and methodological issues for orienting future social and family research initiatives were discussed.
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Affiliation(s)
- Chiara Filipponi
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, 20122, Italy.,Applied Research Division for Cognitive and Psychological Science, IEO European Institute of Oncology IRCCS, Milan, 20141, Italy
| | - Marianna Masiero
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, 20122, Italy.,Applied Research Division for Cognitive and Psychological Science, IEO European Institute of Oncology IRCCS, Milan, 20141, Italy
| | | | - Roberto Grasso
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, 20122, Italy.,Applied Research Division for Cognitive and Psychological Science, IEO European Institute of Oncology IRCCS, Milan, 20141, Italy
| | - Roberta Ferrucci
- Department of Health Sciences, University of Milan, Milan, 20146, Italy
| | - Gabriella Pravettoni
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, 20122, Italy.,Applied Research Division for Cognitive and Psychological Science, IEO European Institute of Oncology IRCCS, Milan, 20141, Italy
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15
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Hill EM, Frost A. Loneliness and Psychological Distress in Women Diagnosed with Ovarian Cancer: Examining the Role of Self-Perceived Burden, Social Support Seeking, and Social Network Diversity. J Clin Psychol Med Settings 2022; 29:195-205. [PMID: 34114151 DOI: 10.1007/s10880-021-09789-x] [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] [Accepted: 05/20/2021] [Indexed: 10/21/2022]
Abstract
The aim of the present study was to examine the role of self-perceived burden, social support seeking, and social network diversity in loneliness and psychological distress among women with ovarian cancer. A cross-sectional design was employed whereby 130 women diagnosed with ovarian cancer, recruited through various online sources (e.g., social media), completed the study via Qualtrics. Participants completed questionnaires that assessed self-perceived burden, social support seeking, social network diversity, loneliness, and psychological distress (anxiety, depressive symptoms). The models examined indicated that there were indirect effects of self-perceived burden and social network diversity on psychological distress via loneliness. Social support seeking was not significant in the models. Loneliness, self-perceived burden, and social network diversity should be of clinical concern among those working to support women with ovarian cancer. Future studies on longitudinal patterns or examining other factors associated with loneliness are needed to better understand the mental health of women with ovarian cancer.
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Affiliation(s)
- Erin M Hill
- Department of Psychology, West Chester University, West Chester, PA, 19383, USA.
| | - Andriana Frost
- Department of Psychology, West Chester University, West Chester, PA, 19383, USA
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16
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Ashton-James CE, Anderson SR, Mackey SC, Darnall BD. Beyond pain, distress, and disability: the importance of social outcomes in pain management research and practice. Pain 2022; 163:e426-e431. [PMID: 34252908 PMCID: PMC8742845 DOI: 10.1097/j.pain.0000000000002404] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 06/30/2021] [Indexed: 11/25/2022]
Affiliation(s)
- Claire E Ashton-James
- School of Medicine, Faculty of Medicine and Health, The University of Sydney, Australia
| | - Steven R Anderson
- Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, United States
| | - Sean C Mackey
- Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, United States
| | - Beth D Darnall
- Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, United States
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17
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Saravia A, Kong KA, Roy R, Barry R, Guidry C, McDaniel LS, Raven MC, Pou AM, Mays AC. Referral Patterns of Outpatient Palliative Care among the Head and Neck Cancer Population. Int Arch Otorhinolaryngol 2022; 26:e538-e547. [DOI: 10.1055/s-0041-1741436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 09/23/2021] [Indexed: 10/19/2022] Open
Abstract
Abstract
Introduction Patients with head and neck cancer (HNC) experience unique physical and psychosocial challenges that impact their health and quality of life. Early implementation of palliative care has been shown to improve various health care outcomes.
Objective The aim of the present study was to evaluate the patterns of referral of patients with HNC to outpatient palliative care as they relate to utilization of resources and end-of-life discussions.
Methods We performed a retrospective review of 245 patients with HNC referred to outpatient palliative care services at two Louisiana tertiary care centers from June 1, 2014, to October 1, 2019. The control group consisted of those that were referred but did not follow-up. Reasons for referral were obtained, and outcome measures such as emergency department (ED) visits, hospital readmissions, and advance care planning (ACP) documentation were assessed according to predictive variables.
Results There were 177 patients in the treatment group and 68 in the control group. Patients were more likely to follow up to outpatient palliative care services if referred for pain management. Hospital system, prior inpatient palliative care, and number of outpatient visits were associated with an increased likelihood for ED visits and hospital readmissions. Those in the palliative care treatment group were also more likely to have ACP discussions.
Conclusion Early implementation of outpatient palliative care among patients with HNC can initiate ACP discussions. However, there are discrepancies in referral reasons to palliative care and continued existing barriers to its effective utilization.
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Affiliation(s)
- Ari Saravia
- Louisiana State University School of Medicine, New Orleans, Louisiana, United States
| | - Keonho Albert Kong
- Department of Otolaryngology, University of North Carolina-Chapel Hill , Chapel Hill, North Carolina USA
| | - Ryan Roy
- Louisiana State University School of Medicine, New Orleans, Louisiana, United States
| | - Rachel Barry
- Barry Ear Nose and Throat. 4212 W Congress St, Suite 1500, Lafayette, Louisiana, USA
| | - Christine Guidry
- Department of Palliative Medicine, Our Lady of the Lake Regional Medical Center, Baton Rouge, Louisiana, United States
| | - Lee S. McDaniel
- Department of Biostatistics, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, Louisiana, United States
| | - Mary C. Raven
- Department of Palliative Medicine, Our Lady of the Lake Regional Medical Center, Baton Rouge, Louisiana, United States
| | - Anna M. Pou
- Oschner Health System, New Orleans, Louisiana, USA
| | - Ashley C. Mays
- Department of Otolaryngology, Louisiana State University Health Sciences Center, New Orleans, Louisiana, United States
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18
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Maheu E, Soriot-Thomas S, Noel E, Ganry H, Lespessailles E, Cortet B. Wearable transcutaneous electrical nerve stimulation (actiTENS®) is effective and safe for the treatment of knee osteoarthritis pain: a randomized controlled trial versus weak opioids. Ther Adv Musculoskelet Dis 2022; 14:1759720X211066233. [PMID: 35069809 PMCID: PMC8777341 DOI: 10.1177/1759720x211066233] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 11/15/2021] [Indexed: 01/22/2023] Open
Abstract
INTRODUCTION Despite their poor tolerance, especially in the elderly, weak opioids (WO) remain commonly prescribed for patients with knee osteoarthritis (KOA). We compared the efficacy and safety of a new wearable transcutaneous electrical nerve stimulation (W-TENS) device with WO for the treatment of moderate-to-severe, nociceptive KOA chronic pain. METHODS The study was a non-inferiority, multicentric, prospective, randomized, single-blind, controlled, 2-parallel groups Trial. A total of 110 patients with KOA were included (Kellgren-Lawrence radiographic grade ⩾2; American College of Rheumatology criteria), with chronic moderate-to-severe nociceptive pain (mean 8-day pain intensity (PI) ⩾ 4 on an 11-point numerical rating scale), in failure to non-opioid analgesics, including nonsteroidal anti-inflammatory drugs (NSAIDs). Patients with neuropathic pain were excluded. The co-primary endpoints were mean PI at 3 months (M3) and number of potentially treatment-related adverse events (TRAEs). Secondary outcomes included Western Ontario MAC Master University function subscale (range, 0-68), additional pain and quality of life measures, and responder rates. RESULTS The non-inferiority of W-TENS was demonstrated in both the per protocol (PP) and intent-to-treat (ITT) populations. At M3, PI in PP population was 3.87 (2.12) compared with 4.66 (2.37) [delta: -0.79 (0.44); 95% CI (-1.65, 0.08)] in W-TENS and WO groups, respectively. A planned superiority analysis showed a significant superiority of W-TENS over WO on PI at M3 (p = 0.0124). The number of TRAEs was significantly lower in the W-TENS group (n = 7) than in the WO group (n = 36) (p < 0.001). Other secondary outcomes also favored W-TENS. CONCLUSION W-TENS was more effective and better tolerated than WO in the treatment of chronic nociceptive KOA pain and offers an interesting non-pharmacological analgesic alternative in the management of KOA.Trial Registration: ClinicalTrials.gov: NCT03902340.
