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Fang Y, Liu M, Wu M, Liu M, Niu T, Zhang X. Pain intensity and self-perceived burden mediate the relationship between family functioning and pain catastrophizing in patients with neuropathic pain. Nurs Health Sci 2024; 26:e13097. [PMID: 38369318 DOI: 10.1111/nhs.13097] [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: 08/08/2023] [Revised: 12/18/2023] [Accepted: 01/25/2024] [Indexed: 02/20/2024]
Abstract
This cross-sectional study aimed to investigate the relationship between family functioning, pain intensity, self-perceived burden, and pain catastrophizing. Moreover, we also wanted to explore the multiple mediating roles of pain intensity and self-perceived burden. From October 2022 to March 2023, 252 Chinese people with neuropathic pain completed face-to-face questionnaires to assess family functioning, pain intensity, self-perceived burden, and pain catastrophizing. Data analysis was done using descriptive statistics and a structural equation model. The results showed better family functioning was significantly associated with more intense pain, less self-perceived burden, and less pain catastrophizing. Mediation analysis showed that family functioning could indirectly affect pain catastrophizing through pain intensity and self-perceived burden in addition to a direct effect on pain catastrophizing. Moreover, the mediating variable of pain intensity played a masking role. These findings suggest that good family functioning can effectively reduce the self-perceived burden and pain catastrophizing in patients with neuropathic pain. However, family functioning cannot show its maximum effectiveness, and it may be necessary to construct a model of family functioning suitable for patients with neuropathic pain in the future.
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Affiliation(s)
- Yu Fang
- School of Nursing, Xuzhou Medical University, Xuzhou, China
| | - Mengjie Liu
- School of Nursing, Xuzhou Medical University, Xuzhou, China
| | - Min Wu
- School of Nursing, Xuzhou Medical University, Xuzhou, China
| | - Mengshi Liu
- School of Nursing, Xuzhou Medical University, Xuzhou, China
| | - Tianchen Niu
- School of Nursing, Xuzhou Medical University, Xuzhou, China
| | - Xiaoman Zhang
- School of Nursing, Xuzhou Medical University, Xuzhou, China
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Rønne PF, Esbensen BA, Brødsgaard A, Andersen LØ, Sørensen BB, Hansen CA. The Effect of Family Nursing Conversations as an Add-on to Multidisciplinary Treatment in Patients with Chronic Non-Cancer Pain: A Quasi-Experimental Trial. SAGE Open Nurs 2024; 10:23779608241256206. [PMID: 38784650 PMCID: PMC11113041 DOI: 10.1177/23779608241256206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 03/20/2024] [Accepted: 04/28/2024] [Indexed: 05/25/2024] Open
Abstract
Introduction Chronic non-cancer pain (CNCP) is a lifelong condition with radical consequences, calling for management involving patients' families. Interventions based on the family systems nursing framework by Wright and Leahey have proved beneficial in other populations but require investigation in a CNCP population. This trial assumed that family nursing conversations (FNCs) based on the family systems nursing framework would increase patients' and family members' self-efficacy concerning CNCP management. Objective To investigate whether an intervention with FNCs as an add-on to the usual multidisciplinary treatment of CNCP would have an effect on patients' and family members' self-efficacy. Additionally, to investigate any impact on family function, health-related quality of life, anxiety, and depression. Methods The trial applied a prospective non-blinded quasi-experimental design with two comparable groups of patients and family members: a historical control group (HCG) and an intervention group (IG). The intervention was executed by nurses employed at a multidisciplinary pain center in the Capital Region of Denmark. HCG data were collected before the nurses' intervention training. The primary outcome was self-efficacy. Secondary outcomes were family function, health-related quality of life, anxiety, and depression. Results In total, 58 patients and 85 family members were included. The primary outcome, self-efficacy, detected no statistically significant between-group differences in mean change for patients, p = .990, or family members, p = .765. A statistically significant effect in favor of the IG was found in between-group differences in mean change in patients' behavioral family function, p = .034, and anxiety, p = .031. No statistically significant between-group differences were detected in family members' secondary outcomes. Conclusion The intervention had no effect on patients' or family members' self-efficacy but a positive effect on patients' behavioral family function and anxiety. The intervention was deeply affected by the COVID-19 pandemic. Hence, any results should be interpreted with caution.
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Affiliation(s)
- Pernille Friis Rønne
- The Multidisciplinary Pain Center and Department of Anaesthesia, Pain and Respiratory Support, The Neuroscience Center, Copenhagen University Hospital Rigshospitalet, Glostrup, Denmark
| | - Bente Appel Esbensen
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, The University of Copenhagen, Copenhagen, Denmark
- Copenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Center of Head and Orthopaedics, Copenhagen University Hospital Rigshospitalet, Glostrup, Denmark
| | - Anne Brødsgaard
- Department of People and Technology, Roskilde University, Roskilde, Denmark
- Faculty of Health, Department of Public Health, Aarhus University, Aarhus, Denmark
- Department of Paediatrics and Adolescent Medicine and Department of Gynaecology and Obstetrics, Copenhagen University Hospital Amager Hvidovre, Hvidovre, Denmark
| | | | - Bo-Biering Sørensen
- CRPS Clinic, Department of Neurology, The Neuroscience Center, Copenhagen University Hospital Rigshospitalet, Glostrup, Denmark
| | - Carrinna Aviaja Hansen
- Department of Regional Health Research, Faculty of Health Sciences, The University of Southern Denmark, Odense, Denmark
- Department of Orthopaedic Surgery, Zealand University Hospital, Koege, Denmark
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Woods SB, Roberson PNE, Abdelkhaleq H. Family strain, but not family support, is linked to worse pain interference among midlife adults reporting new chronic pain. FAMILIES, SYSTEMS & HEALTH : THE JOURNAL OF COLLABORATIVE FAMILY HEALTHCARE 2023; 41:467-477. [PMID: 37410420 PMCID: PMC10770288 DOI: 10.1037/fsh0000825] [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] [Indexed: 07/07/2023]
Abstract
INTRODUCTION Although family relationship quality has been linked to later chronic pain incidence for aging adults, it is unclear whether the quality of these relationships is linked to the impact of pain. We estimated longitudinal associations between family relationship quality (i.e., family support and family strain) and pain interference for adults who develop novel chronic pain across 10 years of midlife. METHOD We conducted a secondary analysis of data from the Midlife in the United States (MIDUS) study. Using path analysis, we tested whether family support and strain reported by participants (54% female, age M = 54.8 years) who denied having chronic pain at the study's second wave (MIDUS 2, 2004-2006) but reported chronic pain 10 years later (MIDUS 3, 2014-2016; N = 406) was associated with the interference of that pain with daily activities after accounting for key covariates, including sociodemographics, depression symptoms, global physical health, and MIDUS 3 reports of family support and strain. RESULTS The hypothesized model demonstrated good fit to the data based on multiple model fit indices. Greater family strain at baseline, but not family support, was significantly associated with greater pain interference 10 years later. DISCUSSION Findings build on prior studies to suggest that not only are stressful family relationships likely associated with the odds of developing chronic pain, but they are also linked to the interference of that chronic pain when it develops. We recommend biopsychosocial screening in primary care that captures family relationship quality and can inform best practices for nonpharmacological, family-based pain management. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Sarah B. Woods
- University of Texas Southwestern Medical Center, Department of Family and Community Medicine, Dallas TX, USA
| | | | - Haneen Abdelkhaleq
- University of Texas Southwestern Medical Center, Department of Family and Community Medicine, Dallas TX, USA
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Hiraga Y, Hara R, Hirakawa Y, Kitajima E, Hida K. Psychological Factors Mediate the Relationship between Physical Activity and Goal Attainment for Occupational Therapy Practice: An Observational Study in Japan. Occup Ther Health Care 2023:1-19. [PMID: 37902559 DOI: 10.1080/07380577.2023.2273994] [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: 04/18/2023] [Accepted: 10/18/2023] [Indexed: 10/31/2023]
Abstract
Occupational therapy can improve physical activity, anxiety, and goal achievement after high tibial osteotomy. However, the role of psychological factors in physical activity and goal attainment after high tibial osteotomy is unclear. We examined how psychological factors mediate the relationship between physical activity and goal achievement. Participants included 55 individuals post-high tibial osteotomy. Physical activity and performance and satisfaction in everyday tasks had a significant indirect effect on the anxiety and depression. Anxiety and depression mediated the physical activity-goal attainment relationship. Thus, occupational therapy practices focusing on anxiety and depression may be important in post- high tibial osteotomy rehabilitation.
