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Ramírez-Maestre C, Barrado-Moreno V, Esteve R, Serrano-Íbañez ER, de la Vega R, Ruiz-Párraga GT, Fernández-Baena M, Jensen MP, López-Martínez AE. Vulnerability Factors, Adjustment, and Opioid Misuse in Chronic Noncancer Pain Individuals. THE JOURNAL OF PAIN 2024:104606. [PMID: 38871145 DOI: 10.1016/j.jpain.2024.104606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 06/03/2024] [Accepted: 06/08/2024] [Indexed: 06/15/2024]
Abstract
Several person variables predate injury or pain onset that increase the probability of maladjustment to pain and opioid misuse. The aim of this study was to evaluate the role of 2 diathesis variables (impulsiveness and anxiety sensitivity [AS]) in the adjustment of individuals with chronic noncancer pain and opioid misuse. The sample comprised 187 individuals with chronic noncancer pain. The hypothetical model was tested using correlation and structural equation modeling analyses. The results show a significant association between impulsiveness and AS and all the maladjustment variables, and between impulsiveness and AS and opioid misuse and craving. However, although the correlation analysis showed a significant association between adjustment to pain and opioid misuse, the structural equation modeling analysis showed a nonsignificant association between them (as latent variables). The findings support the hypothesis that both impulsiveness and AS are vulnerability factors for maladaptive adjustment to chronic pain and opioid misuse. PERSPECTIVE: This article adds to the empirical literature by including AS and impulsiveness as antecedent variables in a model of dual vulnerability to chronic pain maladjustment and opioid misuse. The findings suggest the potential utility of assessing both factors in individuals in the first stages of chronic pain.
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Affiliation(s)
- Carmen Ramírez-Maestre
- Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology and Speech Therapy, University of Málaga, Andalucía Tech, Málaga, Spain; Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain.
| | - Victoria Barrado-Moreno
- Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology and Speech Therapy, University of Málaga, Andalucía Tech, Málaga, Spain
| | - Rosa Esteve
- Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology and Speech Therapy, University of Málaga, Andalucía Tech, Málaga, Spain; Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Elena R Serrano-Íbañez
- Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology and Speech Therapy, University of Málaga, Andalucía Tech, Málaga, Spain; Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Rocío de la Vega
- Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology and Speech Therapy, University of Málaga, Andalucía Tech, Málaga, Spain; Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - Gema T Ruiz-Párraga
- Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology and Speech Therapy, University of Málaga, Andalucía Tech, Málaga, Spain; Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | | | - Mark P Jensen
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington
| | - Alicia E López-Martínez
- Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology and Speech Therapy, University of Málaga, Andalucía Tech, Málaga, Spain; Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
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Cojocaru CM, Popa CO, Schenk A, Marian Ș, Marchean H, Suciu BA, Szasz S, Popoviciu H, Mureșan S. Personality and Pain Outcomes in Rheumatic Disease: The Mediating Role of Psychological Flexibility. Healthcare (Basel) 2024; 12:1087. [PMID: 38891162 PMCID: PMC11171698 DOI: 10.3390/healthcare12111087] [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: 04/22/2024] [Revised: 05/20/2024] [Accepted: 05/23/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND Chronic pain is associated with increased disability and vulnerability to emotional disorders. Personality and psychological flexibility (PF) describe interindividual differences that shape the adjustment to chronic pain. Specifically, PF was found to be associated with pain, fatigue, anxiety, and depression intensity. Although previous studies established strong correlations between personality and pain outcomes, evidence on the nature of this relationship is scarce. Therefore, the objective of this study is to explore the mediating effect of PF on the relationship between personality and distress. METHODS This transversal study included 108 participants (age M = 56.7, SD = 11.3) diagnosed with musculoskeletal chronic pain. Self-reported measures were administered by the medical care team. Multiple mediation models were performed for estimating the indirect effects on each outcome variable. RESULTS After controlling for age and gender covariates, we found that PF completely mediated the relationship between personality traits and all pain outcomes and partially mediated the impact of extraversion on anxiety. In addition, emotional stability also had an indirect effect on anxiety through PF. CONCLUSIONS Personality traits and PF are significant predictors of pain outcomes. PF represents a core process mediating the impact of personality traits on the perceived intensity of pain, fatigue, anxiety, and depression in patients with rheumatic disease. These results could facilitate the application of individualized psychological interventions in clinical contexts targeting the reduction of emotional avoidance and in chronic pain patients.
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Affiliation(s)
- Cristiana-Manuela Cojocaru
- The Doctoral School, George Emil Palade University of Medicine, Pharmacy, Science and Technology, 540142 Targu-Mures, Romania; (C.-M.C.); (A.S.); (H.M.)
| | - Cosmin Octavian Popa
- Department of Ethics and Social Sciences, George Emil Palade University of Medicine, Pharmacy, Science and Technology, 540142 Targu-Mures, Romania
| | - Alina Schenk
- The Doctoral School, George Emil Palade University of Medicine, Pharmacy, Science and Technology, 540142 Targu-Mures, Romania; (C.-M.C.); (A.S.); (H.M.)
| | - Ștefan Marian
- Department of Psychology, West University of Timişoara, 300223 Timişoara, Romania;
| | - Horia Marchean
- The Doctoral School, George Emil Palade University of Medicine, Pharmacy, Science and Technology, 540142 Targu-Mures, Romania; (C.-M.C.); (A.S.); (H.M.)
| | - Bogdan Andrei Suciu
- Department of Anatomy and Morphological Science, George Emil Palade University of Medicine, Pharmacy, Science, and Technology, 540142 Targu-Mures, Romania;
| | - Simona Szasz
- Department of Rheumatology, Physical and Rehabilitation Medicine, George Emil Palade University of Medicine, Pharmacy, Science and Technology, 540142 Targu-Mures, Romania; (S.S.); (H.P.)
| | - Horațiu Popoviciu
- Department of Rheumatology, Physical and Rehabilitation Medicine, George Emil Palade University of Medicine, Pharmacy, Science and Technology, 540142 Targu-Mures, Romania; (S.S.); (H.P.)
| | - Simona Mureșan
- Department of Internal Medicine IV, George Emil Palade University of Medicine, Pharmacy, Science and Technology, 540142 Targu-Mures, Romania;
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Williams MK, Waite L, Van Wyngaarden JJ, Meyer AR, Koppenhaver SL. Beyond yellow flags: The Big-Five personality traits and psychologically informed musculoskeletal rehabilitation. Musculoskeletal Care 2023; 21:1161-1174. [PMID: 37434350 DOI: 10.1002/msc.1797] [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: 06/26/2023] [Revised: 06/29/2023] [Accepted: 06/30/2023] [Indexed: 07/13/2023]
Abstract
BACKGROUND Psychosocial variables are known to play an important role in musculoskeletal pain. Recent efforts incorporating psychological theory into rehabilitative medicine, as part of patient-centred care or psychologically informed physical therapy, have gained broader acceptance. The fear-avoidance model is the dominant psychosocial model and has introduced a variety of phenomena which assess psychological distress (i.e., yellow flags). Yellow flags, such as fear, anxiety and catastrophizing, are useful concepts for musculoskeletal providers but reflect a narrow range of psychological responses to pain. OBJECTIVE Clinicians lack a more comprehensive framework to understand psychological profiles of each patient and provide individualised care. This narrative review presents the case for applying personality psychology and the Big-Five trait model (extraversion, agreeableness, conscientiousness, neuroticism and openness to experience) to musculoskeletal medicine. These traits have strong associations with various health outcomes and provide a robust framework to understand patient emotion, motivation, cognition and behaviour. KEY RESULTS High conscientiousness is associated with positive health outcomes and health promoting behaviours. High neuroticism with low conscientiousness increases the odds of negative health outcomes. Extraversion, agreeableness and openness have less direct effects but have positive correlations with important health behaviours, including active coping, positive affect, rehabilitation compliance, social connection and education level. CLINICAL APPLICATION The Big-Five model offers an evidence-based way for MSK providers to better understand the personality of their patients and how it relates to health. These traits offer the potential for additional prognostic factors, tailored treatments and psychological intervention.