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Affiliation(s)
- Emmanuel Maheu
- Rheumatology Department, St-Antoine Hospital-APHP, 75011 Paris, FrancePrivate Office, 283, Bd Voltaire, Paris, France
| | - Sandrine Soriot-Thomas
- Clinical Research Centre and Orthopaedic and Traumatology Surgery Department, CHU Amiens Picardie, Amiens, France
| | - Eric Noel
- Rheumatologist, Ramsay Santé, Hôpital Privé Jean Mermoz, Centre Orthopédique Santy, Lyon, France
| | | | - Eric Lespessailles
- Rheumatology Department, Regional Hospital of Orleans, University of Orléans, Orléans, France
| | - Bernard Cortet
- Department of Rheumatology, Centre Hospitalier Universitaire de Lille, 59000 Lille, France
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19
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Zhang N, Tang XQ, Lu K, Dong Q, Kong LN, Jiang TT, Xu LY. Illness uncertainty, self-perceived burden and quality of life in patients with chronic myeloid leukaemia: A cross-sectional study. J Clin Nurs 2021; 31:2935-2942. [PMID: 34786783 DOI: 10.1111/jocn.16123] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 10/15/2021] [Accepted: 10/27/2021] [Indexed: 11/26/2022]
Abstract
AIMS AND OBJECTIVES To investigate the relationship between illness uncertainty, self-perceived burden and quality of life and explore the mediating role of self-perceived burden between illness uncertainty and quality of life in patients with chronic myeloid leukaemia. BACKGROUND Patients with chronic myeloid leukaemia need long-term, potentially lifelong therapy to control the disease, which affects their quality of life. There is a need for exploring potentially changeable factors to develop interventions. Little is known about the effects of illness uncertainty and self-perceived burden on quality of life in this population. DESIGN A cross-sectional study. METHODS A convenience sample of 248 patients with chronic myeloid leukaemia was recruited from four university hospitals from February to August 2020. Participants were assessed with the Mishel Uncertainty in Illness Scale, Self-Perceived Burden Scale, and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire. The STROBE checklist was used to report the results. RESULTS Illness uncertainty and self-perceived burden were negatively associated with quality of life in patients with chronic myeloid leukaemia. Self-perceived burden partially mediated the relationship between illness uncertainty and quality of life. The indirect effect was -0.101, accounting for 22.9% of the total effect. CONCLUSION The findings revealed the relationship between illness uncertainty, self-perceived burden and quality of life in patients with chronic myeloid leukaemia. Self-perceived burden exerted a mediating role between illness uncertainty and quality of life in this population. RELEVANCE TO CLINICAL PRACTICE This study alerts healthcare providers to pay attention to patients' illness uncertainty and self-perceived burden, which can contribute to develop effective interventions to improve the quality of life among patients with chronic myeloid leukaemia in the clinical practice.
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Affiliation(s)
- Nan Zhang
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiao-Qiong Tang
- Department of Hematology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Kai Lu
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qian Dong
- Department of Cardiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ling-Na Kong
- School of Nursing, Chongqing Medical University, Chongqing, China
| | - Tian-Tian Jiang
- Department of Hematology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Liu-Yue Xu
- Department of Hematology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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20
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Tait RC, Chibnall JT, Kalauokalani D. Patient Perceptions of Physician Burden in the Treatment of Chronic Pain. THE JOURNAL OF PAIN 2021; 22:1060-1071. [PMID: 33727158 DOI: 10.1016/j.jpain.2021.03.140] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 02/22/2021] [Accepted: 03/01/2021] [Indexed: 12/30/2022]
Abstract
While patient perceptions of burden to caregivers is of recognized clinical significance among people with chronic pain, perceived burden to treating physicians has not been studied. This study examined how people with chronic pain perceived levels of medical evidence (low vs high) and pain severity (4,6,8/10) to influence physician burden and how burden then mediated expected clinical judgments. 476 people with chronic pain read vignettes describing a hypothetical patient with varying levels of medical evidence and pain severity from the perspective of a treating physician, rated the burden that patient care would pose, and made a range of clinical judgments. The effect of pain severity on clinical judgments was expected to interact with medical evidence and be conditionally mediated by burden. Although no associations with burden were found for the pain severity x medical evidence interaction or for pain severity alone, low levels of supporting medical evidence yielded higher burden ratings. Burden significantly mediated medical evidence effects on judgments of symptom credibility, clinical improvement, and psychosocial dysfunction. Results indicate that perceived physician burden negatively influenced judgments of patients with chronic pain, beyond the direct effects of medical evidence. Implications are discussed for clinical practice, as well as future research. PERSPECTIVE: : People with chronic pain expect physicians to view the care of patients without supporting medical evidence as burdensome. Higher burden is associated with less symptom credibility, more psychosocial dysfunction, and less treatment benefit. Perceived physician burden appears to impact how patients approach treatment, with potentially adverse implications for clinical practice.
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Affiliation(s)
- Raymond C Tait
- Department of Psychiatry and Behavioral Neuroscience, Saint Louis University, St. Louis, Missouri.
| | - John T Chibnall
- Department of Psychiatry and Behavioral Neuroscience, Saint Louis University, St. Louis, Missouri
| | - Donna Kalauokalani
- Chairman of the Board, American Chronic Pain Association, Rocklin, California
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21
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Crasta D, Spears AP, Sullivan SR, Britton PC, Goodman M. Better off with you: Exploring congruity between caregivers’ and Veterans’ experience of efforts to cope with suicide. MILITARY PSYCHOLOGY 2021. [DOI: 10.1080/08995605.2021.1959222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Dev Crasta
- Department of Veterans Affairs, VISN 2 Center of Excellence for Suicide Prevention, Canandaigua, New York, USA
- Department of Psychiatry, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | - Angela Page Spears
- Department of Veterans Affairs, VISN 2 Mental Illness Research, Education, & Clinical Center, Bronx, New York, USA
| | - Sarah R. Sullivan
- Department of Veterans Affairs, VISN 2 Mental Illness Research, Education, & Clinical Center, Bronx, New York, USA
| | - Peter C. Britton
- Department of Veterans Affairs, VISN 2 Center of Excellence for Suicide Prevention, Canandaigua, New York, USA
- Department of Psychiatry, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | - Marianne Goodman
- Department of Veterans Affairs, VISN 2 Mental Illness Research, Education, & Clinical Center, Bronx, New York, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, Bronx, New York, USA
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22
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Schwabenbauer AK, Knight CM, Downing N, Morreale-Karl M, Mlinac ME. Adapting a whole health model to home-based primary care: Bridging person-driven priorities with veteran and family-centered geriatric care. FAMILIES, SYSTEMS & HEALTH : THE JOURNAL OF COLLABORATIVE FAMILY HEALTHCARE 2021; 39:374-393. [PMID: 34410781 PMCID: PMC8406673 DOI: 10.1037/fsh0000613] [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] [Indexed: 06/13/2023]
Abstract
Through the integration of Whole Health for Life into the Department of Veterans Affairs (VA) health care system, the VA aims to transform health care delivery from a disease management approach to one that embraces person-centered care. The home-based primary care (HBPC) program is a care model that, within the VA, provides holistic primary care services to homebound veterans with multiple chronic medical conditions, mental health issues, and functional declines. These veterans may have limited access to VA programs delivered in a traditional outpatient format. This article describes adaptations to the whole health model of care that could improve its accessibility and applicability to HBPC veterans, caregivers, and the interdisciplinary teams that serve this population. These modifications are informed by whole-person geriatric and gerontological and family-systems theories and address population-based differences in the focus and approach to care. The focus on care is expanded to (a) reflect the importance of attending to caregiver needs and well-being and (b) shift from a preventative model to one that prioritizes resilience and maintenance. The approach to care emphasizes alternative modes of delivery, adaptations to interventions, and integration of geriatric-specific medical considerations into the self-care domains and more directly centers the collaboration between family, the VA, and community partners. This adapted model also addresses the unique needs of health care teams providing in-home services to medically complex veterans and offers suggestions for enhancing self-care and preventing burnout. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
| | - Cynthia M. Knight
- Veterans Affairs Boston Healthcare System, Boston, Massachusetts, United States
| | - Nicole Downing
- Veterans Affairs Boston Healthcare System, Boston, Massachusetts, United States
| | - Michelle Morreale-Karl
- Veterans Affairs Boston Healthcare System, Boston, Massachusetts, United States
- Department of Medicine, Harvard Medical School
| | - Michelle E. Mlinac
- Veterans Affairs Boston Healthcare System, Boston, Massachusetts, United States
- Department of Psychiatry, Harvard Medical School
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23
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Tait RC, Chibnall JT, Kalauokalani D. A Preliminary Study of Provider Burden in the Treatment of Chronic Pain: Perspectives of Physicians and People with Chronic Pain. THE JOURNAL OF PAIN 2021; 22:1408-1417. [PMID: 33989786 DOI: 10.1016/j.jpain.2021.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 04/13/2021] [Accepted: 04/20/2021] [Indexed: 10/21/2022]
Abstract
This study compared perceptions of the burden of patient care and associated clinical judgments between physicians and people with chronic pain (PWCP) in a 2 × 3 × 2 between-subjects design that varied participant type, patient-reported pain severity (4/6-8/10), and supporting medical evidence (low/high). One hundred and nine physicians and 476 American Chronic Pain Association members were randomly assigned to 1 of 6 conditions. Respondents estimated the clinical burden they would assume as the treating physician of a hypothetical patient with chronic low back pain, and made clinical judgments regarding that patient. Physician burden ratings were significantly higher than PWCP ratings, and clinical impressions (eg, trust in pain report, medical attribution) and management concerns (eg, opioid abuse risk) were relatively less favorable. Neither pain severity nor medical evidence affected burden ratings significantly. High medical evidence was associated with more favorable clinical impressions; higher pain severity led to more discounting of patient pain reports. Burden was significantly correlated with a range of clinical judgments. Results indicate that physicians and PWCP differ in their perceptions of provider burden and related clinical judgments in ways that could impact treatment collaboration. Further research is needed that examines provider burden in actual clinical practice. PERSPECTIVE: Physicians and people with chronic pain (PWCP) estimated the clinical burden of patient care and made judgments about a hypothetical patient with chronic pain. Physician burden ratings were higher and clinical judgments less favorable, relative to PWCP respondents. These differences could impact treatment collaboration and merit study in clinical practice.
