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Cáceres-Matos R, Gil-García E, Vázquez-Santiago S, Cabrera-León A. Factors that influence the impact of Chronic Non-Cancer Pain on daily life: A partial least squares modelling approach. Int J Nurs Stud 2023; 138:104383. [PMID: 36481597 DOI: 10.1016/j.ijnurstu.2022.104383] [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: 10/06/2021] [Revised: 10/09/2022] [Accepted: 10/15/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Chronic Non-Cancer Pain is pain of more than three months' duration and is not associated with an oncological condition. There is ample literature that recognises that Chronic Non-Cancer Pain impacts numerous areas of the life of the person who suffers from it. This impact is difficult to determine and quantify because Chronic Pain is a subjective experience. OBJECTIVE The objective of this study was to test a recursive model of hypothesised factors that comprise the concept of Chronic Non-Cancer Pain Impact on daily life using Partial Least Squares-Structural Equation Modelling. DESIGN A cross-sectional study was carried out. The sample size was calculated using G*Power V.3.1.9.4 with five parameters (two-tailed, large effect size (f2 = 0.35), power of 0.95, statistical significance of 95% (α = 0.05) and 36 predictors). The minimum number of subjects was considered to be 137. METHODS A recursive model was built based on data from a sample of 395 people over 18 years of age with Chronic Non-Cancer Pain. Data collection was conducted between January and March 2020 at Pain Units and Primary Healthcare Centres belonging to the Spanish Public Health System in the province of Seville (Spain). Analyses were based on Partial Least Squares-Structural Equation Modelling. The internal consistency, convergent validity and discriminant validity of the internal measurement model were assessed. For the external measurement model, global model adjustment and structural validity were assessed. The predictive capacity of the final model was also evaluated. All analyses were performed using SmartPLS version 3.3.2 in consistent mode. RESULTS Findings showed an adequate validity of the proposed model, which comprised nine factors: pain catastrophising, hopelessness due to pain, support network, proactivity, treatment compliance, self-care, mobility, resilience, and sleep. The internal validity of the model (Cronbach's alpha and rho_A > 0.70; Average Variance Extracted>0.50; standardised outer loadings>0.60; Heterotrait-Monotrait-Ratio < 0.85), goodness of fit (Standardised Root Mean Square Residuals<0.08; Geodesic and Euclidean distance p-value<0.05) and predictive power with out-of-sample values (Stone-Geisser test>0.5) were adequate. The hypothesised structure of the instrument has also been confirmed (path coefficients>0.3; R2 > 0.1; f2 > 0.2). CONCLUSIONS The results have shown an adequate internal consistency, convergent validity and discriminant validity of the model. Likewise, the model has shown an adequate goodness of fit, and the validity of its structure and the hypothesis have been confirmed. However, more research is needed in this regard as the possible interaction between the different factors evaluated in the model with the confounding or moderating variables that may exist.
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Affiliation(s)
- Rocío Cáceres-Matos
- Nursing Department, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, 6 Avenzoar ST, RI 41009, Seville, Spain.
| | - Eugenia Gil-García
- Nursing Department, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, 6 Avenzoar ST, RI 41009, Seville, Spain.
| | - Soledad Vázquez-Santiago
- Nursing Department, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, 6 Avenzoar ST, RI 41009, Seville, Spain.
| | - Andrés Cabrera-León
- Andalusian School of Public Health, Cuesta del Observatorio, 4, RI 18011, Granada, Spain; Biomedical Research Consortium in Epidemiology and Public Health Network (CIBERESP), Monforte de Lemos Avenue, 3-5, RI 28029, Madrid, Spain; Biosanitary Research Institute of Granada (ibs.GRANADA), Avda. de Madrid, 15, RI 18012, Granada, Spain.
