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Sirotiak Z, Thomas EBK, Wade NG, Brellenthin AG. Associations between forgiveness and physical and mental health in the context of long COVID. J Psychosom Res 2024; 178:111612. [PMID: 38367371 DOI: 10.1016/j.jpsychores.2024.111612] [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: 10/05/2023] [Revised: 02/06/2024] [Accepted: 02/12/2024] [Indexed: 02/19/2024]
Abstract
OBJECTIVE Forgiveness has been positively associated with health in those with functional disorders. This cross-sectional study examined the relationships among dimensions of forgiveness and physical and mental health in individuals with and without long COVID. METHODS Adults (N = 4316) in the United States took part in an online survey study detailing long COVID presence, physical and mental health, and trait forgiveness. T-tests were performed to assess differences in types of trait forgiveness between individuals with and without long COVID. Linear regression models assessed the contribution of demographic covariates and forgiveness subscales to the physical and mental health of individuals with and without long COVID. RESULTS Of 4316 participants, 379 (8.8%) reported current long COVID. Participants were an average age of 43.7, and most identified as female (51.9%), white (87.8%), and non-Hispanic/Latino (86.6%). Individuals with long COVID reported significantly less forgiveness of self (p < 0.001, d = 0.33), forgiveness of others (p = 0.004, d = 0.16), and forgiveness of situations (p < 0.001, d = 0.34) than those without long COVID. Among the long COVID sample, forgiveness of self and situations were positively associated with mental health (p < 0.05), but not physical health (p > 0.05). Forgiveness of others was negatively associated with both physical and mental health (p < 0.05). CONCLUSION Forgiveness may be an important consideration in understanding health among individuals with long COVID, emphasizing the importance of developing a multifaceted understanding of the condition.
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Affiliation(s)
- Zoe Sirotiak
- Iowa State University, Department of Kinesiology, USA; University of Iowa, Department of Psychological and Brain Sciences, USA
| | - Emily B K Thomas
- University of Iowa, Department of Psychological and Brain Sciences, USA
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Roose E, Huysmans E, Leysen L, Mostaqim K, Van Wilgen P, Beckwée D, De Couck M, Timmermans A, Bults R, Nijs J, Lahousse A. Effect of perceived injustice-targeted pain neuroscience education compared with biomedically focused education in breast cancer survivors: a study protocol for a multicentre randomised controlled trial (BCS-PI trial). BMJ Open 2024; 14:e075779. [PMID: 38233049 PMCID: PMC10806532 DOI: 10.1136/bmjopen-2023-075779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 11/08/2023] [Indexed: 01/19/2024] Open
Abstract
INTRODUCTION Current treatments for pain in breast cancer survivors (BCSs) are mostly biomedically focused rather than biopsychosocially driven. However, 22% of BCSs with pain are experiencing perceived injustice, which is a known predictor for adverse pain outcomes and opioid prescription due to increased maladaptive pain behaviour. Educational interventions such as pain neuroscience education (PNE) are suggested to target perceived injustice. In addition, motivational interviewing can be an effective behavioural change technique. This trial aims to examine whether perceived injustice-targeted PNE with the integration of motivational interviewing is superior to biomedically focused pain education in reducing pain after 12 months in BCS with perceived injustice and pain. In addition, improvements in quality of life, perceived injustice and opioid use are evaluated, and a cost-effectiveness analysis will finally result in a recommendation concerning the use of perceived injustice-targeted PNE in BCSs with perceived injustice and pain. METHODS AND ANALYSIS This two-arm multicentre randomised controlled trial will recruit female BCS (n=156) with pain and perceived injustice. Participants will be randomly assigned to perceived injustice-targeted PNE or biomedically focused pain education in each centre. Both interventions include an online session, an information leaflet and three one-to-one sessions. The primary outcome (pain), secondary outcomes (quality of life, perceived injustice and outcomes for cost-effectiveness analysis) and explanatory outcomes (pain phenotyping, sleep, fatigue and cognitive-emotional factors) will be assessed at baseline and at 0, 6, 12 and 24 months postintervention using self-reported questionnaires online. Treatment effects over time will be evaluated using linear mixed model analyses. Additionally, a cost-utility analysis will be done from a healthcare payer and societal perspective. ETHICS AND DISSEMINATION The ethical agreement was obtained from the Main Ethics Committee (B.U.N.1432020000068) at the University Hospital Brussels and all other participating hospitals. Study results will be disseminated through presentations, conferences, social media, press and journals. TRIAL REGISTRATION NUMBER NCT04730154.