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Affiliation(s)
- Yuki Hiraga
- Department of Occupational Therapy, Faculty of Medical Science, Fukuoka International University of Health and Welfare, Fukuoka, Japan
- Department of Health Sciences, International University of Health and Welfare Graduate School, Fukuoka, Japan
| | - Ryusei Hara
- Fukuoka Rehabilitation Hospital, Fukuoka, Japan
| | | | - Eiji Kitajima
- Department of Occupational Therapy, School of Health Science at Odawara, International University of Health and Welfare, Odawara, Japan
| | - Katsuko Hida
- Department of Occupational Therapy, School of Health Science at Fukuoka, International University of Health and Welfare, Fukuoka, Japan
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Čepukienė V, Puzerienė E. Examining pain severity in women with rheumatoid arthritis: the impact of pain self-efficacy and perceived partner's emotional support. HEALTH PSYCHOLOGY REPORT 2023; 12:14-25. [PMID: 38425891 PMCID: PMC10900974 DOI: 10.5114/hpr/167803] [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: 07/27/2022] [Revised: 05/15/2023] [Accepted: 06/09/2023] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Empirical data suggest that psychosocial factors, such as pain self-efficacy (PSE) and emotional support from a partner, may alleviate the suffering caused by rheumatoid arthritis (RA) pain. However, the data are ambiguous and warrant a more comprehensive investigation into the effect of these factors on the severity of RA pain. The objective of the present study was to assess the significance of PSE and emotional support from a partner in relation to pain severity among women with RA. PARTICIPANTS AND PROCEDURE The study included a sample of 196 women diagnosed with RA with the mean age of 41.54. The study employed the following measures: Rheumatoid Arthritis Pain Scale, Pain Self-efficacy Questionnaire, and Communication Based Emotional Support Scale. RESULTS The analysis revealed that higher PSE emerged as the strongest predictor for lower pain severity across all components of RA pain. However, the impact of the partner's emotional support on pain severity was not as evident and varied depending on the specific pain component. Furthermore, the use of pain medications significantly predicted three out of four pain components. Mediation analysis revealed that perceived emotional support from a partner directly affected women's RA pain intensity, as well as indirectly through the PSE as a mediator. Moderated mediation analysis demonstrated that the association between PSE and pain severity weakened as the duration of RA increased. CONCLUSIONS Enhancing women's PSE and providing appropriate training for their partners to offer effective emotional support may play a crucial role in the treatment of RA.
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Affiliation(s)
| | - Erika Puzerienė
- Department of Psychology, Vytautas Magnus University, Kaunas, Lithuania
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Saito T, Shibata M, Hirabayashi N, Honda T, Morisaki Y, Anno K, Sudo N, Hosoi M, Ninomiya T. Family dysfunction is associated with chronic pain in a community-dwelling Japanese population: The Hisayama study. Eur J Pain 2023; 27:518-529. [PMID: 36585949 DOI: 10.1002/ejp.2076] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 12/21/2022] [Accepted: 12/26/2022] [Indexed: 01/01/2023]
Abstract
BACKGROUND Poor family functioning has been reported to be associated with the severity of chronic pain in outpatients, but the association has not been fully addressed in general populations. The present study aimed to examine the association between family dysfunction levels and the presence of chronic pain in a community-dwelling Japanese population. METHODS A total of 2598 participants aged ≥40 years were classified as having healthy, borderline or unhealthy family functioning. Chronic pain was defined as subjective pain for three months or longer, and further classified by pain intensity, the number of chronic pain sites, pain duration and the extent of pain spread. A logistic regression model was used to compute the odds ratios (ORs) for chronic pain outcomes. RESULTS The prevalence of chronic pain was 49%. The age- and sex-adjusted prevalence of total and severe chronic pain were increased significantly with increasing family dysfunction levels (all p for trend <0.01). After adjusting for sociodemographic, physical, social and family structure factors, the ORs (95% confidence intervals [CI]) for having chronic pain among borderline and unhealthy groups were 1.20 (1.01-1.44) and 1.43 (1.15-1.79), respectively, as compared with a healthy family function group. The association was stronger among people who were employed and those who were living with their children. In addition, the ORs for severe chronic pain increased significantly with increasing levels of family dysfunction. CONCLUSIONS The family dysfunction level was positively associated with the presence as well as the severity of chronic pain in a community-dwelling population. SIGNIFICANCE A biopsychosocial burden due to family relationships could worsen the clinical presentation of pain. Social support or family therapy for dysfunctional families would be a potential initiative for the prevention or management of chronic pain.
