Exploring the emotional experiences of young women with chronic pain: The potential role of self-compassion

The use of Arts-Based Research in Chronic Pain: A Scoping Review

Background

As an emerging approach, arts-based research holds potential to advance understanding of the complex and multidimensional experiences of chronic pain and means of communicating this experiential evidence. This scoping review aimed to map and explore the extent of arts-based research in chronic non-cancer pain, understand the rationale behind using arts-based research methods, and identify directions for future research.

Methods

Databases PsycINFO, MEDLINE, EMBASE, and CINAHL were searched for eligible English-language articles from inception to November 2022. Out of 1321 article titles and abstracts screened for eligibility, 18 articles underwent full-text screening, with 14 ultimately meeting all inclusion criteria. We conducted a narrative synthesis of data extracted from the 14 reviewed articles.

Results

The review articles focused on a wide range of chronic non-cancer pain conditions, with 12/14 employing qualitative methods (86%), one repeated measures experimental design, and another a multiphase, multimethod design. Seven articles described the use of drawing, painting, or mixed-media artwork; four used photography; two used body mapping; and one used e-book creation. The rationale for arts-based research included exploring and better understanding patients' experiences with chronic non-cancer pain, constructing an intervention, and investigating or validating a clinical tool. Nine articles reported that their arts-based research methods produced unintended therapeutic benefits for participants. Recommendations for future research included using arts-based research to better understand and communicate with patients and providers, exploring convergence with art therapy, and designing creative and flexible multiphased studies involving collaboration across disciplines.

Conclusions

Despite the wide variation in sample and art modalities across reviewed articles, arts-based methods were considered suitable and highly effective for investigating chronic non-cancer pain.

Reflexivity and Relational Spaces: Experiences of Conducting a Narrative Inquiry Study With Emerging Adult Women Living With Chronic Pain

Clandinin and Connelly's narrative inquiry methodology was used to understand the lived and told stories of two emerging adult women (aged 18-29) living with chronic pain. The aim of this paper is to share the experiences of the first author-a graduate student and novice researcher-of creating relational spaces with emerging adult women living with chronic pain, and the experience of co-creating knowledge through the methodological lens of narrative inquiry. There are 12 qualitative touchstones that narrative inquirers attend to when using narrative inquiry, and we present the experiences of a novice narrative inquirer in relation to selected touchstones. Narrative inquiry can greatly contribute to nursing knowledge, and implications for nursing practice and research are discussed.

Predictors of self-compassion in endometriosis: the role of psychological health and endometriosis symptom burden

STUDY QUESTION

What is the relationship between self-compassion, endometriosis-related symptoms and psychological health in women with symptomatic endometriosis?

SUMMARY ANSWER

Decreased self-compassion is associated with increased psychological distress, extended diagnostic delay and varies according to individual endometriosis-symptom profile.

WHAT IS KNOWN ALREADY

Existing research indicates that endometriosis is associated with reduced psychological health and varied endometriosis-related symptom profiles. Examining the level of self-compassion reported by women with endometriosis is important as greater self-compassion has been found to improve psychological well-being in several chronic health populations.

STUDY DESIGN, SIZE, DURATION

This study utilized a cross-sectional survey design to explore the relationship between self-compassion, psychological health and endometriosis-related symptoms (n = 318).

PARTICIPANTS/MATERIALS, SETTING, METHODS

Women with a self-reported diagnosis of endometriosis were recruited via online advertising through social media platforms. Demographic and endometriosis-specific information (e.g. disease stage, diagnostic delay, symptom experience) was collected in addition to psychological health and self-compassion. Psychological health was measured by the PROMIS Emotional Distress and Anxiety short forms and the Patient Health Questionnaire (PHQ-15). Self-compassion was measured by the Self-Compassion Scale (26-item). Independent t-tests, bivariate correlations and linear regression analyses explored the relationship between specific endometriosis-related symptoms, psychological health and self-compassion.

MAIN RESULTS AND THE ROLE OF CHANCE

Hierarchical multiple regression indicated that psychological symptoms accounted for the greatest variance in levels of self-compassion in the current sample. Depression and anxiety were found to be significant negative predictors of self-compassion. Notable symptoms that were significant in the final model were the presence of dysmenorrhea, lower back pain, dyspareunia, pain after sexual intercourse, fatigue and nausea.

LIMITATIONS, REASONS FOR CAUTION

The cross-sectional nature of the findings prevents direct findings of causality. The information pertaining to endometriosis was self-report in nature and was not medically verified.

WIDER IMPLICATIONS OF THE FINDINGS

These preliminary findings indicate the importance of clinical interventions aimed at enhancing self-compassion and the importance of individual case conceptualization and treatment planning based on endometriosis-related symptomatic profiles.

STUDY FUNDING/COMPETING INTEREST(S)

The study was not associated with research funding. Author L.V.N. is a member of the Endometriosis Australia Clinical Advisory Committee.

TRIAL REGISTRATION NUMBER

N/A.

Does how you treat yourself affect your health? The relationship between health-promoting behaviors and self-compassion among a community sample

This study explores the relationship between self-compassion, or treating oneself with kindness and acceptance, using the Self-Compassion Scale, and health-promoting behaviors, using the Health-Promoting Lifestyle Profile II, among a community sample. Canonical correlation results indicate self-compassion and health-promoting behaviors share 76 percent of the variance within the data set. The positive components of self-compassion are strongly positively correlated with health-promoting behaviors, and the negative components of self-compassion are strongly negatively correlated with health-promoting behaviors. Hierarchical linear regression results indicate self-kindness and mindfulness are significant predictors of health-promoting behaviors after controlling for demographics.

Investigating the Influence and a Potential Mechanism of Self-Compassion on Experimental Pain: Evidence From a Compassionate Self-Talk Protocol and Heart Rate Variability

Previous studies have indicated a positive relationship between self-compassion and psychological and emotional well-being in chronic pain populations. However, evidence on the role and mechanisms of self-compassion in pain perception is largely limited. The current study was designed to investigate the effects and a potential mechanism of self-compassion on experimental pain. Thirty healthy participants underwent a compassionate self-talk protocol, which was followed by cold pain exposure during which high-frequency heart rate variability (HF-HRV) was evaluated. The compassionate self-talk protocol successfully generated compassionate statements among the participants. Our behavioral data showed lower pain ratings in the self-compassion compared to the control condition. Moreover, self-compassion manipulation resulted in higher HF-HRV during pain, which was associated with lower pain ratings. We present interesting findings that a short period of compassionate self-talk may decrease experimental pain as well as mechanistic evidence surrounding bodily control over pain-related arousal indicated by HF-HRV. PERSPECTIVE: This study presents the first line of evidence that a short period of compassionate self-talk may be sufficient to reduce experimental pain. We also demonstrate increased bodily control as a potential mechanism underlying this effect.