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Affiliation(s)
- Matthew K Williams
- Department of Health, Human Performance, and Recreation, Baylor University, Waco, Texas, USA
| | - Lennie Waite
- Department of Psychology, University of St. Thomas, Houston, Texas, USA
| | - Joshua J Van Wyngaarden
- Army-Baylor University, Doctoral Program in Physical Therapy, Baylor University, San Antonio, Texas, USA
| | - Andrew R Meyer
- Department of Health, Human Performance, and Recreation, Baylor University, Waco, Texas, USA
| | - Shane L Koppenhaver
- Department of Health, Human Performance, and Recreation, Baylor University, Waco, Texas, USA
- Doctoral Program in Physical Therapy, Baylor University, Waco, Texas, USA
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Elgaeva EE, Williams FMK, Zaytseva OO, Freidin MB, Aulchenko YS, Suri P, Tsepilov YA. Bidirectional Mendelian Randomization Study of Personality Traits Reveals a Positive Feedback Loop Between Neuroticism and Back Pain. THE JOURNAL OF PAIN 2023; 24:1875-1885. [PMID: 37270142 DOI: 10.1016/j.jpain.2023.05.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 04/11/2023] [Accepted: 05/24/2023] [Indexed: 06/05/2023]
Abstract
We conducted a bidirectional Mendelian randomization study to examine the causal effects of six personality traits (anxiety, neuroticism, extraversion, openness to experience, agreeableness, and conscientiousness) on back pain associated with health care use and the causal effect of back pain on the same risk factors. Genetic instruments for the personality traits and back pain were obtained from the largest published genome-wide association studies conducted in individuals of European ancestry. We used inverse weighted variance meta-analysis and Causal Analysis Using Summary Effect for primary analyses and sensitivity analyses to examine evidence for causal associations. We interpreted exposure-outcome associations as being consistent with a causal relationship if results of at least one primary analysis were statistically significant after accounting for multiple statistical testing (P-value < .0042), and the direction and magnitude of effect estimates were concordant between primary and sensitivity analyses. We found evidence for statistically significant bidirectional causal associations between neuroticism and back pain, with odds ratio 1.51 (95% confidence interval 1.37; 1.67) of back pain per neuroticism sum score standard deviation, P-value = 7.80e-16; and beta = .12, se = .04 of neuroticism sum score standard deviation per log odds of back pain, P-value = 2.48e-03. Other relationships did not meet our predefined criteria for causal association. PERSPECTIVE: The significant positive feedback loop between neuroticism and back pain highlights the importance of considering neuroticism in the management of patients with back pain.
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Affiliation(s)
- Elizaveta E Elgaeva
- Department of Natural Sciences, Novosibirsk State University, Novosibirsk, Russia; Institute of Cytology and Genetics, Novosibirsk, Russia.
| | - Frances M K Williams
- Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King's College London, London, UK
| | | | - Maxim B Freidin
- Department of Biology, School of Biological and Behavioural Sciences, Queen Mary University of London, London, UK
| | - Yurii S Aulchenko
- Institute of Cytology and Genetics, Novosibirsk, Russia; PolyOmica, 's-Hertogenbosch, The Netherlands
| | - Pradeep Suri
- Division of Rehabilitation Care Services, VA Puget Sound Health Care System, Seattle, Washington, USA; Seattle Epidemiologic Research and Information Center, VA Puget Sound Health Care System, Seattle, Washington, USA; Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA; Clinical Learning, Evidence, and Research (CLEAR) Center, University of Washington, Seattle, Washington, USA
| | - Yakov A Tsepilov
- Institute of Cytology and Genetics, Novosibirsk, Russia; Kurchatov Genomics Center, Institute of Cytology & Genetics, Novosibirsk, Russia
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Rubén MC, Soriano Pastor JF, Monsalve Dolz V. Exploring the relationship between personality and chronic pain in adults with osteogenesis imperfecta: A cross-sectional study. Medicine (Baltimore) 2023; 102:e35352. [PMID: 37773867 PMCID: PMC10545165 DOI: 10.1097/md.0000000000035352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 09/01/2023] [Indexed: 10/01/2023] Open
Abstract
Despite the growing body of research on chronic pain in adults with osteogenesis imperfecta (OI), there is still a lack of comprehensive understanding of the influence of psychological factors on pain experienced by individuals with this condition. This study aims to delve into the correlation between personality traits and various aspects of pain, such as frequency, intensity, appraisal, and coping mechanisms, in a significant sample of adults with OI. Additionally, the investigation seeks to identify whether certain personality profiles may be more susceptible to chronic pain within this specific population. A descriptive cross-sectional study was conducted on a sample of 418 adults diagnosed with OI. Participants completed an online survey that assessed sociodemographic and clinical variables, pain parameters, personality traits, pain appraisal, and coping strategies. Subsequently, descriptive, correlational, cluster and comparative analyses were performed. Up to 83% of the participants reported experiencing pain on a regular basis. Regarding personality dimensions, moderate scores were obtained, with no significant differences compared to the general population. Neuroticism emerged as the trait showing the most robust relationships with the evaluated variables. It positively correlated with pain intensity, frequency, and the perception of pain as threatening (P < .001). Conversely, higher levels of extraversion were associated with a reduction in pain and its threatening perception (P < .001). Finally, the cluster analysis revealed a personality profile that showed greater vulnerability in pain adaptation, characterized by high levels of neuroticism and low levels of extraversion, agreeableness, and conscientiousness. Chronic pain is prevalent in adults with OI. Personality dimensions maintain a significant relationship with this pain, acting as vulnerability or protective factors. Consequently, specific personality profiles are associated with poorer adaptation. Understanding these profiles would allow for a deeper comprehension of the pain experience in adults with OI.
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Affiliation(s)
- Muñoz Cortés Rubén
- Fundación AHUCE and University of Valencia (Department of Personality, Evaluation and Psychological Treatments), Valencia, Spain
| | | | - Vicente Monsalve Dolz
- Multidisciplinary Pain Treatment Unit, General University Hospital of Valencia, University of Valencia (Department of Personality, Evaluation and Psychological Treatments), València, Spain
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Delgado-Sanchez A, Brown C, Sivan M, Talmi D, Charalambous C, Jones AKP. Are We Any Closer to Understanding How Chronic Pain Develops? A Systematic Search and Critical Narrative Review of Existing Chronic Pain Vulnerability Models. J Pain Res 2023; 16:3145-3166. [PMID: 37727681 PMCID: PMC10506671 DOI: 10.2147/jpr.s411628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 06/27/2023] [Indexed: 09/21/2023] Open
Abstract
Identifying biopsychosocial factors underlying chronic pain vulnerability is essential for the design of preventative efforts. Multiple chronic pain vulnerability models exist, however, there is a lack of comprehensive evaluation of these models in the literature, potentially due to the lack of guidelines that specify the criteria by which these types of work should be assessed. In this work, we created evaluation criteria (based on the general goals of conceptual models), and we then used them to critically review the chronic pain vulnerability models available in the current peer-reviewed literature (identified through a systematic search). Particularly, we evaluated the models on the basis of conceptual clarity/specificity of measures, depth of description of aetiological and mechanistic factors, use of a whole system approach, and quality of the evidence associated with the models. We found nine conceptual models that have been explored in detail (eg, fear avoidance model, diathesis-stress model). These models excel at clarity and are supported mostly by self-report evidence of a psychological nature (anxiety sensitivity, pain catastrophizing, etc.), but provide little explanation of mechanistic and aetiological factors. In the future, models could be improved by complementing them with proposals from other models and exploring potential causal factors and mechanisms maintaining the condition. This task could be carried out through prospective cohort studies, and computational approaches, amongst others.
