1
|
Fonia D, Aisenberg D. The Effects of Mindfulness Interventions on Fibromyalgia in Adults aged 65 and Older: A Window to Effective Therapy. J Clin Psychol Med Settings 2022:10.1007/s10880-022-09911-7. [PMID: 36163446 DOI: 10.1007/s10880-022-09911-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2022] [Indexed: 11/25/2022]
Abstract
Pain usually receives insufficient attention by individuals due to the misconception that pain is a natural consequence of aging. For persons aged 65 and older, a disease requiring further research is fibromyalgia, characterized by chronic pain without clear pathology. Mind-body therapies like mindfulness are beneficial for this population as they affect psychological and biological aspects of pain. These therapies emphasize a nonjudgmental acceptance of thoughts and attention to the experience without attempting to resist or change them. Despite the potential benefits of mindfulness interventions for persons with fibromyalgia aged 65 and older, only few studies have examined the effects of these therapies, yielding conflicting findings. Importantly, no study has yet to be conducted exclusively on this population. This comprehensive review examined existing literature focusing on the effects of mindfulness-based interventions on the physical and mental well-being of persons with fibromyalgia aged 65 and older. It highlights the need for further research on the relationship between mindfulness, fibromyalgia, and gerontology, calling for a standard protocol of intervention.
Collapse
Affiliation(s)
- Dvir Fonia
- Clinical Psychology of Adulthood and Aging, Ruppin Academic Center, Emek Hefer, Israel.
| | - Daniela Aisenberg
- Clinical Psychology of Adulthood and Aging, Ruppin Academic Center, Emek Hefer, Israel
- The Dror (Imri) Aloni Center for Health Informatics, Ruppin Academic Center, Emek Hefer, Israel
| |
Collapse
|
2
|
Daffin M, Lynch-Milder MK, Gibler RC, Murray C, Green CM, Kashikar-Zuck S. A qualitative study of risk and resilience in young adult women with a history of juvenile-onset fibromyalgia. Pediatr Rheumatol Online J 2021; 19:128. [PMID: 34404452 PMCID: PMC8371844 DOI: 10.1186/s12969-021-00628-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 07/29/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Juvenile-onset Fibromyalgia (JFM) is a chronic pain condition characterized by widespread musculoskeletal pain, fatigue, sleep difficulties, mood concerns, and other associated symptoms. Although diagnosed in childhood, JFM often persists into adulthood can result in continued physical, social, and psychological impairment. The purpose of this qualitative study was to identify themes of risk and resilience for long-term outcomes among young adults diagnosed with JFM in childhood. METHODS The sample included 13 young adults (ages 26-34) who had been diagnosed with JFM in adolescence. Focus groups were used to elicit qualitative information about living with JFM and perceived challenges and buffering factors impacting their adjustment. RESULTS The majority of participants (80%, N = 12) continued to meet criteria for fibromyalgia (FM). An iterative, thematic analysis revealed themes of resilience (e.g., greater acceptance, re-setting expectations, active coping, addressing mental health) and risk (e.g., lack of information, stigma, isolation, negative healthcare experiences). CONCLUSION Results suggest the need for longer follow-up of youth with JFM as they transition to adulthood with multidisciplinary care and more attention to education about JFM and associated symptoms such as fatigue, as well as ongoing support for coping and mental health needs. A holistic approach to care during the transition years could be beneficial to minimize impact of JFM on long-term functioning.
Collapse
Affiliation(s)
- Morgan Daffin
- Department of Pediatrics, Division of Child & Adolescent Psychiatry and Psychology, Norton Children's Medical Group, University of Louisville School of Medicine, 200 East Chestnut Street, Louisville, KY, 40202, USA.