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Affiliation(s)
- Eva Roose
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- REVAL Research Group, Universiteit Hasselt, Diepenbeek, Belgium
- Department of Physical Medicine and Physiotherapy, Universitair Ziekenhuis Brussel, Brussels, Belgium
- Rehabilitation Research Group, Vrije Universiteit Brussel, Brussel, Belgium
| | - Eva Huysmans
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Physiotherapy, Vrije Universiteit Brussel, Brussel, Belgium
- Research Foundation-Flanders, (FWO), Brussels, Belgium
| | - Laurence Leysen
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Kenza Mostaqim
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Research Foundation-Flanders, (FWO), Brussels, Belgium
| | - Paul Van Wilgen
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Transcare Pain Transdisciplinary Pain Treatment Center, Groningen, Netherlands
| | - David Beckwée
- Rehabilitation Research Group, Vrije Universiteit Brussel, Brussel, Belgium
- Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, Antwerpen, Belgium
| | - Marijke De Couck
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | | | - Rinske Bults
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Jo Nijs
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Physical Medicine and Physiotherapy, Universitair Ziekenhuis Brussel, Brussels, Belgium
- Department of Health and Rehabilitation, Unit of Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gotenburg, Sweden
| | - Astrid Lahousse
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Physical Medicine and Physiotherapy, Universitair Ziekenhuis Brussel, Brussels, Belgium
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Roose E, Huysmans E, Lahousse A, Mostaqim K, van Gerven L, Vissers M, Nijs J, Van Wilgen P, Beckwée D, Timmermans A, Bults R, Leysen L. Perceived Injustice in Cancer Survivors: Population-Specific Cut-Off Score and Relations with Personal Factors, Symptoms and Quality of Life-A Cross-Sectional Study. J Clin Med 2023; 12:5780. [PMID: 37762721 PMCID: PMC10531632 DOI: 10.3390/jcm12185780] [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: 08/02/2023] [Revised: 08/25/2023] [Accepted: 08/31/2023] [Indexed: 09/29/2023] Open
Abstract
Fatigue and pain are the most common side effects impacting quality of life (QoL) in cancer survivors. Recent insights have shown that perceived injustice (PI) can play a substantial role in these side effects, but research on cancer survivors is scarce. Furthermore, guidelines for recognizing clinically relevant levels of PI in cancer survivors are missing. The aims of this study are to provide a clinically relevant cut-off for PI and to explore relationships between personal characteristics, symptoms, and QoL with PI. This multicenter, cross-sectional study uses the Injustice Experience Questionnaire (IEQ), Numeric Pain Rating Scale (NPRS), Patient-Specific Complaints (PSC), Multidimensional Fatigue Index (MFI), and European Organization for Research and Treatment of Cancer QoL Questionnaire-C30 (EORTC-QLQ-C30). A clinical cut-off for PI was identified based on the 75th percentile of IEQ scores. Univariate and multivariate regressions explored the relationship between PI and personal characteristics (sex, age, cancer type, treatment type), symptoms (pain intensity, fatigue), and QoL (daily activity complaints, cancer-related QoL). Cancer survivors (n = 121) were included, and a cut-off of 20 was identified. Significant indirect associations were found between chemotherapy, NPRS, PSC, MFI, and EORTC-QLQ-C30 with PI. In the multivariate model, only MFI (B = 0.205; 95% CI: 0.125-0.018) and age (B = 0.086; 95% CI: -0.191-0.285) maintained a significant association with PI.
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Affiliation(s)
- Eva Roose
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (E.H.); (A.L.); (K.M.); (J.N.); (P.V.W.); (R.B.); (L.L.)
- Rehabilitation Research Group, Department of Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium;
- REVAL, Universiteit Hasselt, Agoralaan-gebouw A, 3590 Diepenbeek, Belgium;
- Department of Physical Medicine and Physiotherapy, Universitair Ziekenhuis Brussel, 1090 Brussels, Belgium
| | - Eva Huysmans
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (E.H.); (A.L.); (K.M.); (J.N.); (P.V.W.); (R.B.); (L.L.)
- Department of Physical Medicine and Physiotherapy, Universitair Ziekenhuis Brussel, 1090 Brussels, Belgium
| | - Astrid Lahousse
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (E.H.); (A.L.); (K.M.); (J.N.); (P.V.W.); (R.B.); (L.L.)
- Rehabilitation Research Group, Department of Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium;
- Department of Physical Medicine and Physiotherapy, Universitair Ziekenhuis Brussel, 1090 Brussels, Belgium
- Research Foundation–Flanders (FWO), Leuvensesteenweg 38, 1000 Brussels, Belgium
| | - Kenza Mostaqim
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (E.H.); (A.L.); (K.M.); (J.N.); (P.V.W.); (R.B.); (L.L.)
| | - Lotte van Gerven
- The Berekuyl Academy, Molenweg 4, 3849 Hierden, The Netherlands; (L.v.G.); (M.V.)
| | - Moniek Vissers
- The Berekuyl Academy, Molenweg 4, 3849 Hierden, The Netherlands; (L.v.G.); (M.V.)
| | - Jo Nijs
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (E.H.); (A.L.); (K.M.); (J.N.); (P.V.W.); (R.B.); (L.L.)
- Department of Physical Medicine and Physiotherapy, Universitair Ziekenhuis Brussel, 1090 Brussels, Belgium
- Department of Health and Rehabilitation, Unit of Physiotherapy, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Huvudbyggnad Vasaparken, Universitetsplatsen 1, 41345 Gothenburg, Sweden
| | - Paul Van Wilgen
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (E.H.); (A.L.); (K.M.); (J.N.); (P.V.W.); (R.B.); (L.L.)
