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Sullivan MD, Wilson L, Amick M, Miller-Matero LR, Chrusciel T, Salas J, Zabel C, Lustman PJ, Ahmedani B, Carpenter RW, Scherrer JF. Social support and the association between post-traumatic stress disorder and risk for long-term prescription opioid use. Pain 2024; 165:2379-2386. [PMID: 38833573 PMCID: PMC11408094 DOI: 10.1097/j.pain.0000000000003286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 03/15/2024] [Indexed: 06/06/2024]
Abstract
ABSTRACT Post-traumatic stress disorder (PTSD) is common in patients with chronic pain, adversely affects chronic pain outcomes, and is associated with opioid use and adverse opioid outcomes. Social support is a robust predictor of PTSD incidence and course as well as chronic pain outcome. We determined whether the association between PTSD and persistent opioid use was modified by emotional support in a cohort of patients receiving opioids for noncancer pain. Eligible participants were ≥18 years and had completed a new period of prescription opioid use lasting 30 to 90 days. Bivariate associations between cohort characteristics and each key variable was assessed using χ 2 tests for categorical variables and t -tests for continuous variables. Interaction between PTSD and emotional support was assessed by a priori stratification on low vs high emotional support. Participants (n = 808) were 53.6 (SD ± 11.6) years of age, 69.8% female, 69.6% White, and 26.4% African American. Overall, 17.2% had probable PTSD. High emotional support was significantly ( P < 0.0001) more common among those without probable PTSD. Prescription opioid use at 6-month follow-up was significantly ( P = 0.0368) more common among patients with vs without probable PTSD. In fully adjusted models, PTSD was no longer associated with opioid use at 6-month follow-up among participants with high emotional support. Among those with lower emotional support, PTSD was significantly associated with opioid use at 6-month follow-up in unadjusted (odds ratio = 2.40; 95% confidence interval: 1.24-4.64) and adjusted models (odds ratio = 2.39; 95% confidence interval: 1.14-4.99). Results point to the hypothesis that improvement of emotional support in vulnerable patients with chronic pain and PTSD may help reduce sustained opioid use.
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Affiliation(s)
- Mark D Sullivan
- Department of Psychiatry and Behavioral Science, University of Washington School of Medicine, Seattle, WA, United States
| | - Lauren Wilson
- Department of Family and Community Medicine, Saint Louis University School of Medicine, St. Louis, MO, United States
| | - Matthew Amick
- Department of Family and Community Medicine, Saint Louis University School of Medicine, St. Louis, MO, United States
| | - Lisa R Miller-Matero
- Center for Health Policy and Health Services Research and Behavioral Health Services, Henry Ford Health, One Ford Place, Detroit, MI, United States
| | - Timothy Chrusciel
- Department of Family and Community Medicine, Saint Louis University School of Medicine, St. Louis, MO, United States
- Advanced HEAlth Data (AHEAD) Research Institute, Saint Louis University School of Medicine, St. Louis, MO, United States
- Department of Health and Clinical Outcomes Research, Saint Louis University School of Medicine, St. Louis, MO, United States
| | - Joanne Salas
- Department of Family and Community Medicine, Saint Louis University School of Medicine, St. Louis, MO, United States
- Advanced HEAlth Data (AHEAD) Research Institute, Saint Louis University School of Medicine, St. Louis, MO, United States
| | - Celeste Zabel
- Center for Health Policy and Health Services Research and Behavioral Health Services, Henry Ford Health, One Ford Place, Detroit, MI, United States
| | - Patrick J Lustman
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, United States
| | - Brian Ahmedani
- Center for Health Policy and Health Services Research and Behavioral Health Services, Henry Ford Health, One Ford Place, Detroit, MI, United States
| | - Ryan W Carpenter
- Department of Psychological Sciences, University of Missouri-St. Louis, St. Louis, MO, United States
| | - Jeffrey F Scherrer
- Department of Family and Community Medicine, Saint Louis University School of Medicine, St. Louis, MO, United States
- Advanced HEAlth Data (AHEAD) Research Institute, Saint Louis University School of Medicine, St. Louis, MO, United States
- Department of Psychiatry and Behavioral Neuroscience, Saint Louis University School of Medicine, St. Louis, MO, United States
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2
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Lyu C. Relations between perceived social support and prosocial behavior among Chinese college students during online learning: Testing mediation and moderation models of meaning in life. Heliyon 2024; 10:e37677. [PMID: 39323776 PMCID: PMC11422598 DOI: 10.1016/j.heliyon.2024.e37677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 08/28/2024] [Accepted: 09/08/2024] [Indexed: 09/27/2024] Open
Abstract
Base the protective role of perceived social support and meaning in life, the function of meaning in life as a mediator and moderator of perceived social support and prosocial behavior among Chinese college students enrolled in online learning was examined in this study. This survey was completed by 459 college students in total (Mean age = 19.65, SD = 1.21). The results shown that Chinese college students' perceived social support and prosocial behavior during online learning were significant lower than normal offline learning, but meaning in life was no significant difference. Perceived social support, prosocial behavior and meaning in life were all positive correlated with each other. The relationship between perceived social support and prosocial behavior was mediated and moderated by meaning in life. These findings enrich the research on prosocial behavior among college students by examining possible pathways linking factors associated to prosocial behavior during online learning. The findings suggest the need to promote prosocial behavior development through cultivate perceived social support and meaning in life among college students.
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Affiliation(s)
- Chunwei Lyu
- School of Educational Studies, Universiti Sains Malaysia, Penang, 11800, Malaysia
- School of Humanities and International Education, Baotou Medical College, Baotou, 014040, China
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3
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Monroe KS, Archer KR, Wegener ST, Dionicio P, Arredondo EM, Ayala GX, Rodriguez C, Van Dyke J, Liu J, Gombatto SP. Use of Intervention Mapping to Adapt a Psychologically Informed Physical Therapy Telerehabilitation Intervention for Latino Persons with Chronic Spine Pain. THE JOURNAL OF PAIN 2024:104685. [PMID: 39326719 DOI: 10.1016/j.jpain.2024.104685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 08/02/2024] [Accepted: 09/18/2024] [Indexed: 09/28/2024]
Abstract
The need for culturally tailored pain care is well recognized yet few studies report how existing interventions can be adapted to the needs of culturally and linguistically diverse (CALD) populations. This report describes a formative mixed methods approach using Intervention Mapping-Adapt (IM-Adapt) and the expanded Framework for Reporting Adaptations and Modifications to Evidence based interventions (FRAME) to adapt and report modifications of an existing physical therapy intervention for Latino persons with chronic spine pain in Federally Qualified Health clinics in the southwestern United States (US). Mixed methods included literature reviews, patient surveys, an Adaptation Advisory Panel, and sequential case series with semi-structured interviews. Six steps of IM-Adapt guided the adaptation process and adaptations were prospectively documented with FRAME. A needs assessment revealed an absence of culturally tailored physical therapy interventions for Latino persons with chronic spine pain in the US. An intervention logic model and review of the sociocultural context guided selection of essential interventions, determinants of behavior change, and outcomes. An existing Cognitive Behavioral based Physical Therapy (CBPT) telerehabilitation intervention was selected for adaptation based on accessibility and strong congruency with the logic model. An Adaptation Advisory Panel planned and evaluated iterative adaptations of the CBPT intervention content, activities, delivery, materials, and design. The adapted Goal Oriented Activity for Latino persons with Spine pain (GOALS/Metas) intervention aimed to reduce pain intensity and disability through patient-centered goal setting in physical and cognitive treatment domains. Sequential case series supported feasibility and acceptability of the adapted intervention in the target population. PERSPECTIVE: We describe the systematic adaptation and reporting of an evidence-based physical therapy intervention for culturally and linguistically diverse populations. Greater rigor and transparency in adapting evidence-based interventions using tools such as IM-Adapt and FRAME in future studies will accelerate efforts to reduce ethnic and racial disparities in pain rehabilitation.
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Affiliation(s)
- Katrina S Monroe
- School of Physical Therapy, College of Health and Human Services, San Diego State University, 5500 Campanile Dr., San Diego, CA, 92182, USA.
| | - Kristin R Archer
- Department of Orthopaedic Surgery, Center for Musculoskeletal Research and Department of Physical Medicine and Rehabilitation, Osher Center for Integrative Health, Vanderbilt University Medical Center, 2525 West End Avenue, Suite 1216, Nashville, TN, 37203, USA.
| | - Stephen T Wegener
- Department of Physical Medicine and Rehabilitation, The Johns Hopkins University School of Medicine, 1800 Orleans Street, Baltimore, MD 21287, USA.
| | - Patricia Dionicio
- San Diego State University/University of California, San Diego Joint Doctoral Program in Public Health, 5500 Campanile Dr., San Diego, CA, 92182, USA.
| | - Elva M Arredondo
- Department of Psychology, Institute for Behavioral and Community Health and San Diego State University HealthLINK Center, 9245 Sky Park Court, Suite 221 San Diego, CA 92123, USA.
| | - Guadalupe X Ayala
- Division of Health Promotion and Behavioral Science, School of Public Health, San Diego State University Institute for Behavioral and Community Health and San Diego State University HealthLINK Center, 9245 Sky Park Court, Suite 221 San Diego, CA 92123, USA.
| | | | | | - Jie Liu
- Family Health Centers of San Diego, San Diego, CA, USA.
| | - Sara P Gombatto
- School of Physical Therapy, College of Health and Human Services, San Diego State University, 5500 Campanile Dr., San Diego, CA, 92182, USA.
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4
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Monroe KS, Archer KR, Wegener ST, Gombatto SP. Psychologically Informed Physical Therapy Management of Chronic Musculoskeletal Pain in Culturally Diverse Populations: An Intervention Logic Model. THE JOURNAL OF PAIN 2024:104684. [PMID: 39326720 DOI: 10.1016/j.jpain.2024.104684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 08/02/2024] [Accepted: 09/18/2024] [Indexed: 09/28/2024]
Abstract
Culturally and linguistically diverse (CALD) individuals are underrepresented in pain research, including studies of psychologically informed physical therapy (PIPT) for musculoskeletal pain. This perspective describes a conceptual framework for PIPT management of chronic musculoskeletal pain that identifies essential elements which can be culturally tailored to meet the needs of different CALD populations. Essential interventions, determinants of behavior change, and clinical outcomes were identified from studies of existing PIPT interventions for chronic pain. PIPT approaches shared the following essential interventions: (1) cognitive skill training, (2) general aerobic activity, (3) impairment-based therapeutic exercises, and (4) graded functional movement training. An intervention logic model was developed to conceptualize how these interventions might promote active coping behaviors and greater engagement in physical activity, therapeutic exercise, and functional mobility. The model included physical and cognitive-emotional processes that may contribute to behavioral changes which ultimately reduce pain-related disability. To illustrate cultural tailoring of model constructs, we describe how intervention delivery and assessments were customized for Latino persons with chronic spine pain at a health center located near the United States (US)-Mexico border. A literature review of sociocultural influences on the pain experience of Latino persons was conducted, and essential elements of the model were operationalized to ensure that therapeutic goals, language, content, and processes were compatible with Latino cultural beliefs, values, and behaviors. Future research using the proposed model to adapt and test PIPT interventions for other CALD populations may help identify shared and divergent mechanisms of treatment response for culturally tailored pain management programs. PERSPECTIVE: A novel conceptual framework may help inform cultural tailoring of psychologically informed physical therapy management approaches for chronic musculoskeletal pain by maintaining fidelity to essential treatment elements while also leveraging the unique sociocultural context of different culturally and linguistically diverse communities to improve health outcomes.
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Affiliation(s)
- Katrina S Monroe
- School of Physical Therapy, College of Health and Human Services, San Diego State University, 5500 Campanile Dr., San Diego, CA, 92182, USA.
| | - Kristin R Archer
- Department of Orthopaedic Surgery, Center for Musculoskeletal Research and Department of Physical Medicine and Rehabilitation, Osher Center for Integrative Health, Vanderbilt University Medical Center, 2525 West End Avenue, Suite 1216, Nashville, TN, 37203, USA.
| | - Stephen T Wegener
- Department of Physical Medicine and Rehabilitation, The Johns Hopkins University School of Medicine, 1800 Orleans Street, Baltimore, MD 21287, USA.
| | - Sara P Gombatto
- School of Physical Therapy, College of Health and Human Services, San Diego State University, 5500 Campanile Dr., San Diego, CA, 92182, USA.
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5
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Chen CX, Rogers SK, Li R, Hinrichs RJ, Fortenberry JD, Carpenter JS. Social Determinants of Health and Dysmenorrhea: A Systematic Review. THE JOURNAL OF PAIN 2024; 25:104574. [PMID: 38788887 PMCID: PMC11347097 DOI: 10.1016/j.jpain.2024.104574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 05/14/2024] [Accepted: 05/16/2024] [Indexed: 05/26/2024]
Abstract
Social determinants of health play a key role in health disparities. Dysmenorrhea is a highly prevalent and impactful public health problem affecting reproductive-age females. Systematically examining social determinants of health (SDoH) in dysmenorrhea is important for identifying gaps in the literature and informing research, policy, and clinical practice to reduce the public health burden associated with dysmenorrhea. The purpose of this systematic review was to synthesize the literature on SDoH and dysmenorrhea. The review protocol was prospectively registered. We searched Medline, EMBASE, CINAHL, PsycINFO, Scopus, and Google Scholar through February 2024 using search strategies informed by the literature. Screening of the articles, data extraction, and risk-of-bias (RoB) assessment were conducted independently by at least 2 reviewers on the Covidence platform. Among 2,594 unique records screened, 166 met eligibility criteria and were included for data extraction and RoB assessment. Evidence suggests traumatic experiences, toxic environmental exposures, female genital mutilation, job-related stress, lack of menstrual education, and low social support were associated with worse dysmenorrhea outcomes. However, evidence was equivocal regarding the relationships between dysmenorrhea outcomes and SDoH factors, including socioeconomic status, geographical location, race/ethnicity, employment, and religion. Nearly all articles (99.4%) had a high or very high overall RoB. The relationships between SDoH and dysmenorrhea outcomes were often inconsistent and complicated by heterogeneous study populations and methodologies. More rigorous research examining SDoH in dysmenorrhea is needed to inform policy and clinical practice. PERSPECTIVE: This systematic review synthesizes evidence linking SDoH and dysmenorrhea. The relationships between SDoH and dysmenorrhea were often equivocal and complicated by heterogeneous study populations and methodologies. We identify directions for future research and SDoH factors that could be addressed clinically (eg, trauma, menstrual education, and occupational stress).