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Affiliation(s)
- Takafumi Saito
- Faculty of Rehabilitation, School of Physical Therapy, Reiwa Health Sciences University, Fukuoka, Japan
| | - Mao Shibata
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Department of Psychosomatic Medicine, Kyushu University Hospital, Fukuoka, Japan
- Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Naoki Hirabayashi
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Takanori Honda
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yukiko Morisaki
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kozo Anno
- Department of Psychosomatic Medicine, Kyushu University Hospital, Fukuoka, Japan
- Multidisciplinary Pain Center, Kyushu University Hospital, Fukuoka, Japan
| | - Nobuyuki Sudo
- Department of Psychosomatic Medicine, Kyushu University Hospital, Fukuoka, Japan
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Multidisciplinary Pain Center, Kyushu University Hospital, Fukuoka, Japan
| | - Masako Hosoi
- Department of Psychosomatic Medicine, Kyushu University Hospital, Fukuoka, Japan
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Multidisciplinary Pain Center, Kyushu University Hospital, Fukuoka, Japan
| | - Toshiharu Ninomiya
- Department of Epidemiology and Public Health, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Cáceres-Matos R, Gil-García E, Vázquez-Santiago S, Cabrera-León A. Factors that influence the impact of Chronic Non-Cancer Pain on daily life: A partial least squares modelling approach. Int J Nurs Stud 2023; 138:104383. [PMID: 36481597 DOI: 10.1016/j.ijnurstu.2022.104383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 10/09/2022] [Accepted: 10/15/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Chronic Non-Cancer Pain is pain of more than three months' duration and is not associated with an oncological condition. There is ample literature that recognises that Chronic Non-Cancer Pain impacts numerous areas of the life of the person who suffers from it. This impact is difficult to determine and quantify because Chronic Pain is a subjective experience. OBJECTIVE The objective of this study was to test a recursive model of hypothesised factors that comprise the concept of Chronic Non-Cancer Pain Impact on daily life using Partial Least Squares-Structural Equation Modelling. DESIGN A cross-sectional study was carried out. The sample size was calculated using G*Power V.3.1.9.4 with five parameters (two-tailed, large effect size (f2 = 0.35), power of 0.95, statistical significance of 95% (α = 0.05) and 36 predictors). The minimum number of subjects was considered to be 137. METHODS A recursive model was built based on data from a sample of 395 people over 18 years of age with Chronic Non-Cancer Pain. Data collection was conducted between January and March 2020 at Pain Units and Primary Healthcare Centres belonging to the Spanish Public Health System in the province of Seville (Spain). Analyses were based on Partial Least Squares-Structural Equation Modelling. The internal consistency, convergent validity and discriminant validity of the internal measurement model were assessed. For the external measurement model, global model adjustment and structural validity were assessed. The predictive capacity of the final model was also evaluated. All analyses were performed using SmartPLS version 3.3.2 in consistent mode. RESULTS Findings showed an adequate validity of the proposed model, which comprised nine factors: pain catastrophising, hopelessness due to pain, support network, proactivity, treatment compliance, self-care, mobility, resilience, and sleep. The internal validity of the model (Cronbach's alpha and rho_A > 0.70; Average Variance Extracted>0.50; standardised outer loadings>0.60; Heterotrait-Monotrait-Ratio < 0.85), goodness of fit (Standardised Root Mean Square Residuals<0.08; Geodesic and Euclidean distance p-value<0.05) and predictive power with out-of-sample values (Stone-Geisser test>0.5) were adequate. The hypothesised structure of the instrument has also been confirmed (path coefficients>0.3; R2 > 0.1; f2 > 0.2). CONCLUSIONS The results have shown an adequate internal consistency, convergent validity and discriminant validity of the model. Likewise, the model has shown an adequate goodness of fit, and the validity of its structure and the hypothesis have been confirmed. However, more research is needed in this regard as the possible interaction between the different factors evaluated in the model with the confounding or moderating variables that may exist.
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Affiliation(s)
- Rocío Cáceres-Matos
- Nursing Department, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, 6 Avenzoar ST, RI 41009, Seville, Spain.
| | - Eugenia Gil-García
- Nursing Department, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, 6 Avenzoar ST, RI 41009, Seville, Spain.
| | - Soledad Vázquez-Santiago
- Nursing Department, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, 6 Avenzoar ST, RI 41009, Seville, Spain.
| | - Andrés Cabrera-León
- Andalusian School of Public Health, Cuesta del Observatorio, 4, RI 18011, Granada, Spain; Biomedical Research Consortium in Epidemiology and Public Health Network (CIBERESP), Monforte de Lemos Avenue, 3-5, RI 28029, Madrid, Spain; Biosanitary Research Institute of Granada (ibs.GRANADA), Avda. de Madrid, 15, RI 18012, Granada, Spain.
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Ghasemi M, Behnaz F, Hassanzad N, Taheri F. Evaluating the Relationship Between Depression and Pain Anxiety with Pain Catastrophizing in Patients with COVID-19. Anesth Pain Med 2022; 12:e119354. [PMID: 35433382 PMCID: PMC8995867 DOI: 10.5812/aapm.119354] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 02/05/2022] [Accepted: 02/08/2022] [Indexed: 12/22/2022] Open
Abstract
Background This study aimed to investigate the relationship between depression and pain anxiety with pain catastrophizing in patients with coronavirus disease 2019 (COVID-19). Methods In this descriptive, correlational study, 180 patients with COVID-19 in Akhtar and Imam Hossein hospitals in Tehran, Iran, were included from March 2019 to April 2020. All participants completed three questionnaires, including the Pain Catastrophizing Scale (PCS), Pain Anxiety Symptoms Scale (PASS), and Beck’s Depression Inventory (BDI). The data were analyzed using Pearson correlation coefficient and multivariate regression. Results There was a positive and significant relationship between the dimensions of rumination, magnification, and helplessness with total score of pain catastrophizing, as well as moderate to severe dimensions with total pain anxiety and depression in patients with COVID-19. Conclusions According to the results of regression analysis, pain anxiety based on pain catastrophizing dimensions was statistically significant, so that rumination, magnification, and helplessness could predict pain anxiety and explain a total of 15.1% of changes in pain anxiety. Also, depression was statistically significant based on dimensions of pain catastrophizing, so rumination, magnification, and helplessness could predict the patients’ depression and explain 13.6% of depression changes.
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Affiliation(s)
- Mahshid Ghasemi
- Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Faranak Behnaz
- Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Corresponding Author: Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Nima Hassanzad
- Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farinaz Taheri
- Anesthesiology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Byiers BJ, Roberts CL, Burkitt CC, Merbler AM, Craig KD, Symons FJ. Parental Pain Catastrophizing, Communication Ability, and Post-surgical Pain Outcomes Following Intrathecal Baclofen Implant Surgery for Patients With Cerebral Palsy. FRONTIERS IN PAIN RESEARCH 2022; 2:809351. [PMID: 35295472 PMCID: PMC8915662 DOI: 10.3389/fpain.2021.809351] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 12/29/2021] [Indexed: 11/13/2022] Open
Abstract
There is strong evidence that psychosocial variables, including pain catastrophizing, influence parental and child ratings of pain, pain expression, and long-term outcomes among children with chronic pain. The role of these factors among children who have communication deficits due to cerebral palsy (CP) and other intellectual and developmental disabilities is currently unclear. In this study, parental pain catastrophizing was assessed before intrathecal baclofen (ITB) pump implantation for spasticity management in 40 children and adolescents with CP, aged 4 to 24 years. Pain was assessed before and after surgery with two methods: a parent-reported pain interference scale, and behavioral pain signs during a standardized range of motion exam. Linear mixed models with clinical/demographic factors and scores from the Pain Catastrophizing Scale for Parents (PCS-P), and child spoken language ability as predictors and the pain variables as the outcomes were implemented. On average, both pain outcomes improved after surgery. Only child spoken language ability predicted change in behavioral reactivity scores, with children with phrase speech showing an increase in reactivity at follow-up compared to pre-surgery levels, on average. A significant interaction between PCS-P scores and spoken language ability on change in pain interference scores over time showed that dyads with children with phrase speech whose parents reported high PCS-P scores reported the least improvement in pain interference at follow-up. Due to the preliminary nature of the study, future work is needed to investigate the parental behaviors that mediate the relationships between parental catastrophizing and pain outcomes in this population.