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Teixeira PEP, Zehry HI, Chaudhari S, Dipietro L, Fregni F. Pain perception in chronic knee osteoarthritis with varying levels of pain inhibitory control: an exploratory study. Scand J Pain 2021; 20:651-661. [PMID: 32667903 DOI: 10.1515/sjpain-2020-0016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 04/27/2020] [Indexed: 12/12/2022]
Abstract
Background and aims Pain is a disabling symptom in knee osteoarthritis (KOA) and its underlying mechanism remains poorly understood. Dysfunction of descending pain modulatory pathways and reduced pain inhibition enhance pain facilitation in many chronic pain syndromes but do not fully explain pain levels in chronic musculoskeletal conditions. The objective of this study is to explore the association of clinical variables with pain intensity perception in KOA individuals with varying levels of Conditioned Pain Modulation (CPM) response. Methods This is a cross-sectional, exploratory analysis using baseline data of a randomized clinical trial investigating the effects of a non-invasive brain stimulation treatment on the perception of pain and functional limitations due to KOA. Sixty-three subjects with KOA were included in this study. Data on pain perception, mood perception, self-reported depression, physical function, quality of life, and quantitative sensory testing was collected. Multiple linear regression analysis was performed to explore the association between the clinical variables with pain perception for individuals with different levels of CPM response. Results For KOA patients with limited CPM response, perception of limitations at work/other activities due to emotional problems and stress scores were statistically significantly associated with pain scores, F(2, 37) = 7.02, p < 0.01. R-squared = 0.275. For KOA patients with normal CPM response, general health perception scores were statistically significantly associated with pain scores, F(1, 21) = 5.60, p < 0.05. R-squared = 0.2104. Limitations of this study include methodology details, small sample size and study design characteristics. Conclusions Pain intensity perception is associated differently with clinical variables according to the individual CPM response. Mechanistic models to explain pain perception in these two subgroups of KOA subjects are discussed.
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Affiliation(s)
- Paulo E P Teixeira
- Spaulding Neuromodulation Center, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Hanan I Zehry
- Spaulding Neuromodulation Center, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,Faculty of Nursing, Suez Canal University, Ismailia, Egypt
| | - Swapnali Chaudhari
- Spaulding Neuromodulation Center, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Felipe Fregni
- Spaulding Neuromodulation Center, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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Cáceres-Matos R, Gil-García E, Rivera-Sequeiros A, López-Millán JM. Design and preliminarily validation of a tool to assess the impact of chronic non-cancer pain on people's daily life in Spanish-language: PAIN_Integral Scale ©. J Adv Nurs 2021; 77:3553-3570. [PMID: 33969919 DOI: 10.1111/jan.14877] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 03/05/2021] [Accepted: 04/14/2021] [Indexed: 11/30/2022]
Abstract
AIM To build and preliminarily validate a Spanish-language instrument to assess the impact that CNCP has on the daily lives of people who suffer from it. BACKGROUND The experience of pain is multifactorial and a correct assessment of it helps to control the intensity of pain. Although there are instruments that evaluate areas on which Chronic Non-Cancer Pain impacts, it would be necessary to include other aspects that scientific literature identifies as relevant. DESIGN Instrument and construct cross-sectional study for psychometric validation. METHODS A total of 157 items based on items from validated questionnaires were evaluated by a group of 21 chronic pain experts using Delphi methodology in three evaluation rounds. A final questionnaire of 55 items with a 5-point Likert-type scale was formed. This questionnaire was piloted on a total of 30 patients to assess their understanding of the items and the psychometric validation process was carried out (January to March 2020) on a subsequent sample of 395 people, all of whom attended Pain Units and Primary Care Centres of the Public Health System in Spain. RESULTS The PAIN_Integral Scale© showed acceptable internal consistency scores measured by Cronbach's alpha. Exploratory Factor Analysis indicated a structure of nine factors that explain 71.02% of the total variance, from 157 to a final total of 36 items. Confirmatory Factor Analysis showing adequate values confirmed this structure. The effect size was used to calculate the cut-off points for the overall scale, setting them at scores of 130 and 135. CONCLUSION This instrument would allow to assess other constructs and dimensions not included in the instruments previously available such as treatment compliance, proactivity, resilience, hopelessness due to pain and pain catastrophizing. However, despite the fact that the preliminary analysis shows good results, it is necessary to continue with its validation process in subsequent studies. IMPACT The PAIN_Integral Scale© , once the validation process is finished, could be a complete enough instrument to allow a comprehensive healthcare assessment of Chronic Non-Cancer Pain's impact on daily nursing clinical practice and other healthcare professionals.