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Affiliation(s)
- Chen X Chen
- Indiana University School of Nursing, Indianapolis, Indiana.
| | - Sarah K Rogers
- Department of Psychology, School of Science, Indiana University Purdue University-Indianapolis, Indianapolis, Indiana
| | - Rui Li
- Seattle Children's Research Institute, Seattle, Washington; Department of Anesthesiology and Pain Medicine, School of Medicine, University of Washington, Seattle, Washington
| | - Rachel J Hinrichs
- Indiana University Indianapolis, University Library, Indianapolis, Indiana
| | - J Dennis Fortenberry
- Department of Pediatrics, Indiana University School of Medicine, Indianapolis, Indiana
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6
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Van Alboom M, Baert F, Bernardes SF, Verhofstadt L, Bracke P, Jia M, Musial K, Gabrys B, Goubert L. Examining the Role of Structural and Functional Social Network Characteristics in the Context of Chronic Pain: An Ego-centered Network Design. THE JOURNAL OF PAIN 2024; 25:104525. [PMID: 38609026 DOI: 10.1016/j.jpain.2024.104525] [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: 10/20/2023] [Revised: 03/27/2024] [Accepted: 04/01/2024] [Indexed: 04/14/2024]
Abstract
The well-being and functioning of individuals with chronic pain (CP) vary significantly. Social factors, such as social integration, may help explain this differential impact. Specifically, structural (network size, density) as well as functional (perceived social support, conflict) social network characteristics may play a role. However, it is not yet clear whether and how these variables are associated with each other. Objectives were to examine 1) both social network characteristics in individuals with primary and secondary CP, 2) the association between structural network characteristics and mental distress and functioning/participation in daily life, and 3) whether the network's functionality mediated the association between structural network characteristics and mental distress, respectively, functioning/participation in daily life. Using an online ego-centered social network tool, cross-sectional data were collected from 303 individuals with CP (81.85% women). No significant differences between individuals with fibromyalgia versus secondary CP were found regarding network size and density. In contrast, ANCOVA models showed lower levels of perceived social support and higher levels of conflict in primary (vs secondary) CP. Structural equation models showed that 1) larger network size indirectly predicted lower mental distress via lower levels of conflict; 2) higher network density increased mental distress via the increase of conflict levels. Network size or density did not (in)directly predict functioning/participation in daily life. The findings highlight that the role of conflict, in addition to support, should not be underestimated as a mediator for mental well-being. Research on explanatory mechanisms for associations between the network's structure, functionality, and well-being is warranted. PERSPECTIVE: This paper presents results on associations between structural (network size, density) and functional (social support, conflict) social network characteristics and well-being in the context of CP by making use of an ego-centered network design. Results suggest an indirect association between structural network characteristics and individuals with CP their mental well-being.
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Affiliation(s)
- Maité Van Alboom
- Faculty of Psychology and Educational Sciences, Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium.
| | - Fleur Baert
- Faculty of Psychology and Educational Sciences, Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Sónia F Bernardes
- Department of Social and Organizational Psychology, School of Social Sciences and Humanities, ISCTE - University Institute of Lisbon, Lisboa, Portugal
| | - Lesley Verhofstadt
- Faculty of Psychology and Educational Sciences, Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Piet Bracke
- Faculty of Political and Social Sciences, Department of Sociology, Ghent University, Ghent, Belgium
| | - Mingshan Jia
- Faculty of Engineering, University of Technology Sydney, Sydney, Australia
| | - Katarzyna Musial
- Faculty of Engineering, University of Technology Sydney, Sydney, Australia
| | - Bogdan Gabrys
- Faculty of Engineering, University of Technology Sydney, Sydney, Australia
| | - Liesbet Goubert
- Faculty of Psychology and Educational Sciences, Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium
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7
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Mauersberger H, Springer A, Fotopoulou A, Blaison C, Hess U. Pet dogs succeed where human companions fail: The presence of pet dogs reduces pain. Acta Psychol (Amst) 2024; 249:104418. [PMID: 39153318 DOI: 10.1016/j.actpsy.2024.104418] [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: 03/16/2024] [Revised: 07/03/2024] [Accepted: 07/17/2024] [Indexed: 08/19/2024] Open
Abstract
Social support from family and friends, albeit associated with beneficial health effects, does not always help to cope with pain. This may be because humans elicit mixed expectations of social support and evaluative judgment. The present studies aimed to test whether pet dogs are a more beneficial source of support in a painful situation than human companions because they are not evaluative. For this, 74 (Study 1) and 50 (Study 2) women completed a cold-pressor task in the presence of either their own (S1) or an unfamiliar (S2) dog, a friend (S1), or an unknown human companion (S2), or alone. In both studies, participants reported less pain and exhibited less pain behavior in the presence of dogs compared to human companions. Reactions to pain were moderated by attitudes towards dogs in S2. This suggests that pet dogs may help individuals to cope with painful situations, especially if the individual in pain generally feels affectionate towards dogs.
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Affiliation(s)
| | - Anne Springer
- Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital of Basel, Basel, Switzerland
| | - Aikaterini Fotopoulou
- Research Department of Clinical, Educational, and Health Psychology, University College London, London, United Kingdom
| | | | - Ursula Hess
- Department of Psychology, Humboldt-University, Berlin, Germany
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8
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Borthwick C, Penlington C, Robinson L. Associations Between Adult Attachment, Pain Catastrophizing, Psychological Inflexibility and Disability in Adults with Chronic Pain. J Clin Psychol Med Settings 2024; 31:571-584. [PMID: 38180697 DOI: 10.1007/s10880-023-09989-7] [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: 11/20/2023] [Indexed: 01/06/2024]
Abstract
We investigated whether attachment insecurity (anxiety and avoidance) moderated the association between satisfaction with social support and pain disability. We also tested whether the relationship between insecure attachment and pain disability was serially mediated by pain catastrophising and psychological inflexibility. A large-scale cross-sectional correlational design was employed. Data were collected using an online survey. Correlation, serial mediation and moderated regression analyses were used. Data from 894 people with self-reported chronic pain were analysed. Based on correlations, age, depression, and pain intensity were included as covariates. No direct effect of satisfaction with social support on pain disability was observed in the moderation. Attachment anxiety was positively associated with pain disability (b = 1.20, t = 2.03, p < .05), but attachment avoidance was not (b = -0.08, t = -0.13, p = .90). The association between attachment anxiety and pain disability was partially mediated by pain catastrophising and psychological inflexibility (c = 1.21, t = 4.37, p < .001; a1db2 = 0.33, t = 5.15, p < .001). The relationship between attachment avoidance and pain disability was fully mediated by pain catastrophising and psychological inflexibility (c = 0.15, t = 0.54, p = .59; a1db2 = 0.13, t = 2.24, p < .05). This study provided initial evidence that pain catastrophising and psychological inflexibility mediate the association between insecure attachment and pain disability. Follow-up research using a longitudinal design is recommended.
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Affiliation(s)
- Claire Borthwick
- School of Psychology, Newcastle University, 4th Floor, Dame Margaret Barbour Building, Wallace Street, Newcastle Upon Tyne, NE2 4DR, UK.
| | - Chris Penlington
- School of Dental Sciences, Newcastle University, Newcastle Upon Tyne, UK
| | - Lucy Robinson
- School of Psychology, Newcastle University, 4th Floor, Dame Margaret Barbour Building, Wallace Street, Newcastle Upon Tyne, NE2 4DR, UK
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Borthwick C, Penlington C, Robinson L. Partners' Experiences of Chronic Pain: A Qualitative Evidence Synthesis. J Clin Psychol Med Settings 2024; 31:585-606. [PMID: 38615080 DOI: 10.1007/s10880-024-10012-w] [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: 02/27/2024] [Indexed: 04/15/2024]
Abstract
This systematic review of qualitative studies synthesised evidence on the experience chronic pain from the perspective of romantic partners. Medline via Ovid, Embase via Ovid, CINAHL via EBSCO, APA PsycInfo via Ovid, Scopus, and Web of Science databases were searched. Studies exploring the impact of chronic pain from partners' perspectives using qualitative data collection methods were eligible for inclusion. Thematic synthesis was conducted, and confidence in the review findings was assessed using GRADE CERQual criteria. A total of 198 participants were represented from 15 primary studies. Four interconnected analytical themes were developed: 'life is different', 'internal conflict between two worlds', 'togetherness vs separateness', and 'coping in the longer term'. Out of 27 review findings, 9 were assessed as high confidence, 12 as moderate confidence, 4 as low confidence, and 2 as very low confidence. Socially isolated partners, those in strained relationships, and partners who continually sacrificed their own needs were more likely to experience distressing emotions. Greater recognition of partners' needs is needed within pain management services.
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Affiliation(s)
- Claire Borthwick
- School of Psychology, Newcastle University, 4th Floor, Dame Margaret Barbour Building, Wallace Street, Newcastle upon Tyne, NE2 4DR, UK.
| | - Chris Penlington
- School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Lucy Robinson
- School of Psychology, Newcastle University, 4th Floor, Dame Margaret Barbour Building, Wallace Street, Newcastle upon Tyne, NE2 4DR, UK
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10
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Weiß M, Jachnik A, Lampe EC, Gründahl M, Harnik M, Sommer C, Rittner HL, Hein G. Differential effects of everyday-life social support on chronic pain. BMC Neurol 2024; 24:301. [PMID: 39198777 PMCID: PMC11351827 DOI: 10.1186/s12883-024-03792-z] [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: 06/10/2024] [Accepted: 08/02/2024] [Indexed: 09/01/2024] Open
Abstract
BACKGROUND Social support is a multidimensional construct encompassing emotional support as well as pain-focused care and attention, also known as solicitous support. One the one hand, social support is widely believed to positively influence pain symptoms, their intensity, and the ability to cope and influence pain. On the other hand, social support can be negative if it conflicts with the patient's needs or even causes discomfort. How different types of social support influence pain is not very well understood especially because most of the present research originates from laboratory studies, raising uncertainties about its generalizability to the everyday life of individuals with chronic pain. METHODS Here, we tested the effects of emotional, solicitous, and negative social support on pain intensity cross-sectionally in everyday life. We collected data from 20 patients with acute complex regional pain syndrome using a smartphone-based Ecological Momentary Assessment with up to 30 survey prompts over a period of five consecutive days. RESULTS Our results showed that solicitous social support decreased pain, in particular in male patients. Emotional support was beneficial on pain in women but not in men. CONCLUSIONS Taken together, these findings highlight the differential effects of social support in every-day life on chronic pain.
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Affiliation(s)
- Martin Weiß
- Center of Mental Health, Department of Psychiatry, Psychosomatic and Psychotherapy, Translational Social Neuroscience Unit, University Hospital Würzburg, Margarete-Höppel-Platz 1, 97080, Würzburg, Germany.
- Department of Psychology I: Clinical Psychology and Psychotherapy, Institute of Psychology, University of Würzburg, Würzburg, Germany.
| | - Annalena Jachnik
- Center of Mental Health, Department of Psychiatry, Psychosomatic and Psychotherapy, Translational Social Neuroscience Unit, University Hospital Würzburg, Margarete-Höppel-Platz 1, 97080, Würzburg, Germany
| | - Emilia C Lampe
- Center of Mental Health, Department of Psychiatry, Psychosomatic and Psychotherapy, Translational Social Neuroscience Unit, University Hospital Würzburg, Margarete-Höppel-Platz 1, 97080, Würzburg, Germany
| | - Marthe Gründahl
- Center of Mental Health, Department of Psychiatry, Psychosomatic and Psychotherapy, Translational Social Neuroscience Unit, University Hospital Würzburg, Margarete-Höppel-Platz 1, 97080, Würzburg, Germany
| | - Michael Harnik
- Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, Centre for Interdisciplinary Medicine, University Hospital Würzburg, Würzburg, Germany
- Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Claudia Sommer
- Department of Neurology, University Hospital Würzburg, Würzburg, Germany
| | - Heike L Rittner
- Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, Centre for Interdisciplinary Medicine, University Hospital Würzburg, Würzburg, Germany
| | - Grit Hein
- Center of Mental Health, Department of Psychiatry, Psychosomatic and Psychotherapy, Translational Social Neuroscience Unit, University Hospital Würzburg, Margarete-Höppel-Platz 1, 97080, Würzburg, Germany
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11
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Cordero D. The healing others: the essential role of social support on chronic pain management. Korean J Pain 2024; 37:280-282. [PMID: 38946698 PMCID: PMC11220379 DOI: 10.3344/kjp.24158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Revised: 06/05/2024] [Accepted: 06/10/2024] [Indexed: 07/02/2024] Open
Affiliation(s)
- Dalmacito Cordero
- Department of Theology and Religious Education, De La Salle University, Manila, Philippines
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12
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Woods SB, Roberson PNE, Booker Q, Wood BL, Booker SQ. Longitudinal Associations of Family Relationship Quality With Chronic Pain Incidence and Persistence Among Aging African Americans. J Gerontol B Psychol Sci Soc Sci 2024; 79:gbae064. [PMID: 38767217 PMCID: PMC11161900 DOI: 10.1093/geronb/gbae064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Indexed: 05/22/2024] Open
Abstract
OBJECTIVES This study examines how family relationships convey risk or resilience for pain outcomes for aging African Americans, and to replicate and extend analyses across 2 nationally representative studies of aging health. METHODS African American participants in Midlife in the United States (MIDUS, N = 755) and the Health and Retirement Study (HRS, N = 2,585) self-reported chronic pain status at 2006 waves and then again 10 years later. Logistic regression was used to estimate the odds of pain incidence and persistence explained by family, intimate partner, and parent-child strain and support, as well as average support and average strain across relationships. RESULTS On average, MIDUS participants were younger (M = 52.35, SD = 12.06; 62.1% female) than HRS (M = 66.65, SD = 10.92; 63.7% female). Family support and average support were linked to decreased odds of pain incidence in MIDUS, but only when tested without accounting for strain, whereas parent-child strain was a risk factor for pain incidence in HRS, as was average strain. Family support protected against pain persistence in MIDUS, whereas average support was linked to reduced odds of pain persisting in HRS. DISCUSSION Chronic pain outcomes are worse for African Americans for a number of reasons, but parent-child strain may contribute to the risk of new pain developing over time for older adults. Conversely, family support may offer a protective benefit for pain incidence and persistence among aging African Americans. Findings implicate family relationships as a potential target of pain management interventions.
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Affiliation(s)
- Sarah B Woods
- Department of Family and Community Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | | | - Quiera Booker
- Department of Family and Community Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Beatrice L Wood
- Departments of Psychiatry and Pediatrics, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
| | - Staja Q Booker
- Department of Biobehavioral Nursing Science, College of Nursing, University of Florida, Gainesville, Florida, USA
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Krahé C, Koukoutsakis A, Fotopoulou A. Updating beliefs about pain following advice: Trustworthiness of social advice predicts pain expectations and experience. Cognition 2024; 246:105756. [PMID: 38442585 PMCID: PMC7616089 DOI: 10.1016/j.cognition.2024.105756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 02/09/2024] [Accepted: 02/20/2024] [Indexed: 03/07/2024]
Abstract
Prior expectations influence pain experience. These expectations, in turn, rely on prior pain experience, but they may also be socially influenced. Yet, most research has focused on self rather than social expectations about pain, and hardly any studies examined their combined effects on pain. Here, we adopted a Bayesian learning perspective to investigate how explicitly communicated social expectations ('advice about pain tolerance') affect own pain expectations, and ultimately pain tolerance, under varying conditions of social epistemic uncertainty (trustworthiness of the advice). N = 72 female participants took part in a coldpressor (cold water) task before (self-learning baseline) and after (socially-influenced learning) receiving advice about their likely pain tolerance from a confederate, the trustworthiness of whom was experimentally manipulated. We used path analysis to test the hypothesis that social advice from a highly trustworthy confederate would influence participants' expectations about pain more than advice from a less trustworthy source, and that the degree of this social influence would in turn predict pain tolerance. We further used a simplified, Bayesian learning, computational approach for explicit belief updating to examine the role of latent parameters of precision optimisation in how participants subsequently changed their future pain expectations (prospective posterior beliefs) based on the combined effect of the confederate's advice on their own pain expectations, and their own task experience. Results confirmed that participants adjusted their pain expectations towards the confederate's advice more in the high- vs. low-trustworthiness condition, and this advice taking predicted their pain tolerance. Furthermore, the confederate's trustworthiness influenced how participants weighted the confederate's advice in relation to their own expectations and task experience in forming prospective posterior beliefs. When participants received advice from a less trustworthy confederate, their own sensory experience was weighted more highly than their socially-influenced prior expectations. Thus, explicit social advice appears to impact pain by influencing one's own pain expectations, but low social trustworthiness leads to these expectations becoming more malleable to novel, sensory learning.