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Affiliation(s)
- Raymond C Tait
- Department of Psychiatry and Behavioral Neuroscience, Saint Louis University School of Medicine, St. Louis, Missouri.
| | - John T Chibnall
- Department of Psychiatry and Behavioral Neuroscience, Saint Louis University School of Medicine, St. Louis, Missouri
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Mournet AM, Stanley IH, Snyder DJ, Claassen CA, Pao M, Horowitz LM, Bridge JA. Suicide risk and perceived burden among adult medical inpatients. Gen Hosp Psychiatry 2021; 70:141-142. [PMID: 33810884 DOI: 10.1016/j.genhosppsych.2021.01.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 01/12/2021] [Accepted: 01/13/2021] [Indexed: 11/27/2022]
Affiliation(s)
- Annabelle M Mournet
- Office of the Clinical Director, National Institute of Mental Health, Bethesda, MD, United States of America
| | - Ian H Stanley
- Department of Psychiatry, Boston University School of Medicine & National Center for PTSD and VA Boston Healthcare System, Boston, MA, United States of America
| | - Deborah J Snyder
- Office of the Clinical Director, National Institute of Mental Health, Bethesda, MD, United States of America
| | - Cynthia A Claassen
- John Peter Smith Health Network, Fort Worth, TX, United States of America
| | - Maryland Pao
- Office of the Clinical Director, National Institute of Mental Health, Bethesda, MD, United States of America
| | - Lisa M Horowitz
- Office of the Clinical Director, National Institute of Mental Health, Bethesda, MD, United States of America.
| | - Jeffrey A Bridge
- The Abigail Wexner Research Institute at Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus, OH, United States of America
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Abstract
BACKGROUND Self-perceived burden (SPB) causes stress and negatively impacts the quality of life and mental health of patients. It is important to identify effective coping methods to reduce SPB when supporting advanced cancer patients. OBJECTIVE To qualitatively elucidate advanced cancer patients' strategies for coping with SPB. METHODS Eleven participants with advanced cancer were recruited from 2 palliative care units. The data were collected through semistructured interviews and analyzed by content analysis. RESULTS One of the coping strategies that advanced cancer patients used to reduce their SPB was "making individual efforts to deal with their own circumstances." This category included subcategories: "making proactive action," "expressing their gratitude verbally," "suppressing their feelings," "searching for positive meanings," and "avoiding thinking about the burden on their families." Another coping strategy used was "exploring the solutions with their family," which consisted of one subcategory and indicated an open dialogue between patients and their families to reach acceptable and mutual decisions about patient care. CONCLUSION Nurses should not only support patients' efforts to tackle the situation by themselves, but also help the family as a whole to tackle problems together. By facilitating meaningful dialogue between family members, patients' feelings of SPB can be alleviated. IMPLICATIONS FOR PRACTICE Nurses should facilitate dialogue between patients and their family members in order to help them discover solutions to reduce their SPB and to find positive meanings in the caregiving-receiving situation.
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A qualitative study of the psychological processes in patients with post-herpetic neuralgia. FRONTIERS OF NURSING 2021. [DOI: 10.2478/fon-2020-0047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Objective
To understand the psychological process of patients with post-herpetic neuralgia (PHN) and provide references for the psychological management of PHN.
Methods
The objective sampling method was used to conduct semi-structural in-depth interviews on 10 PHN patients, and Colaizzi's phenomenological analysis method was used for data analysis.
Results
According to the different pain durations of PHN patients, the patients were divided into three stages and five themes were extracted: the need for strong pain relief, the helpless tolerance of pain, the self-feeling burden, the need for health education, and the positive response to pain.
Conclusions
PHN has complex psychological activities, so it is necessary to pay attention to the psychological process of patients and take effective psychological measures to intervene negative psychology so that patients can actively cope with the pain.
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Wang J, Xu J, Ma Z, Jia C, Wang G, Zhou L. The Mediating Role of Depressive Symptoms, Hopelessness, and Perceived Burden on the Association Between Pain Intensity and Late-Life Suicide in Rural China: A Case-Control Psychological Autopsy Study. Front Psychiatry 2021; 12:779178. [PMID: 34966310 PMCID: PMC8710711 DOI: 10.3389/fpsyt.2021.779178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Accepted: 11/04/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Few studies have investigated the roles of psychosocial factors such as depressive symptoms and hopelessness on the relationship between pain and suicide with inconsistent results. The study aimed to analyze the impact of pain intensity on suicide death and to estimate the degree to which depressive symptoms, hopelessness, and perceived burden may explain the association in Chinese rural elderly. Methods: Using a 1:1 matched case-control design, we collected data from 242 elderly suicide cases and 242 living community controls by psychological autopsy method in rural China, including sociodemographic characteristics, pain intensity, depression, hopelessness, perceived burden, physical diseases, and social support. Conditional logistic regression was employed to assess the association between pain intensity and completed suicide. Mediation analysis using the KHB method was applied to explore the mediation effects from depressive symptoms, hopelessness, and perceived burden. Results: The result of multivariable logistic regression showed that unemployment [odds ratio (OR) = 5.06, 95% confidence interval (CI): 1.76-14.49], higher levels of hopelessness (OR = 7.72, 95% CI: 3.49-17.10), depressive symptom (OR = 15.82, 95% CI: 4.53-55.25), and severe pain (OR = 3.46, 95% CI: 1.31-9.13) were significantly associated with elevated suicide risk in older adults in rural China. Depressive symptoms, hopelessness, and perceived burden significantly mediated 43.71% of the pain-suicide association (p = 0.020), with 17.39% due to depressive symptoms, 17.63% due to hopelessness, and 8.69% due to perceived burden. Conclusions: Regular screening of pain, depressive symptoms, hopelessness, and perceived burden using simple but sensitive questions or scales for older adults with pain is vital for the prevention and early detection of suicide risk in Chinese rural areas. Moreover, the importance of pain management and psychological interventions targeted on depressive symptoms and hopelessness should be emphasized.
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Affiliation(s)
- Jiali Wang
- Xiangya School of Public Health, Central South University, Changsha, China
| | - Jiahuan Xu
- Guangzhou Medical University, Guangzhou, China
| | - Zhenyu Ma
- School of Public Health, Guangxi Medical University, Nanning, China
| | - Cunxian Jia
- School of Public Health, Shandong University, Jinan, China
| | | | - Liang Zhou
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
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Ikemoto T, Shiro Y, Ikemoto K, Hayashi K, Arai YC, Deie M, Beeston L, Wood B, Nicholas M. Feasibility of Imported Self-Management Program for Elderly People with Chronic Pain: A Single-Arm Confirmatory Trial. Pain Ther 2020; 9:583-599. [PMID: 32844366 PMCID: PMC7648817 DOI: 10.1007/s40122-020-00192-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Indexed: 02/08/2023] Open
Abstract
INTRODUCTION Multidisciplinary pain management programs incorporating a cognitive-behavioral therapy (CBT) approach have been reported to be helpful for elderly people with chronic pain. However, it is unclear whether the same program for elderly people with chronic pain would translate to different cultures. This study investigated whether a multidisciplinary program based on that of Nicholas et al. (Pain 154(6):824-835, 2013) in Australia would be effective for elderly people with chronic pain in Japan. METHODS Twenty-seven community-dwelling elderly people with chronic pain were enrolled to confirm changes (effect size d = 0.5) in pain disability, which were previously reported by Nicholas et al. The multidisciplinary program consisted of eight sessions (2 sessions a week for 4 weeks). Pain disability was assessed using the Pain Disability Assessment Scale (PDAS) as the primary outcome at the baseline, the beginning and the end of the program, and the 1- and 3-month (final) follow-up. We also assessed the pain severity, catastrophizing, pain self-efficacy, and physical function with the Timed Up and Go test (TUG) and the two-step test as secondary outcomes. RESULTS PDAS, pain catastrophizing, and pain self-efficacy were significantly improved immediately after the program compared with baseline, and these effects were maintained at 3-month follow-up. The effect size (d) for the PDAS score was a medium size (0.54) from baseline to 3-month follow-up. Those who showed improvements in TUG immediately after the program tended to report improved psychometric measures at 3-month follow-up. CONCLUSION These results suggest that the Japanese multidisciplinary program has a similar effect on pain disability as that reported by Nicholas et al. This finding has important implications for the development of pain services in community-dwelling elderly Japanese.