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Cáceres-Matos R, Gil-García E, Barrientos-Trigo S, Porcel-Gálvez AM, Cabrera-León A. Consequences of Chronic Non-Cancer Pain in adulthood. Scoping Review. Rev Saude Publica 2020; 54:39. [PMID: 32321056 PMCID: PMC7135143 DOI: 10.11606/s1518-8787.2020054001675] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 10/01/2019] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE To examine and map the consequences of chronic pain in adulthood. METHOD Documents addressing the impact of chronic pain on the psychological and social spheres of people suffering from chronic pain, published in Spanish and English between 2013 and 2018, were included. Those who addressed pharmacological treatments, chronic pain resulting from surgical interventions or who did not have access to the full text were excluded. Finally, 28 documents from the 485 reviewed were included RESULTS Studies show that pain is related to high rates of limitation in daily activities, sleep disorders and anxiety-depression spectrum disorders. People in pain have more problems to get the workday done and to maintain social relationships. Chronic pain is also associated with worse family functioning. CONCLUSIONS This review shows that limitations in the ability to perform activities of daily living, sleep, psychological health, social and work resources and family functioning are lines of interest in published articles. However, knowledge gaps are detected in areas such as the influence of having suffered pain in childhood or adolescence, the consequences of non-fulfillment of working hours and gender inequalities.
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Affiliation(s)
- Rocío Cáceres-Matos
- Universidad de Sevilla. Facultad de Enfermería, Fisioterapia y Podología. Departamento de Enfermería. Sevilla, España
| | - Eugenia Gil-García
- Universidad de Sevilla. Facultad de Enfermería, Fisioterapia y Podología. Departamento de Enfermería. Sevilla, España
| | - Sergio Barrientos-Trigo
- Universidad de Sevilla. Facultad de Enfermería, Fisioterapia y Podología. Departamento de Enfermería. Sevilla, España
| | - Ana María Porcel-Gálvez
- Universidad de Sevilla. Facultad de Enfermería, Fisioterapia y Podología. Departamento de Enfermería. Sevilla, España
| | - Andrés Cabrera-León
- Escuela Andaluza de Salud Pública. Granada, España.,Centro de Investigación Biomédica en Red de Salud Pública y Epidemiología (CIBERESP). Madrid, España.,Universidad de Granada. Instituto de Investigación Biosanitaria, ibs. Hospitales Universitarios de Granada. Granada, España
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Cáceres-Matos R, Gil-García E, Cabrera-León A, Porcel-Gálvez AM, Barrientos-Trigo S. Factors that Influence Coping with Chronic Noncancer Pain in European Countries: A Systematic Review of Measuring Instruments. Pain Manag Nurs 2020; 21:123-133. [DOI: 10.1016/j.pmn.2019.06.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 06/10/2019] [Accepted: 06/18/2019] [Indexed: 11/26/2022]
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Fagerström C, Elmståhl S, Wranker LS. Analyzing the situation of older family caregivers with a focus on health-related quality of life and pain: a cross-sectional cohort study. Health Qual Life Outcomes 2020; 18:79. [PMID: 32197633 PMCID: PMC7082916 DOI: 10.1186/s12955-020-01321-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 03/09/2020] [Indexed: 11/10/2022] Open
Abstract
Background For a significant proportion of the older population, increasing age is associated with health problems and worsening health. Older family caregivers are largely responsible for care of next-of-kin living at home, which impacts their own physical and mental health both positively and negatively. However, evidence is insufficient regarding the health situation of older caregivers. The aim of this study was to investigate health-related quality of life (HRQoL) and pain, and their associations, among caregivers aged ≥60 years. Methods The participants (n = 3444) were recruited from the Swedish National Study on Aging and Care-Blekinge and Good Aging in Skåne during 2001–2004. Participants aged ≥60 years were selected randomly and underwent cognitive tests, with demographic information obtained through questionnaires. The response rate was 60%. A predefined research protocol was used. HRQoL was measured with the Short-Form Health Survey, dimension mental health. Logistic regression models were used to investigate the associations between HRQoL and pain as well as control factors. Results Family caregiving was reported by 395 (11.5%) of the participants, and 56.7% of the caregivers reported pain. Family caregivers reported lower pain intensity on the Visual Analogue Scale and were younger, on median, than non-caregivers. Irrespective of caregiver status, pain was associated with mental HRQoL. Concerns about personal health and financial status had the strongest associations with mental HRQOL in both groups, but the levels were higher among caregivers. Conclusion Pain was one factor associated with low HRQoL regardless of family caregiver status and remained important when controlling for factors related to advanced age. This finding remained among family caregivers, though they reported lower pain intensity. Factors other than pain were shown to be important to mental HRQoL and should also be taken into consideration when discussing actions for family caregivers to maintain and improve health and HRQoL. Trial registration number Not applicable.