- Transcare Pain Transdisciplinary Pain Treatment Center, 9711 Groningen, The Netherlands
| | - David Beckwée
- Rehabilitation Research Group, Department of Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium;
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, 2610 Wilrijk, Belgium
| | - Annick Timmermans
- REVAL, Universiteit Hasselt, Agoralaan-gebouw A, 3590 Diepenbeek, Belgium;
| | - Rinske Bults
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (E.H.); (A.L.); (K.M.); (J.N.); (P.V.W.); (R.B.); (L.L.)
| | - Laurence Leysen
- Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium; (E.H.); (A.L.); (K.M.); (J.N.); (P.V.W.); (R.B.); (L.L.)
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Garcia-Alcaraz C, Roesch SC, Aguilar RC, Gombatto S, Wells KJ. Pain-Related Anxiety in Spanish-Speaking Mexican Americans Who Report Chronic Pain: Psychometric Evaluation of a New Spanish Adaptation of the 20-Item Pain Anxiety Symptom Scale (PASS-20). THE JOURNAL OF PAIN 2023; 24:1434-1448. [PMID: 37031898 PMCID: PMC10527941 DOI: 10.1016/j.jpain.2023.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 03/10/2023] [Accepted: 03/17/2023] [Indexed: 04/11/2023]
Abstract
The 20-item Pain Anxiety Symptom Scale (PASS-20) was adapted for Spanish-speaking Mexican Americans who report chronic pain (SSMACP). The instrument measures pain-related anxiety with fear, physiological, avoidance/escape, and cognitive anxiety as subtypes. In SSMACP, the Spanish PASS-20's psychometric properties were evaluated while exploring relationships between pain-related anxiety with other variables. Using convenience sampling, 188 SSMACP (women = 108, men = 77; mean age = 37.20 years, standard deviation = 9.87) were recruited across the United States. Confirmatory factor analyses examined the structural validity of the hierarchical factor structure. Hierarchical multiple regression examined incremental validity. Correlational analyses examined convergent validity. Cronbach's coefficient alphas and McDonald's omegas examined internal consistency. Pearson's r, t-tests, and analysis of variance tests examined relationships between demographic variables and PASS-20 scores. Confirmatory factor analyses supported the hierarchical factor structure (root mean square error of approximation = .061, standardized root mean residual = .038, comparative fit index = .940). Total and subscale PASS-20 scores had acceptable convergent validity and internal consistency (range = .75-.93). Hierarchical multiple regression found that total and subscale PASS-20 scores have adequate incremental validity, considering that they contributed uniquely to the prediction of generalized anxiety scores above and beyond other pain-related scores. Demographic variables were significantly related to total and subscale PASS-20 scores. Evidence supports the use of Spanish total and subscale PASS-20 scores in SSMACP. Exploratory evidence also informed on the possible consequences and predictors of their pain-related anxiety. The results also encourage pain research in specific populations from Latin America (eg, Mexican Americans). PERSPECTIVE: The Spanish PASS-20 has adequate psychometric properties in SSMACP. This instrument can help catalyze pain research in SSMACP by informing on their pain-related anxiety and by helping evaluate other pain-related instruments. Evidence also informed on pain-related anxiety in SSMACP.
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Affiliation(s)
- Cristian Garcia-Alcaraz
- SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California; Department of Psychology, San Diego State University, San Diego, California
| | - Scott C Roesch
- SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California; Department of Psychology, San Diego State University, San Diego, California
| | - Rosa Cobian Aguilar
- SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California; Department of Psychology, San Diego State University, San Diego, California
| | - Sara Gombatto
- Doctor of Physical Therapy Program, San Diego State University, San Diego, California
| | - Kristen J Wells
- SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California; Department of Psychology, San Diego State University, San Diego, California.
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Silverberg ND, Mikolić A. Management of Psychological Complications Following Mild Traumatic Brain Injury. Curr Neurol Neurosci Rep 2023; 23:49-58. [PMID: 36763333 DOI: 10.1007/s11910-023-01251-9] [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] [Accepted: 01/13/2023] [Indexed: 02/11/2023]
Abstract
PURPOSE OF REVIEW It has been clear for decades that psychological factors often contribute to mild traumatic brain injury (mTBI) outcome, but an emerging literature has begun to clarify which specific factors are important, when, for whom, and how they impact recovery. This review aims to summarize the contemporary evidence on psychological determinants of recovery from mTBI and its implications for clinical management. RECENT FINDINGS Comorbid mental health disorders and specific illness beliefs and coping behaviors (e.g., fear avoidance) are associated with worse recovery from mTBI. Proactive assessment and intervention for psychological complications can improve clinical outcomes. Evidence-based treatments for primary mental health disorders are likely also effective for treating mental health disorders after mTBI, and can reduce overall post-concussion symptoms. Broad-spectrum cognitive-behavioral therapy may modestly improve post-concussion symptoms, but tailoring delivery to individual psychological risk factors and/or symptoms may improve its efficacy. Addressing psychological factors in treatments delivered primarily by non-psychologists is a promising and cost-effective approach for enhancing clinical management of mTBI. Recent literature emphasizes a bio-psycho-socio-ecological framework for understanding mTBI recovery and a precision rehabilitation approach to maximize recovery. Integrating psychological principles into rehabilitation and tailoring interventions to specific risk factors may improve clinical management of mTBI.