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Affiliation(s)
- Tatsunori Ikemoto
- Department of Orthopaedics, Aichi Medical University, Aichi, Japan
- Pain Management Research Institute, Faculty of Medicine and Health, University of Sydney and Royal North Shore Hospital, Sydney, NSW, Australia
- Research of Pain Science, Non-Profit Organization, Nagoya, Japan
| | | | - Kayo Ikemoto
- Research of Pain Science, Non-Profit Organization, Nagoya, Japan
| | - Kazuhiro Hayashi
- Research of Pain Science, Non-Profit Organization, Nagoya, Japan
| | - Young-Chang Arai
- Research of Pain Science, Non-Profit Organization, Nagoya, Japan
| | - Masataka Deie
- Department of Orthopaedics, Aichi Medical University, Aichi, Japan
| | - Lee Beeston
- Pain Management Research Institute, Faculty of Medicine and Health, University of Sydney and Royal North Shore Hospital, Sydney, NSW, Australia
| | - Bradley Wood
- Pain Management Research Institute, Faculty of Medicine and Health, University of Sydney and Royal North Shore Hospital, Sydney, NSW, Australia
| | - Michael Nicholas
- Pain Management Research Institute, Faculty of Medicine and Health, University of Sydney and Royal North Shore Hospital, Sydney, NSW, Australia
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Validation of CARE Scale-7 in treatment-seeking patients with chronic pain: measurement of sex invariance. Pain Rep 2020; 5:e862. [PMID: 33204930 PMCID: PMC7665255 DOI: 10.1097/pr9.0000000000000862] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 08/31/2020] [Accepted: 09/06/2020] [Indexed: 11/25/2022] Open
Abstract
Supplemental Digital Content is Available in the Text. The CARE Scale-7 is the first validated instrument to assess self-care difficulty in both sexes and may promote individualized care planning among chronic pain patients. Objectives: Social and interpersonal factors impact the trajectory of chronic pain. We previously developed and validated a 2-factor, 7-item measure to assess interpersonal factors, including relationship guilt and worry and difficulty prioritizing self-care in chronic pain. Here, we confirm the factor structure and examine the sex invariance of the two-factor structure of the CARE Scale-7. Methods: Data were collected as part of routine clinical care at a tertiary pain clinic using the Collaborative Health Outcomes Information Registry. Patient participants (67% women) were predominantly middle-aged (M = 50.9 years, SD = 17.8), married (55.2%), and White/non-Hispanic (55.7%). Data included demographics, pain characteristics, CARE Scale-7, pain catastrophizing, and Patient-Reported Outcomes Measurement Information System psychological and physical function measures. Confirmatory factor analysis was conducted to validate the factor structure of the CARE Scale, and a stepwise approach to measurement invariances by sex examined configural, metric, and scalar invariance. Results: Internal consistency of the scale items ensured suitability for factor analyses. Confirmatory factor analysis findings revealed an overall good fit of the 2-factor model among males and females and that CARE Scale-7 is in fact sex invariant. Finally, CARE Scale-7 showed convergent validity with pain-related outcomes. Discussion: The CARE Scale is the first validated instrument to assess self-care in both sexes among patients with chronic pain. The subscale of difficulty prioritizing self-care emerged as a potentially unique factor that should be integrated in clinical assessment. CARE Scale may facilitate standardized measurement in research and clinical contexts, which may inform a comprehensive treatment focus that integrates individualized self-care planning.
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Karos K, McParland JL, Bunzli S, Devan H, Hirsh A, Kapos FP, Keogh E, Moore D, Tracy LM, Ashton-James CE. The social threats of COVID-19 for people with chronic pain. Pain 2020; 161:2229-2235. [PMID: 32694381 PMCID: PMC7382418 DOI: 10.1097/j.pain.0000000000002004] [Citation(s) in RCA: 90] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 07/07/2020] [Accepted: 07/08/2020] [Indexed: 12/23/2022]
Affiliation(s)
- Kai Karos
- Centre for the Psychology of Learning and Experimental Psychopathology, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
- Research Group on Experimental Health Psychology, Department for Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | | | - Samantha Bunzli
- Department of Surgery, University of Melbourne, St Vincent's Hospital, Melbourne, Australia
| | - Hemakumar Devan
- Centre for Health, Activity, and Rehabilitation Research (CHARR), School of Physiotherapy, University of Otago, Wellington, New Zealand
| | - Adam Hirsh
- Department of Psychology, Indiana University—Purdue University Indianapolis, IN, United States
| | - Flavia P. Kapos
- Department of Epidemiology, University of Washington, Seattle, WA, United States
| | - Edmund Keogh
- Department of Psychology, University of Bath, Bath, United Kingdom
| | - David Moore
- Department of Psychology, Liverpool John Moores University, Liverpool, United Kingdom
| | - Lincoln M. Tracy
- School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Claire E. Ashton-James
- Pain Management Research Institute, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
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Abstract
Abstract. We examined the negative outcomes, particularly social costs that result when a person harms their group by performing poorly, and whether self-compassion could buffer against these negative outcomes. In Studies 1 and 2, participants performed poorly and harmed their group or performed equal to their group. Harmful poor-performing participants felt more burdensome, experienced more negative affect, felt more ostracized, anticipated more exclusion, and felt lowered self-esteem than equal-performing participants. Studies 3 and 4 disentangled poor performance from harming a group. Poor-performing participants either harmed the group or caused no harm. Harmful poor-performing participants felt more burdensome and anticipated more exclusion, indicating the additional social consequences of a harmful poor performance over a non-harmful performance. Across studies, trait self-compassion was associated with reduced negative effects.
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Affiliation(s)
- James H. Wirth
- Department of Psychology, Ohio State University at Newark, OH, USA
| | - Ashley Batts Allen
- Department of Psychology, University of North Carolina at Pembroke, NC, USA
| | - Emily M. Zitek
- School of Industrial and Labor Relations, Cornell University, Ithaca, NY, USA
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De Sola H, Maquibar A, Failde I, Salazar A, Goicolea I. Living with opioids: A qualitative study with patients with chronic low back pain. Health Expect 2020; 23:1118-1128. [PMID: 32558064 PMCID: PMC7696128 DOI: 10.1111/hex.13089] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 05/16/2020] [Accepted: 05/19/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Opioids are one of the most prescribed treatments for chronic pain (CP). However, their long-term use (>3 months) has been surrounded by controversy, due to loss of beneficial effects. OBJECTIVE To explore the experiences of people with chronic non-malignant low back pain in Spain undergoing long-term treatment with opioids. DESIGN Qualitative study. SETTING AND PARTICIPANTS We conducted 15 semi-structured interviews at the Pain Clinic with persons taking opioid treatment. METHODS The interviews were analysed by qualitative content analysis as described by Graneheim and Lundman, and developed categories and themes discussed in light of a biomedicalization framework. MAIN RESULTS We developed one overarching theme-Living with opioids: dependence and autonomy while seeking relief-and three categories: The long pathway to opioids due to the invisibility of pain; Opioids: from blind date to a long-term relationship; and What opioids cannot fix. DISCUSSION The long and difficult road to find effective treatments was a fundamental part of coping with pain, involving long-term relationships with the health system. This study reflects the benefits, and drawbacks of opioids, along with struggles to maintain autonomy and make decisions while undergoing long-term treatment with opioids. The paper also highlights the consequences of pain in the economy, family and social life of patients. CONCLUSIONS Patients' experiences should be considered to a greater extent by health-care professionals when giving information about opioids and setting treatment goals. Greater consideration of the social determinants of health that affect CP experiences might lead to more effective solutions to CP.