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Affiliation(s)
- Cecilia Fagerström
- Blekinge Center of Competence, Karlskrona, Sweden. .,Department of Health and Caring Science, Linnaeus University, Kalmar, Sweden.
| | - Sölve Elmståhl
- Division of Geriatric Medicine, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Lena Sandin Wranker
- Division of Geriatric Medicine, Department of Health Sciences, Lund University, Lund, Sweden
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Machado DR, Kimura M, Duarte YADO, Lebrão ML. [Violence perpetrated against the elderly and health-related quality of life: a populational study in the city of São Paulo, Brazil]. CIENCIA & SAUDE COLETIVA 2020; 25:1119-1128. [PMID: 32159679 DOI: 10.1590/1413-81232020253.19232018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2018] [Accepted: 07/28/2018] [Indexed: 11/21/2022] Open
Abstract
The scope of this work was to identify the prevalence of domestic violence against non-institutionalized elderly individuals, and to establish if violence is an independent factor associated with the Physical Component (PC) and Mental Component (MC) scores of the Health-Related Quality of Life (HRQOL) of these elderly individuals. It is a cross-sectional epidemiologic and population-based investigation that is part of the SABE (Wellbeing, Health and Aging) study. A sample of 1,126 elderly individuals filled out the Short-Form 12 (SF-12) Health Survey, namely a generic instrument that assesses HRQOL through the Physical and Mental components. The prevalence of domestic violence against of the elderly was 10% (CI 95% 9.1-13.6). In the multiple analyses, violence against the elderly was significantly associated to the MC (β = -3.03; p = 0.000) and to the PC (β = -1.69; p = 0.017) of HRQOL, independently of the sociodemographic, health, family support, and functional incapacity covariables. The prevalence of domestic violence was high and compromised the physical and mental health of the elderly.
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Affiliation(s)
- Daniel Rodrigues Machado
- Escola de Enfermagem, Universidade de São Paulo (USP). Av. Dr. Enéas Carvalho de Aguiar, Cerqueira César. 05403-000, São Paulo, SP, Brasil.
| | - Miako Kimura
- Escola de Enfermagem, Universidade de São Paulo (USP). Av. Dr. Enéas Carvalho de Aguiar, Cerqueira César. 05403-000, São Paulo, SP, Brasil.
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Shade MY, Herr K, Kupzyk K. Self-Reported Pain Interference and Analgesic Characteristics in Rural Older Adults. Pain Manag Nurs 2019; 20:232-238. [PMID: 31080145 DOI: 10.1016/j.pmn.2019.03.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 03/05/2019] [Accepted: 03/06/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Pain impacts the lives of millions of community-dwelling older adults. An important characteristic of pain is "pain interference" which describes the influence of pain on function. A description of pain interference is limited in rural settings where the number of older adults is expected to increase, and health disparities exist. AIMS The purpose of this study was to describe pain interference and analgesic medication use, highlighting those that may be potentially inappropriate in a sample of rural community-dwelling older adults. DESIGN This secondary analysis was from a cross sectional study. SAMPLE AND SETTINGS Data were analyzed from a sample of 138 rural community-dwelling older adults. METHODS Statistical analyses were performed on demographics, health characteristics, pain interference, and potentially inappropriate analgesic medication data. RESULTS Pain interference with work activity was reported by 76% of older adults overall, with 23% reporting moderate and 4% extreme interference, and 41% reported sleep difficulty due to pain. Higher pain interference was significantly associated with higher body mass index, more health providers, and the daily use of non-steroidal anti-inflammatory drugs (NSAIDs). Older women experienced more sleep difficulties due to pain. Over-the-counter analgesics were used most frequently by rural older adults to manage pain. Of most risk was the daily use of NSAIDs, in which only 30% used medications to protect the gastrointestinal system. CONCLUSIONS Older adults in rural settings experience pain interference and participate in independent-medicating behaviors that may impact safety.
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Affiliation(s)
- Marcia Y Shade
- University of Nebraska Medical Center College of Nursing, Omaha, Nebraska; University of Iowa College of Nursing, Iowa City, Iowa.
| | - Keela Herr
- University of Iowa College of Nursing, Iowa City, Iowa
| | - Kevin Kupzyk
- University of Nebraska Medical Center College of Nursing, Omaha, Nebraska
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Robertson N, Gunn S, Piper R. Psychological and Social Factors Associated with Pain in Inflammatory Bowel Disease: A Systematic Literature Review of the Evidence in Adult and Pediatric Studies. CROHN'S & COLITIS 360 2019. [DOI: 10.1093/crocol/otz003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Pain is commonly experienced in both active and dormant inflammatory bowel disease (IBD). Psychological and social factors, which can be key to pain experience, have been relatively neglected; the only prior comprehensive review focused solely on studies of adults. The present review, therefore, sought to systematically examine relationships between pediatric and adult experience of pain and psychosocial variables.
