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Foldes-Busque G, Dionne CE, Tremblay MA, Turcotte S, Fleet RP, Archambault PM, Denis I. A prospective investigation of the prognosis of noncardiac chest pain in emergency department patients. J Psychosom Res 2024; 186:111883. [PMID: 39213941 DOI: 10.1016/j.jpsychores.2024.111883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 07/25/2024] [Accepted: 08/05/2024] [Indexed: 09/04/2024]
Abstract
OBJECTIVES This study sought to describe the 2-year evolution of the intensity and frequency of noncardiac chest pain (NCCP), NCCP-related disability and health-related quality of life in a cohort of emergency department (ED) patients. It also aimed to identify and characterize subgroups of patients who share similar NCCP trajectories. METHODS 672 consecutive patients with NCCP were prospectively recruited in two EDs. NCCP, physical and mental health-related quality of life and pain-related impairment were assessed at baseline and 6 months, 1 year and 2 years after the index ED visit. RESULTS Significant reductions in the intensity and frequency of NCCP and in NCCP-related disability were observed over time, with 58.1% of patients being considered NCCP-free at the 2-year follow-up. Four trajectories of NCCP intensity were identified through latent class growth mixture modelling: Worsening Trajectory (6.8%), Persistence Trajectory (20.5%), Limited Improvement Trajectory (13.1%) and Remission Trajectory (59.5%). Physical quality of life was significantly higher in the latter two trajectories at all assessment points. Patients in the Remission Trajectory reported a better mental quality of life and a greater decrease in NCCP-related disability over time than those in the other trajectories. CONCLUSIONS Over 40% of ED patients with NCCP experienced persistent biopsychosocial morbidity that warrants further clinical attention.
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Affiliation(s)
- Guillaume Foldes-Busque
- School of Psychology, Université Laval, Québec, Québec, Canada; Research Centre of the Centre intégré de santé et de services sociaux de Chaudière-Appalaches, Lévis, Québec, Canada; Research Centre of the Québec Heart and Lung Institute, Québec, Québec, Canada.
| | - Clermont E Dionne
- Research Centre of the CHU de Québec-Université Laval, Québec, Québec, Canada; Department of Rehabilitation, Faculty of Medicine, Université Laval, Québec, Québec, Canada
| | - Marie-Andrée Tremblay
- School of Psychology, Université Laval, Québec, Québec, Canada; Research Centre of the Centre intégré de santé et de services sociaux de Chaudière-Appalaches, Lévis, Québec, Canada; Research Centre of the Québec Heart and Lung Institute, Québec, Québec, Canada
| | - Stéphane Turcotte
- Research Centre of the Centre intégré de santé et de services sociaux de Chaudière-Appalaches, Lévis, Québec, Canada
| | - Richard P Fleet
- Research Centre of the Centre intégré de santé et de services sociaux de Chaudière-Appalaches, Lévis, Québec, Canada; Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Québec, Québec, Canada
| | - Patrick M Archambault
- Research Centre of the Centre intégré de santé et de services sociaux de Chaudière-Appalaches, Lévis, Québec, Canada; Department of Family Medicine and Emergency Medicine, Faculty of Medicine, Université Laval, Québec, Québec, Canada
| | - Isabelle Denis
- School of Psychology, Université Laval, Québec, Québec, Canada; Research Centre of the Centre intégré de santé et de services sociaux de Chaudière-Appalaches, Lévis, Québec, Canada; Centre de recherche universitaire sur les jeunes et les familles (CRUJeF), Québec, Québec, Canada
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Infante-Gil L, Silverio SA, Fallon V, Wendland J. Postpartum specific anxiety in a French population: Validation of the French version of the Postpartum Specific Anxiety Scale [PSAS-FR]. Perspect Psychiatr Care 2022; 58:418-428. [PMID: 33955561 DOI: 10.1111/ppc.12808] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 03/08/2021] [Indexed: 11/29/2022] Open
Abstract
PURPOSE This study aims to validate the Postpartum-Specific-Anxiety-Scale (PSAS) as a French-language instrument, which assesses maternal and infant-related anxieties during the postpartum period. DESIGN AND METHODS The methodology included six stages: preliminary French translation; selection of most articulate items and back-translation; rectification of discrepancies; pilot study (n = 257); reliability and validity studies (n = 258; n = 874); and test-retest reliability study (n = 231). FINDINGS The PSAS-FR demonstrated good acceptability, high internal consistency of the global scale (Cronbach's α = 0.93), and each of the factors; along with good validity, and test-retest reliability. The receiver operating characteristic analysis suggested a satisfactory screening tool. PRACTICE IMPLICATIONS The PSAS-FR appears to be a valid and reliable tool to screen for postpartum anxieties in the French-speaking population.