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Affiliation(s)
- Charlotte Krahé
- Department of Psychology, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom.
| | - Athanasios Koukoutsakis
- Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
| | - Aikaterini Fotopoulou
- Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
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14
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Weiß M, Gründahl M, Jachnik A, Lampe EC, Malik I, Rittner HL, Sommer C, Hein G. The Effect of Everyday-Life Social Contact on Pain. J Med Internet Res 2024; 26:e53830. [PMID: 38687594 PMCID: PMC11094601 DOI: 10.2196/53830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 02/01/2024] [Accepted: 03/13/2024] [Indexed: 05/02/2024] Open
Abstract
Pain is a biopsychosocial phenomenon, resulting from the interplay between physiological and psychological processes and social factors. Given that humans constantly interact with others, the effect of social factors is particularly relevant. Documenting the significance of the social modulation of pain, an increasing number of studies have investigated the effect of social contact on subjective pain intensity and pain-related physiological changes. While evidence suggests that social contact can alleviate pain, contradictory findings indicate an increase in pain intensity and a deterioration of pain coping strategies. This evidence primarily stems from studies examining the effect of social contact on pain within highly controlled laboratory conditions. Moreover, pain assessments often rely on one-time subjective reports of average pain intensity across a predefined period. Ecological momentary assessments (EMAs) can circumvent these problems, as they can capture diverse aspects of behavior and experiences multiple times a day, in real time, with high resolution, and within naturalistic and ecologically valid settings. These multiple measures allow for the examination of fluctuations of pain symptoms throughout the day in relation to affective, cognitive, behavioral, and social factors. In this opinion paper, we review the current state and future relevance of EMA-based social pain research in daily life. Specifically, we examine whether everyday-life social support reduces or enhances pain. The first part of the paper provides a comprehensive overview of the use of EMA in pain research and summarizes the main findings. The review of the relatively limited number of existing EMA studies shows that the association between pain and social contact in everyday life depends on numerous factors, including pain syndromes, temporal dynamics, the nature of social interactions, and characteristics of the interaction partners. In line with laboratory research, there is evidence that everyday-life social contact can alleviate, but also intensify pain, depending on the type of social support. Everyday-life emotional support seems to reduce pain, while extensive solicitous support was found to have opposite effects. Moreover, positive short-term effects of social support can be overshadowed by other symptoms such as fatigue. Overall, gathering and integrating experiences from a patient's social environment can offer valuable insights. These insights can help interpret dynamics in pain intensity and accompanying symptoms such as depression or fatigue. We conclude that factors determining the reducing versus enhancing effects of social contact on pain need to be investigated more thoroughly. We advocate EMA as the assessment method of the future and highlight open questions that should be addressed in future EMA studies on pain and the potential of ecological momentary interventions for pain treatment.
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Affiliation(s)
- Martin Weiß
- University Hospital Würzburg, Center of Mental Health, Department of Psychiatry, Psychosomatic and Psychotherapy, Translational Social Neuroscience Unit, Würzburg, Germany
| | - Marthe Gründahl
- University Hospital Würzburg, Center of Mental Health, Department of Psychiatry, Psychosomatic and Psychotherapy, Translational Social Neuroscience Unit, Würzburg, Germany
| | - Annalena Jachnik
- University Hospital Würzburg, Center of Mental Health, Department of Psychiatry, Psychosomatic and Psychotherapy, Translational Social Neuroscience Unit, Würzburg, Germany
| | - Emilia Caya Lampe
- University Hospital Würzburg, Center of Mental Health, Department of Psychiatry, Psychosomatic and Psychotherapy, Translational Social Neuroscience Unit, Würzburg, Germany
| | - Ishitaa Malik
- University Hospital Würzburg, Center of Mental Health, Department of Psychiatry, Psychosomatic and Psychotherapy, Translational Social Neuroscience Unit, Würzburg, Germany
| | - Heike Lydia Rittner
- University Hospital Würzburg, Center for Interdisciplinary Medicine, Department of Anaesthesiology, Intensive Care, Emergency and Pain Medicine, Würzburg, Germany
| | - Claudia Sommer
- University Hospital Würzburg, Department of Neurology, Würzburg, Germany
| | - Grit Hein
- University Hospital Würzburg, Center of Mental Health, Department of Psychiatry, Psychosomatic and Psychotherapy, Translational Social Neuroscience Unit, Würzburg, Germany
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McNaughton DT, Roseen EJ, Downie A, Jenkins H, Øverås CK, Young JJ, Fink HA, Stone KL, Cawthon P, Hartvigsen J. Stressful life events and low back pain in older men: A cross-sectional and prospective analysis using data from the MrOS study. Eur J Pain 2024; 28:263-272. [PMID: 37632158 PMCID: PMC10841215 DOI: 10.1002/ejp.2174] [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: 05/12/2023] [Revised: 07/17/2023] [Accepted: 08/09/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND Stressful life events, such as loss of a partner, loss of a pet or financial problems, are more common with increasing age and may impact the experience of pain. The aim of the current study is to determine the cross-sectional and prospective association between stressful life events and low back pain reporting in the Osteoporotic Fracture in Men Study, a cohort of older men aged ≥65 years. METHODS At a study visit (March 2005-May 2006), 5149 men reported whether they had experienced a stressful life event or low back pain in the prior 12 months. Following that visit, data on low back pain patients were gathered through triannual questionnaires every 4 months for 1 year. Multivariable logistic regression analyses estimated the association of stressful life events with recent past low back pain or future low back pain. RESULTS N = 2930, (57%) men reported at least one stressful life event. The presence of a stressful life event was associated with greater odds of any low back pain (OR = 1.42 [1.26-1.59]) and activity-limiting low back pain (OR = 1.74 [1.50-2.01]) in the same period and of any low back pain (OR = 1.56 [1.39-1.74]) and frequent low back pain (OR = 1.80 [1.55-2.08]) in the following year. CONCLUSION In this cohort of men, the presence of stressful life events increased the likelihood of reporting past and future low back pain. SIGNIFICANCE Stressful life events such as accident or illness to a partner are common in later life and may impact the experience of pain. We present cross-sectional and prospective data highlighting a consistent association between stressful life events and low back pain in older men. Further, there is evidence to suggest that this relationship is upregulated by an individual's living situation. This information may be used to strengthen a biopsychosocial perspective of an individual's pain experience.
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Affiliation(s)
- David T McNaughton
- School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Eric J Roseen
- Section of General Internal Medicine, Department of Medicine, Boston University Chobanian & Avedision School of Medicine and Boston Medical Center, Boston, Massachusetts, USA
| | - Aron Downie
- Department of Chiropractic, Macquarie University, Sydney, Australia
| | - Hazel Jenkins
- Department of Chiropractic, Macquarie University, Sydney, Australia
| | - Cecilie K Øverås
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Center for Muscle and Joint Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Justin J Young
- Center for Muscle and Joint Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Schroeder Arthritis Institute, Krembil Research Institute, University Health Network, Toronto, Canada
| | - Howard A Fink
- Geriatric Research Education and Clinical Center, Veterans Affairs Health Care System, Minneapolis, Minnesota, USA
| | - Katie L Stone
- Research Institute, San Francisco, California, USA
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
| | - Peggy Cawthon
- Research Institute, San Francisco, California, USA
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
| | - Jan Hartvigsen
- Center for Muscle and Joint Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Chiropractic Knowledge Hub, Odense, Denmark
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Yang Y, Cui M, Zhao X, Wang S, Wang Y, Wang X. Cancer pain intensity and perceived social support in palliative care: 1-week prospective study. BMJ Support Palliat Care 2024; 13:e894-e897. [PMID: 37402542 PMCID: PMC10850825 DOI: 10.1136/spcare-2023-004236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 06/08/2023] [Indexed: 07/06/2023]
Abstract
OBJECTIVES Pain is a complex and multidimensional experience affected by psychosocial factors. Perceived social support (PSS) has been considered as a positive psychosocial resource for effective regulation of cancer patients' well-being. Our study examined the relationship between PSS and pain intensity under 1-week palliative care. METHODS A prospective study was conducted of terminal cancer inpatients (N=84) recruited from the hospice ward. Pain intensity was assessed on admission and 1 week later, and patients completed self-report questionnaires assessing PSS at admission. The repeated designed analysis of variance was used to explore the correlate of PSS with cancer pain. RESULTS Pain intensity decreased after 1 week (t=2.303, p=0.024), and 47.62% gained pain relief. For pain intensity, there was a significant PSS group×time interaction effect detected (F=4.544, p=0.036). Pain intensity in the high PSS group was significantly reduced 1 week later (p=0.008), while the change of pain intensity was not significant in the low PSS group (p=0.609). CONCLUSIONS PSS at admission predicted the 1-week development of pain intensity. Identifying PSS of terminal cancer patients leads to early interventions that are more effective in improving pain management of palliative care.
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Affiliation(s)
- Yilong Yang
- Department of Health Policy and Management, School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Meng Cui
- Hospice Ward, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Xinxin Zhao
- Hospice Ward, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Simeng Wang
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, China
| | - Yumei Wang
- Hospice Ward, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Xiaohe Wang
- Department of Health Policy and Management, School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang, China
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17
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Kang Y, Trewern L, Jackman J, Irani Nee Soni A, McCartney D. Chronic pain: supported self-management. BMJ 2024; 384:e072362. [PMID: 38167273 DOI: 10.1136/bmj-2022-072362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Affiliation(s)
| | - Louise Trewern
- British Pain Society (patient author)
- Physiotherapy Pain Association
- Get-Involved-Evolving Through Patient Experience Committee at Torbay Hospital Pain Service
- Live Well With Pain
| | - John Jackman
- Oxford University Hospitals NHS Foundation Trust, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences
| | - Anushka Irani Nee Soni
- Division of Rheumatology, Mayo Clinic Florida
- FMRIB Pain Analgesia/Anaesthesia Imaging Neuroscience group
| | - David McCartney
- Oxford City Practice
- Medical Sciences Division, University of Oxford
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18
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Lountzi AZ, Durand H. Help-seeking experiences and intimate partner support in vulvodynia: A qualitative exploration. WOMEN'S HEALTH (LONDON, ENGLAND) 2024; 20:17455057241241866. [PMID: 38554074 PMCID: PMC10981854 DOI: 10.1177/17455057241241866] [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: 11/13/2023] [Revised: 02/20/2024] [Accepted: 03/07/2024] [Indexed: 04/01/2024]
Abstract
BACKGROUND Vulvodynia is a poorly understood chronic pain condition characterized by persistent and unexplained pain in the vulva. Given the intimate nature of the pain, partners may play an important role in promoting self-management and help-seeking behaviours among women with vulvodynia. OBJECTIVES The current study aimed to explore the role of partner support in pain experiences and help-seeking behaviours among women with vulvodynia. DESIGN A qualitative interpretive design was used. METHODS Ten women with vulvodynia (M age = 37.9 years) were interviewed using a semi-structured non-directive topic guide. Data were analysed using reflexive thematic analysis. RESULTS Three themes around help-seeking experiences were constructed from the data: (1) 'It's Been a Battle' - Failed by the Healthcare System; (2) 'It's Just the Vulva' - Dismissed by Healthcare Professionals; and (3) 'I Diagnosed Myself' - The Patient Becomes the Expert. Participants described negative help-seeking experiences characterized by long delays to diagnosis, lack of awareness and understanding from healthcare professionals, minimization of symptoms, and having to advocate for and demand care. A further three themes pertaining to partner support were also developed: (1) 'That Person to Listen to You' - Source of Emotional Support; (2) 'Why Don't You Try This?' - Finding Solutions Together; and (3) 'He Forgets that it's Still There' - Vulvodynia is a Foreign Concept. Partners provided emotional support and showed empathy and understanding, and practical support by accompanying women to medical appointments and help with pain management. However, participants felt partners' understanding of vulvodynia was limited and that this impacted their relationships. CONCLUSIONS Findings highlight a lack of continuity of care and multidisciplinary approach to treatment, with help-seeking experiences being mainly negative in this sample. Increasing public awareness of vulvodynia and improving healthcare access is crucial to improving physical and psychological outcomes for this group. Partners can play an important role in supporting people with vulvodynia; however, other outlets of support should be further explored.
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Affiliation(s)
- Athina Zoi Lountzi
- Division of Psychology, Faculty of Natural Sciences, University of Stirling, Stirling, UK
| | - Hannah Durand
- Division of Psychology, Faculty of Natural Sciences, University of Stirling, Stirling, UK
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19
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Martín Pérez SE, Martín Pérez IM, Álvarez Sánchez A, Acosta Pérez P, Rodríguez Alayón E. Social support in low-income women with Fibromyalgia Syndrome from a sub-urban and peri-urban areas of Tenerife (Canary Islands, Spain): a mixed method study. J Patient Rep Outcomes 2023; 7:135. [PMID: 38129366 PMCID: PMC10739654 DOI: 10.1186/s41687-023-00661-0] [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: 07/06/2023] [Accepted: 11/15/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Women with Fibromyalgia Syndrome (FMS) can benefit form adequate social support to fight the consequences of their illness, but the extent to which this is available to those with low incomes who live in depressed areas of Tenerife (Canary Islands, Spain) is currently unknown. The purpose of this study was to explore social support in low-incomes women with FMS in sub-urban and peri-urban areas of Tenerife. METHODOLOGY A sequential exploratory mixed method study was carried out from January 20, 2023, to June 10, 2023, at the Fibromyalgia and Chronic Fatigue Association of Tenerife (AFITEN) using non-probability convenience sampling. Social support was analyzed quantitatively through MOS-SSS survey and Duke-UNC-11 questionnaire, while qualitative data were obtained through semi-structured interviews to identify social support providers and analyze their satisfactions levels. RESULTS A total of 49 women, with a mean age of 57.80 years-old (SD = 13.25) were finally included in this study. MOSS-SSS and Duke-UNC-11 both indicated lower social support levels at 68.6 (SD =16.3) and 38.0 (SD = 9.74), respectively. The qualitative analysis revealed that partners and friends provided the most significant support with the highest satisfaction scores. CONCLUSIONS The socioeconomic status of low-income women with FMS living in sub-urban and peri-urban areas of Tenerife (Canary Islands, Spain) influences on their social support, with the affective support and confidentiality being the most affected dimensions.
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Affiliation(s)
- Sebastian Eustaquio Martín Pérez
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Health Sciences, Universidad Europea de Canarias, Santa Cruz de Tenerife, 38300, Spain.
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, 28670, Spain.
- Escuela de Doctorado y Estudios de Posgrado, Universidad de La Laguna, Santa Cruz de Tenerife, 38203, Spain.
| | - Isidro Miguel Martín Pérez
- Escuela de Doctorado y Estudios de Posgrado, Universidad de La Laguna, Santa Cruz de Tenerife, 38203, Spain.