| | - Mary K Lynch-Milder
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, USA
| | - Robert C Gibler
- Department of Psychology, University of Cincinnati, Cincinnati, USA
- Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, USA
| | - Caitlin Murray
- Center for Child Health, Behavior & Development, Seattle Children's Research Institute, Seattle, USA
| | - Carly M Green
- Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, USA
| | - Susmita Kashikar-Zuck
- Division of Behavioral Medicine & Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, USA
| |
Collapse
|
3
|
Abstract
Adults with chronic pain cite social support (SS) as an important resource. Research has mostly focused on general SS or pain-specific solicitousness, resulting in a limited understanding of the role of SS in pain experiences. Drawing on SS theoretical models, this review aimed to understand how pain-related SS has been conceptualized and measured and how its relationship with pain experiences has been investigated. Arksey and O'Malley scoping review framework guided the study. A database search (2000-2015) was conducted in PsycINFO, CINAHL, MEDLINE, and EMBASE using a combination of subject headings/keywords on pain and SS; 3864 citations were screened; 101 full texts were assessed for eligibility; references of 52 papers were hand searched. Fifty-three studies were included. Most studies were either a-theoretical or drew upon the operant conditioning model. There are several self-report measures and observational systems to operationalize pain-related SS. However, the Multidimensional Pain Inventory remains the most often used, accounting for the centrality of the concept of solicitousness in the literature. Most studies focused on individuals with chronic pain self-report of spousal pain-related SS and investigated its main effects on pain outcomes. Only a minority investigated the role of pain SS within the stress and coping process (as a buffer or mediator). Little is known about mediating pathways, contextual modulation of the effectiveness of SS exchanges, and there are practically no SS-based intervention studies. Drawing on general SS models, the main gaps in pain-related SS research are discussed and research directions for moving this literature beyond solicitousness are proposed.
Collapse
|
4
|
Assessing the Structure of the Ways of Coping Questionnaire in Fibromyalgia Patients Using Common Factor Analytic Approaches. Pain Res Manag 2016; 2016:7297826. [PMID: 28070160 PMCID: PMC5187479 DOI: 10.1155/2016/7297826] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Revised: 09/30/2016] [Accepted: 10/25/2016] [Indexed: 11/18/2022]
Abstract
The Ways of Coping Questionnaire (WCQ) is a widely used measure of coping processes. Despite its use in a variety of populations, there has been concern about the stability and structure of the WCQ across different populations. This study examines the factor structure of the WCQ in a large sample of individuals diagnosed with fibromyalgia. The participants were 501 adults (478 women) who were part of a larger intervention study. Participants completed the WCQ at their 6-month assessment. Foundational factoring approaches were performed on the data (i.e., maximum likelihood factoring [MLF], iterative principal factoring [IPF], principal axis factoring (PAF), and principal components factoring [PCF]) with oblique oblimin rotation. Various criteria were evaluated to determine the number of factors to be extracted, including Kaiser's rule, Scree plot visual analysis, 5 and 10% unique variance explained, 70 and 80% communal variance explained, and Horn's parallel analysis (PA). It was concluded that the 4-factor PAF solution was the preferable solution, based on PA extraction and the fact that this solution minimizes nonvocality and multivocality. The present study highlights the need for more research focused on defining the limits of the WCQ and the degree to which population-specific and context-specific subscale adjustments are needed.
Collapse
|
5
|
Lynch-Jordan AM, Sil S, Bromberg M, Ting TV, Kashikar-Zuck S. Cross-Sectional Study of Young Adults Diagnosed With Juvenile Fibromyalgia: Social Support and Its Impact on Functioning and Mood. J Adolesc Health 2015; 57:482-7. [PMID: 26372369 DOI: 10.1016/j.jadohealth.2015.07.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Revised: 07/24/2015] [Accepted: 07/25/2015] [Indexed: 11/26/2022]
Abstract
PURPOSE Juvenile-onset fibromyalgia (JFM) affects physical, social, and emotional functioning. Little is known about how social support and social interactions are impacted in the transition to young adulthood for patients diagnosed with JFM. METHODS Young adults (Mage = 21.6) diagnosed with JFM during adolescence (N = 94) and matched healthy controls (N = 33) completed measures of social network size and diversity, perceived social support, physical functioning, and depressive symptoms as part of a cross-sectional survey study. RESULTS No difference in social network diversity was found, although JFM patients reported fewer total people within their social networks. JFM patients reported poorer emotional and tangible support and fewer positive social interactions than healthy controls. After controlling for condition and pain intensity, the level of perceived social support was a significant predictor of physical functioning and depressive symptoms, whereas social network size also contributed uniquely to physical functioning. CONCLUSIONS Given the developmental importance of social support in adolescence and young adulthood, interventions should include methods of improving social support into fibromyalgia management.