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Affiliation(s)
- Lilliam Infante-Gil
- Psychopathology and Health Processes Laboratory, Institute of Psychology, Université de Paris, Paris, France
| | - Sergio A Silverio
- Department of Women & Children's Health, School of Life Course Sciences, King's College London, London, UK.,Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Victoria Fallon
- Department of Psychology, Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Jaqueline Wendland
- Psychopathology and Health Processes Laboratory, Institute of Psychology, Université de Paris, Paris, France.,Vivaldi Parent-Infant Mental Health Unit, Pitié-Salpêtrière University Hospital - AP-HP, Paris, France
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Effects of a preoperative neuromobilization program offered to individuals with carpal tunnel syndrome awaiting carpal tunnel decompression surgery: A pilot randomized controlled study. J Hand Ther 2021; 34:37-46. [PMID: 32151500 DOI: 10.1016/j.jht.2019.12.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Revised: 10/31/2019] [Accepted: 12/31/2019] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Pilot randomized controlled trial with parallel groups. INTRODUCTION Engaging individuals with carpal tunnel syndrome (CTS) awaiting carpal tunnel decompression surgery in a preoperative rehabilitation program may mitigate pain and sensorimotor impairments, enhance functional abilities before surgery, and improve postoperative outcomes. PURPOSE OF THE STUDY To assess the feasibility and the efficacy of a novel preoperative neuromobilization exercise program (NEP). METHODS Thirty individuals with CTS were randomly allocated into a four-week home-based neuromobilization exercise group or a standard care group while awaiting surgery. Outcome measures included feasibility (ie, recruitment, attrition, adherence, satisfaction, and safety) and efficacy metrics (ie, median nerve integrity and neurodynamics, tip pinch grip, pain, and upper limb functional abilities) collected before (ie, at the baseline and about four weeks later) and four weeks after surgery. RESULTS Thirty individuals with CTS were recruited (recruitment rate = 11.8%) and 25 completed the study (attrition rate = 16.7%). Adherence (94%) and satisfaction with the program (eg, enjoy the exercises and likeliness to repeat the NEP (≥4.2/5) were high and no serious adverse event was reported. NEP-related immediate pre- and post-surgery beneficial effects on pain interference were documented (P = .05, η2 = .10), whereas an overall increased neurodynamics (P = .04, η2 = .11) and decreased pain severity (P = .01, η2 = .21) were observed. DISCUSSION Engaging in the proposed NEP has limited beneficial effect as a stand-alone intervention on pre- and post-surgery outcomes for individuals with CTS. Expanding the program's content and attribute by adding other components including desensitization maneuvers and novel therapies promoting corticospinal plasticity is recommended. CONCLUSION A preoperative NEP completed by individuals with CTS awaiting surgery is feasible, acceptable, and safe. However, given the limited beneficial effectsof the program, revision of its content and attributes is recommended before proceeding to large-scale trials.