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Affiliation(s)
- Breanne J. Byiers
- Department of Educational Psychology, University of Minnesota, Minneapolis, MN, United States
- *Correspondence: Breanne J. Byiers
| | - Caroline L. Roberts
- Department of Educational Psychology, University of Minnesota, Minneapolis, MN, United States
| | - Chantel C. Burkitt
- Department of Educational Psychology, University of Minnesota, Minneapolis, MN, United States
- Gillette Children's Specialty Healthcare, Saint Paul, MN, United States
| | - Alyssa M. Merbler
- Department of Educational Psychology, University of Minnesota, Minneapolis, MN, United States
| | - Kenneth D. Craig
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada
| | - Frank J. Symons
- Department of Educational Psychology, University of Minnesota, Minneapolis, MN, United States
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Cáceres-Matos R, Gil-García E, Rivera-Sequeiros A, López-Millán JM. Design and preliminarily validation of a tool to assess the impact of chronic non-cancer pain on people's daily life in Spanish-language: PAIN_Integral Scale ©. J Adv Nurs 2021; 77:3553-3570. [PMID: 33969919 DOI: 10.1111/jan.14877] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 03/05/2021] [Accepted: 04/14/2021] [Indexed: 11/30/2022]
Abstract
AIM To build and preliminarily validate a Spanish-language instrument to assess the impact that CNCP has on the daily lives of people who suffer from it. BACKGROUND The experience of pain is multifactorial and a correct assessment of it helps to control the intensity of pain. Although there are instruments that evaluate areas on which Chronic Non-Cancer Pain impacts, it would be necessary to include other aspects that scientific literature identifies as relevant. DESIGN Instrument and construct cross-sectional study for psychometric validation. METHODS A total of 157 items based on items from validated questionnaires were evaluated by a group of 21 chronic pain experts using Delphi methodology in three evaluation rounds. A final questionnaire of 55 items with a 5-point Likert-type scale was formed. This questionnaire was piloted on a total of 30 patients to assess their understanding of the items and the psychometric validation process was carried out (January to March 2020) on a subsequent sample of 395 people, all of whom attended Pain Units and Primary Care Centres of the Public Health System in Spain. RESULTS The PAIN_Integral Scale© showed acceptable internal consistency scores measured by Cronbach's alpha. Exploratory Factor Analysis indicated a structure of nine factors that explain 71.02% of the total variance, from 157 to a final total of 36 items. Confirmatory Factor Analysis showing adequate values confirmed this structure. The effect size was used to calculate the cut-off points for the overall scale, setting them at scores of 130 and 135. CONCLUSION This instrument would allow to assess other constructs and dimensions not included in the instruments previously available such as treatment compliance, proactivity, resilience, hopelessness due to pain and pain catastrophizing. However, despite the fact that the preliminary analysis shows good results, it is necessary to continue with its validation process in subsequent studies. IMPACT The PAIN_Integral Scale© , once the validation process is finished, could be a complete enough instrument to allow a comprehensive healthcare assessment of Chronic Non-Cancer Pain's impact on daily nursing clinical practice and other healthcare professionals.
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Pourmovahed Z, Yassini Ardekani SM, Mazloomy Mahmoodabad SS, Zareei Mahmoodabadi H. Implementation of the McMaster Model in Family Therapy: Effects on Family Function in Married Couples. IRANIAN JOURNAL OF PSYCHIATRY 2021; 16:60-67. [PMID: 34054984 PMCID: PMC8140298 DOI: 10.18502/ijps.v16i1.5380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Objective: Family function is one of the main effective factors on stability of the family. Family therapy can promote family function and performances. This study aimed to assess the effects of family therapy on family function among couples in Yazd province (Iran) based on the McMaster model. Method: The research population was selected from volunteer couples in Yazd in 2017 who were invited by publicity announcement to participate in this research. Finally, 40 couples were selected and randomly divided into 2 intervention and control groups. Participants answered to the demographic and Family Assessment Device (FAD) questionnaires. The acquired information was analyzed using inferential and descriptive statistics and SPSS 21 software. Results: The outcomes showed significant differences between the intervention and control groups in problem-solving (p = 0.01), communication (p < 0.0001), emotional responsiveness (p = 0.01), emotional involvement (p < 0.0001), and general function (p = 0.04). The roles and behavior control domains were improved after the intervention in 2 groups, but the differences were not significant. Conclusion: Family therapy based on McMaster model can promote the skills of problem- solving, family communication, emotional responsiveness, emotional involvement, and general function in couples. Healthy family functioning is a substantial domain of concern for mental health specialists who provide family interventions. Our findings enhance considerably to family professionals’ knowledge about patterns of family function in Iranian families.
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Affiliation(s)
- Zahra Pourmovahed
- Department of Nursing Education, Research Center for Nursing and Midwifery Care, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Department of Health Education and Promotion, Social Determinants of Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Seyed Mojtaba Yassini Ardekani
- Department of Psychology, Research Center of Addiction and Behavioral Sciences, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Seyed Saied Mazloomy Mahmoodabad
- Department of Health Education and Promotion, Social Determinants of Health Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Hu Y, Yang Z, Li Y, Xu Y, Tian M, Jiang N, Guo N. Prevalence and Associated Factors of Depressive Symptoms Among Patients With Chronic Low Back Pain: A Cross-Sectional Study. Front Psychiatry 2021; 12:820782. [PMID: 35095623 PMCID: PMC8793741 DOI: 10.3389/fpsyt.2021.820782] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 12/20/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Few studies have focused on depressive symptoms among patients with chronic low back pain in China. The aim of this cross-sectional study was to assess the prevalence and associated factors of depressive symptoms in patients with chronic low back pain. Methods: From May to August 2021, 1,172 patients with chronic low back pain were recruited in China. Depressive symptoms were assessed through the Patient Health Questionnaire. Associations of demographic characteristics, clinical characters and social-psychological factors with depressive symptoms were investigated among patients with chronic low back pain. Results: The prevalence of depressive symptoms was 25.00%. Logistic regression analysis found that duration of pain in 1-5 years (1-3 years: OR = 2.91, 95%CI: 1.65-5.14, 3-5 years: OR = 3.09, 95%CI: 1.55-6.15) and more severe pain (OR = 1.13, 95%CI: 1.10-1.17) were associated with higher risks of depressive symptoms. Better family function (good family function: OR = 0.25, 95%CI: 0.15-0.41, moderate family dysfunction: OR = 0.47, 95%CI: 0.29-0.77) and higher pain self-efficacy (OR = 0.94, 95%CI: 0.93-0.95) were associated with lower risks of depressive symptoms. Conclusion: Patients with chronic low back pain have a high prevalence of depressive symptoms in China. Duration of pain, pain severity, family function and pain self-efficacy were predictors of depressive symptoms among chronic low back pain patients in China. Early identification of the associated factors may be helpful for the timely management of depressive symptoms.