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Affiliation(s)
- Ariane Delgado-Sanchez
- Division of Human Communication, Development, and Hearing, University of Manchester, Manchester, UK
| | - Christopher Brown
- Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Manoj Sivan
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
| | - Deborah Talmi
- Department of Psychology, University of Cambridge, Cambridge, UK
| | | | - Anthony K P Jones
- Division of Human Communication, Development, and Hearing, University of Manchester, Manchester, UK
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Suri P, Elgaeva EE, Williams FMK, Freidin MB, Zaytseva OO, Aulchenko YS, Tsepilov YA. Evidence of causal effects of blood pressure on back pain and back pain on type II diabetes provided by a bidirectional Mendelian randomization study. Spine J 2023; 23:1161-1171. [PMID: 37061135 DOI: 10.1016/j.spinee.2023.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 03/01/2023] [Accepted: 04/07/2023] [Indexed: 04/17/2023]
Abstract
BACKGROUND CONTEXT Cardiovascular risk factors (hypertension, dyslipidemia, and type II diabetes) have been proposed as risk factors for back pain. However, few longitudinal studies have found significant associations between cardiovascular risk factors and back pain, and these may be explained by confounding or reverse causation. PURPOSE To examine potential causal effects of cardiovascular risk factors on back pain, and vice versa. STUDY DESIGN Bidirectional Mendelian randomization (MR) study. PATIENT SAMPLES Genome-wide association studies (GWAS) with sample sizes between 173,082 and 1,028,947 participants. OUTCOME MEASURES Outcomes included (1) back pain associated with health care use (BP-HC) in the forward MR; and (2) seven cardiovascular phenotypes in the reverse MR, including 2 measurements used for the evaluation of hypertension (diastolic blood pressure and systolic blood pressure), 4 phenotypes related to dyslipidemia (LDL cholesterol, HDL cholesterol, total cholesterol, and triglycerides), and type II diabetes. METHODS We used summary statistics from large, publicly available GWAS for BP-HC and the 7 cardiovascular phenotypes to obtain genetic instrumental variables. We examined MR evidence for causal associations using inverse-variance weighted (IVW) analysis, Causal Analysis Using Summary Effect (CAUSE), and sensitivity analyses. RESULTS In forward MR analyses of seven cardiovascular phenotypes, diastolic blood pressure was associated with BP-HC across all analyses (IVW estimate: OR = 1.10 per 10.5 mm Hg increase [1.04-1.17], p-value = .001), and significant associations of systolic blood pressure with BP-HC were also found (IVW estimate: OR = 1.09 per 19.3 mm Hg increase [1.04-1.15], p-value = .0006). In reverse MR analyses, only type II diabetes was associated with BP-HC across all analyses (IVW estimate: OR = 1.40 [1.13-1.73], p-value = .002). CONCLUSIONS These findings from analyses of large, population-based samples indicate that higher blood pressure increases the risk of BP-HC, and BP-HC itself increases the risk of type II diabetes.
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Affiliation(s)
- Pradeep Suri
- Division of Rehabilitation Care Services, VA Puget Sound Health Care System, 1660 S. Columbian Way, 98108, Seattle, USA; Seattle Epidemiologic Research and Information Center, VA Puget Sound Health Care System, 1660 S. Columbian Way, 98108, Seattle, USA; Department of Rehabilitation Medicine, University of Washington, 325 Ninth Avenue, 98104, Seattle, USA; Clinical Learning, Evidence, and Research (CLEAR) Center, University of Washington, 325 Ninth Avenue, 98104, Seattle, USA.
| | - Elizaveta E Elgaeva
- Department of Natural Sciences, Novosibirsk State University, Pirogova Street 2, 630090,Novosibirsk, Russia; Laboratory of Recombination and Segregation Analysis, Institute of Cytology and Genetics, 630090, Novosibirsk, Russia
| | - Frances M K Williams
- Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King's College London, Westminster Bridge Road, London, UK
| | - Maxim B Freidin
- Department of Biology, School of Biological and Behavioural Sciences, Queen Mary University of London, Fogg Buliding, Mile End Road, London, UK
| | - Olga O Zaytseva
- Genos Glycoscience Research Laboratory, Borongajska cesta 83H, 10000, Zagreb, Croatia
| | - Yurii S Aulchenko
- Laboratory of Recombination and Segregation Analysis, Institute of Cytology and Genetics, 630090, Novosibirsk, Russia; PolyOmica, Het Vlaggeschip 61, 5237 PA, 's-Hertogenbosch, the Netherlands
| | - Yakov A Tsepilov
- Laboratory of Recombination and Segregation Analysis, Institute of Cytology and Genetics, 630090, Novosibirsk, Russia; Kurchatov Genomics Center, Institute of Cytology & Genetics, 630090, Novosibirsk, Russia
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Diotaiuti P, Corrado S, Mancone S, Cavicchiolo E, Chirico A, Siqueira TC, Andrade A. A psychometric evaluation of the Italian short version of the Fear of Pain Questionnaire-III: Psychometric properties, measurement invariance across gender, convergent, and discriminant validity. Front Psychol 2023; 13:1087055. [PMID: 36726497 PMCID: PMC9886064 DOI: 10.3389/fpsyg.2022.1087055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 12/12/2022] [Indexed: 01/12/2023] Open
Abstract
Introduction The Fear of Pain Questionnaire-III (FPQ-III) is a self-assessment instrument developed specifically to measure fear based on various pain stimuli converging on three factors: severe pain, medical pain, and minor pain. It actually remains the most studied and internationally used tool even in its short versions. The aim of this work was to propose a new validation study oriented to confirm the good psychometric properties of a short model of the FPQ-III for the Italian context. Methods A large sample of participants was recruited (n = 1,064) and Exploratory Factor Analysis (EFA) as well as Confirmatory Factor Analysis (CFA) were performed. Measurement invariance of the FPQ-III across gender was also evaluated. In order to examine convergent validity, a further convenient sample (n = 292) was used and variables related to the individual's pain experience, locus of control and coping orientations were assessed. A final discriminant assessment using experimental manipulation through fear eliciting videos was performed. Results The three factors structure of the 13-item version of the questionnaire was confirmed (χ2 = 148.092, CFI = 0.971, TLI = 0.962, RMSEA = 0.046, RMSEA 90% CI = 0.037-0.056) as well as the measurement invariance across gender. Item internal reliability was satisfactory. The results provided evidence of the good predictive validity of the FPQ-III and the discriminant assessment demonstrated that the instrument is suitable in detecting changes in fear of pain induced by specific situational conditions. Discussion The scale in this short version is suitable for quickly and efficiently gathering information about the perceived intensity of such anticipatory fears that might affect even the healthy person dysfunctionally.
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Affiliation(s)
- Pierluigi Diotaiuti
- Department of Human Sciences, Society and Health, University of Cassino and Lazio, Cassino, Italy,*Correspondence: Pierluigi Diotaiuti,
| | - Stefano Corrado
- Department of Human Sciences, Society and Health, University of Cassino and Lazio, Cassino, Italy
| | - Stefania Mancone
- Department of Human Sciences, Society and Health, University of Cassino and Lazio, Cassino, Italy
| | - Elisa Cavicchiolo
- Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy
| | - Andrea Chirico
- Department of Psychology of Development and Socialization Processes, Sapienza University of Rome, Rome, Italy
| | - Thais Cristina Siqueira
- Health and Sports Science Center, Department of Physical Education, CEFID, Santa Catarina State University, Florianopolis, Santa Catarina, Brazil
| | - Alexandro Andrade
- Health and Sports Science Center, Department of Physical Education, CEFID, Santa Catarina State University, Florianopolis, Santa Catarina, Brazil
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Personality Type and Chronic Pain: The Relationship between Personality Profile and Chronic Low Back Pain Using Eysenck’s Personality Inventory. NEUROSCI 2022. [DOI: 10.3390/neurosci3040049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background: Personality type plays a key role in how individuals respond to a variety of stimuli; however, it is unclear if there is a significant influence on pain perception. While pain is associated with many conditions, chronic low back pain (cLBP) is one of the most prevalent and debilitating problems in modern society. Treating this condition can be a challenge and clinicians must understand all factors that can influence pain perception. Purpose: The present study investigated the relationship between personality type and pain experience in patients experiencing cLBP. Methods: One hundred twenty-four participants completed the Eysenck Personality Inventory (EPI), which identifies two major components of the human personality, neuroticism, and extraversion. Participants also completed the Oswestry Disability Index (ODI), the Tampa Scale for Kinesiophobia (TSK), the Numeric Pain Rating Scale (NPRS), and the Pain Catastrophizing Scale (PCS). The association between pain and personality was determined with a Spearman Rank Correlation Coefficient. A hierarchical cluster analysis with Ward’s clustering method examined for subgroups of individuals based on these variables. Results: The neuroticism score (EPI-N) was found to have a statistically significant relationship with all pain outcome measures. This suggests that people exhibiting a neurotic personality type are likely to have more fear of movement (p = 0.001), greater catastrophizing behavior (p < 0.001), higher self-reported levels of disability (p < 0.001), and higher overall reported levels of pain (p = 0.046) than those with other, more stable personality types. Three clusters were derived with varying levels of pain-related factors and personality. Conclusions: Personality type appears to have an influence on many of the attributes associated with cLBP and may be a useful determinate in both prognosis and interventions.