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Affiliation(s)
- Helena De Sola
- The Observatory of Pain, University of Cádiz, Cádiz, Spain.,Biomedical Research and Innovation Institute of Cádiz (INiBICA), Cádiz, Spain.,Preventive Medicine and Public Health Area, Cádiz, Spain
| | - Amaia Maquibar
- Department of Nursing I, Faculty of Medicine and Nursing, University of the Basque Country UPV/EHU, Leioa, Bizkaia, Spain
| | - Inmaculada Failde
- The Observatory of Pain, University of Cádiz, Cádiz, Spain.,Biomedical Research and Innovation Institute of Cádiz (INiBICA), Cádiz, Spain.,Preventive Medicine and Public Health Area, Cádiz, Spain
| | - Alejandro Salazar
- The Observatory of Pain, University of Cádiz, Cádiz, Spain.,Biomedical Research and Innovation Institute of Cádiz (INiBICA), Cádiz, Spain.,Department of Statistics and Operational Research, University of Cádiz, Cádiz, Spain
| | - Isabel Goicolea
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
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Ni Q, Cheng G, Chen A, Heinonen S. Early detection of mental illness for women suffering high-risk pregnancies: an explorative study on self-perceived burden during pregnancy and early postpartum depressive symptoms among Chinese women hospitalized with threatened preterm labour. BMC Psychiatry 2020; 20:250. [PMID: 32434583 PMCID: PMC7240988 DOI: 10.1186/s12888-020-02667-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 05/13/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The mental health of pregnant women, particularly those with elevated risks, has been an issue of global concern. Thus far, few studies have addressed the mental health of pregnant women with threatened preterm labour (TPL). This study investigated the prevalence of self-perceived burden (SPB) among Chinese women hospitalized due to TPL during pregnancy and early postpartum depressive disorders, exploring the effect of SPB and other potential risk factors on the early signs of postpartum depressive disorders. METHODS A self-reported survey was conducted in the obstetrics department of Anhui Provincial Hospital, China. Women hospitalized with TPL were approached 1 week after delivery. One hundred fifty women were recruited from January 2017 to December 2017. The Self-Perceived Burden Scale (SPBS) and Edinburgh Postnatal Depression Scale (EPDS) were the main measures. Descriptive statistics, Spearman correlations, and a multiple logistic regression were employed for data analysis. RESULTS SPB and early postpartum depressive disorders were commonly experienced by Chinese women hospitalized with TPL, and SPB was positively and significantly correlated with depressive symptoms. A multiple logistic regression analysis revealed that for the women hospitalized with TPL during pregnancy, the emotional aspect of SPB (OR = 1.42, 95% CI = 1.11-1.83, p = 0.006), age (OR = 1.14, 95% CI = 1.02-1.27, p = 0.023), occupation (OR = 3.48, 95% CI = 1.18-10.20, p = 0.023), the history of scarred uterus (OR = 7.96, 95% CI = 1.49-42.48, p = 0.015), the delivery mode of the present birth (OR = 6.19, 95% CI = 1.72-22.30, p = 0.005), and family support during pregnancy (OR = 0.60, 95% CI = 0.45-0.82, p = 0.001) were significant factors predicting early postpartum depressive symptoms. CONCLUSION This study indicates that SPB and early postpartum depressive disorders are prevalent mental issues among Chinese women hospitalized with TPL, and that SPB, especially perceived emotional burden, is a strong predictor of early postpartum depressive disorders. Our study suggests the necessity of paying attention to mental health issues, e.g. SPB and postpartum depressive symptoms among hospitalized women with TPL, and providing appropriate interventions at the prenatal stage to prevent adverse consequences.
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Affiliation(s)
- Qianqian Ni
- grid.59053.3a0000000121679639The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001 Anhui China
| | - Guizhi Cheng
- grid.59053.3a0000000121679639The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, 230001 Anhui China
| | - An Chen
- Institute of Healthcare Engineering, Management and Architecture (HEMA), Department of Industrial Engineering and Management, Aalto University, Maarintie 8, 02150, Espoo, Finland.
| | - Seppo Heinonen
- grid.15485.3d0000 0000 9950 5666Department of Obstetrics and Gynaecology, Helsinki University Hospital and University of Helsinki, Haartmaninkatu 2, 00290 Helsinki, Finland
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Brown LA, Lynch KG, Cheatle M. Pain catastrophizing as a predictor of suicidal ideation in chronic pain patients with an opiate prescription. Psychiatry Res 2020; 286:112893. [PMID: 32146246 PMCID: PMC7442673 DOI: 10.1016/j.psychres.2020.112893] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 02/19/2020] [Accepted: 02/20/2020] [Indexed: 11/28/2022]
Abstract
Chronic pain and opioid use are associated with increased risk for suicidal ideation and behaviors (SIB) in cross-sectional studies, particularly among individuals who catastrophize about their pain. This study examined the longitudinal association between two styles of pain coping, catastrophizing and hoping/praying, as predictors of subsequent SIB, as well as possible mediators of this association among patients with chronic pain receiving long-term opioid therapy. Participants (n = 496) were adults with chronic nonmalignant pain on long-term opioid therapy who did not develop an opioid use disorder. Participants were assessed for pain coping, suicidal ideation, depression, social support and pain interference at baseline, and were reassessed for SI, depression, and pain interference at 6- and 12-month follow-ups. Catastrophizing was a significant predictor of increased subsequent SIB, whereas hoping/praying did not protect against future SIB. The relationship between catastrophizing and future SIB was mediated by depression, but not social support or pain interference. In conclusion, catastrophizing was an important predictor of subsequent SIB due to its effect on increasing depression among patients with chronic nonmalignant pain receiving long-term opioid therapy. Future research should explore the extent to which targeting catastrophizing reduces subsequent depression and suicide risk.
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Affiliation(s)
- Lily A Brown
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, United States; University of Pennsylvania, Department of Psychiatry, Perelman School of Medicine, 3535 Market Street, Philadelphia, PA 19104, United States.
| | - Kevin G Lynch
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, United States; Center for Clinical Epidemiology and Biostatistics (CCEB), University of Pennsylvania, Philadelphia, PA, United States; University of Pennsylvania, Department of Psychiatry, Perelman School of Medicine, 3535 Market Street, Philadelphia, PA 19104, United States
| | - Martin Cheatle
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, United States; University of Pennsylvania, Department of Psychiatry, Perelman School of Medicine, 3535 Market Street, Philadelphia, PA 19104, United States
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Shuldiner J, Tur-Sinai A, Bentur N. Musculoskeletal Pain Medication Use in Middle Age and Older Adults in 15 European Countries and Israel. Pain Manag Nurs 2019; 21:165-171. [PMID: 31837952 DOI: 10.1016/j.pmn.2019.09.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 07/14/2019] [Accepted: 09/20/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND The experience of musculoskeletal pain is widespread among adults and entails high costs to both individuals and society. Few studies look at disparities in pain management. AIMS To examine factors associated with the presence of musculoskeletal pain and the use of pain medication use among individuals aged 50+. DESIGN Cross-sectional analysis of data from the SHARE. PARTICIPANTS 64,281 community-dwelling individuals in 15 European countries and Israel. METHODS Bivariate analysis and logistic regression were used to identify factors associated with the presence of musculoskeletal pain and pain medication use. RESULTS Among our population, the prevalence of musculoskeletal pain at the time of the survey was 40.1%. Women had more pain than men (odds ratio [OR] = 1.477, confidence interval [CI] = 1.428-1.528), those who were 60-69 years old had less pain than younger individuals (OR = 0.927, CI = 0.883-0.973), whereas those who were 80+ years old had more pain than younger individuals (OR = 1.280, CI = 1.199-1.367). About 50% of those with musculoskeletal pain take no medication to manage it. Predictors of pain medication use include male sex (OR = 1.468, CI = 1.389-1.553), more education (OR = 1.034, CI = 1.023-1.041), and better ability to cope economically (OR = 1.446, CI = 1.368-1.527). Those over 70 are less likely than younger individuals to be taking medication to manage their pain (70-79: OR = 0.822, CI = 0.761-0.887), (80+: OR = 0.619, CI = 0.566-0.677). CONCLUSIONS Nurses should be aware of the association of education and income with pain-medication use, which suggests that pain medication use is less accessible to those with fewer resources. Pain is a significant public-health problem, and access to medicine deserves attention from nurses, healthcare workers and policymakers.
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Affiliation(s)
| | - Aviad Tur-Sinai
- Department of Health Systems Management, The Max Stern Yezreel Valley College, Yezreel Valley, Emek Yezreel, Israel; School of Nursing, University of Rochester Medical Center, New York, NY
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Braswell H. US Hospice Structure and its Implications for the "Right to Die" Debate : An Interdisciplinary Study of the "Feeling of Being a Burden to Others". JOURNAL OF BIOETHICAL INQUIRY 2019; 16:525-534. [PMID: 31482474 DOI: 10.1007/s11673-019-09938-w] [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: 09/28/2018] [Accepted: 08/20/2019] [Indexed: 06/10/2023]
Abstract
This article is an analysis of the relationship between US hospice structure and the feeling of being a burden to others (FBO). A goal of US hospice care is to reduce the FBO. But in America, hospice is limited in its ability to do so because of the high caregiver burden it places on family members of dying people. Through a historical study, I show that this burden was excessive when the hospice system was created and has worsened over time. Through three ethnographic vignettes, I demonstrate how this burden inculcates in dying people the FBO. I then examine the bioethical implications of this finding for the existing US debate about physician-assisted suicide (PAS). The presence of FBO due to insufficient hospice care supports arguments made by PAS opponents about the social pressure placed on dying people. This finding is not itself sufficient to resolve the "right to die" debate. But it provides the ground for a compromise, across the debate, to reduce the FBO by changing US hospice structure. The resulting consensus will further the goals of both PAS proponents and opponents.