Method
Systematic searches of 5 databases were conducted to identify studies including measures of pain and psychosocial variables, in pediatric or adult IBD populations. Quality appraisal of studies was undertaken using a qualified assessment tool.
Results
Twenty-three articles met the inclusion criteria. Ten examined relationships between pain and psychosocial variables in adults, and 13 examined in pediatric populations. Inverse relationships were identified between pain and quality of life (QOL) in both populations, with potential differences in pain localization between the two populations. Psychological distress, notably depression, was also important in both populations, with inconsistent evidence for a role for anxiety in pediatric samples. Specific coping styles, and familial responses to communications, also appeared relevant, but with weaker evidence. There was substantial heterogeneity in measures, statistical analyses and sample characteristics, and quality appraisal revealed methodological weaknesses.
Conclusions
Significant relationships were found between pain and various psychological indices, notably QOL and depression. However, most studies were underpowered, did not sufficiently control for key confounds, and almost exclusively reported on Western participants. Adequately powered, statistically sound studies encompassing diverse populations are required to further clarify relationships between pain and psychosocial variables in IBD.
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Affiliation(s)
- Noelle Robertson
- Neuroscience, Psychology and Behaviour, College of Life Sciences, University of Leicester, Leicester, UK
| | | | - Rebecca Piper
- Neuroscience, Psychology and Behaviour, College of Life Sciences, University of Leicester, Leicester, UK
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Gastrointestinal recall questionnaires compare poorly with prospective patient diaries for gastrointestinal symptoms: data from population and primary health centre samples. Eur J Gastroenterol Hepatol 2019; 31:163-169. [PMID: 30394943 DOI: 10.1097/meg.0000000000001296] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND Clinical understanding of gastrointestinal symptoms is commonly based on patient reports of symptom experience. For diagnosis and treatment choices to be appropriate, symptom reports need to be accurate. We examined the agreement between questionnaire recall and prospective diary enumeration of symptoms relevant to the irritable bowel syndrome. PATIENTS AND METHODS Data are reported from a randomly selected general population sample (n=238) and also a primary healthcare centre (PHC) sample (n=503, 10 PHCs). All the patients completed the questionnaires, which included Rome III-qualifying irritable bowel syndrome items and a stool and symptom diary over either 7 or 14 days. Agreement between retrospective questionnaire reports and prospective diaries was evaluated. RESULTS Concordance between questionnaires and diaries was highest for the simple construct of the occurrence of abdominal pain, although after adjusting for possible chance, agreement was only moderate in the general population sample. More complex constructs, such as pain relieved by defecation, yielded poorer concordance. In general, concordance was stronger among PHC respondents than in the general population sample. CONCLUSION Concordance between questionnaires and diaries was generally poor and related to the complexity of the symptom construct and the type of respondent. The information used to classify individuals based on patient self-report may be unreliable, and therefore, more effort is needed to develop data collection instruments.
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Cedraschi C, Ludwig C, Allaz AF, Herrmann FR, Luthy C. Pain and health-related quality of life (HRQoL): a national observational study in community-dwelling older adults. Eur Geriatr Med 2018; 9:881-889. [PMID: 34674476 DOI: 10.1007/s41999-018-0114-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 09/20/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE Regarding the epidemiology of pain in older adults, data are lacking about the association between pain severity and its impact on health-related quality of life (HRQoL). This study was aimed to investigate pain prevalence and sites, self-reported interferences with daily life activities, and the effect of pain severity on HRQoL in a Swiss community-dwelling population aged ≥ 65 years. METHODS This is a cross-sectional survey conducted with a national sample of individuals randomly selected from population records, stratified by age and gender. Respondents answered a face-face interview addressing pain location, intensity and interferences, and quality-of-life variables. Logit regression models were applied for binary outcomes, linear regression for continuous outcomes, and Poisson regression for count outcomes. For each analysis, Wald Chi square and 95% confidence intervals were used. RESULTS Among the 2995 individuals considered, 36.4% reported pain. The results indicate that pain prevalence and intensity increased from age 80 onwards. Pain intensity was strongly associated with functional health, i.e., all scales involving physical activities were affected in individuals reporting severe pain; it was also associated with the individuals' perception of their overall HRQoL. CONCLUSION Our results point to the importance of devoting attention to pain intensity rather than to the number of pain sites. Because of the demographic transition, the management of pain problems should emphasize early referral and timely treatment to prevent the burden of disease and functional loss associated with pain intensity.