Collapse
Affiliation(s)
- Anne M Lynch-Jordan
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio.
| | - Soumitri Sil
- Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
| | - Maggie Bromberg
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, Washington
| | - Tracy V Ting
- Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio; Division of Rheumatology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Susmita Kashikar-Zuck
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio
| |
Collapse
|
6
|
Verhoof EJA, Maurice-Stam H, Heymans HSA, Evers AWM, Grootenhuis MA. Psychosocial well-being in young adults with chronic illness since childhood: the role of illness cognitions. Child Adolesc Psychiatry Ment Health 2014; 8:12. [PMID: 24735489 PMCID: PMC4020606 DOI: 10.1186/1753-2000-8-12] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Accepted: 04/06/2014] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND More and more pediatric patients reach adulthood. Some of them are successfully integrating in adult life, but many others are not. Possibly Illness cognitions (IC) - the way people give meaning to their illness/disability - may play a role in individual differences on long-term adjustment. This study explored the association of IC with disease-characteristics and Health Related Quality of Life (HRQoL), anxiety and depression in young adults with a disability benefit due to childhood-onset chronic condition. METHODS In a cross-sectional study, young adults (22-31 years, N = 377) who claimed a disability benefit because of a somatic condition since childhood, completed the Illness Cognition Questionnaire (acceptance-helplessness-benefits), RAND-36 (HRQoL) and HADS (anxiety and depression) online. Besides descriptive statistics, linear regression analyses were conducted to predict (1) illness cognitions by age, gender and disease-characteristics, and (2) HRQoL (Mental and Physical Component Scale), Anxiety and Depression by illness cognitions, controlling for disease-characteristics, age and gender. RESULTS Respectively 90.2%, 83.8% and 53.3% of the young adults with a disability benefit experienced feelings of acceptance, benefits and helplessness. Several disease-characteristics were associated with IC. More acceptance and less helplessness were associated with better mental (β = 0.31; β = -0.32) and physical (β = 0.16; β = -0.15) HRQoL and with less anxiety (β = -0.27; β = 0.28) and depression (β = -0.29; β = 0.31). CONCLUSIONS IC of young adult beneficiaries were associated with their HRQoL and feelings of anxiety and depression. Early recognition of psychological distress and negative IC might be a key to the identification of pediatric patients at risk for long-term dysfunction. Identification of maladaptive illness cognitions enables the development of psychosocial interventions to optimise their well-being and adaptation to society.
Collapse
Affiliation(s)
- Eefje JA Verhoof
- Psychosocial Department, Emma Children’s Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Heleen Maurice-Stam
- Psychosocial Department, Emma Children’s Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands,Psychosocial Department, Room A3-241, Emma Children’s Hospital, Academic Medical Center, PO Box 22660, 1100 DD Amsterdam, The Netherlands
| | - Hugo SA Heymans
- Department of Pediatrics, Emma Children’s Hospital, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Andrea WM Evers
- Institute of Psychology, Health, Medical and Neuropsychology, Leiden University, Leiden, The Netherlands
| | - Martha A Grootenhuis
- Psychosocial Department, Emma Children’s Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| |
Collapse
|
7
|
Ullrich A, Hauer J, Farin E. Communication preferences in patients with fibromyalgia syndrome: descriptive results and patient characteristics as predictors. Patient Prefer Adherence 2014; 8:135-45. [PMID: 24520192 PMCID: PMC3917950 DOI: 10.2147/ppa.s53474] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Communication with patients with fibromyalgia syndrome (FMS) is often considered difficult. The primary objective of this explorative study was to describe the communication preferences of FMS patients in comparison with other chronic diseases, and the secondary objective was to identify patient-related predictors of those communication preferences. METHODS A total of 256 FMS patients were asked to fill out the KOPRA [(Kommunikationspraeferenzen), communication preferences of patients with chronic illness] questionnaire at the beginning of their rehabilitation, answering questions about their communication preferences. The KOPRA's descriptive parameters were calculated and compared with other diagnosis groups. In order to include as many influencing factors as possible, data on patient-related sociodemographic, medical, pain impact and psychologic variables were gathered. A hierarchical regression analysis with four steps was performed to identify patient-related predictors of patients' communication preferences. RESULTS FMS patients consider an open and patient-centered communication style to be especially important. Emotionally supportive communication and communication about personal circumstances are important for FMS patients, but the preferences of individual patients vary widely. FMS patients reveal higher values in all the subdimensions of communication preferences compared with patients with low back pain or chronic ischemic heart disease. Only a few variables appear to predict patient communication preferences. The explained variance ranged from 3.1% to 9.7%. Psychologic variables have been identified as predictors in conjunction with all communication preferences. CONCLUSION Health care providers who communicate with FMS patients should employ an open and patient-centered communication style, and affective communication components should be adapted to accommodate each patient.