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Affiliation(s)
- Harold Braswell
- Albert Gnaegi Center for Health Care Ethics, Saint Louis University, Salus Center, 3545 Lafayette Ave., Room 507, St. Louis, MO, 63104, USA.
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CARE Scale-7: Development and Preliminary Validation of a Measure to Assess Factors Impacting Self-Care in Chronic Pain. Clin J Pain 2019; 34:818-824. [PMID: 29554031 DOI: 10.1097/ajp.0000000000000606] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVES Social and interpersonal factors may impact chronic pain self-care and self-management; however, no integrated measure exists to assess the interplay of these factors. We developed and tested a measure designed to assess salient interpersonal factors, including relationship guilt and worry, and difficulty prioritizing self-care in chronic pain. METHODS We tested self-report items broadly relevant to locus of care, limit-setting capacity, and worry/guilt about relationships in 3 discrete chronic pain samples (total N=1,452): (1) online sample of chronic pain clinic patients (N=729; 21 candidate CARE items, sociodemographics, and measures of psychological and physical functioning). Analytic results supported a final 7-item CARE scale that was next tested in (2) an anonymous online sample of 578 adults with chronic pain. (3) Finally, preliminary validation of the CARE scale was performed in a tertiary pain clinic sample (N=145). RESULTS Exploratory factor analysis revealed a 7-item, 2-factor solution (difficulty prioritizing self-care and guilt/worry) that accounted for a combined total of 58% of the variance. CARE scale-7 had modest convergent validity with pain intensity, pain-related interference, and emotional distress. Extreme difficulty with both factors was reported by about one-third of the total sample, suggesting that relationship factors significantly impact pain management and self-care. DISCUSSION Social factors are gaining attention for their influence on the trajectory of chronic pain. The CARE scale is a brief, integrated measure that may be used to reveal specific interpersonal and personal impediments to self-care, and identify important therapeutic targets to optimize self-management behaviors.
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Schenk S, Grothus S, Genent D, Selent F, Zernikow B, Wager J. [Interdisciplinary multimodal inpatient pain treatment for young adults : Influence of autonomy on effectiveness]. Schmerz 2019; 34:41-51. [PMID: 31549245 DOI: 10.1007/s00482-019-00417-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Emerging adulthood between the ages of 18 and 25 are vulnerable years that offer many opportunities and simultaneously represent huge challenges for autonomy and identity development. Chronic pain in this vulnerable stage of life is associated with long-term negative consequences. So far, knowledge regarding the effectiveness of treatment offers for this patient group is scarce. OBJECTIVE The aim of this study is to examine the effectiveness of a multimodal inpatient pain therapy for young adults with chronic pain. In addition, the change and influence of the autonomy development will be investigated. MATERIALS AND METHODS The present longitudinal study examined the effectiveness of a 3-week multimodal inpatient pain treatment in young adults with chronic pain. Three-month follow-up data from 74 patients aged 18-25 years (75.7% female) were included in the study. Standardized questionnaires were used to investigate pain characteristics, pain-associated and emotional impairments quality of life, and various facets of autonomy. RESULTS The results show that pain-related and emotional impairments are significantly reduced after therapy. Furthermore, there is a significant improvement in the quality of life and resilience. The increased quality of life and reduced pain-related and emotional impairment are associated with a gain of autonomy convictions. DISCUSSION Multimodal inpatient pain treatment seems to be effective during emerging adulthood. Autonomy convictions seem to be an important starting point for therapeutic success and have a modulating importance in terms of positive changes in emotional impairment and quality of live. Therefore, this aspect should be considered when pain treatment offers are developed for this age group.
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Affiliation(s)
- Sabrina Schenk
- Deutsches Kinderschmerzzentrum, Vestische Kinder- und Jugendklinik Datteln, Universität Witten/Herdecke, Dr.-Friedrich-Steiner-Str. 5, 45711, Datteln, Deutschland.
- Lehrstuhl für Kinderschmerztherapie und Pädiatrische Palliativmedizin, Department für Humanmedizin, Fakultät für Gesundheit, Universität Witten/Herdecke, Witten, Deutschland.
| | - Susanne Grothus
- Deutsches Kinderschmerzzentrum, Vestische Kinder- und Jugendklinik Datteln, Universität Witten/Herdecke, Dr.-Friedrich-Steiner-Str. 5, 45711, Datteln, Deutschland
- Lehrstuhl für Kinderschmerztherapie und Pädiatrische Palliativmedizin, Department für Humanmedizin, Fakultät für Gesundheit, Universität Witten/Herdecke, Witten, Deutschland
| | - Dunja Genent
- Deutsches Kinderschmerzzentrum, Vestische Kinder- und Jugendklinik Datteln, Universität Witten/Herdecke, Dr.-Friedrich-Steiner-Str. 5, 45711, Datteln, Deutschland
- Lehrstuhl für Kinderschmerztherapie und Pädiatrische Palliativmedizin, Department für Humanmedizin, Fakultät für Gesundheit, Universität Witten/Herdecke, Witten, Deutschland
| | - Felix Selent
- Deutsches Kinderschmerzzentrum, Vestische Kinder- und Jugendklinik Datteln, Universität Witten/Herdecke, Dr.-Friedrich-Steiner-Str. 5, 45711, Datteln, Deutschland
| | - Boris Zernikow
- Deutsches Kinderschmerzzentrum, Vestische Kinder- und Jugendklinik Datteln, Universität Witten/Herdecke, Dr.-Friedrich-Steiner-Str. 5, 45711, Datteln, Deutschland
- Lehrstuhl für Kinderschmerztherapie und Pädiatrische Palliativmedizin, Department für Humanmedizin, Fakultät für Gesundheit, Universität Witten/Herdecke, Witten, Deutschland
| | - Julia Wager
- Deutsches Kinderschmerzzentrum, Vestische Kinder- und Jugendklinik Datteln, Universität Witten/Herdecke, Dr.-Friedrich-Steiner-Str. 5, 45711, Datteln, Deutschland
- Lehrstuhl für Kinderschmerztherapie und Pädiatrische Palliativmedizin, Department für Humanmedizin, Fakultät für Gesundheit, Universität Witten/Herdecke, Witten, Deutschland
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Tur-Sinai A, Shuldiner J, Bentur N. Sociodemographic inequality in joint-pain medication use among community-dwelling older adults in Israel. HEALTH & SOCIAL CARE IN THE COMMUNITY 2019; 27:1167-1174. [PMID: 30969452 DOI: 10.1111/hsc.12754] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 03/07/2019] [Accepted: 03/13/2019] [Indexed: 06/09/2023]
Abstract
Joint pain is a common experience among adults aged 65 and over. Although pain management is multifaceted, medication is essential in it. The paper examines the use of medication among older adults with joint pain in Israel and asks whether socioeconomic factors are associated with this usage. The data, harvested, from the Survey of Health, Aging and Retirement in Europe (SHARE), include 1,294 randomly selected community-dwelling individuals aged 65 and over in Israel. Bivariate analysis and logistic regression are used to identify factors associated with the presence of joint pain medication use. About 38% of respondents report experiencing joint pain and 45% of those who so report are not taking prescription medication. Back pain is the most common location, reported by 64% of individuals who report joint pain. Taking medication is independently associated with younger age (OR = 0.965, 95% CI = 0.939-0.991), more education (OR = 1.044, 95% CI = 0.998-1.091), and better ability to cope economically (OR = 1.964, 95% CI = 1.314-2.936). However, older age and ability to cope economically are independently associated with women (OR = 0.964, 95% CI = 0.932-0.998 and OR = 2.438, 95% CI = 1.474-4.032, respectively) but not with men. It is suggested that socioeconomic inequality exists in healthcare access among adults aged 65 and over. Since income and gender are strongly associated with taking pain medication, physicians should follow-up on women and less affluent people to ensure that medication prescribed has been obtained. Policymakers should consider programs that would facilitate better access to pain medication among vulnerable older individuals.
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Affiliation(s)
- Aviad Tur-Sinai
- Department of Health Systems Management, The Max Stern Yezreel Valley College, Emek Yezreel, Israel
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Development of a cancer pain self-management resource to address patient, provider, and health system barriers to care. Palliat Support Care 2019; 17:472-478. [PMID: 31010454 DOI: 10.1017/s1478951518000792] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE The majority of self-management interventions are designed with a narrow focus on patient skills and fail to consider their potential as "catalysts" for improving care delivery. A project was undertaken to develop a patient self-management resource to support evidence-based, person-centered care for cancer pain and overcome barriers at the levels of the patient, provider, and health system. METHOD The project used a mixed-method design with concurrent triangulation, including the following: a national online survey of current practice; two systematic reviews of cancer pain needs and education; a desktop review of online patient pain diaries and other related resources; consultation with stakeholders; and interviews with patients regarding acceptability and usefulness of a draft resource. RESULT Findings suggested that an optimal self-management resource should encourage pain reporting, build patients' sense of control, and support communication with providers and coordination between services. Each of these characteristics was identified as important in overcoming established barriers to cancer pain care. A pain self-management resource was developed to include: (1) a template for setting specific, measureable, achievable, relevant and time-bound goals of care, as well as identifying potential obstacles and ways to overcome these; and (2) a pain management plan detailing exacerbating and alleviating factors, current strategies for management, and contacts for support. SIGNIFICANCE OF RESULTS Self-management resources have the potential for addressing barriers not only at the patient level, but also at provider and health system levels. A cluster randomized controlled trial is under way to test effectiveness of the resource designed in this project in combination with pain screening, audit and feedback, and provider education. More research of this kind is needed to understand how interventions at different levels can be optimally combined to overcome barriers and improve care.