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Affiliation(s)
- Noah D Silverberg
- Department of Psychology, University of British Columbia, 2136 West Mall, Vancouver, BC, V6T 1Z4, Canada.
- Rehabilitation Research Program, Vancouver Coastal Health Research Institute, Vancouver, BC, V5Z 1M9, Canada.
| | - Ana Mikolić
- Department of Psychology, University of British Columbia, 2136 West Mall, Vancouver, BC, V6T 1Z4, Canada
- Rehabilitation Research Program, Vancouver Coastal Health Research Institute, Vancouver, BC, V5Z 1M9, Canada
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Parnes Y, Pincus T, Sullivan M, Ben Ami N. Cross-cultural adaptation and validation of the Hebrew version of the Injustice Experience Questionnaire - long and short versions. Disabil Rehabil 2023; 45:696-702. [PMID: 35142566 DOI: 10.1080/09638288.2022.2036255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
PURPOSE To translate, validate, and culturally adapt the Injustice Experience Questionnaire (IEQ) and IEQ Short Form (IEQ-SF) into Hebrew, as measuring tools for examining feelings of injustice in cases of accidents and chronic pain. METHODS The translation was performed in several steps following the cross-cultural adaptation process. A sample of 150 patients suffering from traumatic injury fill out a battery of questionnaires: IEQ, IEQ-SF, Hospital Anxiety and Depression Scale (HADS), Numeric Pain Rating Scale (NPRS), and Pain Catastrophizing Scale (PCS), which were used for calculating construct validity. A test-retest was performed on 41 patients. RESULTS The IEQ and IEQ-SF found Cronbach's alpha of 0.92 and 0.84, respectively. Test-retest reliability for IEQ (ICC: 0.94) was found to be excellent. Spearman's correlation coefficient between IEQ and PCS was 0.68, NPRS (severe pain: 0.45, average pain: 0.51), HADS (anxiety: 0.62, depression: 0.60). The correlation between IEQ-SF and PCS was 0.67, with HADS (anxiety: 0.52, depression: 0.48). A weak correlation was found for NPRS (severe pain: 0.30, average pain: 0.34). CONCLUSIONS The Israeli translation and cross-cultural adaptation of the IEQ and IEQ-SF questionnaires were found to be valid and reliable.Implications for rehabilitationThe perception of injustice is a significant mental and psychological factor for recovery after accidents and injuries.This study translated, validated and culturally adapted the Injustice Experience Questionnaire (IEQ) and the short form into Hebrew.The questionnaires were found to be valid and reliable in Hebrew.
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Affiliation(s)
- Yael Parnes
- Department of Physiotherapy, Ariel University, Ariel, Israel.,Department of Physiotherapy, Clalit Health Services, Tel Aviv, Israel
| | - Tamar Pincus
- Department of Psychology, Royal Holloway University of London, London, UK
| | | | - Noa Ben Ami
- Department of Physiotherapy, Ariel University, Ariel, Israel
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Kersten L. A Model Solution: On the Compatibility of Predictive Processing and Embodied Cognition. Minds Mach (Dordr) 2022. [DOI: 10.1007/s11023-022-09617-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AbstractPredictive processing (PP) and embodied cognition (EC) have emerged as two influential approaches within cognitive science in recent years. Not only have PP and EC been heralded as “revolutions” and “paradigm shifts” but they have motivated a number of new and interesting areas of research. This has prompted some to wonder how compatible the two views might be. This paper looks to weigh in on the issue of PP-EC compatibility. After outlining two recent proposals, I argue that further clarity can be achieved on the issue by considering a model of scientific progress. Specifically, I suggest that Larry Laudan’s “problem solving model” can provide important insights into a number of outstanding challenges that face existing accounts of PP-EC compatibility. I conclude by outlining additional implications of the problem solving model for PP and EC more generally.