- Departamento de Farmacología y Medicina Física, Área de Radiología y Medicina Física, Facultad de Ciencias de la Salud, Universidad de La Laguna, Santa Cruz de Tenerife, 38200, Spain.
| | - Ania Álvarez Sánchez
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, 28670, Spain
| | - Paula Acosta Pérez
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, 28670, Spain
| | - Eliana Rodríguez Alayón
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Sport Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, 28670, Spain
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20
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Chang AH, Almagor O, Lee J(J, Song J, Muhammad LN, Chmiel JS, Moisio KC, Sharma L. The Natural History of Knee Osteoarthritis Pain Experience and Risk Profiles. THE JOURNAL OF PAIN 2023; 24:2175-2185. [PMID: 37442402 PMCID: PMC10782816 DOI: 10.1016/j.jpain.2023.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 06/28/2023] [Accepted: 07/01/2023] [Indexed: 07/15/2023]
Abstract
The study aimed to characterize the natural history of the pain experience, concurrently considering intermittent and constant pain over 4 years, and determine baseline factors associated with unfavorable trajectories in individuals with chronic knee pain. The Osteoarthritis Initiative (OAI) is a prospective, observational study of people with or at higher risk for knee osteoarthritis. The Intermittent and Constant Osteoarthritis Pain (ICOAP) was assessed annually at 48-to-96-month OAI visits. Twenty-eight baseline sociodemographic, knee-specific, and health-related characteristics were assessed. Group-based dual-trajectory modeling identified pain experience patterns indicated by ICOAP intermittent and constant pain scores over 4 years. Multivariable multinomial logistic regression models determined baseline factors associated with membership in each dual-trajectory group. Four longitudinal pain experience patterns were identified (n = 3,584, mean age = 64.8 [standard deviation 9.0] years, BMI = 28.6 [5.0] kg/m2; 57.9% women). Group 1 (37.7%) had minimal intermittent and no constant pain; Group 2 (35.1%) had mild intermittent and no constant pain; Group 3 (18.5%) had mild intermittent and low-grade constant pain; and Group 4 (8.7%) had moderate intermittent and constant pain. Baseline widespread pain, knee stiffness, back pain, hip pain, ankle pain, obesity, depressive symptoms, more advanced radiographic disease, and analgesic use were each associated with an increased risk of membership in less favorable Groups 2, 3, and 4. These distinct courses of pain experience may be driven by different underlying pain mechanisms. The benchmarked ICOAP scores could be used to stratify patients and tailor management. Addressing and preventing the development of modifiable risks (eg, widespread pain and knee joint stiffness) may reduce the chance of belonging to unfavorable dual-trajectory groups. PERSPECTIVE: Concurrently tracking intermittent versus constant pain experience, group-based dual-trajectory modeling identified 4 distinct pain experience patterns over 4 years. The benchmarked ICOAP scores in these dual trajectories could aid in stratifying patients for tailored management strategies and intensity of care.
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Affiliation(s)
- Alison H. Chang
- Department of Physical Therapy and Human Movement Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Orit Almagor
- Division of Rheumatology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Jungwha (Julia) Lee
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Jing Song
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Lutfiyya N. Muhammad
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Joan S. Chmiel
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Kirsten C. Moisio
- Department of Physical Therapy and Human Movement Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Leena Sharma
- Division of Rheumatology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Barr GA, Opendak M, Perry RE, Sarro E, Sullivan RM. Infant pain vs. pain with parental suppression: Immediate and enduring impact on brain, pain and affect. PLoS One 2023; 18:e0290871. [PMID: 37972112 PMCID: PMC10653509 DOI: 10.1371/journal.pone.0290871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 08/18/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND In the short term, parental presence while a human infant is in pain buffers the immediate pain responses, although emerging evidence suggests repeated social buffering of pain may have untoward long-term effects. METHODS/FINDING To explore the short- and long-term impacts of social buffering of pain, we first measured the infant rat pup's [postnatal day (PN) 8, or 12] response to mild tail shock with the mother present compared to shock alone or no shock. Shock with the mother reduced pain-related behavioral activation and USVs of pups at both ages and reduced Fos expression in the periaqueductal gray, hypothalamic paraventricular nucleus, and the amygdala at PN12 only. At PN12, shock with the mother compared to shock alone differentially regulated expression of several hundred genes related to G-protein-coupled receptors (GPCRs) and neural development, whereas PN8 pups showed a less robust and less coherent expression pattern. In a second set of experiments, pups were exposed to daily repeated Shock-mother pairings (or controls) at PN5-9 or PN10-14 (during and after pain sensitive period, respectively) and long-term outcome assessed in adults. Shock+mother pairing at PN5-9 reduced adult carrageenan-induced thermal hyperalgesia and reduced Fos expression, but PN10-14 pairings had minimal impact. The effect of infant treatment on adult affective behavior showed a complex treatment by age dependent effect. Adult social behavior was decreased following Shock+mother pairings at both PN5-9 and PN10-14, whereas shock alone had no effect. Adult fear responses to a predator odor were decreased only by PN10-14 treatment and the infant Shock alone and Shock+mother did not differ. CONCLUSIONS/SIGNIFICANCE Overall, integrating these results into our understanding of long-term programming by repeated infant pain experiences, the data suggest that pain experienced within a social context impacts infant neurobehavioral responses and initiates an altered developmental trajectory of pain and affect processing that diverges from experiencing pain alone.
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Affiliation(s)
- Gordon A. Barr
- Department of Anesthesiology and Critical Care Medicine, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, United States of America
- Perelman School of Medicine at the University of Pennsylvania, Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Maya Opendak
- Child Study Center, Center for Early Childhood Health & Development, Child & Adolescent Psychiatry, New York University School of Medicine, New York, New York, United States of America
- Emotional Brain Institute, Nathan Kline Institute, Orangeburg, New York, United States of America
| | - Rosemarie E. Perry
- Child Study Center, Center for Early Childhood Health & Development, Child & Adolescent Psychiatry, New York University School of Medicine, New York, New York, United States of America
- Emotional Brain Institute, Nathan Kline Institute, Orangeburg, New York, United States of America
| | - Emma Sarro
- Child Study Center, Center for Early Childhood Health & Development, Child & Adolescent Psychiatry, New York University School of Medicine, New York, New York, United States of America
- Emotional Brain Institute, Nathan Kline Institute, Orangeburg, New York, United States of America
| | - Regina M. Sullivan
- Child Study Center, Center for Early Childhood Health & Development, Child & Adolescent Psychiatry, New York University School of Medicine, New York, New York, United States of America
- Emotional Brain Institute, Nathan Kline Institute, Orangeburg, New York, United States of America
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Franqueiro AR, Yoon J, Crago MA, Curiel M, Wilson JM. The Interconnection Between Social Support and Emotional Distress Among Individuals with Chronic Pain: A Narrative Review. Psychol Res Behav Manag 2023; 16:4389-4399. [PMID: 37915959 PMCID: PMC10617401 DOI: 10.2147/prbm.s410606] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 10/21/2023] [Indexed: 11/03/2023] Open
Abstract
Chronic pain is a public health concern affecting over 100 million U.S. adults. Because chronic pain is multifactorial, it requires a biopsychosocial approach to understand how biological, psychological, and social factors contribute to both the development and maintenance of pain. On average, individuals with chronic pain report higher levels of emotional distress compared to pain-free individuals. Research has demonstrated that social support is associated with better pain outcomes and less emotional distress. It has been proposed that social support may improve pain outcomes by reducing the influence of stressors. However, the majority of research exploring the relationships between social support and pain-related outcomes has focused on the direct relationship between these variables, largely overlooking the process by which social support has a positive influence on pain. This narrative review synthesizes research on how chronic pain, emotional distress, and social support are highly interconnected, yet research investigating chronic pain and emotional distress within a social context is limited. We then highlight disparities in chronic pain, such that the burden of chronic pain is unequal between demographic groups. Next, we discuss existing evidence for the use of group-based interventions to address pain-related outcomes. Lastly, we summarize limitations of prior research studies and highlight gaps in the current literature. Overall, longitudinal research comprehensively investigating the distinct nuances in the measurement of social support and how these nuances relate to emotional distress and pain outcomes is needed and may provide insight into the unique needs of individuals or subgroups. Further, demographically diverse randomized controlled trials are needed to identify the process by which group-based interventions improve pain outcomes and whether these interventions are more effective for particular groups in order to personalize treatment approaches and address inequities in pain care.
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Affiliation(s)
- Angelina R Franqueiro
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Boston, MA, 02115, USA
| | - JiHee Yoon
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Boston, MA, 02115, USA
| | - Madelyn A Crago
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Boston, MA, 02115, USA
| | - Marie Curiel
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Boston, MA, 02115, USA
| | - Jenna M Wilson
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Boston, MA, 02115, USA
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Gombatto SP, Archer KR, Wegener ST, Hernandez Y, Lin SF, Godino J, Van Dyke J, Liu J, Monroe KS. Protocol for a Parallel Group Randomized Clinical Trial Comparing a Culturally Adapted Cognitive Behavioral Telerehabilitation Intervention to Usual Physical Therapy for Latino Patients With Chronic Spine Pain. Phys Ther 2023; 103:pzad068. [PMID: 37364033 PMCID: PMC10492001 DOI: 10.1093/ptj/pzad068] [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: 10/26/2022] [Revised: 02/24/2023] [Accepted: 05/03/2023] [Indexed: 06/28/2023]
Abstract
OBJECTIVE Disparities exist in health care access, diagnosis, and treatment of chronic pain in Latino populations and other minority populations. Cognitive behavioral-based physical therapy (CBPT) interventions have been shown to be effective in predominantly non-Hispanic white populations with chronic spine pain. However, there is a need for culturally adapted CBPT interventions that focus on the conservative management of chronic spine pain. The primary purpose of the study described in this protocol is to test the efficacy of an adapted cognitive behavioral-based hybrid telerehabilitation intervention for Latino patients with chronic spine pain. METHODS A single-blind, 2-arm parallel group, superiority randomized clinical trial is planned to compare an adapted CBPT intervention to Usual Care physical therapy. Goal Oriented Activity for Latinos with chronic Spine pain (GOALS/Metas) is an 8-week hybrid telerehabilitation intervention that integrates guideline-based physical therapy and pain management interventions using cognitive behavioral approaches and has been adapted for Latino patients with chronic spine pain. Usual Care physical therapy will be administered based on institutional standards at the referring health center. Outcome measures will be evaluated preintervention and at 1-week, 3-months, and 6-months postintervention. The primary outcome is pain-related disability 1-week postintervention using the Brief Pain Inventory Pain Interference subscale. Secondary outcome measures include behavioral measures of functional activity, social participation, physical activity, and sleep. Determinants of treatment effect, including pain-related psychological measures, posture and movement, self-efficacy, treatment expectancy, and therapeutic alliance, will be included in the secondary moderation and mediation analyses. IMPACT This clinical trial will provide information on the extent to which an adapted CBPT hybrid telerehabilitation intervention is effective in reducing pain-related disability for Latino patients with chronic spine pain. This information will be useful for clinicians to integrate in their practice, given the growing population of Latino patients who experience disparities in health care management of chronic pain.
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Affiliation(s)
- Sara P Gombatto
- Doctor of Physical Therapy Program, Department of Exercise and Nutritional Sciences, San Diego State University, San Diego, California, USA
- SDSU HealthLINK Center for Transdisciplinary Health Disparities Research, San Diego, California, USA
| | - Kristin R Archer
- Orthopaedic Surgery and Physical Medicine and Rehabilitation, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Stephen T Wegener
- Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, Maryland, USA
| | - Yessenia Hernandez
- SDSU HealthLINK Center for Transdisciplinary Health Disparities Research, San Diego, California, USA
| | - Shih-Fan Lin
- SDSU HealthLINK Center for Transdisciplinary Health Disparities Research, San Diego, California, USA
| | - Job Godino
- Laura Rodriguez Research Institute, Family Health Centers of San Diego, San Diego, California, USA
| | - Jason Van Dyke
- Laura Rodriguez Research Institute, Family Health Centers of San Diego, San Diego, California, USA
| | - Jie Liu
- Laura Rodriguez Research Institute, Family Health Centers of San Diego, San Diego, California, USA
| | - Katrina S Monroe
- Doctor of Physical Therapy Program, Department of Exercise and Nutritional Sciences, San Diego State University, San Diego, California, USA
- SDSU HealthLINK Center for Transdisciplinary Health Disparities Research, San Diego, California, USA
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24
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Geier TJ, Simske N, Melin S, Trevino C, Murphy P, Schroeder ME, Brandolino A, deRoon-Cassini T, Schramm AT. Psychiatric comorbidity in emergency general surgery patients: a prospective observational study. Trauma Surg Acute Care Open 2023; 8:e001117. [PMID: 37622160 PMCID: PMC10445363 DOI: 10.1136/tsaco-2023-001117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 08/04/2023] [Indexed: 08/26/2023] Open
Abstract
Objectives Annually, approximately 27 million individuals in the United States are admitted to hospitals for emergency general surgery (EGS). Approximately 50% develop postoperative complications and 22% require unplanned readmission within 90 days, highlighting a need to understand factors impacting well-being and recovery. Psychiatric comorbidity can impact medical treatment adherence, cost, and premature mortality risk. Despite the severity of illness in EGS, there is limited research on psychiatric comorbidity in EGS patients. Thus, the purpose of the current study was to characterize EGS patient mental health and to assess its relationship with pain, social support, and healthcare utilization (ie, length of stay, readmission). Methods Adult EGS patients were screened for participation during hospitalization. Inclusion criteria included: (1) 18 years or older, (2) communicate fluently in English, and (3) assessed within 7 days of admission. Participants (n=95) completed assessment, which included a structured clinical diagnostic interview. Record review captured medical variables, including length of stay, discharge disposition, narcotic prescription, and 90-day readmission rates. Results Ninety-five patients completed the assessment, and 31.6% met criteria for at least one current psychiatric diagnosis; 21.3% with a major depressive episode, 9.6% with a substance use disorder, and 7.5% with post-traumatic stress disorder (PTSD). Lower perceived social support and greater pain severity and interference were significantly related to more severe depression and anxiety. Depression was associated with longer length of stay, and those with PTSD were more likely to be re-admitted. Conclusion The EGS patient sample exhibited psychiatric disorder rates greater than the general public, particularly regarding depression and anxiety. Screening protocols and incorporation of psychological and social interventions may assist in recovery following EGS. Level of evidence Level II, prognostic.
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Affiliation(s)
- Timothy J Geier
- Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Natasha Simske
- Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Sarah Melin
- Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Colleen Trevino
- Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Patrick Murphy
- Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | | | - Amber Brandolino
- Comprehensive Injury Center, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Terri deRoon-Cassini
- Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
- Comprehensive Injury Center, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Andrew T Schramm
- Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
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Pinto AM, Luís M, Geenen R, Palavra F, Lumley MA, Ablin JN, Amris K, Branco J, Buskila D, Castelhano J, Castelo-Branco M, Crofford LJ, Fitzcharles MA, Häuser W, Kosek E, López-Solà M, Mease P, Marques TR, Jacobs JWG, Castilho P, da Silva JAP. Neurophysiological and Psychosocial Mechanisms of Fibromyalgia: A Comprehensive Review and Call for An Integrative Model. Neurosci Biobehav Rev 2023:105235. [PMID: 37207842 DOI: 10.1016/j.neubiorev.2023.105235] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 05/07/2023] [Accepted: 05/14/2023] [Indexed: 05/21/2023]
Abstract
Research into the neurobiological and psychosocial mechanisms involved in fibromyalgia has progressed remarkably in recent years. Despite this, current accounts of fibromyalgia fail to capture the complex, dynamic, and mutual crosstalk between neurophysiological and psychosocial domains. We conducted a comprehensive review of the existing literature in order to: a) synthesize current knowledge on fibromyalgia; b) explore and highlight multi-level links and pathways between different systems; and c) build bridges connecting disparate perspectives. An extensive panel of international experts in neurophysiological and psychosocial aspects of fibromyalgia discussed the collected evidence and progressively refined and conceptualized its interpretation. This work constitutes an essential step towards the development of a model capable of integrating the main factors implicated in fibromyalgia into a single, unified construct which appears indispensable to foster the understanding, assessment, and intervention for fibromyalgia.