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Affiliation(s)
- Yueming Hu
- Department of Orthopedics, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, China.,Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, China
| | - Zechuan Yang
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yong Li
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yong Xu
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Mengge Tian
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Nan Jiang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ningfeng Guo
- Department of Orthopedics, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, China.,Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, China
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13
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Pereira M, Roios E, Leite Â, Pereira MG. Subjective suffering in patients with low back pain. Int J Rheum Dis 2020; 23:1379-1387. [PMID: 32869482 DOI: 10.1111/1756-185x.13936] [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: 03/11/2020] [Revised: 06/18/2020] [Accepted: 07/15/2020] [Indexed: 11/28/2022]
Abstract
AIM Low back pain (LPB) is a prevalent rheumatic and musculoskeletal disease and patients often experience physical discomfort and functional limitations. This study aimed to evaluate how subjective suffering relates to illness perceptions, pain intensity and psychological morbidity as well as to understand the mediator (direct and indirect) effects on functional disability. METHODS A cross-sectional study with 125 patients who received physiotherapy and answered the following instruments: Illness Perception Questionnaire-Revised; Illness Subjective Suffering Inventory; Hospital Anxiety and Depression Scale and the Oswestry LBP Incapacity Questionnaire. RESULTS In the structural equation modeling analysis, subjective suffering totally mediated the relationship between both emotional response (estimate = 0.068, 95% highest posterior density interval [HPDI] = [0.017, 0.133]), consequences (estimate = 0.118, 95% HPDI = [0.035, 0.211]) and functional disability. The relationship between coherence and disability was partially mediated by subjective suffering (estimate = -0.067, 95% HPDI = [-0.134, -0.016]). Only identity and pain intensity showed direct effects on functional disability. CONCLUSION Intervention in patients with LBP should focus on subjective suffering to reduce functional disability, providing information and promoting the acceptance of disease and pain.
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Affiliation(s)
- Marta Pereira
- School of Psychology, Psychology Research Center (CIPsi), University of Minho, Braga, Portugal
| | - Edite Roios
- School of Psychology, Psychology Research Center (CIPsi), University of Minho, Braga, Portugal
| | - Ângela Leite
- School of Psychology, Psychology Research Center (CIPsi), University of Minho, Braga, Portugal
| | - M Graça Pereira
- School of Psychology, Psychology Research Center (CIPsi), University of Minho, Braga, Portugal
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14
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Elhamiasl M, Dehghani M, Heidari M, Khatibi A. The Relationship Between Ruminating the Catastrophic Consequences of Bodily Changes and Positive Reappraisal and Practical Problem-Solving Strategies in Individuals With Illness Anxiety Disorder. Basic Clin Neurosci 2020; 11:639-648. [PMID: 33643557 PMCID: PMC7878061 DOI: 10.32598/bcn.9.10.240] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Revised: 05/22/2019] [Accepted: 11/05/2019] [Indexed: 11/20/2022] Open
Abstract
Introduction: Cognitive emotion regulation is suggested to contribute to Illness Anxiety Disorder (IAD). Reappraisal and suppression are essential ER strategies with controversial data about their roles in IAD. Relevant studies are mostly limited to exploring these two strategies in individuals without such disorder. Therefore, we aimed to study the role of emotion regulation in the psychopathology of IAD by evaluating other ER strategies in illness-anxious individuals. Furthermore, we investigated the relationship between IAD and emotion regulation by targeting the role of interpretation bias for health-related information. Methods: The study participants were 60 university students. They underwent a semi-structured clinical interview to assess the presence or absence of IAD symptoms (n=30/group). They completed a battery of questionnaires measuring IAD, emotion regulation, and interpretation bias. Results: The illness-anxious group applied significantly less reappraisal and refocus on planning and more rumination, catastrophizing, and acceptance strategies, compared to the controls. Besides, interpretation bias was positively correlated with rumination and catastrophizing; while its association with reappraisal and planning was negative. Conclusion: Both functional (e.g. reappraisal & planning) and dysfunctional strategies (e.g. rumination & catastrophizing) contributed to the psychopathology of IAD. The biased interpretation of bodily information could make individuals prone to ruminate about the catastrophic consequences of bodily changes; such conditions interrupt fostering more positive reappraisal or practical problem-solving strategies.
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Affiliation(s)
- Mina Elhamiasl
- Department of Psychology, Faculty of Education and Psychology, Shahid Beheshti University, Tehran, Iran
| | - Mohsen Dehghani
- Department of Psychology, Faculty of Education and Psychology, Shahid Beheshti University, Tehran, Iran
| | - Mahmood Heidari
- Department of Psychology, Faculty of Education and Psychology, Shahid Beheshti University, Tehran, Iran
| | - Ali Khatibi
- Interdisciplinary Program in Neuroscience, Bilkent University, Ankara, Turkey
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15
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Ranjbar S, Mazidi M, Sharpe L, Dehghani M, Khatibi A. Attentional control moderates the relationship between pain catastrophizing and selective attention to pain faces on the antisaccade task. Sci Rep 2020; 10:12885. [PMID: 32732895 PMCID: PMC7393078 DOI: 10.1038/s41598-020-69910-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 05/07/2020] [Indexed: 11/09/2022] Open
Abstract
Cognitive models of chronic pain emphasize the critical role of pain catastrophizing in attentional bias to pain-related stimuli. The aim of this study was (a) to investigate the relationship between pain catastrophizing and the ability to inhibit selective attention to pain-related faces (attentional bias); and (b) to determine whether attentional control moderated this relationship. One hundred and ten pain-free participants completed the anti-saccade task with dynamic facial expressions, specifically painful, angry, happy, and neutral facial expressions and questionnaires including a measure of pain catastrophizing. As predicted, participants with high pain catastrophizing had significantly higher error rates for antisaccade trials with pain faces relative to other facial expressions, indicating a difficulty disinhibiting attention towards painful faces. In moderation analyses, data showed that attentional control moderated the relationship between attentional bias to pain faces and pain catastrophizing. Post-hoc analyses demonstrated that it was shifting attention (not focusing) that accounted for this effect. Only for those with high self-reported ability to shift attention was there a significant relationship between catastrophizing and attentional bias to pain. These findings confirm that attentional control is necessary for an association between attentional bias and catastrophizing to be observed, which may explain the lack of relationships between attentional bias and individual characteristics, such as catastrophizing, in prior research.
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Affiliation(s)
- Seyran Ranjbar
- Psychology Department, Shahid Beheshti University, Tehran, Iran
| | - Mahdi Mazidi
- Centre for the Advancement of Research on Emotion, The University of Western Australia, Crawley, WA, Australia
| | - Louise Sharpe
- School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | - Mohsen Dehghani
- Psychology Department, Shahid Beheshti University, Tehran, Iran
| | - Ali Khatibi
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, B15 2TT, UK.
- Centre for Human Brain Health, University of Birmingham, Birmingham, UK.