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Paquette P, Higgins J, Gagnon DH. Peripheral and Central Adaptations After a Median Nerve Neuromobilization Program Completed by Individuals With Carpal Tunnel Syndrome: An Exploratory Mechanistic Study Using Musculoskeletal Ultrasound Imaging and Transcranial Magnetic Stimulation. J Manipulative Physiol Ther 2020; 43:566-578. [PMID: 32861518 DOI: 10.1016/j.jmpt.2019.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Revised: 10/11/2019] [Accepted: 10/22/2019] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Neuromobilization exercises are increasingly advocated in the conservative management of individuals with carpal tunnel syndrome (CTS), as they may mitigate CTS-related signs and symptoms via potential peripheral (ie, musculoskeletal) and central (ie, neurophysiological) adaptations. However, the mechanisms underlying these adaptations have not been studied extensively. Hence, this exploratory and mechanistic study aims to evaluate the potential peripheral and central adaptations that may result in individuals with CTS who have completed a neuromobilization program. METHODS Fourteen individuals with CTS were evaluated before and 1 week after the completion of a 4-week neuromobilization program that incorporated median nerve sliding exercises. Pain and upper limb functional abilities were assessed using standardized questionnaires. The biological integrity and mechanical properties of the median nerve and the corticospinal excitability were quantified using musculoskeletal ultrasound imaging and transcranial magnetic stimulation, respectively. RESULTS Upon completion of the program, participants reported both large and moderate improvements in pain (P ≤ .03) and upper limb functional abilities (P = .02), respectively. The biological integrity and mechanical properties of the median nerve remained unchanged (P ≥ .22), whereas a small significant increase in corticospinal excitability (P = .04) was observed. CONCLUSION The proposed neuromobilization program appears promising to improve pain and upper limb functional abilities in individuals with CTS. These improvements may be preferentially mediated via central, rather than peripheral, adaptations. Future studies, especially with a larger sample size, longer intervention duration, and additional measurement times, are needed to strengthen current evidence.
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Affiliation(s)
- Philippe Paquette
- School of Rehabilitation, Université de Montréal, Montréal, Québec, Canada.
| | - Johanne Higgins
- School of Rehabilitation, Université de Montréal, Montréal, Québec, Canada
| | - Dany H Gagnon
- School of Rehabilitation, Université de Montréal, Montréal, Québec, Canada
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Bailly F, Fautrel B, Gossec L. Pain assessment in rheumatology – How can we do better? A literature review. Joint Bone Spine 2016; 83:384-8. [DOI: 10.1016/j.jbspin.2016.01.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/17/2015] [Indexed: 12/20/2022]
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Cetin AA, Bektas H, Ozdogan M. The West Haven Yale Multidimensional Pain Inventory: Reliability and validity of the Turkish version in individuals with cancer. Eur J Oncol Nurs 2015; 20:1-9. [PMID: 25937491 DOI: 10.1016/j.ejon.2015.03.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Revised: 03/24/2015] [Accepted: 03/25/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE Pain is a complex, multidimensional and subjective phenomenon that is common in patients with cancer. The translation of existing pain measurement scales is considered important in producing internationally comparable measures for evidence based practice. In measuring the pain experience, the WHYMPI is a widely used instrument to measure assessment of clinical pain, and it has not been validated in Turkey. The present study aimed to assess the reliability and validity of the Turkish version of the West Haven Yale Multidimensional Pain Inventory (WHYMPI). METHOD In this methodological study, the scale was translated into simplified Turkish by the cross-culture translation method, and 520 participants with cancer were assessed. The internal consistency, item analysis, and test-retest methods were used to determine the reliability of the Turkish WHYMPI. Content validity, criterion validity, convergent/divergent validity, and exploratory factor analysis were used to test the construct validity of the Turkish WHYMPI. RESULTS Cronbach's alpha and item-total correlations results suggested that there was good internal reliability. The Cronbach's alpha for internal consistency of the pain experience, responses by significant others, and daily activities were 0.85, 0.60, and 0.83, respectively. The internal consistency coefficient for test-retest reliability of the pain experience, responses by significant others, and daily activities were acceptable: 0.82, 0.66, and 0.81, respectively. Factor loadings were significant, with standardised loadings ranging from 0.40 to 0.92. CONCLUSIONS WHYMPI is reliable and valid instrument for the measurement of pain in patients with cancer in Turkey. Its use is recommended for clinical and research purposes.