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Özlü A, Leblebicier MA, Ünver G. Examination of Type D personality, depression and perceived social support in women With fibromyalgia. Perspect Psychiatr Care 2022; 58:2154-2160. [PMID: 35124812 DOI: 10.1111/ppc.13042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 01/18/2022] [Accepted: 01/29/2022] [Indexed: 11/30/2022] Open
Abstract
PURPOSE This study aims to evaluate the relationship between Type D personality, depression, perceived social support, and disease activity in women with fibromyalgia (FM). DESIGN AND METHODS One hundred and forty women applied to the physical medicine rehabilitation outpatient clinic between October 2019 and February 2020 who also had been diagnosed with FM were recruited. Age, occupation, marital status, chronic diseases, body mass index, duration of FM, smoking and alcohol use, sleep patterns, difficulty with daily work and self-care, physical therapy, and rehabilitation status were all recorded as demographic data of subjects. All patients participating in the study were evaluated with a Type D Personality Scale, Beck Depression Inventory, Visual Analog Scale (VAS), Fibromyalgia Impact Questionnaire (FIQ), and Multidimensional Scale of Perceived Social Support (MSPSS). FINDINGS It has been determined that more than half of the women diagnosed with FM had the disease for more than 2 years, the average age was 46, 70% of patients were 40 years or older, more than half were overweight or obese and 63.6% had Type D personality. Eighty-nine women diagnosed with FM had a Type D personality and a significant correlation was found between Type D personality and depression, VAS, FIQ, and the subparameters of MSPSS. PRACTICAL IMPLICATIONS The determination of a relationship between the Type D personality and depression, VAS, FIQ, and MSPSS in women with FM plays a very important role in the care of FM in terms of treatment and prognosis and it can be said that determining the personality traits of such patients may be beneficial for clinicians.
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Affiliation(s)
- Aysun Özlü
- Department of Physical Therapy and Rehabilitation, Faculty of Medicine, Kutahya Health Sciences University, Kutahya, Turkey
| | - Merve A Leblebicier
- Department of Physical Therapy and Rehabilitation, Faculty of Medicine, Kutahya Health Sciences University, Kutahya, Turkey
| | - Gamze Ünver
- Department of Internal Medicine Nursing, Faculty of Health Sciences, Kutahya Health Sciences University, Kutahya, Turkey
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Piao JJ, Gu Y, Ling Y, Chi L, Chen Y, Wang R. Mediating effect of kinesiophobia between self-efficacy and physical activity levels in post-CABG patients: protocol for a prospective, multicentre, cross-sectional study in China. BMJ Open 2022; 12:e062013. [PMID: 35951463 PMCID: PMC9301793 DOI: 10.1136/bmjopen-2022-062013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 06/06/2022] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Physical activity (PA) can improve cardiac function, exercise capacity, and quality of life, in addition to reducing mortality by 20%-30% and preventing the recurrence of adverse cardiovascular events in patients following coronary artery bypass graft (CABG). However, PA levels are low in patients after CABG. This study intends to explore the mediating effect of kinesiophobia between self-efficacy and PA levels in patients following CABG. METHODS AND ANALYSIS The proposed study constitutes a prospective, multicentre and cross-sectional study comprising 413 patients. Four teaching hospitals with good reputations in CABG will be included in the study. All of them are located in Beijing, China, and provide medical service to the whole country. This study will assess the following patient-reported outcome measures: demographic information, International Physical Activity Questionnaire-Long, Social Support Rating Scale, Cardiac Exercise Self-Efficacy Instrument, Multidimensional Fatigue Inventory, Hospital Anxiety and Depression Scale, and Tampa Scale for Kinesiophobia Heart. ETHICS AND DISSEMINATION This study conforms to the principles of the Declaration of Helsinki and relevant ethical guidelines. Ethical approval has been obtained from the Ethics Committee of The Sixth Medical Centre of PLA General Hospital (approval number: HZKY-PJ-2022-2). All study participants will provide written informed consent. Findings from this study will be published in Chinese or English for widespread dissemination of the results. TRIAL REGISTRATION NUMBER Chinese Clinical Trial Register, ChiCTR2100054098.
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Affiliation(s)
- Jing Jing Piao
- Faculty of Nursing, Hebei University of Chinese Medicine, Shijiazhuang, China
| | - Yanmei Gu
- Faculty of Nursing, Hebei University of Chinese Medicine, Shijiazhuang, China
| | - Yunpeng Ling
- Department of Adult Cardiovascular Surgery, Peking University Third Hospital, Beijing, China
| | - Liqun Chi
- Department of Adult Cardiovascular Surgery, Capital Medical University Affiliated Anzhen Hospital, Beijing, China
| | - Yu Chen
- Department of Adult Cardiovascular Surgery, Peking University People's Hospital, Beijing, China
| | - Rong Wang
- Department of Adult Cardiovascular Surgery, Sixth Medical Center of PLA General Hospital, Beijing, China
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Teixidó-Abiol L, de Arriba-Arnau A, Seguí Montesinos J, Herradón Gil-Gallardo G, Sánchez-López MJ, De Sanctis Briggs V. Psychopathological and Personality Pro file in Chronic Nononcologic Nociceptive and Neuropathic pain: Cross-sectional Comparative Study. Int J Psychol Res (Medellin) 2022; 15:51-67. [PMID: 37274511 PMCID: PMC10233962 DOI: 10.21500/20112084.5631] [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: 10/07/2021] [Accepted: 05/10/2022] [Indexed: 06/06/2023] Open
Abstract
Introduction Adaptation to chronic non-oncologic pain is associated with the development of psychopathology and personality disorders, creating severity, chronicity, poorer treatment response, and exacerbations in patients with neuropathy. Objective To identify the psychopathological and personality profiles of patients with chronic nociceptive and neuropathic pain and their association with pain progression and intensity. Method A cross-sectional, descriptive and comparative study was conducted in the Pain Treatment Unit of Hospital Universitari Sagrat Cor, with systematic randomized recruitment for 25 months; 115 patients were evaluated using the Hamilton Depression and Anxiety Rating Scale (HAM-D, HAM-A) and the Millon Clinical MultiaxialInventory-III (MCMI-III). Results The neuropathic group achieved significantly higher scores for pain intensity and depressive and anxiety symptoms. With greater magnitude and frequency, the neuropathic group related pain intensity and progression with depressive/anxiety symptoms, clinical syndromes, and personality patterns. Both groups revealed tendencies towards a compulsive personality pattern, followed by narcissistic, histrionic, and schizoid patterns. Conclusions When treating chronic pain, the presence of various psychopathological indicators requires an individualized strategy.