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16
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Mohammadi S, Alinajimi F, Esmaeilian N, Dehghani M, Khatibi A. Pain Catastrophizing Thoughts Explain the Link Between Perceived Caregiver Responses and Pain Behaviors of Patients With Chronic Musculoskeletal Pain. Front Psychol 2020; 11:1386. [PMID: 32719637 PMCID: PMC7349588 DOI: 10.3389/fpsyg.2020.01386] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 05/25/2020] [Indexed: 11/13/2022] Open
Abstract
PURPOSE Caregivers' responses to pain behaviors of patients with chronic pain have an essential role in how patients perceive their pain condition. The current study investigated the mediating role of pain catastrophizing on the link between perceived caregiver responses and patient pain behaviors. MATERIALS AND METHODS The sample of this cross-sectional study consisted of 200 patients with chronic pain (mean of age = 44.6; 71.5% were female). Participants responded to measures assessing their perception of their caregiver responses to their pain, their pain catastrophizing thoughts, and their pain behaviors. RESULTS The mediation analyses showed that perceived distracting responses were negatively related to pain catastrophizing level in patients, which in turn was positively associated with expressing pain behaviors. Besides, perceived caregiver negative responses were positively associated with catastrophizing thoughts, which in turn was positively related to expressing pain behaviors. CONCLUSION Patients' perceptions regarding how their caregiver responds to their pain condition can be related to their thoughts about their pain and how they react to their pain situation. Investigating the external sources that might have an impact on patients' reactions to their pain, especially when those external sources are caregivers who, in most situations, are with the patients for a prolonged duration, is essential.
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Affiliation(s)
- Somayyeh Mohammadi
- Department of Occupational Science and Occupational Therapy, Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | | | - Nasrin Esmaeilian
- Department of Clinical Psychology and Health, Shahid Beheshti University, Tehran, Iran
| | - Mohsen Dehghani
- Department of Clinical Psychology and Health, Shahid Beheshti University, Tehran, Iran
- Neuroepidemiology Unit, The Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, Australia
| | - Ali Khatibi
- Centre of Precision Rehabilitation for Spinal Pain, School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, United Kingdom
- Centre for Human Brain Health, University of Birmingham, Birmingham, United Kingdom
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17
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Cáceres-Matos R, Gil-García E, Barrientos-Trigo S, Porcel-Gálvez AM, Cabrera-León A. Consequences of Chronic Non-Cancer Pain in adulthood. Scoping Review. Rev Saude Publica 2020; 54:39. [PMID: 32321056 PMCID: PMC7135143 DOI: 10.11606/s1518-8787.2020054001675] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 10/01/2019] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE To examine and map the consequences of chronic pain in adulthood. METHOD Documents addressing the impact of chronic pain on the psychological and social spheres of people suffering from chronic pain, published in Spanish and English between 2013 and 2018, were included. Those who addressed pharmacological treatments, chronic pain resulting from surgical interventions or who did not have access to the full text were excluded. Finally, 28 documents from the 485 reviewed were included RESULTS Studies show that pain is related to high rates of limitation in daily activities, sleep disorders and anxiety-depression spectrum disorders. People in pain have more problems to get the workday done and to maintain social relationships. Chronic pain is also associated with worse family functioning. CONCLUSIONS This review shows that limitations in the ability to perform activities of daily living, sleep, psychological health, social and work resources and family functioning are lines of interest in published articles. However, knowledge gaps are detected in areas such as the influence of having suffered pain in childhood or adolescence, the consequences of non-fulfillment of working hours and gender inequalities.
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Affiliation(s)
- Rocío Cáceres-Matos
- Universidad de Sevilla. Facultad de Enfermería, Fisioterapia y Podología. Departamento de Enfermería. Sevilla, España
| | - Eugenia Gil-García
- Universidad de Sevilla. Facultad de Enfermería, Fisioterapia y Podología. Departamento de Enfermería. Sevilla, España
| | - Sergio Barrientos-Trigo
- Universidad de Sevilla. Facultad de Enfermería, Fisioterapia y Podología. Departamento de Enfermería. Sevilla, España
| | - Ana María Porcel-Gálvez
- Universidad de Sevilla. Facultad de Enfermería, Fisioterapia y Podología. Departamento de Enfermería. Sevilla, España
| | - Andrés Cabrera-León
- Escuela Andaluza de Salud Pública. Granada, España.,Centro de Investigación Biomédica en Red de Salud Pública y Epidemiología (CIBERESP). Madrid, España.,Universidad de Granada. Instituto de Investigación Biosanitaria, ibs. Hospitales Universitarios de Granada. Granada, España
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18
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Khatibi A, Moradi N, Rahbari N, Salehi T, Dehghani M. Development and Validation of Fear of Relapse Scale for Relapsing-Remitting Multiple Sclerosis: Understanding Stressors in Patients. Front Psychiatry 2020; 11:226. [PMID: 32265764 PMCID: PMC7100001 DOI: 10.3389/fpsyt.2020.00226] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 03/09/2020] [Indexed: 12/04/2022] Open
Abstract
Chronic diseases are associated with patients' long-term stress and development of fear to things related to the source of stress. Better management of a patients' condition requires investigation of the underlying mechanisms that contribute to the process of development of chronic stress. Multiple Sclerosis (MS) is a debilitating chronic disease in most cases diagnosed after a relapse and characterized by the periodic occurrence of relapses in most patients. Due to the unpredictable course of the disease and relapses, patients with Relapsing-Remitting MS (RRMS) may deal with the stress of anticipation of relapse and its unpredictable consequences. The role of relapses and related stress on patients' quality of life has not been previously investigated. This study is the first effort to develop a self-report measure of Fear of Relapse (FoR) in patients with RRMS. Thirty-one items were extracted from in-depth clinical interviews with 33 RRMS patients to develop the preliminary version of the scale. Subsequently, 168 RRMS patients completed the questionnaire, the Intolerance of Uncertainty Scale (IUS) and Depression, Anxiety, and Stress Scale (DASS). Fifty-one patients completed the scale one more time a month later. Factor analysis revealed three components, and five items failed to load on any of them. To test the FoR's independence from similar measures, responses to 26 items were pooled once with DASS items and once with IUS items, and each time were subjected to confirmatory factor analysis (two-component solution). Despite significant correlations between FoR, DASS, and IUS Independent loadings of items belonging to FoR and DASS, and FoR and IUS revealed independence and unique contribution of FoR to the evaluation of patients. Cronbach's alpha for the 26-item version was 0.92. Test-retest reliability for total score was equal to 0.74. These findings provide preliminary evidence of the validity and reliability of the measure. This scale can help researchers and clinicians to have a more comprehensive understanding of patients' experience with the uncertain nature of MS, which is necessary for future efforts to address this stressor by targeting the underlying mechanism.