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Affiliation(s)
| | - Hicran Bektas
- Akdeniz University Faculty of Nursing, Department of Internal Medicine Nursing, Antalya, Turkey.
| | - Mustafa Ozdogan
- Memorial Antalya Hospital, Medical Oncology Unit, Antalya, Turkey
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MPI Profile Classifications and Associated Clinical Findings Among Litigating Motor Vehicle Collision Patients. Clin J Pain 2014; 30:860-8. [DOI: 10.1097/ajp.0000000000000052] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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De Wandele I, Rombaut L, Malfait F, De Backer T, De Paepe A, Calders P. Clinical heterogeneity in patients with the hypermobility type of Ehlers-Danlos syndrome. RESEARCH IN DEVELOPMENTAL DISABILITIES 2013; 34:873-881. [PMID: 23291504 DOI: 10.1016/j.ridd.2012.11.018] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2012] [Revised: 11/06/2012] [Accepted: 11/21/2012] [Indexed: 06/01/2023]
Abstract
EDS-HT is a connective tissue disorder characterized by large inter-individual differences in the clinical presentation, complicating diagnosis and treatment. We aim to describe the clinical heterogeneity and to investigate whether differences in the symptom profile are also reflected as disparity in functional impairment and pain experience. In this study, 78 patients were asked to describe their symptoms due to EDS-HT. Next, a hierarchical cluster analysis was performed using the Jaccard measure of similarity to assess whether subgroups could be distinguished based on the symptoms reported. This analysis yielded 3 clusters of participants with distinct complaint profiles. The key differences were found in the domain of non-musculoskeletal complaints, which was significantly larger in cluster 2. Furthermore, cluster 2 was characterized by a worse physical and psychosocial health, a higher pain severity and a larger pain interference in daily life. The results emphasize that non-musculoskeletal symptoms are an important complication of EDS-HT, as the number of these complaints was found to be a significant predictor for both functional health status (SIP) and pain experience (MPI). In conclusion, this study confirms that EDS-HT is a heterogeneous entity and encourages the clinician to be more aware of the large variety of EDS-HT symptoms, in order to improve disease recognition and to establish more tailored treatment strategies.
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Affiliation(s)
- Inge De Wandele
- Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Artevelde University College, Ghent, Belgium.
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Catastrophizers with chronic pain display more pain behaviour when in a relationship with a low catastrophizing spouse. Pain Res Manag 2011; 16:293-9. [PMID: 22059198 DOI: 10.1155/2011/247940] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The present study examined the relationship between couple concordance of catastrophizing and adverse pain outcomes. Possible mechanisms underlying the relationship between couple concordance of catastrophizing and pain outcomes were also explored. Fifty-eight couples were recruited for the study. The chronic pain patients were filmed while lifting a series of weighted canisters. The spouse was later invited to view the video and answer questions about the pain experience of their partner. Median splits on Pain Catastrophizing Scale scores were used to create four 'catastrophizing concordance' groups: low catastrophizing patient-low catastrophizing spouse; low catastrophizing patient-high catastrophizing spouse; high catastrophizing patient-low catastrophizing spouse; and high catastrophizing patient-high catastrophizing spouse. Analyses revealed that high catastrophizing pain patients who were in a relationship with a low catastrophizing spouse displayed more pain behaviours than patients in all other groups. These findings suggest that high catastrophizing chronic pain patients may need to increase the 'volume' of pain communication to compensate for low catastrophizing spouses' tendency to underestimate the severity of their pain experience. Patients' perceived solicitousness and punitive response from the spouse could not explain the group differences in pain behaviour. Theoretical and clinical implications of the findings are discussed.
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Impairment and impact of pain in female patients with Ehlers-Danlos syndrome: A comparative study with fibromyalgia and rheumatoid arthritis. ACTA ACUST UNITED AC 2011; 63:1979-87. [DOI: 10.1002/art.30337] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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