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Affiliation(s)
- Laura Teixidó-Abiol
- Servicio de Psiquiatría y Unidad del dolor, Servicio de Anestesiología, Hospital Universitari Sagrat Cor, Grupo Hospitalario Quirónsalud; CEINDO Escuela Internacional de Doctorado, Universitat Abat Oliba CEU, CEU Universities, Madrid y Barcelona, España.CEU UniversitiesMadrid y BarcelonaEspaña
| | - Aida de Arriba-Arnau
- Servicio de Psiquiatría, Hospital Universitari Sagrat Cor, Grupo Hospitalario Quirón- salud, Barcelona, España.Hospital Universitari Sagrat CorBarcelonaEspaña
| | - Juan Seguí Montesinos
- Servicio de Psiquiatría, Hospital Universitari Sagrat Cor, Grupo Hospitalario Quirón- salud, Barcelona, España.Hospital Universitari Sagrat CorBarcelonaEspaña
| | - Gonzalo Herradón Gil-Gallardo
- Departamento de Ciencias Farmacéuticas y de la Salud, Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Madrid, España.Facultad de FarmaciaCEU UniversitiesMadridEspaña
| | - María José Sánchez-López
- Servicio de Biblioteca, Hospital Universitari Sagrat Cor, Grupo Hospitalario Quirónsalud, Barcelona, España.Hospital Universitari Sagrat Cor
| | - Vicente De Sanctis Briggs
- Unidad del dolor, Servicio de Anestesiología, Hospital Universitari Sagrat Cor, Grupo Hospitalario Quirónsalud, Barcelona, España.BarcelonaEspaña
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Factors influencing kinesiophobia during the "blanking period" after radiofrequency catheter ablation in patients with atrial fibrillation by the fear-avoidance model. Int J Cardiol 2022; 363:49-55. [PMID: 35716943 DOI: 10.1016/j.ijcard.2022.06.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 05/31/2022] [Accepted: 06/10/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND The influencing factors of kinesiophobia (fear of movement) in patients with atrial fibrillation(AF)during the post-operative "Blanking Period" are not known. The aims were to investigate the status of kinesiophobia in patients with AF during the post-operative "Blanking Period", then further describe the occurrence and analyze the influencing factors of patients' kinesiophobia by the Fear-Avoidance Model. MATERIALS AND METHODS In total,400 patients diagnosed with atrial fibrillation, during the post-operative "Blanking Period" from the selected hospital were included in this study. The Tampa Scale for Kinesiophobia Heart (TSK-SV Heart), the Self-efficacy for Exercise (SEE) scale, and the Geriatric Locomotive Function Scale (GLFS) were used to assess kinesiophobia, exercise self-efficacy, and physical function. The study adopted a cross-sectional design. RESULTS The score of kinesiophobia during the "Blanking Period" after operation in patients with atrial fibrillation was (44.06 ± 10.77), and the rate of high kinesiophobia was 71.61%.Logistic regression results showed that age, education, household monthly income, resting heart rate, EHRA symptom classification, exercise self-efficacy, and physical function influenced the kinesiophobia of patients during the post-operative "Blanking Period"(p<0.05, p<0.01). CONCLUSIONS Kinesiophobia is common in patients with atrial fibrillation during the postoperative "Blanking Period", and the fear of movement is related to age, education, household monthly income, resting heart rate, EHRA symptom classification, exercise self-efficacy, and physical function. Clinical and nursing staff should pay close attention to the psychological problems in the post-operation "Blanking Period" of exercise rehabilitation in patients with atrial fibrillation, make timely interventions to reduce patients' fear of movement, and improve patients' compliance with exercise rehabilitation.
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The Impact of the COVID-19 Pandemic on Youth with Chronic Pain and Their Parents: A Longitudinal Examination of Who Are Most at Risk. CHILDREN 2022; 9:children9050745. [PMID: 35626922 PMCID: PMC9139609 DOI: 10.3390/children9050745] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/17/2022] [Accepted: 05/18/2022] [Indexed: 12/02/2022]
Abstract
Objectives: Chronic pain and mental illness in youth and parents are poised to reach new heights amidst the societal and healthcare impacts of the COVID-19 pandemic. Evidence from natural disasters (i.e., hurricanes) suggests that a degree of personal impact and individual personality may moderate the effects of high stress events, such as the COVID-19 pandemic, on mental health. Methods: In a pre-existing cohort of 84 youth with chronic pain (Mage = 14.39; 12–18 years; 67.8% female) and 90 parents (86.7% female), we examined changes in youth pain interference and youth and parent mental health (depression, anxiety) from before to during the first wave of the COVID-19 pandemic, and the influence of personal impact of the pandemic (i.e., financial, familial, health, social, occupational, and educational domains) and individual personality (neuroticism, conscientiousness, extroversion). Results: Overall, youth reported significantly lower pain interference and anxiety as compared to pre-pandemic; however, those more personally impacted by the pandemic reported worsening pain interference and anxiety symptoms. Overall, parents reported greater depressive symptoms as compared to pre-pandemic; however, those more personally impacted by the pandemic reported increased anxiety symptoms. Personality traits (high neuroticism, and low conscientiousness and extroversion) predicted worsened pain and mental health, and exacerbated effects of COVID-19-related personal impact on youth and parent anxiety symptoms. Discussion: Identifying risk and resilience profiles in youth and parents at high risk for worsening pain and mental health may better inform matching interventions to individual need.
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Evaluation of Cognitive Behavioral Therapy on Improving Pain, Fear Avoidance, and Self-Efficacy in Patients with Chronic Low Back Pain: A Systematic Review and Meta-Analysis. Pain Res Manag 2022; 2022:4276175. [PMID: 35345623 PMCID: PMC8957446 DOI: 10.1155/2022/4276175] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 12/09/2021] [Accepted: 02/24/2022] [Indexed: 12/24/2022]
Abstract
Background. Cognitive-behavioral therapy (CBT) is commonly adopted in pain management programs for patients with chronic low back pain (CLBP). However, the benefits of CBT are still unclear. Objectives. This review investigated the effectiveness of CBT on pain, disability, fear avoidance, and self-efficacy in patients with CLBP. Methods. Databases including PubMed, EMBASE, Web of Science, Cochrane Library, and PsycINFO were searched. RCTs examining the effects of CBT in adults with CLBP were included. The data about the outcome of pain, disability, fear avoidance, and self-efficacy were retained. Subgroup analysis about the effects of CBT on posttreatment was conducted according to CBT versus control groups (waiting list/usual care, active therapy) and concurrent CBT versus CBT alone. A random-effects model was used, and statistical heterogeneity was explored. Results. 22 articles were included. The results indicated that CBT was superior to other therapies in improving disability (SMD −0.44, 95% CI −0.71 to −0.17,
), pain (SMD −0.32, 95% CI −0.57 to −0.06,
), fear avoidance (SMD −1.24, 95% CI −2.25 to −0.23,
), and self-efficacy (SMD 0.27, 95% CI 0.15 to 0.40,
) after intervention. No different effect was observed between CBT and other therapies in all the follow-up terms. Subgroup analysis suggested that CBT in conjunction with other interventions was in favor of other interventions alone to reduce pain and disability (
). Conclusion. CBT is beneficial in patients with CLBP for improving pain, disability, fear avoidance, and self-efficacy in CLBP patients. Further study is recommended to investigate the long-term benefits of CBT. This meta-analysis is registered with Prospero (registration number CRD42021224837).