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Magasi S, Buono S, Yancy CW, Ramirez RD, Grady KL. Preparedness and Mutuality Affect Quality of Life for Patients With Mechanical Circulatory Support and Their Caregivers. Circ Cardiovasc Qual Outcomes 2019; 12:e004414. [DOI: 10.1161/circoutcomes.117.004414] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Susan Magasi
- Department of Occupational Therapy and Department of Disability Studies, University of Illinois at Chicago (S.M.)
| | - Sarah Buono
- Department of Medical Social Sciences (S.B.), Northwestern University, Chicago, IL
| | - Clyde W. Yancy
- Division of Cardiology, Department of Medicine and Department of Medical Social Sciences (C.W.Y.), Northwestern University, Chicago, IL
| | - Ricardo D. Ramirez
- Department of Occupational Therapy, University of Illinois at Chicago (R.D.R.)
| | - Kathleen L. Grady
- Division of Cardiac Surgery, Department of Surgery and Department of Medicine, Feinberg School of Medicine (K.L.G.), Northwestern University, Chicago, IL
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Swartwout E, El-Zein A, Barnett SD, Drenkard K. The Design and Testing of the Psychometric Properties of the Person Engagement Index Instrument to Measure a Person's Capacity to Engage in Health Care. J Nurs Meas 2018; 26:278-295. [PMID: 30567945 DOI: 10.1891/1061-3749.26.2.278] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE Patient engagement has been considered a powerful tool to improve health outcomes. A composite instrument to measure the factors that impact a person's capacity to engage in his or her health care was an identified gap in the literature. This study developed and tested the psychometric properties of the Person Engagement Index (PEI) instrument. METHODS The instrument was tested among 338 medical-surgical inpatients at four health care systems (five facilities), with psychometric evaluation for validity, reliability, and exploratory factor analysis. RESULTS Exploratory factor analysis revealed a four-factor solution that accounted for 63.9% of the total variance. Internal consistency results were Cronbach's α = .896 for the overall scale and each subscale: Engagement in Health Care = .885, Technology Use in Health Care = .854, Proactive Approach to Health Care = .728, and Psychosocial Support = .880. CONCLUSIONS The results of the PEI study indicate that it is a valid and reliable instrument among the adult medical-surgical population. Further testing of the instrument is recommended among other populations and across the care continuum.
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Racine M. Chronic pain and suicide risk: A comprehensive review. Prog Neuropsychopharmacol Biol Psychiatry 2018; 87:269-280. [PMID: 28847525 DOI: 10.1016/j.pnpbp.2017.08.020] [Citation(s) in RCA: 185] [Impact Index Per Article: 30.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 08/07/2017] [Accepted: 08/23/2017] [Indexed: 12/24/2022]
Abstract
Death by suicide is one of the leading causes of mortality worldwide. Because individuals with chronic pain are at least twice as likely to report suicidal behaviors or to complete suicide, it is of utmost importance to target which risk factors contribute the most to increasing suicidality. This comprehensive review aims to provide an update on research advancements relating to the identification of potential risk factors for suicidality in individuals with chronic pain. Supporting the results of prior reviews, we found robust evidence that chronic pain itself, regardless of type, was an important independent risk factor for suicidality. The only sociodemographic factor found to be associated with suicidality in individuals with chronic pain was being unemployed/disabled. Depressive symptoms, anger problems, harmful habits (e.g. smoking, alcohol misuse, illicit drugs), childhood or adulthood adversities, and family history of depression/suicide were all also identified as general risk factors. Regarding pain-related factors, sleep problems, poorer perceived mental health, concurrent chronic pain conditions, and more frequent episodes of intermittent pain, were all found to be predictors of suicidality. Unexpectedly, pain characteristics (e.g. type, duration, and intensity/severity) and physical status (e.g. pain interference or disability) were not related to suicide risk. We also identified promising new psychosocial factors (e.g. mental defeat, pain catastrophizing, hopelessness, perceived burdensomeness and thwarted belongingness) associated with suicidality outcomes. A large number of these factors are amenable to change through targeted intervention, highlighting the importance of comprehensively assessing chronic pain patients at risk for suicide, while also incorporating a suicide prevention component into chronic pain management programs.
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Affiliation(s)
- Mélanie Racine
- Department of Clinical Neurological Sciences, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada.
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Kuo SC, Chou WC, Hou MM, Wu CE, Shen WC, Wen FH, Tang ST. Changes in and modifiable patient- and family caregiver-related factors associated with cancer patients’ high self-perceived burden to others at the end of life: A longitudinal study. Eur J Cancer Care (Engl) 2018; 27:e12942. [DOI: 10.1111/ecc.12942] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2017] [Revised: 05/18/2018] [Accepted: 09/02/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Su-Ching Kuo
- Department of Nursing; Yuanpei University of Medical Technology; Hsinchu Taiwan
- Graduate Institute of Clinical Medical Sciences; Chang Gung University; Taoyuan Taiwan
| | - Wen-Chi Chou
- Division of Hematology-Oncology; Chang Gung Memorial Hospital at Linkou; Taoyuan Taiwan
| | - Ming-Mo Hou
- Division of Hematology-Oncology; Chang Gung Memorial Hospital at Linkou; Taoyuan Taiwan
| | - Chiao-En Wu
- Division of Hematology-Oncology; Chang Gung Memorial Hospital at Linkou; Taoyuan Taiwan
| | - Wen-Chi Shen
- Division of Hematology-Oncology; Chang Gung Memorial Hospital at Linkou; Taoyuan Taiwan
| | - Fur-Hsing Wen
- Department of International Business; Soochow University; Taipei Taiwan
| | - Siew-Tzuh Tang
- Division of Hematology-Oncology; Chang Gung Memorial Hospital at Linkou; Taoyuan Taiwan
- School of Nursing; Chang Gung University; Taoyuan Taiwan
- Department of Nursing; Chang Gung Memorial Hospital at Kaohsiung; Kaohsiung Taiwan
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Hayes CJ, Li X, Li C, Shah A, Kathe N, Bhandari NR, Payakachat N. Health-Related Quality of Life among Chronic Opioid Users, Nonchronic Opioid Users, and Nonopioid Users with Chronic Noncancer Pain. Health Serv Res 2018; 53:3329-3349. [PMID: 29479700 PMCID: PMC6153159 DOI: 10.1111/1475-6773.12836] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE Evaluate the association between opioid therapy and health-related quality of life (HRQoL) in participants with chronic, noncancer pain (CNCP). DATA SOURCES Medical Expenditure Panel Survey Longitudinal, Medical Conditions, and Prescription Files. STUDY DESIGN Using a retrospective cohort study design, the Mental Health Component (MCS12) and Physical Health Component (PCS12) scores of the Short Form-12 Version 2 were assessed to measure mental and physical HRQoL. DATA COLLECTION Chronic, noncancer pain participants were classified as chronic, nonchronic, and nonopioid users. One-to-one propensity score matching was employed to match chronic opioid users to nonchronic opioid users plus nonchronic opioid users and chronic opioid users to nonopioid users. PRINCIPAL FINDINGS A total of 5,876 participants were identified. After matching, PCS12 was not significantly different between nonchronic versus nonopioid users (LSM Diff = -0.98, 95% CI: -2.07, 0.10), chronic versus nonopioid users (LSM Diff = -2.24, 95% CI: -4.58, 0.10), or chronic versus nonchronic opioid users (LSM Diff = -2.23, 95% CI: -4.53, 0.05). Similarly, MCS12 was not significantly different between nonchronic versus nonopioid users (LSM Diff = 0.76, 95% CI: -0.46, 1.98), chronic versus nonopioid users (LSM Diff = 1.08, 95% CI: -1.26, 3.42), or chronic versus nonchronic opioid users (LSM Diff = -0.57, 95% CI: -2.90, 1.77). CONCLUSIONS Clinicians should evaluate opioid use in participants with CNCP as opioid use is not correlated with better HRQoL.