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Affiliation(s)
- Ana Margarida Pinto
- University of Coimbra, Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences, Rua do Colégio Novo, s/n, 3000-115 Coimbra, Portugal; University of Coimbra, University Clinic of Rheumatology, Faculty of Medicine, Rua Larga - FMUC, Pólo I - Edifício Central, 3004-504 Coimbra, Portugal; University of Coimbra, Psychological Medicine Institute, Faculty of Medicine, Rua Larga - FMUC, Pólo I - Edifício Central, 3004-504 Coimbra, Portugal.
| | - Mariana Luís
- Rheumatology Department, Coimbra Hospital and University Centre, Praceta Mota Pinto, 3004-561 Coimbra, Portugal.
| | - Rinie Geenen
- Department of Psychology, Utrecht University, Martinus J. Langeveldgebouw, Heidelberglaan 1, 3584 CS Utrecht, the Netherlands; Altrecht Psychosomatic Medicine Eikenboom, Vrijbaan 2, 3705 WC Zeist, the Netherlands.
| | - Filipe Palavra
- Centre for Child Development, Neuropediatric Unit. Pediatric Hospital, Coimbra Hospital and University Centre, Avenida Afonso Romão, 3000-602 Coimbra, Portugal; Coimbra Institute for Clinical and Biomedical Research (i.CBR), Faculty of Medicine, University of Coimbra, Azinhaga Santa Comba, 3000-548 Coimbra, Portugal.
| | - Mark A Lumley
- Department of Psychology, Wayne State University, 5057 Woodward Ave., Suite 7908, Detroit, MI 48202, USA.
| | - Jacob N Ablin
- Internal Medicine H, Tel-Aviv Sourasky Medical Center, 6 Weizmann Street, Tel Aviv 6423906, Israel; Sackler School of Medicine, Tel Aviv University, Ramat Aviv 69978, Israel.
| | - Kirstine Amris
- The Parker Institute, Department of Rheumatology, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Nordre Fasanvej 57, 2000 Frederiksberg, Denmark.
| | - Jaime Branco
- Rheumatology Department, Egas Moniz Hospital - Lisboa Ocidental Hospital Centre (CHLO-EPE), R. da Junqueira 126, 1349-019 Lisbon, Portugal; Comprehensive Health Research Center (CHRC), Chronic Diseases Research Centre (CEDOC), NOVA Medical School, NOVA University Lisbon (NMS/UNL), Campo Mártires da Pátria 130, 1169-056 Lisbon, Portugal.
| | - Dan Buskila
- Ben Gurion University of the Negev Beer-Sheba, Israel.
| | - João Castelhano
- University of Coimbra, Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), ICNAS, Edifício do ICNAS, Polo 3, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal, Portugal.
| | - Miguel Castelo-Branco
- University of Coimbra, Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), ICNAS, Edifício do ICNAS, Polo 3, Azinhaga de Santa Comba, 3000-548 Coimbra, Portugal, Portugal.
| | - Leslie J Crofford
- Division of Rheumatology and Immunology, Department of Medicine, Vanderbilt University Medical Center, 1211 Medical Center Drive, Nashville, TN 37232, USA.
| | - Mary-Ann Fitzcharles
- Division of Rheumatology, Department of Medicine, McGill University, 1650 Cedar Ave, Montreal, Quebec, Canada, H3G 1A4.
| | - Winfried Häuser
- Department Psychosomatic Medicine and Psychotherapy, Technical University of Munich, Ismaninger Straße 22, 81675 Munich, Germany.
| | - Eva Kosek
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm 171 77, Sweden; Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
| | - Marina López-Solà
- Serra Hunter Programme, Department of Medicine and Health Sciences, University of Barcelona.
| | - Philip Mease
- Swedish Medical Center/Providence St. Joseph Health, Seattle, WA, USA; University of Washington School of Medicine, Seattle, WA, USA.
| | - Tiago Reis Marques
- Psychiatric Imaging Group, MRC London Institute of Medical Sciences (LMS), Hammersmith Hospital, Imperial College London, South Kensington, London SW7 2BU, UK; Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, Strand, London WC2R 2LS, UK.
| | - Johannes W G Jacobs
- Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, Netherlands.
| | - Paula Castilho
- University of Coimbra, Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences, Rua do Colégio Novo, s/n, 3000-115 Coimbra, Portugal.
| | - José A P da Silva
- University of Coimbra, University Clinic of Rheumatology, Faculty of Medicine, Rua Larga - FMUC, Pólo I - Edifício Central, 3004-504 Coimbra, Portugal; Rheumatology Department, Coimbra Hospital and University Centre, Praceta Mota Pinto, 3004-561 Coimbra, Portugal; Coimbra Institute for Clinical and Biomedical Research (i.CBR), Faculty of Medicine, University of Coimbra, Azinhaga Santa Comba, 3000-548 Coimbra, Portugal
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Bartley EJ, Makhoul M, Palit S, Robinson ME, Fillingim RB. Examining Physical and Cognitive Function in Chronic Low Back Pain Through the Use of a Multisystem Resilience Framework. PAIN MEDICINE (MALDEN, MASS.) 2023; 24:547-555. [PMID: 36269196 PMCID: PMC10406157 DOI: 10.1093/pm/pnac156] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 09/02/2022] [Accepted: 10/06/2022] [Indexed: 02/05/2023]
Abstract
OBJECTIVES Chronic pain results in significant impairment in older adults, yet some individuals maintain adaptive functioning. Limited research has considered the role of positive resources in promoting resilience among older adults. Likewise, these factors have largely been examined independently. We aimed to identify resilience domains based on biopsychosocial factors and explore whether resilience phenotypes vary across sleep disturbance, fatigue, and cognitive function. METHODS Sixty adults (ages ≥60 years) with chronic low back pain completed measures of psychological, health, and social functioning. On the basis of previously published analyses, principal-components analysis was conducted to create composite domains for these measures, followed by cluster analysis to identify phenotypes. RESULTS Four profiles emerged: Cluster 1, with high levels of psychosocial and health-related functioning; Cluster 2, with high health-related functioning and low psychosocial functioning; Cluster 3, with high psychosocial functioning and poorer health; and Cluster 4, with low levels of functioning across all domains. Significant differences across cluster membership emerged for sleep disturbance (ηp2 = 0.29), fatigue (ηp2 = 0.29), and cognitive abilities (ηp2 = 0.47). Individuals with the highest levels of resilience demonstrated more optimal outcomes in sleep and fatigue (P values ≤0.001) than did individuals with a less resilient phenotype. Furthermore, the High-Resilience group (Cluster 1) and the High Psychosocial / Low Health group (Cluster 3) had lower cognitive impairment than did the High Health / Low Psychosocial group (Cluster 2) and the Low-Resilience group (Cluster 4) (P values ≤0.009). CONCLUSIONS A higher array of protective resources could buffer against the negative sequelae associated with chronic low back pain. These exploratory findings support the multidimensional nature of resilience and suggest that targeting resilience from a multisystem perspective might help to optimize interventions for older adults with chronic pain.
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Affiliation(s)
- Emily J Bartley
- Correspondence to: Emily J. Bartley, PhD, Department of Community Dentistry and Behavioral Science, College of Dentistry, University of Florida, 1329 SW 16 St., Suite 5192, Gainesville, FL 32610, USA. Tel: 352-273-8934; Fax: 352-273-5985; E-mail:
| | - Melissa Makhoul
- Hariri School of Nursing, American University of Beirut, Beirut, Lebanon
| | - Shreela Palit
- Nemours Children’s Health, Center for Healthcare Delivery Science, Jacksonville, Florida, USA
| | - Michael E Robinson
- Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida, USA
| | - Roger B Fillingim
- Department of Community Dentistry and Behavioral Science, University of Florida, Gainesville, Florida, USA
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Badreldin N, Ditosto JD, Grobman WA, Yee LM. Maternal psychosocial factors associated with postpartum pain. Am J Obstet Gynecol MFM 2023; 5:100908. [PMID: 36809840 PMCID: PMC10121962 DOI: 10.1016/j.ajogmf.2023.100908] [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: 10/31/2022] [Revised: 02/06/2023] [Accepted: 02/15/2023] [Indexed: 02/22/2023]
Abstract
BACKGROUND The experience of pain is shaped by a host of psychological, cultural, and social factors. Although pain is the most common postpartum complaint, data on its relationship with psychosocial factors and postpartum pain are limited. OBJECTIVE This study aimed to examine the relationship between self-reported postpartum pain scores and patient-level psychosocial factors, including relationship status, pregnancy intendedness, employment, education, and psychiatric diagnosis. STUDY DESIGN This was a secondary analysis of data from a prospective observational study of postpartum patients at 1 institution (May 2017 to July 2019) who used an oral opioid at least once during their postpartum hospitalization. Enrolled participants completed a survey, which included questions regarding their social situation (including relationship status), psychiatric diagnoses, and perceptions of their pain control during their postpartum hospitalization. The primary outcome was self-reported overall pain during the postpartum hospitalization (score of 0-100). Multivariable analyses accounted for age, body mass index, nulliparity, and mode of delivery. RESULTS In this cohort of 494 postpartum patients, most patients (84.0%) underwent cesarean delivery, and 41.3% of patients were nulliparous. In a pain score of 0 to 100, participants reported a median pain score of 47. On bivariable analyses, there was no significant difference in pain score between patients with and without an unplanned pregnancy or a psychiatric diagnosis. Patients who were unpartnered, those without a college education, and those who were unemployed reported significantly higher pain scores (57.5 vs 44.8 [P<.01], 52.6 vs 44.6 [P<.01], and 53.6 vs 44.6 [P<.01], respectively). In multivariable analyses, patients who were unpartnered and unemployed reported significantly higher adjusted pain scores than patients who were partnered and employed (adjusted beta coefficients: 7.93 [95% confidence interval, 2.29-13.57] vs 6.67 [95% confidence interval, 2.28-11.05]). CONCLUSION Psychosocial factors, such as relationship and employment statuses, which are indicators of social support, are associated with the experience of pain postpartum. These findings suggest that addressing social support, such as via enhanced support from the health care team, warrants exploration as a nonpharmacologic means of improving the postpartum pain experience.
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Affiliation(s)
- Nevert Badreldin
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL (Dr Badreldin, Ms Ditosto, and Dr Yee).
| | - Julia D Ditosto
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL (Dr Badreldin, Ms Ditosto, and Dr Yee)
| | - William A Grobman
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, OH (Dr Grobman)
| | - Lynn M Yee
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL (Dr Badreldin, Ms Ditosto, and Dr Yee)
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28
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Kaplan J, Colgan DD, Klee D, Hanes D, Oken BS. Patterns of Respiration Rate Reactivity in Response to a Cognitive Stressor Associate With Self-Reported Mental Health Outcomes. Psychol Rep 2023:332941231171887. [PMID: 37083201 DOI: 10.1177/00332941231171887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Abstract
Many studies have examined physiological responses to acute stress in healthy and clinical populations. Some have documented exaggerated physiological stress reactivity in response to acute stress, while others have reported blunted physiological stress reactivity. Although the literature is conflicted, the relationship between abnormal physiological stress reactivity and negative outcomes is well-established. However, past research has neglected a critical aspect of physiological stress response - respiration - and it is unclear whether differences in respiration rate responses to acute stress are related to health outcomes. This secondary cross-sectional analysis explored differences in outcomes between three subgroups: blunted, moderate, and exaggerated respiration rate reactivity to an acute stress task. In a sample of at least mildly-stressed older adults (n = 55), we found that perceived stress (b = -7.63; p = .004) and depression (b = -9.13; p = .007) were significantly lower in the moderate reactivity group compared to the high reactivity group, and that self-reported mindfulness (b = 10.96; p = .008) was significantly lower in the moderate reactivity group as compared to the low reactivity group. Across outcomes, participants in the moderate range of physiological reactivity showed less negative and more positive psychological attributes and better health outcomes, while the blunted subgroup demonstrated more negative and less positive psychological attributes and worse health outcomes overall, when compared to the exaggerated and moderate groups. This study extends the literature by adding respiration to markers of acute physiological stress reactivity and demonstrating the effects of blunted respiration reactivity on negative psychological attributes and health outcomes.
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Affiliation(s)
- Josh Kaplan
- Oregon Health and Science University, Department of Neurology, Portland, OR, USA
| | | | - Daniel Klee
- Oregon Health and Science University, Department of Neurology, Portland, OR, USA
| | - Douglas Hanes
- Providence Center for Cardiovascular Analytics, Research + Data Science
| | - Barry S Oken
- Oregon Health and Science University, Departments of Behavioral Neuroscience and Biomedical Engineering, Portland, OR, USA
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29
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Bernardes SF, Almeida I, Forgeron P. Friend or Foe? A Thematic Analysis of Adult Friendships and Chronic Pain Adjustment. Pain Manag Nurs 2023:S1524-9042(23)00060-7. [PMID: 37037702 DOI: 10.1016/j.pmn.2023.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 03/06/2023] [Accepted: 03/09/2023] [Indexed: 04/12/2023]
Abstract
BACKGROUND Chronic pain is a worldwide public health challenge. Despite chronic pain having biopsychosocial dimensions, its social contexts are less investigated. Although current evidence shows that chronic pain shapes and is shaped by interactions with romantic partners, research about friendships and chronic pain is scarce, and mostly focused on adolescents. AIM Drawing upon theories on friendship and social support, this study aimed to investigate the role of adult friendships on chronic pain adjustment and, the effect of chronic pain on adult friendships. METHODS This study drew upon a qualitative descriptive methodology. Sixteen adults with primary or secondary (non-cancer) chronic pain participated in individual semi-structured interviews, conducted using voice over internet protocol applications. Data analysis was guided by Clarke and Brown's guidelines for thematic analysis. RESULTS The analysis of participants' (87.5% women; Mage = 43 years) stories revealed two themes. The first captured how friends promote/hinder adjustment to chronic pain by being: (1) (un)available and providing (un)needed support; and (2) (not)accepting and (not)accommodating to support life engagement. The second captured the negative effect of chronic pain on both parties' attitudes and behaviors towards the relationship, leading to smaller and more homogeneous friendship networks. CONCLUSIONS This study stresses the relevance of including adult friends in interventions to reduce the negative effect of chronic pain on friendships, harnessing their power to promote chronic pain adjustment. The findings bring new insights on a topic that has rarely been investigated in the pain field, hence pointing out innovative directions for future research and practice.