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Kerckhove N, Delage N, Cambier S, Cantagrel N, Serra E, Marcaillou F, Maindet C, Picard P, Martiné G, Deleens R, Trouvin AP, Fourel L, Espagne-Dubreuilh G, Douay L, Foulon S, Dufraisse B, Gov C, Viel E, Jedryka F, Pouplin S, Lestrade C, Combe E, Perrot S, Perocheau D, De Brisson V, Vergne-Salle P, Mertens P, Pereira B, Djiberou Mahamadou AJ, Antoine V, Corteval A, Eschalier A, Dualé C, Attal N, Authier N. eDOL mHealth App and Web Platform for Self-monitoring and Medical Follow-up of Patients With Chronic Pain: Observational Feasibility Study. JMIR Form Res 2022; 6:e30052. [PMID: 35234654 PMCID: PMC8928045 DOI: 10.2196/30052] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 09/14/2021] [Accepted: 11/29/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Chronic pain affects approximately 30% of the general population, severely degrades quality of life (especially in older adults) and professional life (inability or reduction in the ability to work and loss of employment), and leads to billions in additional health care costs. Moreover, available painkillers are old, with limited efficacy and can cause significant adverse effects. Thus, there is a need for innovation in the management of chronic pain. Better characterization of patients could help to identify the predictors of successful treatments, and thus, guide physicians in the initial choice of treatment and in the follow-up of their patients. Nevertheless, current assessments of patients with chronic pain provide only fragmentary data on painful daily experiences. Real-life monitoring of subjective and objective markers of chronic pain using mobile health (mHealth) programs can address this issue. OBJECTIVE We hypothesized that regular patient self-monitoring using an mHealth app would lead physicians to obtain deeper understanding and new insight into patients with chronic pain and that, for patients, regular self-monitoring using an mHealth app would play a positive therapeutic role and improve adherence to treatment. We aimed to evaluate the feasibility and acceptability of a new mHealth app called eDOL. METHODS We conducted an observational study to assess the feasibility and acceptability of the eDOL tool. Patients completed several questionnaires using the tool over a period of 2 weeks and repeated assessments weekly over a period of 3 months. Physicians saw their patients at a follow-up visit that took place at least 3 months after the inclusion visit. A composite criterion of the acceptability and feasibility of the eDOL tool was calculated after the completion of study using satisfaction surveys from both patients and physicians. RESULTS Data from 105 patients (of 133 who were included) were analyzed. The rate of adherence was 61.9% (65/105) after 3 months. The median acceptability score was 7 (out of 10) for both patients and physicians. There was a high rate of completion of the baseline questionnaires and assessments (mean 89.3%), and a low rate of completion of the follow-up questionnaires and assessments (63.8% (67/105) and 61.9% (65/105) respectively). We were also able to characterize subgroups of patients and determine a profile of those who adhered to eDOL. We obtained 4 clusters that differ from each other in their biopsychosocial characteristics. Cluster 4 corresponds to patients with more disabling chronic pain (daily impact and comorbidities) and vice versa for cluster 1. CONCLUSIONS This work demonstrates that eDOL is highly feasible and acceptable for both patients with chronic pain and their physicians. It also shows that such a tool can integrate many parameters to ensure the detailed characterization of patients for future research works and pain management. TRIAL REGISTRATION ClinicalTrial.gov NCT03931694; http://clinicaltrials.gov/ct2/show/NCT03931694.
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Affiliation(s)
- Nicolas Kerckhove
- Service de Pharmacologie médicale, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - Noémie Delage
- Centre d'évaluation et de traitement de la douleur, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - Sébastien Cambier
- Centre d'évaluation et de traitement de la douleur, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - Nathalie Cantagrel
- Centre d'évaluation et de traitement de la douleur, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Eric Serra
- Centre d'évaluation et de traitement de la douleur, Centre Hospitalier Universitaire d'Amiens, Amiens, France
| | - Fabienne Marcaillou
- Centre d'évaluation et de traitement de la douleur, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - Caroline Maindet
- Centre d'évaluation et de traitement de la douleur, Centre Hospitalier Universitaire de Grenoble, Grenoble, France
| | - Pascale Picard
- Centre d'évaluation et de traitement de la douleur, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - Gaelle Martiné
- Centre d'évaluation et de traitement de la douleur, Centre Hospitalier Universitaire de Limoges, Limoges, France
| | - Rodrigue Deleens
- Centre d'évaluation et de traitement de la douleur, Centre Hospitalier Universitaire de Rouen, Rouen, France
| | - Anne-Priscille Trouvin
- Centre d'évaluation et de traitement de la douleur, Assistance Publique-Hôpitaux de Paris Cochin, Paris, France
| | - Lauriane Fourel
- Centre d'évaluation et de traitement de la douleur, Centre Hospitalier Régional de Bayeux, Bayeux, France
| | - Gaelle Espagne-Dubreuilh
- Centre d'évaluation et de traitement de la douleur, Centre Hospitalier Universitaire de Limoges, Limoges, France
| | - Ludovic Douay
- Centre d'évaluation et de traitement de la douleur, Centre Hospitalier Universitaire d'Amiens, Amiens, France
| | - Stéphane Foulon
- Centre d'évaluation et de traitement de la douleur, Centre Hospitalier Universitaire d'Amiens, Amiens, France
| | - Bénédicte Dufraisse
- Centre d'évaluation et de traitement de la douleur, Centre Hospitalier Universitaire de Limoges, Limoges, France
| | - Christian Gov
- Centre d'évaluation et de traitement de la douleur, Hospices Civils de Lyon Pierre Wertheimer, Lyon, France
| | - Eric Viel
- Centre d'évaluation et de traitement de la douleur, Centre Hospitalier Universitaire de Nîmes, Nîmes, France
| | - François Jedryka
- Centre d'évaluation et de traitement de la douleur, Centre Hospitalier Universitaire de Nîmes, Nîmes, France
| | - Sophie Pouplin
- Centre d'évaluation et de traitement de la douleur, Centre Hospitalier Universitaire de Rouen, Rouen, France
| | - Cécile Lestrade
- Centre d'évaluation et de traitement de la douleur, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Emmanuel Combe
- Centre d'évaluation et de traitement de la douleur, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Serge Perrot
- Centre d'évaluation et de traitement de la douleur, Assistance Publique-Hôpitaux de Paris Cochin, Paris, France
| | - Dominique Perocheau
- Centre d'évaluation et de traitement de la douleur, Assistance Publique-Hôpitaux de Paris Cochin, Paris, France
| | - Valentine De Brisson
- Centre d'évaluation et de traitement de la douleur, Centre Hospitalier Régional de Bayeux, Bayeux, France
| | - Pascale Vergne-Salle
- Centre d'évaluation et de traitement de la douleur, Centre Hospitalier Universitaire de Limoges, Limoges, France
| | - Patrick Mertens
- Centre d'évaluation et de traitement de la douleur, Hospices Civils de Lyon Pierre Wertheimer, Lyon, France
| | - Bruno Pereira
- Centre d'évaluation et de traitement de la douleur, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | | | - Violaine Antoine
- Laboratoire d'Informatique, de Modélisation et d'Optimisation des Systèmes, Université Clermont Auvergne, Aubière, France
| | | | | | - Christian Dualé
- Centre d'évaluation et de traitement de la douleur, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - Nadine Attal
- Institut National de la Santé et de la Recherche Médicale, Unité 987 - Centre d'évaluation et de traitement de la douleur, Assistance Publique-Hôpitaux de Paris Ambroise Paré, Paris, France
| | - Nicolas Authier
- Centre d'évaluation et de traitement de la douleur, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
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Wettstein M, Schilling OK, Wahl HW. Trajectories of Pain in Very Old Age: The Role of Eudaimonic Wellbeing and Personality. FRONTIERS IN PAIN RESEARCH 2022; 3:807179. [PMID: 35295803 PMCID: PMC8915612 DOI: 10.3389/fpain.2022.807179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 01/26/2022] [Indexed: 11/27/2022] Open
Abstract
Pain is common in very old age and in the last years prior to death. However, little is known regarding longitudinal trajectories of pain in very old age and at the end of life. Moreover, whereas medical and morbidity-related factors contributing to pain are established, the role of psychosocial factors, such as eudaimonic wellbeing or personality as potential determinants of late-life pain trajectories has so far not been sufficiently investigated. We used data from the LateLine project. The sample consisted of n = 118 very old adults (M = 90.5 years, SD = 2.8 years) who were living alone at baseline and who had died between 2009 and 2021. They took part in up to 16 measurement occasions (M = 5.2, SD = 4.7, range 1–16) within an observational interval of 7 years. Assessment of pain was based on the SF-36 bodily pain subscale. Key indicators of eudaimonic wellbeing (autonomy, environmental mastery, and purpose in life) as well two of the Big Five personality traits (neuroticism and extraversion) were included as predictors. We controlled in all analyses for gender, education, subjective health, and depressive symptoms. Contrasting pain trajectories over chronological age (time since birth) vs. time to death, a time-to-death-related model resulted in a better model fit and accounted for a larger amount of pain variability than the age-related model. Mean-level change in pain, both over age and time to death, was not significant, but there was substantial interindividual variability in intraindividual trajectories. Age-related change in pain was significantly predicted by autonomy and neuroticism, with increasing pain among those who had lower initial autonomy scores and higher initial neuroticism scores. With regard to time-to-death-related trajectories of pain, higher purpose in life as well as lower extraversion at baseline predicted less increase or even steeper decrease in pain with approaching death. Our findings suggest that, despite overall mean-level stability in pain both over age and time to death, there is a substantial proportion of individuals who reveal deterioration in pain over time. Regarding the role of psychosocial predictors, personality traits and eudaimonic wellbeing are related with late-life pain trajectories both over age and time-to-death.
