Resilience profile of patients with chronic pain

Chronic Pain Resilience Across Clinical Populations: A Concept Analysis

BACKGROUND

Chronic pain resilience is a concept that is frequently used in research but lacks theoretical clarity. Understanding chronic pain resilience is germane to developing interventions to improve it and the overall quality of life among individuals with chronic pain.

AIMS

To uncover and clarify the unique characteristics of the concept of chronic pain resilience.

DESIGN

A concept analysis using Rodgers' evolutionary method.

METHODS

Full-text articles published after 2000 in English were used to inform the concept analysis. Scopus, PubMed, PsychINFO, Embase, and CINAHL Plus with Full Text were utilized for literature searches. Rodgers' evolutionary approach was used to clarify the attributes, antecedents, and consequences.

RESULTS

The search yielded 31 articles that were used in the analysis. The key attributes of chronic pain resilience included engagement in meaningful activities despite pain, maintaining positive psychological homeostasis, buffering against negative mental outcomes, seeking support, and self-empowerment. After considering surrogate terms, antecedents, attributes, and consequences, chronic pain resilience may be defined as the development of the capacity to successfully adapt to chronic pain. This adaptation results in a move toward optimal social, physical, mental, and behavioral functioning by balancing negative and positive psychosocial factors, despite the additional challenges brought about by living with chronic pain.

Heterogeneity of resilience and the curvilinear relationship between childhood trauma and resilience among people with schizophrenia

Background

As a group with a high incidence of childhood trauma, the differential characteristics of resilience in schizophrenia and its relationship with childhood trauma are still unclear.

Methods

A total of 626 individuals diagnosed with schizophrenia were selected from four psychiatric hospitals in northern China. Childhood trauma and resilience were measured using the Childhood Trauma Questionnaire-short form (CTQ-SF) and Connor-Davidson Resilience Scale (CD-RISC), respectively. Latent profile analysis (LPA) was used to identify the potential classes of resilience. A generalized additive mixed model (GAMM) and restricted cubic spline (RCS) was used to explore and determine the shape of the relationship between childhood trauma and resilience.

Results

Model fits of LPA showed three heterogeneous classes of resilience: moderate resilience levels (n = 312; 49.06%); high resilience levels (n = 171; 26.89%) and low resilience levels (n = 153; 24.06%). Resilience scores fluctuated depending on amount of exposure to childhood trauma. The GAMM results verified the non-linear relationship between resilience and childhood trauma, with an estimated degree of freedom higher than 1 (4.573) and p = 0.003. RCS fitted for ordinary least square (OLS) regression models determined a smooth continuous cubic curve of resilience across childhood trauma levels, and the two turning points of the curve line were 41.04 and 54.74 for childhood trauma.

Discussion

Our findings confirm the people-specific differences in the level of resilience in schizophrenia and describe the cubic curvilinear relationship between childhood trauma and resilience, which provides data support for mechanistic research and intervention in related fields.

Resilience in women with primary Sjögren's syndrome

To assess the relationship between resilience and several diseases and individual features in primary Sjӧgren's Syndrome (SS) patients. Resilience was assessed using the Resilience Scale (RS-14). Disease activity, damage, and reported symptoms were assessed by means of ESSDAI (EULAR Sjögren's syndrome disease activity index), SSDDI (Sjӧgren's Syndrome Disease Damage Index) and ESSPRI (EULAR Sjӧgren's Syndrome Patient Reported Index). EuroQol, HADS (Hospital Anxiety and Depression Scale), SF-12 (Short-form 12 health survey), FAS (Fatigue Assessment Scale), FACIT-F (Functional Assessment of Chronic Illness Therapy - Fatigue), and IPAQ (International Physical Activity Questionnaire) questionnaires were submitted to evaluate physical and mental well-being of the recruited patients. Data about the autoimmune profile, systemic manifestations, and current therapy were collected. Educational qualifications and work activities were also considered. Descriptive, correlational, and linear regression analysis were performed. 74 consecutive women with primary SS and 74 sex and age-matched healthy subjects as a control group were recruited. SS patients displayed a moderate value of resilience (median 78.5) with no significant difference compared to controls (p = 0.38). An inverse relationship was found between resilience and mood disorders such as anxiety (p = 0.038) and depression (p < 0.001). Greater resilience was associated with a better perception of the quality of life (p = 0.02) and general health (p < 0.001), as well as with less fatigue (p = 0.008) and a more physically active lifestyle (p = 0.001). No significant relationship was found neither between resilience and age, socio-demographic and disease characteristics, nor with ESSDAI (p = 0.26), ESSPRI (p = 0.83) and SSDDI (p = 0.67). This is the first study assessing resilience in a large group of unselected primary SS patients. Most resilient primary SS patients are less depressed and show a better perception of their health. Greater resilience tends to correlate with less anxiety, physical and mental fatigue, and a more active lifestyle, while no association with disease activity and duration, damage, and socio-demographic features was detected. Considering the well-known role of resilience in helping to better cope with chronic illnesses, its assessment in SS patients should not be overlooked and the possible strategies for its improvement should be better explored and further implemented.