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Rabey M, Buldo B, Duesund Helland M, Pang C, Kendell M, Beales D. Significant other interactions in people with chronic low back pain: Subgrouping and multidimensional profiles. Br J Pain 2021; 16:326-340. [DOI: 10.1177/20494637211062045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background: Back pain is complex. Social support and significant other interactions influence the pain experience. Purpose: To statistically derive subgroups of people with chronic low back pain based upon their interactions with significant others, and profile subgroups across multidimensional variables. Research Design: Longitudinal cohort study. Study Sample: People with chronic axial low back pain ( n = 262). Data Collection and Analysis: Latent class analysis of significant other interaction data was used to derive subgroups of people with chronic low back pain. Subgroups were profiled across baseline multidimensional variables and one-year follow-up pain intensity, disability and bothersomeness. Results: Three clusters were identified: Cluster 1 (7.6%) characterised by the lowest distracting, punishing and solicitous interactions. Cluster 2 (16.0%) characterised by the highest distracting and solicitous responses and social support. Cluster 3 (76.3%) characterised by the highest punishing and lowest social support. Cluster 1 reported less disability than Clusters 2 and 3. Mindfulness was significantly different across all subgroups with Cluster 1 being most mindful and Cluster 3 least mindful. Depression, anxiety and stress were significantly higher in Cluster 3 than Cluster 1. Pain catastrophising was higher for Cluster 2 than Clusters 1 and 3. Cluster 2 had lower pressure pain threshold than Clusters 1 and 3. Conclusions: These results support the association between significant other interactions and the experience of back pain. Considering significant other interactions in clinical practice may be important for managing some people’s presentation.
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Affiliation(s)
- Martin Rabey
- Curtin enAble Institute and Curtin School of Allied Health Curtin University, Perth, WA, Australia
- Thrive Physiotherapy, Guernsey
| | - Brendan Buldo
- Curtin enAble Institute and Curtin School of Allied Health Curtin University, Perth, WA, Australia
| | - Magnus Duesund Helland
- Curtin enAble Institute and Curtin School of Allied Health Curtin University, Perth, WA, Australia
| | - Courtenay Pang
- Curtin enAble Institute and Curtin School of Allied Health Curtin University, Perth, WA, Australia
| | - Michelle Kendell
- Curtin enAble Institute and Curtin School of Allied Health Curtin University, Perth, WA, Australia
| | - Darren Beales
- Curtin enAble Institute and Curtin School of Allied Health Curtin University, Perth, WA, Australia
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Brazenor GA, Malham GM, Teddy PJ. Can Central Sensitization after injury persist as an autonomous pain generator? - A comprehensive search for evidence. PAIN MEDICINE 2021; 23:1283-1298. [PMID: 34718773 DOI: 10.1093/pm/pnab319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 10/11/2021] [Accepted: 10/21/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To conduct a comprehensive search for evidence whether Central Sensitization following an injury can act as a persistent autonomous pain generator after the inducing injury has healed. METHODS We searched Medline on PubMed and the Cochrane Library, screening 3,572 abstracts, from which 937 full text articles were obtained, with 186 of these discarded as irrelevant to the question being posed. The remaining 751 articles were studied for evidence. RESULTS Fourteen publications were judged to provide weak evidence for the hypothesis of central sensitization as a persisting autonomous pain generator, but none addressed the question directly. No strong evidence for the affirmative answer was found.Sixty-two publications were judged to provide weak evidence for a negative answer, and nine judged to provide strong evidence.Unexpectedly, serious weaknesses were discovered in the literature underpinning the validity of the clinical diagnosis of Central Sensitization in man:(i) Inappropriate extrapolation, in many publications, of laboratory animal data to humans.(ii) Failure to demonstrate the absence of peripheral pain generators which might be perpetuating Central Sensitization.(iii) Many factors now shown to confound what is being measured by quantitative sensory testing, conditioned pain modulation, and Central Sensitization Inventory. CONCLUSIONS We found no evidence proving that central sensitization can persist as an autonomous pain generator after the initiating injury has healed.Our review has also shown that the evidential basis for the diagnosis of CS in individual patients is seriously in question.
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Affiliation(s)
| | | | - Peter J Teddy
- Royal Melbourne Hospital, Parkville, Victoria, Australia
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Litwin P, Miłkowski M. Unification by Fiat: Arrested Development of Predictive Processing. Cogn Sci 2021; 44:e12867. [PMID: 32594580 PMCID: PMC7378938 DOI: 10.1111/cogs.12867] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 04/25/2020] [Accepted: 05/15/2020] [Indexed: 01/24/2023]
Abstract
Predictive processing (PP) has been repeatedly presented as a unificatory account of perception, action, and cognition. In this paper, we argue that this is premature: As a unifying theory, PP fails to deliver general, simple, homogeneous, and systematic explanations. By examining its current trajectory of development, we conclude that PP remains only loosely connected both to its computational framework and to its hypothetical biological underpinnings, which makes its fundamentals unclear. Instead of offering explanations that refer to the same set of principles, we observe systematic equivocations in PP‐based models, or outright contradictions with its avowed principles. To make matters worse, PP‐based models are seldom empirically validated, and they are frequently offered as mere just‐so stories. The large number of PP‐based models is thus not evidence of theoretical progress in unifying perception, action, and cognition. On the contrary, we maintain that the gap between theory and its biological and computational bases contributes to the arrested development of PP as a unificatory theory. Thus, we urge the defenders of PP to focus on its critical problems instead of offering mere re‐descriptions of known phenomena, and to validate their models against possible alternative explanations that stem from different theoretical assumptions. Otherwise, PP will ultimately fail as a unified theory of cognition.