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Affiliation(s)
- Ali Khatibi
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
- Centre for Human Brain Health, University of Birmingham, Birmingham, United Kingdom
| | - Nahid Moradi
- Department of Neurology, Royal Melbourne Hospital, Melbourne, VIC, Australia
| | - Naghmeh Rahbari
- Department of Cognitive Psychology, Institute for Cognitive Science Studies, Tehran, Iran
| | - Taranom Salehi
- Department of Psychology, Allameh Tabatabaei University, Tehran, Iran
| | - Mohsen Dehghani
- Department of Psychology, Shahid Beheshti University, Tehran, Iran
- Neuroepidemiology Unit, School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
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19
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Hiraga Y, Hisano S, Mizunoe A, Nomiyama K. The mediating effect of psychological factors on the relationship between pain intensity and wrist joint function: a longitudinal study with mediation analysis. Disabil Rehabil 2019; 43:1814-1818. [PMID: 31599170 DOI: 10.1080/09638288.2019.1676318] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE Psychological factors and pain intensity are associated with wrist function. However, the mediating role of psychological factors in the relationship between pain intensity and wrist function in distal radius fractures remains unclear. We performed mediation analysis to investigate how psychological factors mediate the relationship between pain intensity and wrist function. METHODS Twenty-one patients with distal radius fractures were included in this longitudinal study. Patient-rated wrist evaluation, one pain intensity-related outcome measure (numerical rating scale), and three psychological outcome measures (pain catastrophizing scale, hospital anxiety and depression scale, and pain self-efficacy questionnaire) were assessed. The mediation analysis with a bootstrap sampling procedure was used to assess indirect effects. The level of significance was set at 5%. RESULTS Mediation analysis showed that the pain intensity, as measured by patient-rated wrist evaluation, had significant indirect effects on the hospital anxiety and depression scale-anxiety (95% bootstrapped confidence interval: 0.96-9.62) and pain self-efficacy questionnaire (95% bootstrapped confidence interval: 0.43-8.11) scores. CONCLUSIONS The relationship between pain intensity and wrist function was mediated by anxiety and self-efficacy. Our findings suggest that interventions focused on psychological factors, particularly anxiety and self-efficacy, may be important in distal radius fractures rehabilitation.IMPLICATIONS FOR REHABILITATIONIn patients with distal radius fractures, early post-operative pain mediates psychological factors and affects wrist function.Anxiety and self-efficacy are psychological factors that should be noted, and rehabilitation, including self-management, should be considered.Rehabilitative interventions for distal radius fractures should focus on psychological factors and management of post-operative pain.
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Affiliation(s)
- Yuki Hiraga
- Fukuoka Rehabilitation Hospital, Fukuoka, Japan.,Department of Health Care Administration and Management, Graduate School of Kyushu University, Fukuoka, Japan
| | - Shinya Hisano
- Department of Occupational Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima, Hiroshima, Japan
| | - Aya Mizunoe
- Fukuoka Rehabilitation Hospital, Fukuoka, Japan
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20
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Mazidi M, Dehghani M, Sharpe L, Dolatshahi B, Ranjbar S, Khatibi A. Time course of attentional bias to painful facial expressions and the moderating role of attentional control: an eye-tracking study. Br J Pain 2019; 15:5-15. [PMID: 33633849 DOI: 10.1177/2049463719866877] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction This study investigated the time course of attention to pain and examined the moderating effect of attentional control in the relationship between pain catastrophizing and attentional bias in chronic pain patients. Methods A total of 28 patients with chronic pain and 29 pain-free individuals observed pictures of pain, happy and neutral facial expressions while their gaze behaviour was recorded. Pain intensity and duration, anxiety, depression, stress, attentional control and pain catastrophizing were assessed by questionnaires. Results In all subjects, the pattern of attention for pain faces was characterized by initial vigilance, followed by avoidance. No significant difference was found between the two groups in terms of orientation towards the stimuli, the duration of first fixation, the average duration of fixation or number of fixations on the pain stimuli. Attentional control moderated the relationship between catastrophizing and overall dwell time for happy faces in pain patients, indicating that those with high attentional control and high catastrophizing focused more on happy faces, whereas the reverse was true for those with low attentional control. Conclusion This study supported the vigilance-avoidance pattern of attention to painful facial expressions and a moderation effect of attentional control in the association between pain catastrophizing and attentional bias to happy faces among pain patients.
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Affiliation(s)
- Mahdi Mazidi
- Department of Clinical Psychology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.,Centre for the Advancement of Research on Emotion, The University of Western Australia, Crawley, WA, Australia
| | - Mohsen Dehghani
- Department of Psychology, Shahid Beheshti University, Tehran, Iran
| | - Louise Sharpe
- School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | - Behrooz Dolatshahi
- Department of Clinical Psychology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Seyran Ranjbar
- Department of Psychology, Shahid Beheshti University, Tehran, Iran
| | - Ali Khatibi
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK.,Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada.,Montreal Neurological Institute, McGill University, Montreal, QC, Canada
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21
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Family Strain, Depression, and Somatic Amplification in Adults with Chronic Pain. Int J Behav Med 2019; 26:427-436. [DOI: 10.1007/s12529-019-09799-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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23
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Pain Intensity Is Not Always Associated with Poorer Health Status: Exploring the Moderating Role of Spouse Personality. Pain Res Manag 2018; 2018:7927656. [PMID: 30356426 PMCID: PMC6178490 DOI: 10.1155/2018/7927656] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 09/12/2018] [Indexed: 12/04/2022]
Abstract
Background Past decades have seen a surge of studies investigating the role of spouses in chronic illness. The present study explored an interpersonal model of health-related quality of life in chronic pain settings. Spouse personality was tested as a moderator of pain intensity-to-health associations in patients with chronic pain. Methods This is a cross-sectional study. Participants were 185 noncancer chronic pain patients and their spouses. Patients were mostly females (58.4%). Mean age was approximately 56 years for patients and spouses. Patients completed a measure of pain intensity, health-related quality of life, and personality. Spouses also reported on their personality characteristics. Spouse personality was used as the moderator in the relationship between patients' pain intensity and health status. Patient personality was used as a covariate in the moderation analyses. Results Spouse neuroticism moderated the relationship between pain intensity and physical health status, while spouse introversion moderated the pain-to-mental health association. Conclusions Results support the idea that the relationship between a chronic stressor, namely, chronic pain, and health-related quality of life may be complex and contextually determined by spousal characteristics. Clinical implications are discussed in the context of couples.
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24
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Dehghani M, Mohammadi S, Sharpe L, Khatibi A. Attentional Bias to Threat-Related Information Among Individuals With Dental Complaints: The Role of Pain Expectancy. Front Psychol 2018; 9:786. [PMID: 29875723 PMCID: PMC5974166 DOI: 10.3389/fpsyg.2018.00786] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 05/02/2018] [Indexed: 01/08/2023] Open
Abstract
Expecting pain can be perceived as a threat may involve recruitment of cognitive strategies (such as attentional avoidance) which might help the person to reduce distress. The ecological validity of the paradigms aiming to study the attentional biases toward or away from threatening stimuli by manipulating the perception of threat in experimental settings has been questioned. Therefore, the current study aims to investigate the attentional bias toward or away from the threat when a confrontation with a real threatening and painful condition would be expected (i.e., dental treatment). One hundred and twenty-seven patients referred to three dentistry clinics for a dental treatment (experiment participants) and 30 individuals with no dental complaints (control participants) completed this study. Patients were randomly allocated to a high pain expectancy (HPE: n = 65) or a low pain expectancy (LPE: n = 62) expectancy condition. All participants completed questionnaires of distress, fear of pain, and fear of dental pain. Furthermore, they participated in a dot-probe task that assessed their attention to painful faces, dental pictures, and happy faces. In addition, before the treatment, participants reported their anticipated pain intensity and after the treatment, they reported the pain intensity that they perceived during the treatment using two separate visual analog scales. Patients in the HPE group showed a bias away from dental pictures compared to LPE and control group participants. HPE group patients also reported greater pain intensity during the treatment compared to LPE patients. Greater attentional bias away from dental pictures among HPE patients was associated with higher levels of fear of pain, fear of dental pain, and stress. Avoidance of highly salient threatening images can be seen as an unhelpful emotion-regulation strategy that individuals use to manage their fears. However, in this study, avoidance was associated with poorer outcomes.