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Affiliation(s)
- Christine Cedraschi
- Division of General Medical Rehabilitation, Geneva University Hospitals, University of Geneva, 4 Rue Gabrielle Perret-Gentil, 1211, Geneva 14, Switzerland. .,Division of Clinical Pharmacology and Toxicology, Multidisciplinary Pain Centre, Geneva University Hospitals, University of Geneva, 1211, Geneva 14, Switzerland.
| | - C Ludwig
- School of Health Sciences, Geneva, University of Applied Sciences and Arts of Western Switzerland, 1206, Geneva, Switzerland
| | - A F Allaz
- Division of General Medical Rehabilitation, Geneva University Hospitals, University of Geneva, 4 Rue Gabrielle Perret-Gentil, 1211, Geneva 14, Switzerland
| | - F R Herrmann
- Division of Geriatrics, Geneva University Hospitals, University of Geneva, 1226, Geneva, Switzerland
| | - C Luthy
- Division of General Medical Rehabilitation, Geneva University Hospitals, University of Geneva, 4 Rue Gabrielle Perret-Gentil, 1211, Geneva 14, Switzerland
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Wranker LS, Elmståhl S, Ekström H. Pain and alcohol: a comparison of two cohorts of 60 year old women and men: findings from the Good Aging in Skåne study. Scand J Pain 2018; 18:611-620. [PMID: 29995637 DOI: 10.1515/sjpain-2018-0064] [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] [Received: 04/02/2018] [Accepted: 06/16/2018] [Indexed: 11/15/2022]
Abstract
Background and aims Pain, use of painkillers and alcohol are highly prevalent in the general population. Aims of the study were to describe differences in pain, alcohol consumption and use of painkillers among two 60 year old birth cohorts stratified by gender. Methods Participants were recruited from the Skåne centre of The Swedish National study on Aging and Care, a multicentre, prospective, longitudinal study. The sample comprised 60 year old men and women born between 1941 and 1943 and recruited to the study between 2001 and 2004 (n=663) and 60 year old men and women born in the period 1952-1954 and recruited to the study between 2013 and 2015 (n=924). Specially trained research staff conducted the interviews. For descriptive statistics the variables were presented in total numbers, percentages, mean and standard deviation, and 1st and 3rd quartile are also shown. The sample was divided into four groups: men and women born in the period 1941-1943, men and women born in the period 1952-1954, respectively. Results No difference in alcohol intake was detected between the two birth cohorts. All participants, regardless of pain or not, reported alcohol use below the specified risk level for both sexes. Teetotallers were more common in the 1952-1954 male cohort, 128 (29%), p<0.029. Two hundred and eighty one Men born between 1952 and 1954 reported pain (59.0%), compared to 173 men born between 1941 and 1943 (51.6%), p<0.034. There was no difference between the male cohorts in use of painkillers, p<0.062. No difference was found between the two female cohorts in terms of pain, p<0.144. One hundred and ten women in the 1941-43 cohort used painkillers (53.1%) compared to 119 women born between 1952 and 1954 (40.1%), p<0.004. When comparing men and women with pain born between 1941 and 1942, men with moderate pain use more alcohol, 157 g/month (q1 10, q3 365) than women, 44 g/month (q1 0, q3 134), p<0.001. Men with severe pain also use more alcohol, 96 g/month (q1 17, q3 324) than women, 27 g/month (q1 0, q1 118), p<0.030, and when those with pain were merged into a group, men use more alcohol, 175 g/month (q1 31, q3 356), than women, 68 g/month (q1 1, q3 207), p<0.001. This also applies to the later cohort; men, 132 g/month (q1 22, q3 270), compared to women, 76 g/month (q1 8, q3 182), p<0.001. When merging all pain into one group women use more painkillers both in the 1941-43 cohort, men (39.9%) compared to women (53.1%), p<0.010 and in the 1952-54 cohort, men (18.5%) compared to women (26.6%), p<0.003. Use of analgesics and alcohol is common but the highest percentage is among women born between 1941 and 1943, 45 (48.9%). Conclusions Pain and alcohol use are common among 60 year old women and men. A gender difference is that women use more painkillers. In the 1941-43 cohort almost every second woman with moderate pain who took painkillers also consumed alcohol. Implications It is time to alert prescribers that a large section of the population uses alcohol combined with painkillers. More research is needed to better understand the long-term perspective on health when using both painkillers and alcohol.