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Affiliation(s)
- Piotr Litwin
- Faculty of Psychology, University of Warsaw.,Institute of Philosophy and Sociology, Polish Academy of Sciences
| | - Marcin Miłkowski
- Institute of Philosophy and Sociology, Polish Academy of Sciences
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11
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Lacasse A, Gagnon V, Nguena Nguefack HL, Gosselin M, Pagé MG, Blais L, Guénette L. Chronic pain patients' willingness to share personal identifiers on the web for the linkage of medico-administrative claims and patient-reported data: The chronic pain treatment cohort. Pharmacoepidemiol Drug Saf 2021; 30:1012-1026. [PMID: 33901339 PMCID: PMC8360172 DOI: 10.1002/pds.5255] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 04/20/2021] [Indexed: 12/12/2022]
Abstract
PURPOSE The linkage between patient-reported data and medico-administrative claims is of great interest for epidemiologic research. The goal of this study was to assess the willingness of people living with chronic pain to share personal identifiers on the web for the linkage of medico-administrative and patient-reported data. METHODS This methodological investigation was achieved in the context of the implementation of the chronic pain treatment (COPE) cohort. A web-based recruitment initiative targeting adults living with chronic pain was conducted in the province of Quebec (Canada). RESULTS A total of 1935 participants completed the questionnaire (mean age: 49.86 ± 13.27; females: 83.69%), 921 (47.60%) of which agreed to data linkage and shared their personal identifiers (name, date of birth, health insurance number online). The most common reasons for refusal were: (1) concerns regarding data security/privacy (25.71%) and (2) the belief that the requested data were too personal/intrusive (13.52%). Some participants did not understand the relevance of data linkage (11.81%). Participants from the COPE cohort and those from the subsample who agreed to data linkage were comparable to other random samples of chronic pain individuals in terms of age and pain characteristics. CONCLUSIONS Although approximately half of the participants refused data linkage, our approach allowed for the implementation of a data platform that contains a diverse and substantial sample. This investigation has also led to the formulation of recommendations for web-based data linkage, including placing items designed to assess willingness to share personal identifiers at the end of the questionnaire, adding explanatory videos, and using a mixed-mode questionnaire.
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Affiliation(s)
- Anaïs Lacasse
- Département des sciences de la santéUniversité du Québec en Abitibi‐Témiscamingue (UQAT)Rouyn‐NorandaCanada
| | - Véronique Gagnon
- Département des sciences de la santéUniversité du Québec en Abitibi‐Témiscamingue (UQAT)Rouyn‐NorandaCanada
| | | | - Mélissa Gosselin
- Département des sciences de la santéUniversité du Québec en Abitibi‐Témiscamingue (UQAT)Rouyn‐NorandaCanada
| | - M. Gabrielle Pagé
- Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM)MontréalQuébecCanada
- Département d'anesthésiologie et de médecine de la douleur, Faculté de médecineUniversité de MontréalMontréalQuébecCanada
| | - Lucie Blais
- Faculté de pharmacieUniversité de MontréalMontréalCanada
| | - Line Guénette
- Faculté de pharmacieUniversité LavalQuébecQuébecCanada
- Centre de recherche du CHU de Québec – Université LavalQuébecQuébecCanada
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12
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Penn TM, Overstreet DS, Aroke EN, Rumble DD, Sims AM, Kehrer CV, Michl AN, Hasan FN, Quinn TL, Long DL, Trost Z, Morris MC, Goodin BR. Perceived Injustice Helps Explain the Association Between Chronic Pain Stigma and Movement-Evoked Pain in Adults with Nonspecific Chronic Low Back Pain. PAIN MEDICINE 2021; 21:3161-3171. [PMID: 32330282 DOI: 10.1093/pm/pnaa095] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE For most patients with chronic low back pain (cLBP), the cause is "nonspecific," meaning there is no clear association between pain and identifiable pathology of the spine or associated tissues. Laypersons and providers alike are less inclined to help, feel less sympathy, dislike patients more, suspect deception, and attribute lower pain severity to patients whose pain does not have an objective basis in tissue pathology. Because of these stigmatizing responses from others, patients with cLBP may feel that their pain is particularly unjust and unfair. These pain-related injustice perceptions may subsequently contribute to greater cLBP severity. The purpose of this study was to examine whether perceived injustice helps explain the relationship between chronic pain stigma and movement-evoked pain severity among individuals with cLBP. METHODS Participants included 105 patients with cLBP who completed questionnaires assessing chronic pain stigma and pain-related injustice perception, as well as a short physical performance battery for the assessment of movement-evoked pain and physical function. RESULTS Findings revealed that perceived injustice significantly mediated the association between chronic pain stigma and cLBP severity (indirect effect = 6.64, 95% confidence interval [CI] = 2.041 to 14.913) and physical function (indirect effect = -0.401, 95% CI = -1.029 to -0.052). Greater chronic pain stigma was associated with greater perceived injustice (P = 0.001), which in turn was associated with greater movement-evoked pain severity (P = 0.003). CONCLUSIONS These results suggest that perceived injustice may be a means through which chronic pain stigma impacts nonspecific cLBP severity and physical function.