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Affiliation(s)
- Mohsen Dehghani
- Department of Psychology, Shahid Beheshti University, Tehran, Iran
| | - Somayyeh Mohammadi
- GF Strong Rehabilitation Centre, Department of Occupational Science and Occupational Therapy, The University of British Columbia, Vancouver, BC, Canada
| | - Louise Sharpe
- School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | - Ali Khatibi
- Psychology Department, Bilkent University, Ankara, Turkey.,Interdisciplinary Program in Neuroscience, Sabuncu Brain Research Center, Bilkent University, Ankara, Turkey.,National Magnetic Resonance Research Center (UMRAM), Sabuncu Brain Research Center, Bilkent University, Ankara, Turkey
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25
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Corrigendum to "Incorporating Family Function into Chronic Pain Disability: The Role of Catastrophizing". Pain Res Manag 2017; 2017:3808520. [PMID: 29209137 PMCID: PMC5676477 DOI: 10.1155/2017/3808520] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2017] [Accepted: 06/22/2017] [Indexed: 11/24/2022]
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26
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Jongen PJ, Ruimschotel RP, Museler-Kreijns YM, Dragstra T, Duyverman L, Valkenburg-Vissers J, Cornelissen J, Lagrand R, Donders R, Hartog A. Improved health-related quality of life, participation, and autonomy in patients with treatment-resistant chronic pain after an intensive social cognitive intervention with the participation of support partners. J Pain Res 2017; 10:2725-2738. [PMID: 29238216 PMCID: PMC5716312 DOI: 10.2147/jpr.s137609] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Despite the availability of various specific treatments, most patients with chronic pain (CP) consider their pain problem as undertreated. Recently, multiple sclerosis (MS) patients who were given an intensive 3-day social cognitive treatment with the participation of support partners experienced lasting improvements in health-related quality of life (HRQoL) and self-efficacy. In this study, a similar intervention was given to treatment-resistant CP patients with stressors, relational problems with support partner, and distress, anxiety or depression. Before and 1, 3, and 6 months after the intervention, patients completed the Euro-Qol 5 Dimensions 5 Levels (EQ-5D-5L) and Impact on Participation and Autonomy (IPA) questionnaires (primary outcomes), and the Survey Of Pain Attitudes (SOPA), the Four-Dimensional Symptom Questionnaire (4DSQ) (distress, depression, anxiety, and somatization), and Visual Analog Scale for pain intensity, whereas the support partners completed the Caregiver Strain Index (CSI) questionnaire. Differences between baseline and post-treatment were tested via paired t-tests (significance level 0.05). Of the 39 patients who were included, 34 (87.2%) completed the 3-day treatment. At 1, 3, and 6 months, improvements were seen in EQ-5D-5L-Index (+40.6%; +22.4%; +31.7%), Health Today (+61.8%; +36.3%; +46.8%), Control attitude (+45.8%; not significant [NS]; +55.0%) and decreases in IPA-Problems (−14.8%; NS; −20.4%), Harm attitude (−18.9%; −15.0%; −17.7%), Distress (−17.7%; −31.8%; −37.1%), and Depression (−37.4%; −31.4%; −35.7%) scores. The CSI score had decreased by −29.0%, −21.4%, and −25.9%, respectively. In conclusion, after an intensive 3-day social cognitive intervention, treatment-resistant CP patients experienced substantial and lasting improvements in HRQoL and in problematic limitations to participation and autonomy, in association with improvements in pain attitudes, depression, and distress. To assess whether this innovative approach may be an effective treatment for this subgroup of CP patients, future randomized controlled studies are needed.
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Affiliation(s)
- Peter Joseph Jongen
- Department of Community and Occupational Medicine, University Medical Centre Groningen, Groningen.,MS4 Research Institute, Nijmegen
| | | | | | | | | | | | | | - R Lagrand
- Fysio- en Manuele Therapie R. & Y.M. Lagrand, Rotterdam
| | - Rogier Donders
- Department for Health Evidence, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - A Hartog
- DC Klinieken Rotterdam, Rotterdam
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Mahmoodi-Aghdam M, Dehghani M, Ahmadi M, Khorrami Banaraki A, Khatibi A. Chronic Pain and Selective Attention to Pain Arousing Daily Activity Pictures: Evidence From an Eye Tracking Study. Basic Clin Neurosci 2017; 8:467-478. [PMID: 29942430 PMCID: PMC6010654 DOI: 10.29252/nirp.bcn.8.6.467] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Introduction According to the pain research literature, attentional bias for pain is the mechanism responsible for the development and maintenance of fear of pain in patients with chronic pain. However, there is still some debate about the exact mechanism and the role of faster engagement versus difficulty in disengagement in the development of attentional bias. Methods To investigate attentional bias in patients with chronic pain, we used an eye-tracker with the pictures of pain-provoking activities and compared the results with an age- and gender-matched group of pain-free participants. In addition, other measures of pain-related cognition and pain severity ratings were included to assess their contribution to the attentional bias toward pain-related information. Results Calculating the frequency of the first fixations showed that both groups fixated initially on pain-provoking pictures compared to neutral one. Calculating the speed of fixations showed that control participants were faster in fixating on neutral stimuli, but patients with pain were faster in fixating on pain-provoking pictures, indicating a relative vigilance for the pain-related stimuli among them. These patients reported that the intensity of pain in the previous week was positively correlated with the speed of their fixation on the painful stimuli. Conclusion Although these results did not provide unequivocal support for the vigilance-avoidance hypothesis, they are generally consistent with the results of studies using eye tracking technology. Furthermore, our findings put a question over characterization of attentional biases in patients with chronic pain by simply relating that to difficulty in disengaging from pain-related stimuli.
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Affiliation(s)
- Masoumeh Mahmoodi-Aghdam
- Department of Cognitive Psychology, Institute for Cognitive Science Studies (ICSS), Tehran, Iran
| | - Mohsen Dehghani
- Family Research Institute, Shahid Beheshti University, Tehran, Iran
| | - Mehrnoosh Ahmadi
- Department of Cognitive Psychology, Institute for Cognitive Science Studies (ICSS), Tehran, Iran.,Department of Psychiatry, Roozbeh Psychiatry Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Ali Khatibi
- Department of Psychology, Faculty of Economics, Administrative, and Social Sciences, Bilkent University, Ankara, Turkey.,Interdisciplinary Program in Neuroscience, Bilkent University, Ankara, Turkey.,National Magnetic Resonance Research Center (UMRAM), Bilkent University, Ankara, Turkey
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