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Affiliation(s)
- Markus Wettstein
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
- Network Aging Research, Heidelberg University, Heidelberg, Germany
- *Correspondence: Markus Wettstein
| | - Oliver Karl Schilling
- Department of Psychological Aging Research, Psychological Institute, Heidelberg University, Heidelberg, Germany
| | - Hans-Werner Wahl
- Network Aging Research, Heidelberg University, Heidelberg, Germany
- Department of Psychological Aging Research, Psychological Institute, Heidelberg University, Heidelberg, Germany
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Examining Association of Personality Characteristics and Neuropsychiatric Symptoms in Post-COVID Syndrome. Brain Sci 2022; 12:brainsci12020265. [PMID: 35204028 PMCID: PMC8870488 DOI: 10.3390/brainsci12020265] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 02/10/2022] [Accepted: 02/10/2022] [Indexed: 02/05/2023] Open
Abstract
Background: We aimed to evaluate personality traits in patients with post-COVID syndrome, as well as the association with neuropsychiatric symptoms present in this disorder. Methods: The Big Five Structure Inventory was administered to 93 consecutive patients with a diagnosis of post-COVID syndrome as defined by the WHO and to demographically matched controls. We also performed a comprehensive evaluation of depression, anxiety, fatigue, sleep quality, cognitive function, and olfactory function. Results: Patients with post-COVID syndrome scored lower for emotional stability, equanimity, positive mood, and self-control. Extraversion, emotional stability, and openness correlated negatively with anxiety and depression levels. Conscientiousness correlated negatively with anxiety. No statistically significant correlations were observed between personality traits and cognitive function, sleep quality, olfactory function, or fatigue. Personality scores explained 36.3% and 41% of the variance in scores on the anxiety and depression scales, respectively. Two personality profiles with lower levels of emotional stability were associated with depression and anxiety. Conclusions: Our study shows higher levels of neuroticism in patients with post-COVID syndrome. Personality traits were predictive of the presence of depression and anxiety, but not cognitive function, sleep quality, or fatigue, in the context of post-COVID syndrome. These findings may have implications for the detection of patients at risk of depression and anxiety in post-COVID syndrome, and for the development of preventive and therapeutic interventions.
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Gharavi Roudsari E, Mousavi Nasab SH, Ghavidel-Parsa B, Yazdi F, Khezri Moghadam N. Personality and pain intensity in rheumatoid arthritis patients: The mediating role of pain catastrophizing and cognitive emotion regulation strategies. PERSONALITY AND INDIVIDUAL DIFFERENCES 2022. [DOI: 10.1016/j.paid.2021.111390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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20
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Pinto SM, Cheung JPY, Samartzis D, Karppinen J, Zheng YP, Pang MYC, Wong AYL. Are Morphometric and Biomechanical Characteristics of Lumbar Multifidus Related to Pain Intensity or Disability in People With Chronic Low Back Pain After Considering Psychological Factors or Insomnia? Front Psychiatry 2022; 13:809891. [PMID: 35492728 PMCID: PMC9053572 DOI: 10.3389/fpsyt.2022.809891] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 03/14/2022] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Lumbar multifidus muscle (LMM) dysfunction is thought to be related to pain and/or disability in people with chronic low back pain (CLBP). Although psychosocial factors play a major role in pain/disability, they are seldom considered as confounders in analyzing the association between LMM and CLBP. OBJECTIVES This study aimed to determine: (1) differences in psychological factors, insomnia, and LMM characteristics between people with and without CLBP; (2) associations between psychological factors, insomnia, or LMM characteristics and low back pain (LBP) intensity or LBP-related disability in people with CLBP; and (3) whether LMM characteristics are related to LBP symptoms in people with CLBP after considering confounders. METHODS Seventy-eight volunteers with CLBP and 73 without CLBP provided sociodemographic information, filled the 11-point numeric pain rating scale and Roland-Morris disability questionnaire (RMDQ). They completed the Hospital Anxiety and Depression Scale (HADS), Pain Catastrophizing Scale (PCS), Fear Avoidance Belief Questionnaire (FAB), and Insomnia Severity Index Scale (ISI). Resting and contracted thickness of LMM at L4-S1 levels were measured from brightness-mode ultrasound images. Percent thickness changes of LMM at L4-S1 levels during contraction were calculated. Resting LMM stiffness at L4-S1 was measured by shear wave elastography. Associations among LMM, psychosocial or insomnia parameters and clinical outcomes were analyzed by univariate and multivariate analyses. RESULTS People with CLBP demonstrated significantly higher LBP-intensity, RMDQ, HADS, FAB, PCS, and ISI scores than asymptomatic controls (p < 0.05). The former also had significantly smaller percent thickness changes of LMM at L4/L5 during contraction. LBP-intensity was positively related to scores of PCS-total, PCS-helplessness, FAB-total, FAB-work, and ISI in people with CLBP (p < 0.05). RMDQ scores were positively associated with the scores of HADS-total, HADS-depression, PCS-total, FAB-total, FAB-physical activity, PCS-helplessness, and ISI in people with CLBP (p < 0.05). FAB-work and ISI scores together explained 24% of LBP-intensity. FAB-total scores alone explained 34% of variance of LBP-related disability in people with CLBP. CONCLUSION More fear-avoidance belief or insomnia is related to greater LBP-intensity and/or LBP-related disability in people with CLBP. Although people with CLBP were thought to have aberrant LMM morphometry/function, no LMM characteristics were related to LBP-intensity or LBP-related disability after considering other confounders.