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Affiliation(s)
- Terence M Penn
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Demario S Overstreet
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Edwin N Aroke
- School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama
| | - Deanna D Rumble
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Andrew M Sims
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, Alabama
| | - Caroline V Kehrer
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Ava N Michl
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Fariha N Hasan
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Tammie L Quinn
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama
| | - D Leann Long
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, Alabama
| | - Zina Trost
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Matthew C Morris
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Burel R Goodin
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama
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13
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Martínez-Borba V, Ripoll-Server P, Yakobov E, Suso-Ribera C. Predicting the Physical and Mental Health Status of Individuals With Chronic Musculoskeletal Pain From a Biopsychosocial Perspective: A Multivariate Approach. Clin J Pain 2021; 37:211-218. [PMID: 33399397 DOI: 10.1097/ajp.0000000000000913] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 12/12/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Chronic pain is theoretically conceptualized from a biopsychosocial perspective. However, research into chronic pain still tends to focus on isolated, biological, psychological, or social variables. Simultaneous examination of these variables in the prediction of outcomes is important because communalities between predictors exist. Examination of unique contributions might help guide research and interventions in a more effective way. METHODS The participants were 114 individuals with chronic pain (mean age=58.81, SD=11.85; 58.8% women and 41.2% men) who responded to demographics (age and sex), pain characteristics (duration and sensory qualities), psychological (catastrophizing and perceived injustice), and social (marital adjustment) measures. Multivariate analyses were conducted to investigate their unique contributions to pain-related health variables pain severity, pain interference, disability, anxiety, and depressive symptoms. RESULTS Bivariate analyses evidenced significant associations between pain sensory qualities, catastrophizing, perceived injustice, and all health variables. In multivariate analyses, pain sensory qualities were associated with pain severity (β=0.10; 95% confidence interval [CI]=0.05, 0.14; t=4.28, P<0.001), while perceived injustice was associated with pain interference (β=0.08; 95% CI=0.03, 0.12; t=3.59, P<0.001), disability (β=0.25; 95% CI=0.08, 0.42; t=2.92, P=0.004), anxiety (β=0.18; 95% CI=0.08, 0.27; t=3.65, P<0.001), and depressive symptoms (β=0.14; 95% CI=0.05, 0.23; t=2.92, P=0.004). Age, sex, pain duration, and marital adjustment were not associated with health variables either in bivariate or in multivariate analyses (all P>0.010). DISCUSSION As expected, communalities between biopsychosocial variables exist, which resulted in a reduced number of unique contributions in multivariate analyses. Perceived injustice emerged as a unique contributor to variables, which points to this psychological construct as a potentially important therapeutic target in multidisciplinary treatment of pain.
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Affiliation(s)
- Verónica Martínez-Borba
- Department of Basic and Clinical Psychology and Psychobiology, Universitat Jaume I, Castelló de la Plana, Spain
| | - Paula Ripoll-Server
- Department of Basic and Clinical Psychology and Psychobiology, Universitat Jaume I, Castelló de la Plana, Spain
| | - Esther Yakobov
- Department of Psychology, McGill University, Montreal, Quebec, Canada
| | - Carlos Suso-Ribera
- Department of Basic and Clinical Psychology and Psychobiology, Universitat Jaume I, Castelló de la Plana, Spain
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14
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Towards health equity for people experiencing chronic pain and social marginalization. Int J Equity Health 2021; 20:53. [PMID: 33531018 PMCID: PMC7852178 DOI: 10.1186/s12939-021-01394-6] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 01/24/2021] [Indexed: 12/31/2022] Open
Abstract
Objective For people who experience social inequities and structural violence, pain and related care are inexorably linked to experiences of injustice and stigma. The purpose of this study was to examine in greater depth the experiences of pain and discrimination and stigma across diverse marginalized communities in order to recommend equity-oriented healthcare approaches. Methods This community-based qualitative study reports on four focus groups that included 36 people living with pain. All participants identified with one of three groups known to experience high levels of inequities and structural violence including an Indigenous group, a LGBTQ2S group, and two newcomer and refugee groups. Results Pain was entangled with and shaped by: social locations and identities, experiences of violence, trauma and related mental health issues, experiences of discrimination, stigma and dismissal, experiences of inadequate and ineffective health care, and the impacts of these intersecting experiences. Conclusions Equity-oriented responses to chronic pain would recognize pain not only as a biomedical issue but as a social justice issue. The EQUIP Framework is an approach to integrating trauma- and violence-informed care; culturally-safe care; and harm reduction in health care that may hold promise for being tailored to people experiencing pain and social marginalization.