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Affiliation(s)
- Lena Sandin Wranker
- Department of Health Sciences, Division of Geriatric Medicine, Lund University, Lund, Sweden
| | - Sölve Elmståhl
- Department of Clinical Sciences, Division of Geriatric Medicine, Lund University, Lund, Sweden
| | - Henrik Ekström
- Department of Clinical Sciences, Division of Geriatric Medicine, Lund University, Lund, Sweden
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Thibaut A, Zafonte R, Morse LR, Fregni F. Understanding Negative Results in tDCS Research: The Importance of Neural Targeting and Cortical Engagement. Front Neurosci 2017; 11:707. [PMID: 29311787 PMCID: PMC5732989 DOI: 10.3389/fnins.2017.00707] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 12/01/2017] [Indexed: 12/14/2022] Open
Affiliation(s)
- Aurore Thibaut
- Department of Physical Medicine and Rehabilitation, Neuromodulation Center, Spaulding Rehabilitation Hospital, Harvard Medical School, Harvard University, Boston, MA, United States.,Coma Science Group, GIGA-Consciousness, University Hospital of Liege, University of Liege, Liege, Belgium
| | - Ross Zafonte
- Spaulding-Harvard SCI Model System Center, Spaulding Rehabilitation Hospital, Boston, MA, United States.,Massachusetts General Hospital, Harvard Medical School, Harvard University, Boston, MA, United States.,Brigham and Women's Hospital, Harvard Medical School, Harvard University, Boston, MA, United States
| | - Leslie R Morse
- Spaulding-Harvard SCI Model System Center, Spaulding Rehabilitation Hospital, Boston, MA, United States.,Rocky Mountain Regional Spinal Injury System, Craig Rehabilitation Hospital, Englewood, CO, United States.,Department of PMR, University of Colorado School of Medicine, University of Colorado, Aurora, CO, United States
| | - Felipe Fregni
- Department of Physical Medicine and Rehabilitation, Neuromodulation Center, Spaulding Rehabilitation Hospital, Harvard Medical School, Harvard University, Boston, MA, United States.,Spaulding-Harvard SCI Model System Center, Spaulding Rehabilitation Hospital, Boston, MA, United States
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14
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A grounded theory of attitudes towards online psychological pain management interventions in chronic pain patients. COMPUTERS IN HUMAN BEHAVIOR 2017. [DOI: 10.1016/j.chb.2017.07.034] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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15
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Everyday Health among Older People: A Comparison between Two Countries with Variant Life Conditions. J Aging Res 2017; 2017:2720942. [PMID: 28875042 PMCID: PMC5569869 DOI: 10.1155/2017/2720942] [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: 03/24/2017] [Revised: 07/09/2017] [Accepted: 07/11/2017] [Indexed: 11/25/2022] Open
Abstract
This study described health factors of importance for everyday health, such as pain, tiredness, and sleeping problems, in a cross-national context. Data for persons 60+ years were obtained from the Poverty and Health in Aging study, Bangladesh, and the Swedish National Study on Aging and Care-Blekinge. The strongest associations with everyday health in Sweden were found for pain and tiredness, while in Bangladesh they were financial status, tiredness, and sleeping problems. As similarities were found regarding the associations of tiredness on everyday health, tiredness may be a universal predictor of everyday health in older adults irrespective of country context.
