Evaluating chronic pain impact among patients in primary care: further validation of a brief assessment instrument

Validity of Current Assessment Tools Aiming to Measure the Affective Component of Pain: A Systematic Review

The objective of this study was to identify patient-reported outcome measures (PROMs), which aim to measure the affective component of pain and to assess their content validity, unidimensionality, measurement invariance, and Internal consistency in patients with chronic pain. The study was reported according to the PRISMA guidelines. A protocol of the review was submitted to PROSPERO before data extraction. Eligible studies were any type of study that investigated at least one of the domains: PROM development, content validity, dimensionality, internal consistency, or measurement invariance of any type of scale that claimed to measure the affective component of pain among patients with chronic pain. The databases Medline, Embase, PsycINFO, and the Cochrane Library were searched for eligible studies. The database search was supplemented by looking for relevant articles in the reference list of included studies, ie backtracking. All included studies were assessed independently by two authors according to the “COSMIN methodology on Systematic Reviews of Patient-Reported Outcome Measures”. Descriptive data synthesis of the identified PROMs was conducted. The search yielded 11,242 titles of which 283 were assessed at the full-text level. Full-text screening led to the inclusion of 11 studies and an additional 28 studies were identified via backtracking, leading to the inclusion of 39 studies in total in the review. Included studies described the development and validity of 10 unique PROMs, all of which we assessed to have potentially inadequate content validity and doubtful psychometric properties. No studies reported whether the PROMs possessed invariant measurement properties. The existing PROMs measuring affective components of chronic pain potentially lack content validity and have inadequate psychometric measurement properties. There is a need for new PROMs measuring the affective component of chronic pain that possess high content validity and adequate psychometric measurement properties.

Patient Experience of Living with Orofacial Pain: An Interpretive Phenomenological Study

This study investigated the experience of living with chronic orofacial pain. Participating in this study's individual in-depth interviews were 6 participants with chronic orofacial pain who were undergoing treatment at a pain clinic. In consideration of the empirical nature of the study, the interviews were transcribed verbatim and analyzed from an interpretive phenomenological approach. The participants in the study experienced various types of loss as a result of chronic pain, such as the loss of employment, self-identity, and the ability to enjoy eating and engaging in social activities. Other findings revealed a disbelief among the families and medical community in the pain reported by the participants in this study. In addition, the current study explores the dissatisfaction of these participants with their journey through the health care system. Previous studies have concentrated on chronic pain predominantly through quantitative methods based on measurements, such as questionnaires. The biomedical aspects of pain are essential to report, yet the emphasis on this can result in overlooking the experience of living with chronic pain. Qualitative methodologies are necessary for gaining a more profound understanding of and appreciation for the individual patient and his or her unique perspective. The present study may benefit those living with chronic pain, since this sharing of experiences can help sufferers feel less isolated in their agony. The current article's intention is to report these experiences in such a way that chronic pain sufferers and laypeople can comprehend and relate to them. In addition, the findings of this study should promote the knowledge and understanding of health care providers who deal with chronic pain sufferers, so that treatment is provided with more empathy and compassion. Knowledge Transfer Statement: The findings of the present study may assist health care professionals interacting regularly with sufferers of chronic pain to gain a deeper understanding of the chronic pain experience and how to best support these patients.

Chronic postsurgical pain and persistent opioid use following surgery: the need for a transitional pain service

AIM

To identify the 3-month incidence of chronic postsurgical pain and long-term opioid use in patients at the Toronto General Hospital.

METHODS

200 consecutive patients presenting for elective major surgery completed standardized questionnaires by telephone at 3 months after surgery.

RESULTS

51 patients reported a preoperative chronic pain condition, with 12 taking opioids preoperatively. 3 months after surgery 35% of patients reported having surgical site pain and 13.5% continued to use opioids for postsurgical pain relief. Postoperative opioid use was associated with interference with walking and work, and lower mood.

CONCLUSION

Chronic postsurgical pain and ongoing opioid use are concerns that warrant the implementation of a Transitional Pain Service to modify the pain trajectories and enable effective opioid weaning following major surgery.

Pain-Contingent Interruption and Resumption of Work Goals: A Within-Day Diary Analysis

Daily pain-related attributions for and negative affective reactions to the nonpursuit of work goals and individual differences in chronic pain severity and stress were used to predict work goal resumption in a sample of 131 adults with chronic pain. Variables were assessed via questionnaires and a 21-day diary. On days when participants reported nonpursuit of work goals in the afternoon, increases in pain-related attributions for goal interruption were positively associated with higher negative affective reactions which, in turn, were associated with an increased likelihood of same-day work goal resumption. Stress amplified the relation between pain-related attributions and negative affective reactions, and chronic pain severity was positively related to work goal resumption.

PERSPECTIVE

Under certain circumstances, chronic pain and pain-related attributions can have positive motivational effects on work goal resumption. The findings of the present study may contribute to the development of interruption management techniques in vocational settings that leverage the roles of pain-related attributions, goal cognition, and emotionality.

Psychosocial and demographic correlates of employment vs disability status in a national community sample of adults with chronic pain: toward a psychology of pain presenteeism

BACKGROUND

Although chronic pain is a source of work-related disability, relatively little research has addressed the psychological factors that differentiate individuals in chronic pain who leave the workforce from those who remain on the job despite their pain.

OBJECTIVE

The present study examined a small set of attitudinal and coping-related factors as potential correlates of pain-related disability vs continued part- or full-time employment over and above the role of well-known risk factors.

METHODS

A large sample of adult men and women with chronic pain drawn from across the United States (N = 1,293) by means of random digit dialing was subdivided into two groups: working (N = 859) and on disability (N = 434). Both groups were interviewed (by telephone) to complete a set of instruments (called the Profile of Chronic Pain: Extended Assessment battery) measuring pain attitudes and coping methods.

RESULTS

Logistic regression analysis revealed that continued employment status was inversely related to pain severity and was positively related to higher education and being Hispanic. After controlling for severity and demographic factors, belief in a medical cure and catastrophizing tendencies were significant inverse predictors, and task persistence was a positive predictor of continued employment.

CONCLUSIONS

Results revealed both demographic and attitudinal predictors of continued employment and highlight the value of harnessing insights from the psychology of work engagement to better understand the processes underlying pain presenteeism. Interventions designed to keep persons with pain in the active work force should build upon and extend the present findings.