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Affiliation(s)
- Sabina M Pinto
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Jason P Y Cheung
- Department of Orthopaedics and Traumatology, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Dino Samartzis
- Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, United States.,International Spine Research and Innovation Initiative, Rush University Medical Center, Chicago, IL, United States
| | - Jaro Karppinen
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.,Rehabilitation Services of South Karelia Social and Health Care District, Lappeenranta, Finland.,Finnish Institute of Occupational Health, Oulu, Finland
| | - Yong-Ping Zheng
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Marco Y C Pang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Arnold Y L Wong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
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21
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Labrenz F, Woud ML, Elsenbruch S, Icenhour A. The Good, the Bad, and the Ugly-Chances, Challenges, and Clinical Implications of Avoidance Research in Psychosomatic Medicine. Front Psychiatry 2022; 13:841734. [PMID: 35250678 PMCID: PMC8894646 DOI: 10.3389/fpsyt.2022.841734] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 01/28/2022] [Indexed: 12/12/2022] Open
Abstract
Avoidance behaviors are shaped by associative learning processes in response to fear of impending threats, particularly physical harm. As part of a defensive repertoire, avoidance is highly adaptive in case of acute danger, serving a potent protective function. However, persistent or excessive fear and maladaptive avoidance are considered key factors in the etiology and pathophysiology of anxiety- and stress-related psychosomatic disorders. In these overlapping conditions, avoidance can increase the risk of mental comorbidities and interfere with the efficacy of cognitive behavioral treatment approaches built on fear extinction. Despite resurging interest in avoidance research also in the context of psychosomatic medicine, especially in conditions associated with pain, disturbed interoception, and disorders of the gut-brain axis, current study designs and their translation into the clinical context face significant challenges limiting both, the investigation of mechanisms involved in avoidance and the development of novel targeted treatment options. We herein selectively review the conceptual framework of learning and memory processes, emphasizing how classical and operant conditioning, fear extinction, and return of fear shape avoidance behaviors. We further discuss pathological avoidance and safety behaviors as hallmark features in psychosomatic diseases, with a focus on anxiety- and stress-related disorders. Aiming to emphasize chances of improved translational knowledge across clinical conditions, we further point out limitations in current experimental avoidance research. Based on these considerations, we propose means to improve existing avoidance paradigms to broaden our understanding of underlying mechanisms, moderators and mediators of avoidance, and to inspire tailored treatments for patients suffering from psychosomatic disorders.
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Affiliation(s)
- Franziska Labrenz
- Department of Medical Psychology and Medical Sociology, Ruhr University Bochum, Bochum, Germany
| | - Marcella L Woud
- Mental Health Research and Treatment Center, Department of Psychology, Ruhr-University Bochum, Bochum, Germany
| | - Sigrid Elsenbruch
- Department of Medical Psychology and Medical Sociology, Ruhr University Bochum, Bochum, Germany.,Department of Neurology and Center for Translational Neuro- and Behavioral Sciences, University Hospital Essen, Essen, Germany
| | - Adriane Icenhour
- Department of Medical Psychology and Medical Sociology, Ruhr University Bochum, Bochum, Germany
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22
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Smyrnioti ME, Lyrakos G, Meindani M, Matsota P, Kostopanagiotou G, Batistaki C. The Impact of the First Wave of the COVID-19 Pandemic on Patients' Perceptions of Chronic Pain. J Pain Res 2021; 14:2571-2581. [PMID: 34456587 PMCID: PMC8387638 DOI: 10.2147/jpr.s323568] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 08/05/2021] [Indexed: 12/23/2022] Open
Abstract
Purpose On 10 March 2020, Greece entered an increasingly restrictive 42-day lockdown, in order to contain the first wave of the COVID-19 pandemic. All scheduled appointments and activities of the pain clinics around the country were postponed indefinitely. The aim of this prospective study was to assess the perceived impact of the first wave of the pandemic on pain, quality of life, and access to treatment, during the first austere lockdown in Greece. Patients and Methods In this cross-sectional study, 101 patients suffering from chronic pain completed a structured questionnaire. Levels of depression, anxiety, stress, personal wellbeing, optimism and personality traits were also evaluated, using the Depression, Anxiety and Stress Scale (DASS42), the Ten Item Personality Index (TIPI), the Life Orientation Test-Revised (GrLOT-R) and the Personal Wellbeing Index (PWI). Results Despite the dramatic decrease in health care visitations before, during and after the imposed lockdown, most patients did not feel that access to pain physicians and medication was significantly affected. Higher levels of stress, anxiety, depression, neuroticism, openness to experience and general satisfaction with life seemed to be important determinant factors in how patients experienced their level, intensity and duration of pain, quality of life and response to medication. Conclusion The effects of the lockdown had a more severe impact on patients than the pandemic itself. For most, the level of their pain was not affected by the pandemic and was affected only slightly by the lockdown. Quality of life, however, was affected formost participants. Both the necessity and the complications of introducing the use of telemedicine to Greek chronic pain patients became evident during the study.
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Affiliation(s)
- Maria Eleni Smyrnioti
- 2nd Department of Anaesthesiology, School of Medicine, National and Kapodistrian University of Athens, Pain Management Unit, Attikon Hospital, Athens, Greece
| | - Georgios Lyrakos
- Psychiatric Ward and Thalassaemia Transfusion Unit, General Hospital of Nikaia, Piraeus, Greece
| | - Maria Meindani
- 2nd Department of Anaesthesiology, School of Medicine, National and Kapodistrian University of Athens, Pain Management Unit, Attikon Hospital, Athens, Greece
| | - Paraskevi Matsota
- 2nd Department of Anaesthesiology, School of Medicine, National and Kapodistrian University of Athens, Pain Management Unit, Attikon Hospital, Athens, Greece
| | - Georgia Kostopanagiotou
- 2nd Department of Anaesthesiology, School of Medicine, National and Kapodistrian University of Athens, Pain Management Unit, Attikon Hospital, Athens, Greece
| | - Chrysanthi Batistaki
- 2nd Department of Anaesthesiology, School of Medicine, National and Kapodistrian University of Athens, Pain Management Unit, Attikon Hospital, Athens, Greece
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23
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Kiel S, Raus C, Sierocinski E, Knauthe P, Chenot JF. Concordance of patient beliefs and expectations regarding the management of low back pain with guideline recommendations - a cross-sectional study in Germany. BMC FAMILY PRACTICE 2020; 21:275. [PMID: 33342429 PMCID: PMC7751122 DOI: 10.1186/s12875-020-01352-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 12/10/2020] [Indexed: 12/19/2022]
Abstract
Background Low back pain is a common reason for patients to seek medical care. Physician non-adherence to clinical guidelines has been observed. We investigated the extent to which patient expectations correspond to recommendations of the German national guideline for management of low back pain (G-LBP) and whether patient characteristics, history of LBP and previous treatment experience are associated with expectations. Methods A cross-sectional study including patients from 13 general practices was conducted. Data were collected using a questionnaire. Inverse probability weights were used to address non-response bias. Descriptive analysis and multivariate logistic regression models were performed. Results A total of 977 patients were included in analyses (median age 57 years, 39% male). 75% of patients reported experiencing LBP currently or within the last year. More than 65% indicated they would agree to forgo further examinations if their LBP was judged by their physician to be of no serious concern. This was associated with the highest level of education and no prior imaging, and negatively associated with good-to-poor health status and moderate-to-severe pain intensity. 40% of participants expected imaging. The highest educational level, female gender and no prior imaging were associated with a decreased expectation of imaging. 70% expected prescriptions for massages. Females, participants with good-to-poor health status, current LBP or LBP in the last 12 months had an increased expectation for massages. Expectations for injection therapy (45%) were mainly associated with previous injections. Expectations for physiotherapy (64%) were associated with female gender, lower educational level, good-to-poor health status, current LBP or in the last 12 months. The perspective that daily activities should be continued (66%) was associated with female gender and higher educational level. Participants who agreed to the statement ‘There is no effective treatment for LBP’ (11%) had a poor health status, current LBP and a severe pain intensity. Conclusion Patient views regarding LBP management are partially concordant with guideline recommendations and are strongly influenced by previous treatment experiences and education level. Exploration of patient expectations and experiences in LBP treatment may help minimize dissatisfaction of patients expecting treatments not endorsed by guidelines and simultaneously increase physician guideline adherence.
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Affiliation(s)
- Simone Kiel
- Department of General Practice, Institute of Community Medicine, University Medicine Greifswald, Fleischmannstraße 6, 17475, Greifswald, Germany.
| | - Christina Raus
- Department of General Practice, Institute of Community Medicine, University Medicine Greifswald, Fleischmannstraße 6, 17475, Greifswald, Germany
| | - Elizabeth Sierocinski
- Department of General Practice, Institute of Community Medicine, University Medicine Greifswald, Fleischmannstraße 6, 17475, Greifswald, Germany
| | | | - Jean-François Chenot
- Department of General Practice, Institute of Community Medicine, University Medicine Greifswald, Fleischmannstraße 6, 17475, Greifswald, Germany
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