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15
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Esteve R, López-Martínez AE, Ruíz-Párraga GT, Serrano-Ibáñez ER, Ramírez-Maestre C. Pain Acceptance and Pain-Related Disability Predict Healthcare Utilization and Medication Intake in Patients with Non-Specific Chronic Spinal Pain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17155556. [PMID: 32752085 PMCID: PMC7432233 DOI: 10.3390/ijerph17155556] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 07/28/2020] [Accepted: 07/30/2020] [Indexed: 02/05/2023]
Abstract
Longitudinal research is needed to determine predictive factors of healthcare utilization and medication intake in people with non-specific spinal pain. This study aims to prospectively examine the predictive value of sex, age, work status, pain intensity, pain acceptance, disability, depression, pain anxiety, and catastrophizing in relation to healthcare utilization and medication intake in people with non-specific spinal pain. Participants were 79 patients with non-specific spinal pain of 6 to 9 months’ duration. They were followed-up at 6 months and 12 months. At enrolment they were administered a battery of questionnaires assessing the predictive variables. Healthcare utilization and medication intake were assessed at follow-ups 1 and 2. At follow-up 1, higher pain acceptance was associated with less healthcare utilization and less medication intake, while male sex was associated with less medication intake. At follow-up 2, higher pain-related disability was associated with higher healthcare use, and pain intensity was associated with higher medication intake. These results suggest that during the early stages of non-specific spinal pain chronification, pain acceptance and the avoidance of pain-related disability—understood as giving up normal activities—can lead to reductions in healthcare utilization and medication intake.
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Affiliation(s)
- Rosa Esteve
- Instituto de Investigación Biomédica de Málaga, Facultad de Psicología, Andalucía Tech, Universidad de Málaga, 29071 Málaga, Spain; (R.E.); (A.E.L.-M.); (G.T.R.-P.); (E.R.S.-I.)
| | - Alicia Eva López-Martínez
- Instituto de Investigación Biomédica de Málaga, Facultad de Psicología, Andalucía Tech, Universidad de Málaga, 29071 Málaga, Spain; (R.E.); (A.E.L.-M.); (G.T.R.-P.); (E.R.S.-I.)
| | - Gema Teresa Ruíz-Párraga
- Instituto de Investigación Biomédica de Málaga, Facultad de Psicología, Andalucía Tech, Universidad de Málaga, 29071 Málaga, Spain; (R.E.); (A.E.L.-M.); (G.T.R.-P.); (E.R.S.-I.)
| | - Elena Rocío Serrano-Ibáñez
- Instituto de Investigación Biomédica de Málaga, Facultad de Psicología, Andalucía Tech, Universidad de Málaga, 29071 Málaga, Spain; (R.E.); (A.E.L.-M.); (G.T.R.-P.); (E.R.S.-I.)
- Facultad de Ciencias de la Salud, Área de Psicología, Universidad Isabel I, 09003 Burgos, Spain
| | - Carmen Ramírez-Maestre
- Instituto de Investigación Biomédica de Málaga, Facultad de Psicología, Andalucía Tech, Universidad de Málaga, 29071 Málaga, Spain; (R.E.); (A.E.L.-M.); (G.T.R.-P.); (E.R.S.-I.)
- Correspondence: ; Tel.: +34-952-132-389
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16
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Perceived Injustice Mediates the Relationship Between Perceived Childhood Neglect and Current Function in Patients with Chronic Pain: A Preliminary Pilot Study. J Clin Psychol Med Settings 2020; 28:349-360. [PMID: 32382872 DOI: 10.1007/s10880-020-09722-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Cumulative evidence supports the association between perceived childhood neglect and adulthood psychological and physical health. To date, pathways mediating this association remain largely unknown, though other evidence suggests that negative patterns of appraisal, including injustice perception related to pain, may be shaped by prior adverse social experiences. Consequently, the current study examined perceived injustice about chronic pain as a possible factor connecting childhood neglect and pain-related outcomes, given its relevance for both adaptation to chronic pain and to prior adverse life experiences. Patients (n = 742) visiting a tertiary pain clinic completed a survey administered via the Collaborative Health Outcomes Information Registry. Path modeling analyses were used to examine perceived injustice as a mediator of the relationships between childhood neglect and affective distress and physical function, after controlling for pain intensity and pain catastrophizing. Patients endorsing childhood neglect reported higher levels of perceived injustice and worse affective distress and physical function. Further, inclusion of perceived injustice as a mediator fully accounted for the relationship between neglect and current levels of physical function, and accounted for a significant proportion of the relationship between neglect and current levels of affective distress. These preliminary findings suggest that perceived injustice appears to be a more proximal factor by which prior experiences of neglect may adversely affect adaptation to chronic pain. Given the single-item assessment of childhood neglect and cross-sectional nature of the current findings, further research may focus on replicating these findings in longitudinal studies with validated measures and examining other adverse social experiences (e.g., abuse, social disparities) that may contribute to injustice perception and poor pain-related outcomes.
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17
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Clauw DJ, Essex MN, Pitman V, Jones KD. Reframing chronic pain as a disease, not a symptom: rationale and implications for pain management. Postgrad Med 2019; 131:185-198. [DOI: 10.1080/00325481.2019.1574403] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Daniel J. Clauw
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI, USA
| | | | - Verne Pitman
- Global Medical Affairs, US Medical Affairs, Pfizer Inc, New York, NY, USA
| | - Kim D. Jones
- School of Nursing, Linfield College, Portland, OR, USA
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