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Affiliation(s)
- Sónia F Bernardes
- From the Iscte-University Institute of Lisbon, Centre for Social Research and Intervention (Cis-iscte), Portugal.
| | - Inês Almeida
- From the Iscte-University Institute of Lisbon, Centre for Social Research and Intervention (Cis-iscte), Portugal
| | - Paula Forgeron
- Faculty of Health Sciences, University of Ottawa, Canada
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Sergooris A, Verbrugghe J, Matheve T, Van Den Houte M, Bonnechère B, Corten K, Bogaerts K, Timmermans A. Clinical phenotypes and prognostic factors in persons with hip osteoarthritis undergoing total hip arthroplasty: protocol for a longitudinal prospective cohort study (HIPPROCLIPS). BMC Musculoskelet Disord 2023; 24:224. [PMID: 36964541 PMCID: PMC10039547 DOI: 10.1186/s12891-023-06326-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 03/15/2023] [Indexed: 03/26/2023] Open
Abstract
BACKGROUND Large heterogeneity exists in the clinical manifestation of hip osteoarthritis (OA). It is therefore not surprising that pain and disability in individuals with hip OA and after total hip arthroplasty (THA) cannot be explained by biomedical variables alone. Indeed, also maladaptive pain-related cognitions and emotions can contribute to pain and disability, and can lead to poor treatment outcomes. Traumatic experiences, mental disorders, self-efficacy and social support can influence stress appraisal and strategies to cope with pain, but their influence on pain and disability has not yet been established in individuals with hip OA undergoing THA. This study aims (1) to determine the influence of traumatic experiences and mental disorders on pain processing before and shortly after THA (2) to identify preoperative clinical phenotypes in individuals with hip OA eligible for THA, (3) to identify pre- and early postoperative prognostic factors for outcomes in pain and disability after THA, and (4) to identify postoperative clinical phenotypes in individuals after THA. METHODS This prospective longitudinal cohort study will investigate 200 individuals undergoing THA for hip OA. Phenotyping variables and candidate prognostic factors include pain-related fear-avoidance behaviour, perceived injustice, mental disorders, traumatic experiences, self-efficacy, and social support. Peripheral and central pain mechanisms will be assessed with thermal quantitative sensory testing. The primary outcome measure is the hip disability and osteoarthritis outcome score. Other outcome measures include performance-based measures, hip muscle strength, the patient-specific functional scale, pain intensity, global perceived effect, and outcome satisfaction. All these measurements will be performed before surgery, as well as 6 weeks, 3 months, and 12 months after surgery. Pain-related cognitions and emotions will additionally be assessed in the early postoperative phase, on the first, third, fifth, and seventh day after THA. Main statistical methods that will be used to answer the respective research questions include: LASSO regression, decision tree learning, gradient boosting algorithms, and recurrent neural networks. DISCUSSION The identification of clinical phenotypes and prognostic factors for outcomes in pain and disability will be a first step towards pre- and postoperative precision medicine for individuals with hip OA undergoing THA. TRIAL REGISTRATION ClinicalTrials.gov: NCT05265858. Registered on 04/03/2022.
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Affiliation(s)
- Abner Sergooris
- REVAL Rehabilitation Research, Faculty of Rehabilitation Sciences, Hasselt University, Agoralaan Building A - B-3590, Diepenbeek, Belgium.
| | - Jonas Verbrugghe
- REVAL Rehabilitation Research, Faculty of Rehabilitation Sciences, Hasselt University, Agoralaan Building A - B-3590, Diepenbeek, Belgium
| | - Thomas Matheve
- REVAL Rehabilitation Research, Faculty of Rehabilitation Sciences, Hasselt University, Agoralaan Building A - B-3590, Diepenbeek, Belgium
- Spine, Head and Pain Research Unit Ghent, Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Maaike Van Den Houte
- REVAL Rehabilitation Research, Faculty of Rehabilitation Sciences, Hasselt University, Agoralaan Building A - B-3590, Diepenbeek, Belgium
- Laboratory for Brain-Gut Axis Studies (LABGAS), Translational Research Center for Gastrointestinal Disorders (TARGID), Department of Chronic Diseases and Metabolism, University of Leuven, Leuven, Belgium
| | - Bruno Bonnechère
- REVAL Rehabilitation Research, Faculty of Rehabilitation Sciences, Hasselt University, Agoralaan Building A - B-3590, Diepenbeek, Belgium
| | - Kristoff Corten
- Department of Orthopaedics - Hip Unit, Ziekenhuis Oost-Limburg, Genk, Belgium
- Centre for Translational Psychological Research (TRACE), Ziekenhuis Oost-Limburg, Genk, Belgium
| | - Katleen Bogaerts
- REVAL Rehabilitation Research, Faculty of Rehabilitation Sciences, Hasselt University, Agoralaan Building A - B-3590, Diepenbeek, Belgium
- Health Psychology, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Annick Timmermans
- REVAL Rehabilitation Research, Faculty of Rehabilitation Sciences, Hasselt University, Agoralaan Building A - B-3590, Diepenbeek, Belgium
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Sanjanwala AR, Lim G, Krans EE. Opioids and Opioid Use Disorder in Pregnancy. Obstet Gynecol Clin North Am 2023; 50:229-240. [PMID: 36822706 DOI: 10.1016/j.ogc.2022.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
Overdose is a leading cause of pregnancy-associated morbidity and mortality in the United States. As such, all obstetric providers have a responsibility to provide evidence-based care for patients with opioid use disorder to mitigate adverse outcomes associated with substance use during pregnancy.
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Affiliation(s)
- Aalok R Sanjanwala
- Department of Obstetrics, Gynecology & Reproductive Sciences, Division of Maternal-Fetal Medicine, University of Pittsburgh School of Medicine, 300 Halket Street Pittsburgh, PA 15213, USA
| | - Grace Lim
- Department of Anesthesiology and Perioperative Medicine, University of Pittsburgh School of Medicine, 300 Halket Street, Pittsburgh, PA 15213, USA; Department of Obstetrics, Gynecology & Reproductive Sciences, University of Pittsburgh School of Medicine, 300 Halket Street, Pittsburgh, PA 15213, USA
| | - Elizabeth E Krans
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of Pittsburgh School of Medicine, Magee-Womens Research Institute, 300 Halket Street, Pittsburgh, PA 15213, USA.
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Ashton-James CE, Anderson SR, Hirsh AT. Understanding the contribution of racially and ethnically discordant interactions to pain disparities: proximal mechanisms and potential solutions. Pain 2023; 164:223-229. [PMID: 35594518 PMCID: PMC9675882 DOI: 10.1097/j.pain.0000000000002698] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 05/12/2022] [Indexed: 02/06/2023]
Affiliation(s)
- Claire E Ashton-James
- Sydney Medical School, Kolling Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Steven R Anderson
- Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Stanford, CA, United States
| | - Adam T Hirsh
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States
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Brady B, Sidhu B, Jennings M, Boland R, Hassett G, Chipchase L, Tang C, Yaacoub S, Pavlovic N, Sayad S, Andary T, Ogul S, Naylor J. The feasibility of implementing a cultural mentoring program alongside pain management and physical rehabilitation for chronic musculoskeletal conditions: results of a controlled before-and-after pilot study. BMC Musculoskelet Disord 2023; 24:47. [PMID: 36658511 PMCID: PMC9850562 DOI: 10.1186/s12891-022-06122-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 12/28/2022] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Culturally diverse communities face barriers managing chronic musculoskeletal pain conditions including navigation challenges, sub-optimal healthcare provider engagement and difficulty adopting self-management behaviours. OBJECTIVES To explore the feasibility and trends of effectiveness of implementing a cultural mentoring program alongside clinical service delivery. METHODS This quasi-experimental controlled before-and-after multiple case study was conducted in three hospital-based services that provide treatment for patients with musculoskeletal pain. Two prospective cohorts, a pre-implementation and a post-implementation cohort, of adults with chronic musculoskeletal pain who attended during the 6-month recruitment phase, were eligible if they self-identified with one of the cultures prioritised for mentoring by the clinic. The pre-implementation cohort received routine care for up to 3-months, while the post-implementation cohort received up to 3-months of cultural mentoring integrated into routine care (3 to 10 sessions), provided by a consumer (n = 6) with lived experience. Feasibility measures (recruitment and completion rates, attendance, satisfaction), and trends of effectiveness (Patient Activation Measure and Health Literacy Questionnaire items one and six) were collated over 3-months for both cohorts. Outcomes were presented descriptively and analysed using Mann-Whitney U-tests for between-group comparisons. Translation and transcription of post-treatment semi-structured interviews allowed both cohorts' perspectives of treatment to be analysed using a Rapid Assessment Process. RESULTS The cultural mentor program was feasible to implement in clinical services with comparable recruitment rates (66% pre-implementation; 61% post-implementation), adequate treatment attendance (75% pre-implementation; 89% post-implementation), high treatment satisfaction (97% pre-implementation; 96% post-implementation), and minimal participant drop-out (< 5%). Compared to routine care (n = 71), patients receiving mentoring (n = 55) achieved significantly higher Patient Activation Measure scores (median change 0 vs 10.3 points, p < 0.01) at 3-months, while Health Literacy Questionnaire items did not change for either cohort over time. Three themes underpinned participant experiences and acceptability of the mentoring intervention: 'expectational priming', 'lived expertise' and 'collectivist orientation' to understand shared participant experiences and explore the potential differential effect of the mentoring intervention. CONCLUSION Participant experiences and observations of improved patient activation provide support for the acceptability of the mentoring intervention integrated into routine care. These results support the feasibility of conducting a definitive trial, while also exploring issues of scalability and sustainability.
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Affiliation(s)
- Bernadette Brady
- grid.410692.80000 0001 2105 7653Liverpool Hospital, South Western Sydney Local Health District, Locked Bag 7103 Liverpool, BC, Sydney, NSW 1871 Australia ,grid.1029.a0000 0000 9939 5719School of Health Sciences, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751 Australia ,grid.1013.30000 0004 1936 834XSydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006 Australia
| | - Balwinder Sidhu
- grid.410692.80000 0001 2105 7653Multicultural Health Unit, South Western Sydney Local Health District, 5/39 Stanley Street, Bankstown, NSW 2200 Australia
| | - Matthew Jennings
- grid.410692.80000 0001 2105 7653Liverpool Hospital, South Western Sydney Local Health District, Locked Bag 7103 Liverpool, BC, Sydney, NSW 1871 Australia
| | - Robert Boland
- grid.1013.30000 0004 1936 834XSydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006 Australia ,grid.410692.80000 0001 2105 7653Fairfield Hospital, South Western Sydney Local Health District, PO Box 5, Fairfield, Sydney, NSW 1851 Australia
| | - Geraldine Hassett
- grid.410692.80000 0001 2105 7653Liverpool Hospital, South Western Sydney Local Health District, Locked Bag 7103 Liverpool, BC, Sydney, NSW 1871 Australia
| | - Lucy Chipchase
- grid.1014.40000 0004 0367 2697Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Sturt Rd, Bedford Park, SA 5042 Australia
| | - Clarice Tang
- grid.1029.a0000 0000 9939 5719School of Health Sciences, Western Sydney University, Locked Bag 1797, Penrith, NSW 2751 Australia ,grid.410692.80000 0001 2105 7653South Western Sydney Local Health District, Locked Bag 7103, Liverpool BC, Sydney, NSW Australia
| | - Sylvia Yaacoub
- grid.410692.80000 0001 2105 7653Fairfield Hospital, South Western Sydney Local Health District, PO Box 5, Fairfield, Sydney, NSW 1851 Australia
| | - Natalie Pavlovic
- grid.410692.80000 0001 2105 7653Fairfield Hospital, South Western Sydney Local Health District, PO Box 5, Fairfield, Sydney, NSW 1851 Australia
| | - Samia Sayad
- grid.410692.80000 0001 2105 7653Fairfield Hospital, South Western Sydney Local Health District, PO Box 5, Fairfield, Sydney, NSW 1851 Australia ,grid.410692.80000 0001 2105 7653South Western Sydney Local Health District, Locked Bag 7103, Liverpool BC, Sydney, NSW Australia
| | - Toni Andary
- grid.410692.80000 0001 2105 7653Fairfield Hospital, South Western Sydney Local Health District, PO Box 5, Fairfield, Sydney, NSW 1851 Australia
| | - Shaniya Ogul
- grid.410692.80000 0001 2105 7653Fairfield Hospital, South Western Sydney Local Health District, PO Box 5, Fairfield, Sydney, NSW 1851 Australia
| | - Justine Naylor
- grid.410692.80000 0001 2105 7653South Western Sydney Local Health District, Locked Bag 7103, Liverpool BC, Sydney, NSW Australia ,grid.1005.40000 0004 4902 0432SWS Clinical School UNSW, Locked Bag 7103, Liverpool BC, Sydney, NSW 1871 Australia ,grid.429098.eIngham Institute Applied Medical Research, 1 Campbell St, Liverpool, Liverpool, NSW 2170 Australia
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Associations between postpartum pain type, pain intensity and opioid use in patients with and without opioid use disorder: a cross-sectional study. Br J Anaesth 2023; 130:94-102. [PMID: 36371258 PMCID: PMC9900726 DOI: 10.1016/j.bja.2022.09.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 09/25/2022] [Accepted: 09/30/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Pain is a multidimensional construct. The purpose of this cross-sectional, single-centre study was to evaluate the relationship between postpartum pain type with pain intensity and opioid use in people with and without opioid use disorder (OUD). METHODS Postpartum pain type was coded from McGill Pain Questionnaire and Patient-Reported Outcome Measurement Information System (PROMIS) inventories in people with or without OUD after childbirth in a 4-month period. The co-primary outcomes were pain intensity (0-10 scale) and total inpatient oxycodone (mg). Multivariable linear mixed-effects models assessed between- and within-person relationships for pain type (primary predictor) and outcomes. RESULTS There were 44 522 unique pain scores and types from 2610 people. Pain types were associated with pain intensity (P<0.001). Between-person comparisons showed affective pain was associated with a small but higher total oxycodone dose (difference 1.04 mg compared with no affective pain, P<0.001). Among people with OUD, within-person comparisons showed that the presence of affective pain resulted in pain scores 1 point higher than when affective pain was not present (P=0.002); between-person comparisons showed that people with affective pain had pain scores 6 points higher (P=0.048). Within-person and between-person comparisons among OUD showed that nociceptive/neuropathic pain was associated with a higher total oxycodone dose (1.6 and 11.4 mg, respectively). CONCLUSIONS Postpartum pain type was associated with pain intensity and opioid use. Further research is required to address the multiple dimensions of postpartum pain in people with and without OUD to improve treatment of postpartum pain.
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Samulowitz A, Haukenes I, Grimby-Ekman A, Bergman S, Hensing G. Psychosocial resources predict frequent pain differently for men and women: A prospective cohort study. PLoS One 2023; 18:e0283222. [PMID: 36930629 PMCID: PMC10022772 DOI: 10.1371/journal.pone.0283222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 03/03/2023] [Indexed: 03/18/2023] Open
Abstract
INTRODUCTION Psychosocial resources, psychological and social factors like self-efficacy and social support have been suggested as important assets for individuals with chronic pain, but the importance of psychosocial resources for the development of pain is sparsely examined, especially sex and gender differences. The aim of this study was to investigate associations between psychosocial resources and sex on the development of frequent pain in a general population sample, and to deepen the knowledge about sex and gender patterns. METHODS A sample from the Swedish Health Assets Project, a longitudinal cohort study, included self-reported data from 2263 participants, 53% women, with no frequent pain at baseline. The outcome variable was frequent pain at 18-months follow-up. Psychosocial resources studied were general self-efficacy, instrumental and emotional social support. Log binomial regressions in a generalised linear model were used to calculate risk ratios (RRs), comparing all combinations of men with high psychosocial resources, men with low psychosocial resources, women with high psychosocial resources and women with low psychosocial resources. RESULTS Women with low psychosocial resources had higher risk of frequent pain at follow-up compared to men with high resources: general self-efficacy RR 1.82, instrumental social support RR 2.33 and emotional social support RR 1.94. Instrumental social support was the most important protective resource for women, emotional social support was the most important one for men. Results were discussed in terms of gender norms. CONCLUSIONS The psychosocial resources general self-efficacy, instrumental and emotional support predicted the risk of developing frequent pain differently among and between men and women in a general population sample. The results showed the importance of studying sex and gender differences in psychological and not least social predictors for pain.