Collapse
Affiliation(s)
- Antje Ullrich
- Medical Center, University of Freiburg, Institute for Quality Management and Social Medicine, Freiburg, Germany
- Correspondence: Antje Ullrich, Medical Center, University of Freiburg, Institute for Quality Management and Social Medicine, Engelbergerstr. 21, D-79106 Freiburg, Germany, Tel +49 761 270 74870, Fax +49 761 270 73310, Email
| | - Johannes Hauer
- Medical Center, University of Freiburg, Institute for Quality Management and Social Medicine, Freiburg, Germany
| | - Erik Farin
- Medical Center, University of Freiburg, Institute for Quality Management and Social Medicine, Freiburg, Germany
| |
Collapse
|
8
|
Fear of movement and avoidance behaviour toward physical activity in chronic-fatigue syndrome and fibromyalgia: state of the art and implications for clinical practice. Clin Rheumatol 2013; 32:1121-9. [DOI: 10.1007/s10067-013-2277-4] [Citation(s) in RCA: 82] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Accepted: 04/19/2013] [Indexed: 10/26/2022]
|
9
|
Geenen R, Newman S, Bossema ER, Vriezekolk JE, Boelen PA. Psychological interventions for patients with rheumatic diseases and anxiety or depression. Best Pract Res Clin Rheumatol 2013; 26:305-19. [PMID: 22867928 DOI: 10.1016/j.berh.2012.05.004] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2012] [Revised: 05/14/2012] [Accepted: 05/21/2012] [Indexed: 11/16/2022]
Abstract
The prevalence of clinical anxiety and clinical depression in rheumatic diseases is about twice the prevalence seen in the general population. At a milder level, the occurrence of psychological distress that does not fulfil diagnostic criteria of anxiety and depression is even higher. Evidence indicates that this high prevalence is multifactorial. Correlational studies suggest that possible factors for anxiety and depression include the suffering accompanying somatic symptoms, functional limitations, pro-inflammatory cytokines, helplessness due to the uncontrollable, unpredictable and progressive nature of the disease, and other factors associated with having a chronic disease. This article reviews the prevalence and diagnosis of anxiety and depression in rheumatic diseases and it examines the contents and the impact of psychological interventions to address these difficulties for patients.
Collapse
Affiliation(s)
- Rinie Geenen
- Utrecht University, Department of Clinical and Health Psychology, Utrecht, The Netherlands.
| | | | | | | | | |
Collapse
|
10
|
Vriezekolk JE, Geenen R, van den Ende CHM, Slot H, van Lankveld WGJM, van Helmond T. Behavior change, acceptance, and coping flexibility in highly distressed patients with rheumatic diseases: feasibility of a cognitive-behavioral therapy in multimodal rehabilitation. PATIENT EDUCATION AND COUNSELING 2012; 87:171-177. [PMID: 21978928 DOI: 10.1016/j.pec.2011.09.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2011] [Revised: 08/30/2011] [Accepted: 09/01/2011] [Indexed: 05/31/2023]
Abstract
OBJECTIVE To describe the development and feasibility of the integration of a cognitive-behavioral therapy (CBT) within a multimodal rehabilitation program for highly distressed patients with rheumatic diseases. METHODS Development included the detailed specification of the theoretical and empirical-based underpinnings of the CBT and the comprehensive description of its design and content. Feasibility was assessed by percentage of eligible patients, attrition and attendance rates, and patient satisfaction. RESULTS The developed CBT component seeks to decrease psychological distress and improve activities and participation across multiple life domains by accomplishing behavior change, acceptance, and coping flexibility. Motivational interviewing was applied to endorse patients' own reasons to change. Forty percent (35/87) of the eligible patients were admitted to the program. Attendance rate (>95%) was high. Patient satisfaction ranged from 6.8 to 8.0 (10-point scale). CONCLUSION Integrating CBT within a multimodal rehabilitation program is feasible. An acceptable proportion of the intended patient sample is eligible and patient's attendance and satisfaction is high. PRACTICE IMPLICATIONS Patients with impaired physical and psychosocial functioning despite adequate medical treatment pose a great challenge. Their treatment outcome may be improved by screening and selecting highly distressed patients and offering them a CBT embedded in multimodal rehabilitation program.