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Affiliation(s)
- Corey J. Hayes
- Division of Pharmaceutical Evaluation and PolicyDepartment of Pharmacy PracticeUniversity of Arkansas for Medical Sciences College of PharmacyLittle RockAR
- NIDAT32 Addiction Research Training Program, Psychiatric Research InstituteUniversity of Arkansas for Medical Sciences College of MedicineLittle RockAR
| | - Xiaocong Li
- Department of Health Policy and ManagementUniversity of Arkansas for Medical Sciences College of Public HealthLittle RockAR
| | - Chenghui Li
- Division of Pharmaceutical Evaluation and PolicyDepartment of Pharmacy PracticeUniversity of Arkansas for Medical Sciences College of PharmacyLittle RockAR
| | - Anuj Shah
- Division of Pharmaceutical Evaluation and PolicyDepartment of Pharmacy PracticeUniversity of Arkansas for Medical Sciences College of PharmacyLittle RockAR
| | - Niranjan Kathe
- Division of Pharmaceutical Evaluation and PolicyDepartment of Pharmacy PracticeUniversity of Arkansas for Medical Sciences College of PharmacyLittle RockAR
| | - Naleen Raj Bhandari
- Division of Pharmaceutical Evaluation and PolicyDepartment of Pharmacy PracticeUniversity of Arkansas for Medical Sciences College of PharmacyLittle RockAR
| | - Nalin Payakachat
- Division of Pharmaceutical Evaluation and PolicyDepartment of Pharmacy PracticeUniversity of Arkansas for Medical Sciences College of PharmacyLittle RockAR
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Wilson KG, Castillo D, Kowal J, Yong AG, McWilliams LA. Validation of a Limitations in Daily Activities Scale for Chronic Pain. THE JOURNAL OF PAIN 2018; 20:68-82. [PMID: 30172706 DOI: 10.1016/j.jpain.2018.08.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 07/19/2018] [Accepted: 08/11/2018] [Indexed: 02/06/2023]
Abstract
Limitations in physical function and participation are important domains of assessment in chronic pain. In 1995, the International Association for the Study of Pain distributed a self-report measure of functional limitations. Although the questionnaire has been used in research studies, it has never been subjected to a thorough investigation of its measurement properties. In this study, 941 patients with chronic pain completed the 16-item Limitations in Daily Activities Scale (LIDAS) at 2 pretreatment and 1 post-treatment assessment points. Individual item analysis favored a 13-item scale. This 13-item LIDAS had a confirmed 3-factor structure consisting of limitations in personal care, global participation, and specific tasks. Reliability analyses for the total scale (α = .90), as well as for each factor individually (αs = .82-.84), indicated good internal consistency, test-retest reliability (intraclass correlations = .65-.88 over varying time intervals), and responsiveness to change with treatment. LIDAS scores correlated as expected with measures of pain intensity, pain cognitions, and depression, as well as with other self-report and clinician-administered measures of functional performance. Using patient global ratings as anchors, a minimal clinically important difference of 5 points was established as a criterion for meaningful individual improvement after treatment. In conclusion, the LIDAS is a reliable, valid, and clinically relevant option for assessing limitations in physical function and participation in patients with chronic pain. PERSPECTIVE: Physical function and participation comprise a core dimension in the assessment of chronic pain. This study demonstrates that the LIDAS is a reliable and valid measure of this dimension, with good applicability for documenting clinically important change with treatment.
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Affiliation(s)
- Keith G Wilson
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada; Department of Medicine, University of Ottawa, Ottawa, ON, Canada; School of Psychology, University of Ottawa, Ottawa, ON, Canada; Department of Psychology, The Ottawa Hospital Rehabilitation Centre, Ottawa, ON, Canada.
| | - Dyana Castillo
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - John Kowal
- School of Psychology, University of Ottawa, Ottawa, ON, Canada; Department of Psychology, The Ottawa Hospital Rehabilitation Centre, Ottawa, ON, Canada; Department of Anesthesiology, University of Ottawa, Ottawa, ON, Canada
| | - An Gie Yong
- School of Psychology, University of Ottawa, Ottawa, ON, Canada
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Boselie J, Vancleef L, Peters M. Filling the glass: Effects of a positive psychology intervention on executive task performance in chronic pain patients. Eur J Pain 2018; 22:1268-1280. [PMID: 29573513 PMCID: PMC6055672 DOI: 10.1002/ejp.1214] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2018] [Indexed: 01/10/2023]
Abstract
BACKGROUND Chronic pain is associated with emotional problems as well as difficulties in cognitive functioning. Prior experimental studies have shown that optimism, the tendency to expect that good things happen in the future, and positive emotions can counteract pain-induced task performance deficits in healthy participants. More specifically, induced optimism was found to buffer against the negative effects of experimental pain on executive functioning. This clinical experiment examined whether this beneficial effect can be extended to a chronic pain population. METHODS Patients (N = 122) were randomized to a positive psychology Internet-based intervention (PPI; n = 74) or a waiting list control condition (WLC; n = 48). The PPI consisted of positive psychology exercises that particularly target optimism, positive emotions and self-compassion. RESULTS Results demonstrated that patients in the PPI condition scored higher on happiness, optimism, positive future expectancies, positive affect, self-compassion and ability to live a desired life despite pain, and scored lower on pain catastrophizing, depression and anxiety compared to patients in the WLC condition. However, executive task performance did not improve following completion of the PPI, compared to the WLC condition. CONCLUSIONS Despite the lack of evidence that positive emotions and optimism can improve executive task performance in chronic pain patients, this study did convincingly demonstrate that it is possible to increase positive emotions and optimism in chronic pain patients with an online positive psychology intervention. It is imperative to further explore amendable psychological factors that may reduce the negative impact of pain on executive functioning. SIGNIFICANCE We demonstrated that an Internet-based positive psychology intervention strengthens optimism and positive emotions in chronic pain patients. These emotional improvements are not associated with improved executive task performance. As pain itself often cannot be relieved, it is imperative to have techniques to reduce the burden of living with chronic pain.
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Affiliation(s)
- J.J.L.M. Boselie
- Clinical Psychological ScienceMaastricht UniversityMaastrichtThe Netherlands
| | - L.M.G. Vancleef
- Clinical Psychological ScienceMaastricht UniversityMaastrichtThe Netherlands
| | - M.L. Peters
- Clinical Psychological ScienceMaastricht UniversityMaastrichtThe Netherlands
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McWilliams LA, Kowal J, Verrier MJ, Dick BD. Do Pain-Related Support Preferences Moderate Relationships Between Chronic Pain Patients' Reports of Support Received and Psychosocial Functioning? PAIN MEDICINE 2018; 18:2331-2339. [PMID: 28122940 DOI: 10.1093/pm/pnw346] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objective The operant theory of chronic pain and related research suggest pain-related solicitous support promotes disability. The current study investigated the hypotheses that solicitous support is positively associated with both disability and relationship satisfaction and that these relationships are moderated by the level of desire for this type of support. Methods Patients with chronic pain (N = 147) and in a relationship were recruited from a multidisciplinary pain treatment center. They provided self-reports of the amount of three types of pain-related support wanted and received (i.e., solicitous, encouragement, and suppression), disability, and relationship satisfaction. Results A hierarchical regression analysis indicated that solicitous support received was not significantly associated with disability. However, a moderation effect was found regarding encouragement. Encouragement received was negatively associated with disability, and this relationship was strongest at lower levels of interest in encouragement. Solicitous support received had a large positive association with relationship satisfaction. Conclusions The findings suggest the influence of pain-related support is more complex than suggested by the operant conditioning model of chronic pain, which emphasizes the possible detrimental impact of solicitous support. Further research is warranted regarding the potential relationship enhancing effects of solicitous support and the influence of encouragement on disability experienced by those with chronic pain.
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Affiliation(s)
| | - John Kowal
- The Ottawa Hospital Rehabilitation Centre, Ottawa, ON, Canada
| | - Michelle J Verrier
- Department of Anesthesiology and Pain Medicine, University of Alberta, Edmonton, AB, Canada
| | - Bruce D Dick
- Department of Anesthesiology and Pain Medicine, University of Alberta, Edmonton, AB, Canada
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Rosenrot SA, Lewis SP. Barriers and responses to the disclosure of non-suicidal self-injury: a thematic analysis. COUNSELLING PSYCHOLOGY QUARTERLY 2018. [DOI: 10.1080/09515070.2018.1489220] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Twomey D, Stuart S, Baker K. Pain in Parkinson's disease: the lived experience. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2018. [DOI: 10.12968/ijtr.2018.25.6.301] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Doireann Twomey
- Senior neurological physiotherapist, Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Science, Northumbria University, Newcastle Upon Tyne, UK
| | - Samuel Stuart
- Research associate, Institute of Neuroscience/Newcastle University Institute of Ageing, Newcastle University, Newcastle upon Tyne; Newastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Katherine Baker
- Senior lecturer in physiotherapy, Department of Sport, Exercise and Rehabilitation, Faculty of Health and Life Science, Northumbria University, Newcastle Upon Tyne, UK
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