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Affiliation(s)
- Anke Samulowitz
- School of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Inger Haukenes
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Research Unit for General Practice, NORCE Norwegian Research Centre, Bergen, Norway
| | - Anna Grimby-Ekman
- School of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Stefan Bergman
- School of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Spenshult Research and Development Centre, Halmstad, Sweden
| | - Gunnel Hensing
- School of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Gerdle B, Dragioti E, Rivano Fischer M, Ringqvist Å. Pain intensity and psychological distress show different associations with interference and lack of life control: A clinical registry-based cohort study of >40,000 chronic pain patients from SQRP. FRONTIERS IN PAIN RESEARCH 2023; 4:1093002. [PMID: 36937562 PMCID: PMC10017552 DOI: 10.3389/fpain.2023.1093002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 02/14/2023] [Indexed: 03/06/2023] Open
Abstract
Background Both chronic pain and depressive and/or anxiety symptoms are associated with negative impacts on daily living, including interference and lack of life control. However, little is known about how pain and psychological distress affect these impacts. Aim The first aim was to assess how pain intensity, psychological distress, and social support interact with interference and lack of life control. A second aim was to investigate whether the strength of these relationships is moderated by the presence or absence of depression and/or anxiety. Subjects and methods Patient-Reported Outcome Measures (PROMs), which are available in the Swedish Quality Registry for Pain Rehabilitation (SQRP), were retrieved for patients with chronic pain (N = 40,184). A theoretical model with the constructs/latent variables pain intensity, psychological distress, interference, lack of life control, and social support was proposed and analyzed using Partial Least Squares Structural Equation Modelling (PLS-SEM). Indicators for these constructs were identified from the PROMs of the SQRP. Two models of the total cohort, which differed with respect to the causal relationship between pain intensity and psychological distress, were investigated. The moderating effects of anxiety and/or depression were also analyzed. Results Relatively low correlation and explanatory power (R 2 = 0.16) were found for the pain intensity-psychological distress relationship. Pain intensity had a stronger effect on interference than on lack of life control. The reverse was found for psychological distress - i.e., psychological distress seemed to have a higher negative influence on function than on interference. The underlying assumption of the causal relationship between pain intensity and psychological distress determined how strong pain intensity and psychological distress influenced interference and lack of life control. Social support showed very similar absolute significant correlations with interference and lack of life control. Interference and lack of life control showed relatively weak associations. The psychological distress level was a moderating factor for several of the paths investigated. Discussion and conclusion A clinical treatment consequence of the low correlation between pain intensity and psychological distress may be that clinically treating one may not reduce the effect of the other. The relative importance of pain intensity and psychological distress on interference and lack of life control depends on the underlying assumption concerning the pain intensity-psychological distress relationship. Interference and lack of life control showed relatively weak associations, underscoring the need to clinically assess them separately. Social support influenced both impact constructs investigated. The cohort display heterogeneity and thus presence of definite signs of anxiety and/or depression or not was a moderating factor for several of the associations (paths) investigated. The results are important both for the assessments and the design of treatments for patients with chronic pain.
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Affiliation(s)
- Björn Gerdle
- Pain and Rehabilitation Centre, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Correspondence: Björn Gerdle
| | - Elena Dragioti
- Pain and Rehabilitation Centre, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Marcelo Rivano Fischer
- Department of Neurosurgery and Pain Rehabilitation, Skåne University Hospital, Lund, Sweden
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Åsa Ringqvist
- Department of Neurosurgery and Pain Rehabilitation, Skåne University Hospital, Lund, Sweden
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Pierce J, Presto J, Hinckley E, Hassett AL, Dickens J, Schneiderhan JR, Grace K, McAfee J. Perceived social support partially mediates the association between childhood abuse and pain-related characteristics. FRONTIERS IN PAIN RESEARCH (LAUSANNE, SWITZERLAND) 2022; 3:1075605. [PMID: 36618580 PMCID: PMC9815443 DOI: 10.3389/fpain.2022.1075605] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 11/23/2022] [Indexed: 12/24/2022]
Abstract
Higher perceived social support has been shown to buffer the impact of negative stressful events like childhood abuse on health outcomes. Yet, the role of perceived social support as a mediator of the association between childhood abuse and pain-related characteristics is not well understood. The present study explored this premise. Patients (n = 1,542) presenting to a tertiary-care, outpatient pain clinic completed a cross-sectional survey consisting of regularly collected clinical data and validated measures. Path analysis suggested that the impact of childhood abuse on sensory and affective pain-related characteristics was partially explained by perceived emotional support. Survivors of childhood abuse display a more complex clinical pain phenotype and this extends to more negative perceptions of social support. Our findings may reflect processes whereby childhood abuse negatively impacts social relationships across the lifespan, and these negative social perceptions and relationships influence sensory and affective components of pain.
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Affiliation(s)
- Jennifer Pierce
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI, United States,Correspondence: Jennifer Pierce
| | - Jacob Presto
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI, United States
| | - Elizabeth Hinckley
- Department of Pediatric Neurology, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Afton L. Hassett
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI, United States
| | - Joseph Dickens
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI, United States
| | - Jill R. Schneiderhan
- Department of Family Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Kathryn Grace
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI, United States
| | - Jenna McAfee
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI, United States
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Samulowitz A, Hensing G, Haukenes I, Bergman S, Grimby-Ekman A. General self-efficacy and social support in men and women with pain - irregular sex patterns of cross-sectional and longitudinal associations in a general population sample. BMC Musculoskelet Disord 2022; 23:1026. [PMID: 36447177 PMCID: PMC9707264 DOI: 10.1186/s12891-022-05992-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 11/16/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The study of sex and gender patterns in psychosocial resources is a growing field of interest in pain research with importance for pain rehabilitation and prevention. The aims of this study were first, to estimate cross-sectional differences in psychosocial resources (general self-efficacy and social support) across men and women in a population with frequent musculoskeletal pain (pain in the back or neck/shoulder nearly every day or now and again during the week for the last 12 months) and to compare these differences with a population with no frequent pain. Second, to examine if psychosocial resources at baseline were associated with pain at follow-up among men and women in the frequent pain population. METHODS This study was based on survey data from the Swedish Health Assets Project, including The General Self-Efficacy Scale and social support questions. Participants (n = 4010, 55% women) were divided into no frequent pain (n = 2855) and frequent pain (n = 1155). General self-efficacy and social support were analyzed (cross-sectional and longitudinal data) with linear and logistic regressions. RESULTS Men, with and without frequent pain, had higher general self-efficacy than the corresponding groups in women. Women, with and without frequent pain, had stronger emotional social support than the corresponding groups in men. Men with no frequent pain had weaker instrumental social support than women with no frequent pain (OR = 0.64 (95% CI 0.47-0.87)), men with frequent pain did not (OR = 1.32 (95% CI 0.86-2.01)). In the frequent pain population, the interaction between sex and strong (compared to weak) emotional social support was statistically significant (p = 0.040) for no frequent pain at follow-up, with women having OR = 1.81 and men OR = 0.62. Among women, strong emotional social support was associated with no frequent pain at follow-up. Among men, strong emotional social support was associated with frequent pain at follow-up. CONCLUSION Some of the associations between general self-efficacy, social support and musculosceletal pain showed unexpected sex patterns. Gendered expectations might have relevance for some of the results.
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Affiliation(s)
- Anke Samulowitz
- grid.8761.80000 0000 9919 9582School of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Box 463, 40530 Gothenburg, Sweden
| | - Gunnel Hensing
- grid.8761.80000 0000 9919 9582School of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Box 463, 40530 Gothenburg, Sweden
| | - Inger Haukenes
- grid.509009.5Research Unit for General Practice, NORCE Norwegian Research Centre, Bergen, Norway ,grid.7914.b0000 0004 1936 7443Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Stefan Bergman
- grid.8761.80000 0000 9919 9582School of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Box 463, 40530 Gothenburg, Sweden ,Spenshult Research and Development Centre, Halmstad, Sweden
| | - Anna Grimby-Ekman
- grid.8761.80000 0000 9919 9582School of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Box 463, 40530 Gothenburg, Sweden
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Potential impact of COVID-19 pandemic on endometriosis. REPRODUCTIVE AND DEVELOPMENTAL MEDICINE 2022. [PMID: 37521529 PMCID: PMC9924788 DOI: 10.1097/rd9.0000000000000015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The impact of coronavirus disease 2019 (COVID-19) on endometriosis (EM) is currently unclear. Here, we aimed to describe the potential influence of COVID-19 on the pathogenesis, clinical symptoms, and treatment of EM. The cytokine storm caused by COVID-19 may induce the occurrence and progression of EM, and immunosuppression of COVID-19 may help the ectopic endometrium escape from immune clearance. Consequently, the forced social isolation and the cancelation of non-emergency medical treatment during the COVID-19 pandemic aggravate anxiety and psychological pressure, which can aggravate the symptoms related to EM and delay routine medical services.
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Sharvit G, Schweinhardt P. The influence of social signals on the self-experience of pain: A neuroimaging review. Front Neurol 2022; 13:856874. [PMID: 36090868 PMCID: PMC9459049 DOI: 10.3389/fneur.2022.856874] [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: 01/17/2022] [Accepted: 07/25/2022] [Indexed: 11/13/2022] Open
Abstract
Researchers in cognitive neuroscience have investigated extensively how psychological factors shape the processing and perception of pain using behavioral, physiological, and neuroimaging methods. However, social influences of pain, an essential part of biopsychosocial pain models, have received relatively little attention. This is particularly true for the neurobiological mechanisms underlying social modulations on pain. Therefore, this review discusses the findings of recent neuroimaging studies measuring the effects of social manipulations on pain perception (e.g., verbal and non-verbal social signals, social interaction style, conformity, social support, and sociocultural mediators). Finally, a schematic summary of the different social modulatory themes is presented.
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Affiliation(s)
- Gil Sharvit
- Department of Chiropractic Medicine, Integrative Spinal Research, Balgrist University Hospital, University of Zurich (UZH), Zurich, Switzerland
- Neuroscience Center Zurich (ZNZ), University of Zurich (UZH), Zurich, Switzerland
- *Correspondence: Gil Sharvit
| | - Petra Schweinhardt
- Department of Chiropractic Medicine, Integrative Spinal Research, Balgrist University Hospital, University of Zurich (UZH), Zurich, Switzerland
- Neuroscience Center Zurich (ZNZ), University of Zurich (UZH), Zurich, Switzerland
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41
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Otero-Ketterer E, Peñacoba-Puente C, Ferreira Pinheiro-Araujo C, Valera-Calero JA, Ortega-Santiago R. Biopsychosocial Factors for Chronicity in Individuals with Non-Specific Low Back Pain: An Umbrella Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191610145. [PMID: 36011780 PMCID: PMC9408093 DOI: 10.3390/ijerph191610145] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/12/2022] [Accepted: 08/14/2022] [Indexed: 06/12/2023]
Abstract
Low back pain (LBP) is a global and disabling problem. A considerable number of systematic reviews published over the past decade have reported a range of factors that increase the risk of chronicity due to LBP. This study summarizes up-to-date and high-level research evidence on the biopsychosocial prognostic factors of outcomes in adults with non-specific low back pain at follow-up. An umbrella review was carried out. PubMed, the Cochrane Database of Systematic Reviews, Web of Science, PsycINFO, CINAHL Plus and PEDro were searched for studies published between 1 January 2008 and 20 March 2020. Two reviewers independently screened abstracts and full texts, extracted data and assessed review quality. Fifteen systematic reviews met the eligibility criteria; all were deemed reliable according to our criteria. There were five prognostic factors with consistent evidence of association with poor acute-subacute LBP outcomes in the long term (high levels of pain intensity and disability, high emotional distress, negative recovery expectations and high physical demands at work), as well as one factor with consistent evidence of no association (low education levels). For mixed-duration LBP, there was one predictor consistently associated with poor outcomes in the long term (high pain catastrophism). We observed insufficient evidence to synthesize social factors as well as to fully assess predictors in the chronic phase of LBP. This study provides consistent evidence of the predictive value of biological and psychological factors for LBP outcomes in the long term. The identified prognostic factors should be considered for inclusion into low back pain explanatory models.
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Affiliation(s)
- Emilia Otero-Ketterer
- Escuela Internacional de Doctorado, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
- Physiotherapy Department, Mutua Universal Mugenat, 28001 Alcalá de Henares, Spain
| | | | | | - Juan Antonio Valera-Calero
- Valtradofi Research Group, Department of Physiotherapy, Faculty of Health, Universidad Camilo José Cela, Villanueva de la Cañada, 28692 Madrid, Spain
| | - Ricardo Ortega-Santiago
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
- Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
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42
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Ding Y, Liu C, Xu H, Wang M, Zhang J, Gu J, Cui Y, Wei L, Zhang Y. Effect of social support on illness perception in patients with atrial fibrillation during "Blanking Period": Mediating role of sense of mastery. Nurs Open 2022; 10:115-122. [PMID: 35855521 PMCID: PMC9748061 DOI: 10.1002/nop2.1284] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 04/12/2022] [Accepted: 06/05/2022] [Indexed: 01/04/2023] Open
Abstract
AIM To explore whether sense of mastery can mediate the relationship between social support and illness perception in patients with atrial fibrillation (AF) who were at the "Blanking Period." DESIGN A cross-sectional design. METHODS 405 patients with AF who were at the "Blanking Period" in the Affiliated Hospital of Qingdao University were recruited; they completed a set of questionnaires, including the Perceived Social Support Scale, the Personal Mastery Scale and the Brief Illness Perception Questionnaire. RESULTS Social support and sense of mastery were both adversely connected to illness perception. The indirect effect of social support on illness perception through sense of mastery was negative, accounting for 86.04% of the total effect. CONCLUSION During the "Blanking Period," better social support and sense of mastery contribute to a positive illness perception of AF patients. Social support also can influence patients' illness perception indirectly via the mediator of sense of mastery.
