Pain experiences and intrapersonal change among patients with chronic non-cancer pain after using a pain diary: a mixed-methods study

Experiences of patients with endometriosis with a digital health application: a qualitative analysis

BACKGROUND

Endometriosis is a frequent disease in women of reproductive age in which the endometrium occurs outside the uterine cavity. Multimodal treatment approaches are necessary due to loss of quality of life and the chronic nature of the disease. Digital health applications (DiGa) are becoming increasingly important. This research project investigates how a healthcare app can influence the subjective experience of illness in patients with endometriosis.

METHODS

Empiric data were collected through semi-structured interviews. Data analysis was carried out using qualitative focussed interview analysis. Reliability was ensured by joint interdisciplinary and interprofessional evaluation of the interviews by experts and those affected.

RESULTS

Ten patients with endometriosis and the prescribed healthcare app Endo-App© were examined. Categories were defined from the superordinate categories "Factors influencing the experience of illness" and "Evaluation of the app". The app provided reliable information, promoted self-efficacy through exercises and strengthened the perception of the individuality of the illness. It helped to minimise nocebo effects from internet research and enabled a positive change of perspective. Patients criticised the time required for data input and had data protection concerns. The educational elements were often seen as redundant. Some patients only used the app briefly, or not at all.

CONCLUSION

Once a DiGa has been prescribed, it may be useful to explain its use on an outpatient basis and validate regular use. Blind re-prescribing of DiGas should be avoided. Younger patients with a recent diagnosis or patients following rehabilitation may benefit more from prescribing.

When does self-report of pain occur?: A study of older adults

Technologies for self-care can drive participatory health and promote independence of older adults. One self-care activity is regularly measuring and registering personal health indicators (self-reporting). Older adults may benefit from this practice, as they are more likely to have chronic health issues and have specific self-monitoring needs. However, self-reporting technologies are usually not designed specifically for them. Pain is usually measured using patient reports compiled during medical appointments, although this process may be affected by memory bias and under reporting of fluctuating pain. To address these issues, we introduced a simple tangible interface to self-report pain levels and conducted a three-hour evaluation with 24 older adults. The goal of this study was to identify whether specific activities, activity levels or pain levels trigger older adults to self-report their pain level, besides to understand how older adults would use such a device. Within the limited time frame of the experiment, the majority of our participants chose to report pain when they felt it most, not reporting lower levels of pain. No evidence was found to suggest a relationship between the reporting of pain and the activity (or activity level). Several design insights intended to improve the design of technologies are provided.

Development of the opioid self-management scale for advanced Cancer patients with pain and examination of its validity and reliability

Background

Approximately 60% of outpatients with advanced cancer experience pain; therefore, self-management of opioid use is important for appropriate pain relief. To date, no studies have clearly described the concept of opioid self-management or assessed the factors involved, including the improvement of self-management abilities. This study developed, and evaluated the validity and reliability of an opioid self-management scale for advanced cancer patients with pain (OSSA). Opioid self-management in advanced cancer patients with pain was defined as the management of opioid medication performed by patients with advanced cancer to relieve cancer pain on their own.

Methods

Three phases were required for validation and reliability of the OSSA: 1) testing content validity, 2) testing face validity, and 3) testing construct validity, concurrent validity and reliability.

Results

After a three-phase process, the OSSA consisted of 33 items on six subscales. The structural equation modeling was such that the χ² value was 709.8 (p < 0.001, df = 467), goodness-of-fit index was 0.78, adjusted goodness-of-fit index was 0.73, root mean squares of approximation was 0.063, and comparative fit index was 0.92. The Pearson correlation coefficients between the total OSSA score and the 24-hour average pain or pain relief over 24 hours were − 0.21 (p < 0.05) and 0.26 (p < 0.01), respectively. Cronbach’s α was 0.93. The intraclass correlation coefficient range was 0.59–0.90.

Conclusion

The findings of this study show that the OSSA has acceptable validity and reliability, and that better self-management leads to greater pain relief. The OSSA can be considered effective for use in research, but shortened version should be prepared for realistic and practical clinical use.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12904-022-00987-4.

The association between daily physical exercise and pain among women with fibromyalgia: the moderating role of pain catastrophizing

Daily physical exercise is associated with more self-reported pain intensity in women with fibromyalgia pain, particularly among those with higher levels of pain catastrophizing.

Introduction:

Fibromyalgia (FM) is a condition marked by widespread chronic pain and an array of somatic and psychological symptoms. The primary objective of this study was to explore daily associations between physical activity and pain intensity among a sample of women with FM and the potential moderation of this association by pain catastrophizing.

Methods:

Women with FM (N = 107) completed questionnaires assessing pain, FM symptoms, and psychological measures and were then asked to report their levels of daily pain catastrophizing, physical activity, and pain intensity once per day for a period of 1 week using daily electronic diary-based tracking. In addition, objective measures of physical activity were collected using an activity tracker (Fitbit Flex), which measured step counts. Daily self-report physical activity was used as the independent variable and pain intensity (Brief Pain Inventory) was the outcome, whereas daily pain catastrophizing was tested in the model as the potential moderator.

Results:

Moderation analyses demonstrated associations between physical activity and pain intensity, which were moderated by patient's level of catastrophizing (B = 0.003, SE = 0.001, P < 0.05), with patients scoring higher in daily catastrophizing showing a relatively stronger link between higher day-to-day physical activity and increased daily FM pain. Significant associations were observed between pain catastrophizing, pain intensity, and Fitbit Flex step count (P < 0.05).

Conclusions:

Our findings suggest that increases in daily physical activity is associated with more self-reported pain intensity in women with FM pain, particularly among those with higher levels of pain catastrophizing.