Collapse
|
11
|
Fibromyalgia: mechanisms and potential impact of the ACR 2010 classification criteria. Nat Rev Rheumatol 2012; 8:108-16. [DOI: 10.1038/nrrheum.2011.216] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
|
12
|
Ahlstrand I, Björk M, Thyberg I, Börsbo B, Falkmer T. Pain and daily activities in rheumatoid arthritis. Disabil Rehabil 2011; 34:1245-53. [PMID: 22191990 DOI: 10.3109/09638288.2011.638034] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AIM The aim of this study was to describe experiences of pain and its relationship to daily activities in people with rheumatoid arthritis (RA). METHOD Seven semi-structured focus group discussions were conducted with 33 men and women of different ages with RA. Data were analysed with content analysis. RESULTS Pain affected everyday life and may be a barrier to perform valued activities. Regarding the impact of pain on participation and independence, personal factors and the social environment were found to be important. It could be a struggle to find the right activity balance, since it was easy to be overactive, triggering subsequent elevation of pain levels. However, the participants also described activities as a mediator of pain and a distraction from it. CONCLUSION The relationship between pain and daily activities in RA was complex. Pain as an impairment was expressed to be related to activity limitations and participation restrictions, as well as to contextual factors. These findings highlight the clinical importance of paying attention to the complexity of pain and its relation to daily activities and participation.
Collapse
Affiliation(s)
- Inger Ahlstrand
- Department of Rehabilitation, School of Health Sciences, Jönköping University, Sweden.
| | | | | | | | | |
Collapse
|
13
|
A randomized, controlled trial of acceptance and commitment therapy and cognitive-behavioral therapy for chronic pain. Pain 2011; 152:2098-2107. [DOI: 10.1016/j.pain.2011.05.016] [Citation(s) in RCA: 335] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2010] [Revised: 05/05/2011] [Accepted: 05/16/2011] [Indexed: 01/18/2023]
|
14
|
Curtis K, Osadchuk A, Katz J. An eight-week yoga intervention is associated with improvements in pain, psychological functioning and mindfulness, and changes in cortisol levels in women with fibromyalgia. J Pain Res 2011; 4:189-201. [PMID: 21887116 PMCID: PMC3160832 DOI: 10.2147/jpr.s22761] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2011] [Indexed: 01/22/2023] Open
Abstract
Objectives: Fibromyalgia (FM) is a chronic condition characterized by widespread musculoskeletal pain, fatigue, depression, and hypocortisolism. To date, published studies have not investigated the effects of yoga on cortisol in FM. This pilot study used a time series design to evaluate pain, psychological variables, mindfulness, and cortisol in women with FM before and after a yoga intervention. Methods: Participants (n = 22) were recruited from the community to participate in a 75 minute yoga class twice weekly for 8 weeks. Questionnaires concerning pain (intensity, unpleasantness, quality, sum of local areas of pain, catastrophizing, acceptance, disability), anxiety, depression, and mindfulness were administered pre-, mid- and post-intervention. Salivary cortisol samples were collected three times a day for each of two days, pre- and post-intervention. Results: Repeated measures analysis of variance (ANOVA) revealed that mean ± standard deviation (SD) scores improved significantly (p < 0.05) from pre- to post-intervention for continuous pain (pre: 5.18 ± 1.72; post: 4.44 ± 2.03), pain catastrophizing (pre: 25.33 ± 14.77; post: 20.40 ± 17.01), pain acceptance (pre: 60.47 ± 23.43; post: 65.50 ± 22.93), and mindfulness (pre: 120.21 ± 21.80; post: 130.63 ± 20.82). Intention-to-treat analysis showed that median AUC for post-intervention cortisol (263.69) was significantly higher (p < 0.05) than median AUC for pre-intervention levels (189.46). Mediation analysis revealed that mid-intervention mindfulness scores significantly (p < 0.05) mediated the relationship between pre- and post-intervention pain catastrophizing scores. Discussion: The results suggest that a yoga intervention may reduce pain and catastrophizing, increase acceptance and mindfulness, and alter total cortisol levels in women with FM. The changes in mindfulness and cortisol levels may provide preliminary evidence for mechanisms of a yoga program for women with FM. Future studies should use an RCT design with a larger sample size.