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Hellström A, Nilsson C, Nilsson A, Fagerström C. Leg ulcers in older people: a national study addressing variation in diagnosis, pain and sleep disturbance. BMC Geriatr 2016; 16:25. [PMID: 26797291 PMCID: PMC4722676 DOI: 10.1186/s12877-016-0198-1] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Accepted: 01/12/2016] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Leg ulcers commonly emerge as a symptom of other comorbidities, often in older people. As a consequence of the ulcer, pain and sleep disturbances might occur. Due to the complex illness, the responsibility of treatment is unclear between health caregivers. The interaction between ulcer type, sleep and pain has not previously been investigated. This study aimed to explore pain in older men and women (65 years and older) with different diagnoses of leg ulcers and to investigate the associations of sleep disturbances and pain in people with leg ulcer diagnosis. METHODS The study used a cross-sectional design and data from the Swedish Registry of Ulcer Treatment, collected between May 2009 and December 2013. One thousand and eight hundred and twenty four people were included, and 62.9% were women. The mean age was 83.4 years (SD 8.8). For the analyses, the chi-square test, Mann-Whitney U-test, t-test, one-way ANOVA and logistic regression was performed. Pain was measured by the Numeric Rating Scale (NRS), and sleep disturbances was assessed dichotomously. RESULTS We found the prevalence of pain intensity ≥ 5 on the NRS to be 34.8% in those reporting pain. Additionally, the pain intensity was associated with the number of ulcers (p = 0.003). Sleep disturbances were associated with pain (p < 0.001) and were found in 34.8% of the total sample. Although more women than men reported pain and scored higher on the NRS, no significant gender difference in sleep disturbances was found (p = 0.606). The mean NRS scores did not differ significantly between the ulcer types; however, arterial and venous-arterial ulcers increased the risk of sleep disturbances, as did higher pain scores. CONCLUSIONS The majority of the participants were of advanced age (>80 years) and frequently suffered from pain and sleep disturbances. Further research is needed regarding pain, sleep and wound healing in the oldest old with leg ulcers. Ulcer pain sometimes appears to receive less attention in ulcer management, as do sleep disturbances, implying that individual needs might not be satisfactorily met. National guidelines in managing leg ulcers, which also consider consequences such as sleep disturbances, pain and discomfort, are needed.
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Affiliation(s)
- Amanda Hellström
- Department of Health and Care Sciences, Linnaeus University, Stagneliusg. 14, SE-392 34, Kalmar, Sweden.
| | | | | | - Cecilia Fagerström
- Blekinge Institute of Technology, Blekinge Centre of Competence, Karlskrona, Sweden.
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17
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Wranker LS, Rennemark M, Berglund J. Pain among older adults from a gender perspective: findings from the Swedish National Study on Aging and Care (SNAC-Blekinge). Scand J Public Health 2015; 44:258-63. [PMID: 26647094 DOI: 10.1177/1403494815618842] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND AIMS Pain is common in the elderly population and its prevalence varies according to the studied disease, clinical setting, sex and age. This study examines pain in an aging population from a gender perspective. METHODS The Swedish National study on Aging and Care (SNAC) is conducted at four research centres. Participants were recruited from the baseline sample (n=1402) at one of the research centres, SNAC-Blekinge. Individuals aged 60 years and older were included and non-participation was documented. Research personnel conducted the medical examination on two occasions. RESULTS The prevalence of pain was 769/1402 (54.8%), distributed as 496/817 (64.5%) women and 273/585 (35.5%) men,p<0.01. Women reported more pain located in the vertebral column,p<0.01. The most common pain location was the legs and feet. About 84% reported pain intensity as 4 or higher on the visual analogue scale (VAS). Pain intensity declines with age among men,p<0.01. The most frequent treatment was painkillers. A total of 128/263 (48.7%) of the men received no pain treatment compared with 177/478 (37.0%) of the women,p<0.01. In a multivariate logistic regression model, women yielded the highest OR [OR 1.94 (C.I. 1.51-2.49)] for pain. CONCLUSIONS Pain is common among older adults and there are significant differences between the sexes. Almost 55% of participants reported pain, predominantly women. In the majority of cases the intensity was rated as moderate or severe (VAS >4) and women rated higher than men p<002. Almost half of the men (48.7%) did not receive any treatment compared to 37% of the women, p<001.
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Affiliation(s)
- Lena Sandin Wranker
- Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden Department of Health Sciences, Division of Geriatric Medicine, Lund University, Sweden
| | | | - Johan Berglund
- Department of Health, Blekinge Institute of Technology, Karlskrona, Sweden
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18
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Ekdahl AW. The importance of studying personality traits and pain in the oldest adults. Scand J Pain 2015; 7:1-2. [DOI: 10.1016/j.sjpain.2014.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Anne W. Ekdahl
- Department of Geriatric Medicine , Vrinnevihospital and Karolinska Institutet, Division of clinical Geriatrics, Department of Neurobiology, Care Sciences and Society , Karlskrona , Sweden
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Breivik H. Low health related quality of life (QoL) in older adults is associated with chronic pain in women and with disturbed sleep in men. Scand J Pain 2014; 5:268-269. [PMID: 29913719 DOI: 10.1016/j.sjpain.2014.08.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Harald Breivik
- University of Oslo and Oslo University Hospital, Departments of Anaesthesiology and Pain Management and Research, Nydalen PB 4950, 0424 Oslo, Norway
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