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Affiliation(s)
- Yun‐Mei Ding
- School of NursingQingdao UniversityQingdaoChina,Affiliated Hospital of Qingdao UniversityQingdaoChina
| | | | - Hong‐Xuan Xu
- Department of Health SciencesLund UniversityLundSweden
| | - Mao‐Jing Wang
- Affiliated Hospital of Qingdao UniversityQingdaoChina
| | | | - Jia‐Yun Gu
- School of NursingQingdao UniversityQingdaoChina
| | - Yan Cui
- Affiliated Hospital of Qingdao UniversityQingdaoChina
| | - Lili Wei
- Department of NursingAffiliated Hospital of Qingdao UniversityQingdaoChina
| | - Yan Zhang
- Department of NursingAffiliated Hospital of Qingdao UniversityQingdaoChina
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43
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Dispositional pain catastrophising in non-clinical sample: The role of depression, perceived stress and social support. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-020-00956-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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44
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Finlay KA, Madhani A, Anil K, Peacock SM. Patient-to-Patient Interactions During the Pain Management Programme: The Role of Humor and Venting in Building a Socially Supportive Community. FRONTIERS IN PAIN RESEARCH 2022; 3:875720. [PMID: 35571144 PMCID: PMC9091594 DOI: 10.3389/fpain.2022.875720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 03/21/2022] [Indexed: 11/20/2022] Open
Abstract
Objectives Social support is most positively perceived when there is an optimal match between a patient's need for communication and the purpose of their interaction. Maladaptive communication patterns may inhibit social bonding or mutual support, negatively impacting clinical outcomes. This study aimed to identify how people with chronic pain naturalistically converse together about their pain in the context of a Pain Management Programme (PMP). Methods Seven participants (4 females; 3 males) with ongoing chronic pain who were attending a PMP in a regional hospital in the United Kingdom were audio/video recorded during breaks in their PMP. Interactions were transcribed using Jeffersonian Transcription and analyzed using Conversation Analysis. Results Two conversational mechanisms were identified: (1) Conversational humor; and (2) A venting cycle. Participants used their pain-related experiences construct a motive for a joke, then proceeded to deliver the joke, which initiated a joke return from observers. The sequence was completed by a collaborative punchline. In the venting cycle, an initial complaint was escalated by the sharing of comparable experiences, after which the vent was concluded through a joke punchline, acting as a pivot to move the conversation forwards, terminating the venting. Conclusions Humorous interpersonal interactions about chronic pain provided a forum for social support-building within the PMP. Humor was affiliative and built social collaboration, helping individuals to together make sense of their pain in a prosocial atmosphere, approaching pain-related experiences with levity. Patient-to-patient interactions within the PMP were strongly prosocial and inclusive, potentially facilitating enhanced PMP clinical outcomes through collaboration.
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Affiliation(s)
- Katherine A. Finlay
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
| | - Adam Madhani
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
| | - Krithika Anil
- Peninsula Allied Health Centre, School of Health Professions, University of Plymouth, Plymouth, United Kingdom
| | - Sue M. Peacock
- Pain in the Mind, Independent Practice, The Saxon Clinic, Milton Keynes, United Kingdom
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45
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Yessick LR, Jackowich RA, Coyle SM, Salomons TV, Pukall CF. Investigation of the Relationships among Self-Efficacy, Stress, and Dyspareunia during the COVID-19 Pandemic. JOURNAL OF SEX & MARITAL THERAPY 2022; 48:819-832. [PMID: 35410584 DOI: 10.1080/0092623x.2022.2060887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
This study examined whether low self-efficacy and heightened perceived stress were associated with dyspareunia at two timepoints during COVID-19. Sixty-two participants (31 with and 31 without dyspareunia) completed a longitudinal online survey. Self-efficacy declined during the pandemic, and individuals with dyspareunia reported lower self-efficacy compared to those without dyspareunia. Although stress was greater for those with dyspareunia, both groups reported stress reductions over time. Lower stress was associated with increases in self-efficacy. This study is the first to examine longitudinal trends of dyspareunia during the COVID-19 pandemic and illuminates psychological factors that may influence the experience of dyspareunia.
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Affiliation(s)
- Lindsey R Yessick
- Department of Psychology, Queen's University, Kingston, Ontario, Canada
| | - Robyn A Jackowich
- Department of Psychology, Queen's University, Kingston, Ontario, Canada
| | - Shannon M Coyle
- Department of Psychology, Queen's University, Kingston, Ontario, Canada
| | - Tim V Salomons
- Department of Psychology, Queen's University, Kingston, Ontario, Canada
| | - Caroline F Pukall
- Department of Psychology, Queen's University, Kingston, Ontario, Canada
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46
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Mallon T, Schäfer I, Fuchs A, Gensichen J, Maier W, Riedel-Heller S, König HH, Mergenthal K, Schön G, Wegscheider K, Weyerer S, Wiese B, van den Bussche H, Scherer M. The moderating effects of social support and depressive symptoms on pain among elderly multimorbid patients-data from the multicentre, prospective, observational cohort study MultiCare. Aging Ment Health 2022; 26:803-809. [PMID: 33949271 DOI: 10.1080/13607863.2021.1916882] [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] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Depressive symptoms and chronic pain are common among patients with multimorbidity creating a complex medical condition for both the patient and the general practitioner. Perceived social support may function as a protective measure. UNLABELLED To examine the impact of perceived social support as a potential moderator between depressive symptoms and pain intensity and pain disability in daily activities in multimorbid patients aged 75+. METHOD Data from 3,189 patients of the German longitudinal cohort study MultiCare were obtained at baseline and follow-ups during 5 years. Multilevel linear mixed-effects analyses were conducted for pain intensity (model 1) and pain disability in daily activities (model 2). The interaction term social support by depression score was included to test for moderation. RESULTS The interaction between social support and depressive symptoms was significantly associated with the pain intensity score 0.41 (SE=.17; 95-CI[.08;.74]) but not with the pain disability score 0.35 (SE=.19; 95-CI[-.01;.72]). Additionally, men and individuals with medium or higher educational level showed reduced pain intensity and disability scores. Pain disability scores increased with age and depressive symptoms. Increased pain scores were also found for body mass index and burden of multimorbidity. CONCLUSION Perceived social support amplified the association of depressive symptoms on pain intensity and did not show a protective function. The high scores of perceived social support among the participants may point to the practice of secondary gain due to the patients immense health burden.
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Affiliation(s)
- Tina Mallon
- Department of Primary Medical Care, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Ingmar Schäfer
- Department of Primary Medical Care, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Angela Fuchs
- Institute of General Practice, University Düsseldorf, Düsseldorf, Germany
| | - Jochen Gensichen
- Institute of General Practice and Family Medicine, University Hospital of Ludwig-Maximilians-University Munich, Munich, Germany
| | - Wolfgang Maier
- Department of Psychiatry and Psychotherapy, University Bonn, Bonn, Germany
| | - Steffi Riedel-Heller
- Institute for Social Medicine, Occupational Health and Public Health, University Leipzig, Leipzig, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Karola Mergenthal
- Institute of General Practice, Goethe University Frankfurt Am Main, Frankfurt Am Main, Germany
| | - Gerhard Schön
- Department of Medical Biometry and Epidemiology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Karl Wegscheider
- Department of Medical Biometry and Epidemiology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Siegfried Weyerer
- Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Birgitt Wiese
- Institute of General Practice, WG Medical Statistics and IT-Infrastructure, Hannover Medical School, Hannover, Germany
| | - Hendrik van den Bussche
- Department of Primary Medical Care, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Martin Scherer
- Department of Primary Medical Care, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
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47
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Izadi M, Franklin S, Bellafiore M, Franklin DW. Motor Learning in Response to Different Experimental Pain Models Among Healthy Individuals: A Systematic Review. Front Hum Neurosci 2022; 16:863741. [PMID: 35399361 PMCID: PMC8987932 DOI: 10.3389/fnhum.2022.863741] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 02/28/2022] [Indexed: 12/30/2022] Open
Abstract
Learning new movement patterns is a normal part of daily life, but of critical importance in both sport and rehabilitation. A major question is how different sensory signals are integrated together to give rise to motor adaptation and learning. More specifically, there is growing evidence that pain can give rise to alterations in the learning process. Despite a number of studies investigating the role of pain on the learning process, there is still no systematic review to summarize and critically assess investigations regarding this topic in the literature. Here in this systematic review, we summarize and critically evaluate studies that examined the influence of experimental pain on motor learning. Seventeen studies that exclusively assessed the effect of experimental pain models on motor learning among healthy human individuals were included for this systematic review, carried out based on the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement. The results of the review revealed there is no consensus regarding the effect of pain on the skill learning acquisition and retention. However, several studies demonstrated that participants who experienced pain continued to express a changed motor strategy to perform a motor task even 1 week after training under the pain condition. The results highlight a need for further studies in this area of research, and specifically to investigate whether pain has different effects on motor learning depending on the type of motor task.
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Affiliation(s)
- Mohammad Izadi
- Sport and Exercise Research Unit, Department of Psychology, Educational Sciences and Human Movement, University of Palermo, Palermo, Italy
| | - Sae Franklin
- Institute for Cognitive Systems, Department of Electrical and Computer Engineering, Technical University of Munich, Munich, Germany
| | - Marianna Bellafiore
- Sport and Exercise Research Unit, Department of Psychology, Educational Sciences and Human Movement, University of Palermo, Palermo, Italy
| | - David W. Franklin
- Neuromuscular Diagnostics, Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
- Munich School of Robotics and Machine Intelligence, Technical University of Munich, Munich, Germany
- Munich Data Science Institute, Technical University of Munich, Munich, Germany
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48
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Fernandes LG, Devan H, Fioratti I, Kamper SJ, Williams CM, Saragiotto BT. At my own pace, space, and place: a systematic review of qualitative studies of enablers and barriers to telehealth interventions for people with chronic pain. Pain 2022; 163:e165-e181. [PMID: 34433776 DOI: 10.1097/j.pain.0000000000002364] [Citation(s) in RCA: 39] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 06/04/2021] [Indexed: 11/26/2022]
Abstract
ABSTRACT Telehealth is a promising approach to support self-management with the potential to overcome geographical barriers. Understanding patient perspectives will identify practical challenges to delivering self-management strategies by telehealth. The aim of this study was to synthesize the perceptions of people with chronic musculoskeletal pain for engaging in interventions delivered using telehealth. We searched MEDLINE, Embase, CINAHL, LILACS, and PsycINFO databases. We included qualitative studies that explored perceptions or experiences or attitudes of people with chronic musculoskeletal pain engaging with telehealth. We assessed the methodological quality using the Critical Appraisal Skills Programme checklist. Meta-synthesis was guided by a thematic synthesis approach. The level of confidence of review findings was assessed using the Confidence in the Evidence from Reviews of Qualitative Studies (GRADE-CERQual). Twenty-one studies were included (n = 429). Telehealth comprised web-based, videoconference-based, telephone-based, video-based, and smartphone app-based programs delivered solely or combined. Chronic musculoskeletal conditions included people with knee or hip osteoarthritis, chronic low back pain, persistent pain (chronic joint pain or nonspecific chronic musculoskeletal pain), rheumatoid arthritis, and functional fatigue syndrome. The enablers for engaging in telehealth interventions were as follows: (1) "at my own pace, space, and place" and (2) empowered patient. Barriers to engaging in telehealth interventions were as follows: (1) impersonal, (2) technological challenges, (3) irrelevant content, and (4) limited digital (health) literacy. Telehealth interventions with well-designed interactive platforms, flexibility to fit patients' routine, and the broad availability of material may favor better engagement. Encouragement of self-efficacy is linked to successful telehealth-delivered self-management programs.
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Affiliation(s)
- Lívia G Fernandes
- Masters and Doctoral Programs in Physical Therapy, Universidade Cidade São Paulo (UNICID), São Paulo, Brazil
| | - Hemakumar Devan
- Centre for Health, Activity and Rehabilitation Research (CHARR), School of Physiotherapy, University of Otago, Wellington, New Zealand
| | - Iuri Fioratti
- Masters and Doctoral Programs in Physical Therapy, Universidade Cidade São Paulo (UNICID), São Paulo, Brazil
| | - Steven J Kamper
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Nepean Blue Mountains Local Health District, Nepean Hospital, Penrith NSW, Australia
- Institute for Musculoskeletal Health, Sydney Local Health District and The University of Sydney, Camperdown, Australia
| | - Christopher M Williams
- School of Medicine and Public Health, Hunter Medical Research Institute, University of Newcastle, Newcastle, Australia
- Hunter New England Population Health, Hunter New England Local Health District, Wallsend, Australia
| | - Bruno T Saragiotto
- Masters and Doctoral Programs in Physical Therapy, Universidade Cidade São Paulo (UNICID), São Paulo, Brazil
- Institute for Musculoskeletal Health, Sydney Local Health District and The University of Sydney, Camperdown, Australia
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49
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Ebbesen CL, Froemke RC. Automatic mapping of multiplexed social receptive fields by deep learning and GPU-accelerated 3D videography. Nat Commun 2022; 13:593. [PMID: 35105858 PMCID: PMC8807631 DOI: 10.1038/s41467-022-28153-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Accepted: 01/06/2022] [Indexed: 12/25/2022] Open
Abstract
Social interactions powerfully impact the brain and the body, but high-resolution descriptions of these important physical interactions and their neural correlates are lacking. Currently, most studies rely on labor-intensive methods such as manual annotation. Scalable and objective tracking methods are required to understand the neural circuits underlying social behavior. Here we describe a hardware/software system and analysis pipeline that combines 3D videography, deep learning, physical modeling, and GPU-accelerated robust optimization, with automatic analysis of neuronal receptive fields recorded in interacting mice. Our system ("3DDD Social Mouse Tracker") is capable of fully automatic multi-animal tracking with minimal errors (including in complete darkness) during complex, spontaneous social encounters, together with simultaneous electrophysiological recordings. We capture posture dynamics of multiple unmarked mice with high spatiotemporal precision (~2 mm, 60 frames/s). A statistical model that relates 3D behavior and neural activity reveals multiplexed 'social receptive fields' of neurons in barrel cortex. Our approach could be broadly useful for neurobehavioral studies of multiple animals interacting in complex low-light environments.
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Affiliation(s)
- Christian L Ebbesen
- Skirball Institute of Biomolecular Medicine, New York University School of Medicine, New York, NY, 10016, USA.
- Neuroscience Institute, New York University School of Medicine, New York, NY, 10016, USA.
- Department of Otolaryngology, New York University School of Medicine, New York, NY, 10016, USA.
- Department of Neuroscience and Physiology, New York University School of Medicine, New York, NY, 10016, USA.
- Center for Neural Science, New York University, New York, NY, 10003, USA.
| | - Robert C Froemke
- Skirball Institute of Biomolecular Medicine, New York University School of Medicine, New York, NY, 10016, USA.
- Neuroscience Institute, New York University School of Medicine, New York, NY, 10016, USA.
- Department of Otolaryngology, New York University School of Medicine, New York, NY, 10016, USA.
- Department of Neuroscience and Physiology, New York University School of Medicine, New York, NY, 10016, USA.
- Center for Neural Science, New York University, New York, NY, 10003, USA.
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Gu Y, Chao X. How Labor Values Affect Mental Health: An Analysis From the Perspective of Social Support. Front Psychol 2022; 12:783569. [PMID: 34975674 PMCID: PMC8716935 DOI: 10.3389/fpsyg.2021.783569] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 11/05/2021] [Indexed: 01/07/2023] Open
Abstract
To explore the positive and negative effects of labor values on mental health from the aspects of life satisfaction and psychological distress, and further verify the mediating role of social support. A total of 2,691 primary and secondary school students were surveyed by Labor Values Scale, the Multidimensional Scale of Social Support, General Health Questionnaire and Satisfaction with Life Scale, and the results of which showed that as: (1) labor values can positively predict life satisfaction, while they are negatively correlated with psychological distress; (2) social support can play a mediating role between labor values and life satisfaction; and (3) social support can also play a mediating role in the relationship between labor values and psychological distress. This study revealed that the specific path and mechanism of labor values on mental health. This provided a reference for families and schools to further implement the education of labor values on primary and secondary school students and helped to promote the social construction of an education system that aimed at cultivating individual all-round development.
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Affiliation(s)
- Yuliang Gu
- Department of Sociology, Hunan Normal University, Changsha, China
| | - Xiaomei Chao
- Department of Education, Hunan Normal University, Changsha, China
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