Collapse
Affiliation(s)
- Kathryn Curtis
- Department of Psychology, Faculty of Health, York University, Toronto, ON, Canada
| | | | | |
Collapse
|
15
|
Evers AWM, Zautra A, Thieme K. Stress and resilience in rheumatic diseases: a review and glimpse into the future. Nat Rev Rheumatol 2011; 7:409-15. [PMID: 21691322 DOI: 10.1038/nrrheum.2011.80] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Stress resilience factors, and interventions to ease stress and enhance resilience, are gaining increasing attention for the treatment of rheumatic conditions. This Review presents a digest of empirical work on the factors that determine the risk of adapting poorly to a rheumatic condition, and on the resilience factors that counteract such risks. We consider the types of stress-management and resilience treatments that are most effective in promoting the physical and psychological functioning of patients at risk of long-term adjustment problems. Prospective research shows that cognitive-behavioral and social risk and resilience factors predict the long-term physical and psychological functioning of patients with rheumatic conditions. Furthermore, validated screening instruments are becoming increasingly useful in clinical practice to identify and select patients at risk. Stress-management and resilience interventions offer promising ways to improve the long-term functioning of patients. These treatment methods might be especially useful when they are tailored to the specific risk and resilience factors of patients, and when they incorporate innovative approaches to the delivery of services, including internet applications such as eHealth, to increase efficiency and availability of treatments, and to optimize patient empowerment in rheumatic conditions.
Collapse
Affiliation(s)
- Andrea W M Evers
- Department of Medical Psychology (840), Radboud University Nijmegen Medical Center, PO Box 9101, 6500 HB, Nijmegen, the Netherlands.
| | | | | |
Collapse
|
16
|
Vallejo MA, Rivera J, Esteve-Vives J, Rejas J. A confirmatory study of the Combined Index of Severity of Fibromyalgia (ICAF*): factorial structure, reliability and sensitivity to change. Health Qual Life Outcomes 2011; 9:39. [PMID: 21649886 PMCID: PMC3127741 DOI: 10.1186/1477-7525-9-39] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2011] [Accepted: 06/07/2011] [Indexed: 11/30/2022] Open
Abstract
Background Fibromyalgia (FM) is a complex syndrome that affects many aspects of the patients life and it is very difficult to evaluate in clinical practice. A recent study has developed the Combined Index of Severity of Fibromyalgia (ICAF), an instrument that evaluates diverse aspects of FM and offers five indices: emotional, physical, active coping, passive coping and total. The objective of this study is to confirm the structure of the ICAF, check its test-retest reliability, assess its sensitivity to change, and compare the results obtained in a sample of patients with fibromyalgia with another sample of healthy controls. Methods A total of 232 patients took part in the study, 228 women and 4 men, with a mean age of 47.73 years of age (SD = 8.61) and a time of disease evolution since diagnosis of 4.28 years (SD = 4.03). The patients from the FM group completed the ICAF. Between one and two weeks later, they again attended the clinic and complete the 59 items on the ICAF (retest) and immediately afterwards they began treatment (according to daily clinical practice criteria). A sample of healthy subjects was also studied as a control group: 110 people were included (106 women and 4 men) with a mean age of 46.01 years of age (SD = 9.35). The study was conducted in Spain. Results The results obtained suggest that the four-factor model obtained in the previous study adequately fits the data obtained in this study. The test-retest reliability and internal consistency were all significant and show a high degree of correlation for all the factors as well as in overall score. With the exception of the passive coping factor, all the other scores, including the overall score, were sensitive to change after the therapeutic intervention. The ICAF scores of the patients with fibromyalgia compared with those of the control group were markedly different. Conclusions The findings suggest that the ICAF is a valid, reliable, sensitive to change instrument with the added advantage that it offers some additional domains (factors) that provide very valuable information regarding the most delicate aspects of the patient, which must be addressed at the time of treatment in daily clinical practice.
Collapse
Affiliation(s)
- Miguel A Vallejo
- Facultad de Psicología, Universidad Nacional de Educación a Distancia, Madrid, Spain.
| | | | | | | | | |
Collapse
|