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Spinuzza N, McHugh TR, Garland JS, Roddy WT, Hewitt MA, Harrington CJ, Thaper A, Reini J, Smith DG, Pasquina PF. The lived experience of military beneficiaries with amputations at the hip and pelvic level. Prosthet Orthot Int 2024; 48:337-343. [PMID: 38857166 DOI: 10.1097/pxr.0000000000000338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 12/21/2023] [Indexed: 06/12/2024]
Abstract
BACKGROUND Hip- and pelvic-level amputations are devastating injuries that drastically alter patient function and quality of life. This study examined the experience of military beneficiaries with a hip- or pelvic-level amputation to better characterize their challenges and specific needs and to optimize treatment in the future. METHODS We conducted a retrospective review of the Military Health System and identified 118 patients with a history of one or more amputation(s) at the hip or pelvic level between October 2001 and September 2017. Surviving participants (n = 97) were mailed a letter which explained the details of the study and requested participation in a telephonic interview. A total of six individuals (one female, five males) participated in structured interviews. RESULTS The study group included four participants with hip disarticulations and two participants with hemipelvectomies (one internal, one external). All six participants reported significant challenges with activities related to prosthetic use, mobility, residual limb health, pain, gastrointestinal and genitourinary function, psychiatric health, and sexual function. CONCLUSIONS These interviews highlight the unique needs of individuals with hip- and pelvic-level amputations and may improve access to higher echelons of care that would enhance the function and quality of life for these participants.
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Affiliation(s)
- Nicholas Spinuzza
- Department of Physical Medicine and Rehabilitation, The Center for Rehabilitation Sciences Research, Uniformed Services University of Health Sciences, Bethesda, MD
- Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD
| | - Terrence R McHugh
- Department of Physical Medicine and Rehabilitation, The Center for Rehabilitation Sciences Research, Uniformed Services University of Health Sciences, Bethesda, MD
- Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD
| | - Jared S Garland
- Department of Physical Medicine and Rehabilitation, The Center for Rehabilitation Sciences Research, Uniformed Services University of Health Sciences, Bethesda, MD
- Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD
| | - William T Roddy
- Department of Physical Medicine and Rehabilitation, The Center for Rehabilitation Sciences Research, Uniformed Services University of Health Sciences, Bethesda, MD
- Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD
| | - Melissa A Hewitt
- Department of Physical Medicine and Rehabilitation, The Center for Rehabilitation Sciences Research, Uniformed Services University of Health Sciences, Bethesda, MD
- Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD
| | - Colin J Harrington
- Department of Orthopaedic Surgery, Walter Reed National Military Medical Center, Bethesda, MD
| | - Akshay Thaper
- Department of Physical Medicine and Rehabilitation, The Center for Rehabilitation Sciences Research, Uniformed Services University of Health Sciences, Bethesda, MD
- Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD
| | - Josh Reini
- Department of Physical Medicine and Rehabilitation, The Center for Rehabilitation Sciences Research, Uniformed Services University of Health Sciences, Bethesda, MD
- Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD
| | - Douglas G Smith
- Department of Physical Medicine and Rehabilitation, The Center for Rehabilitation Sciences Research, Uniformed Services University of Health Sciences, Bethesda, MD
- Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD
| | - Paul F Pasquina
- Department of Physical Medicine and Rehabilitation, The Center for Rehabilitation Sciences Research, Uniformed Services University of Health Sciences, Bethesda, MD
- Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD
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2
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Cheung CK, Tsang EYH. Distress as a Function of Social Exclusion and Assertiveness among Homosexual/Bisexual People. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:633. [PMID: 38791847 PMCID: PMC11120836 DOI: 10.3390/ijerph21050633] [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: 04/16/2024] [Revised: 05/07/2024] [Accepted: 05/14/2024] [Indexed: 05/26/2024]
Abstract
Homosexual (lesbian or gay) and bisexual (i.e., LGB) people tend to suffer from social exclusion and thus distress. To prevent or relieve distress, the people's assertiveness about justice and rights is an advocated means, but its effectiveness is uncertain, considering possible conflict with social exclusion. To clarify the effectiveness, this study analyzed data collected from 189 Chinese LGB adults in Hong Kong, which is a special administrative region of China generally Westernized and liberal to sexual orientation. Controlling for prior distress reported, the analysis showed that distress was lower when assertiveness was higher or social exclusion experienced was lower. However, distress was higher when both assertiveness and social exclusion experienced were higher. The higher distress implies a conflict between assertiveness and social exclusion to raise distress. It also implies the need to avoid conflict when promoting assertiveness and eliminating social exclusion to prevent distress in LGB people.
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Affiliation(s)
- Chau-kiu Cheung
- Department of Social and Behavioural Sciences, College of Liberal Arts and Social Sciences, City University of Hong Kong, Hong Kong, China;
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3
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Burgess DJ, Hagel Campbell EM, Branson M, Calvert C, Evans R, Allen KD, Bangerter A, Cross LJ, Driscoll MA, Hennessy S, Ferguson JE, Friedman JK, Matthias MS, Meis LA, Polusny MA, Taylor SL, Taylor BC. Exploring Gender Differences in Veterans in a Secondary Analysis of a Randomized Controlled Trial of Mindfulness for Chronic Pain. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2024; 5:82-92. [PMID: 38404673 PMCID: PMC10890953 DOI: 10.1089/whr.2023.0086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/10/2024] [Indexed: 02/27/2024]
Abstract
Background Although studies have documented higher rates of chronic pain among women Veterans compared to men Veterans, there remains a lack of comprehensive information about potential contributors to these disparities. Materials and Methods This study examined gender differences in chronic pain and its contributors among 419 men and 392 women Veterans, enrolled in a mindfulness trial for chronic pain. We conducted descriptive analyses summarizing distributions of baseline measures, obtained by survey and through the electronic health record. Comparisons between genders were conducted using chi-square tests for categorical variables and t-tests for continuous measures. Results Compared to men, women Veterans were more likely to have chronic overlapping pain conditions and had higher levels of pain interference and intensity. Women had higher prevalence of psychiatric and sleep disorder diagnoses, greater levels of depression, anxiety, post-traumatic stress disorder, fatigue, sleep disturbance, stress and pain catastrophizing, and lower levels of pain self-efficacy and participation in social roles and activities. However, women were less likely to smoke or have a substance abuse disorder and used more nonpharmacological pain treatment modalities. Conclusion Among Veterans seeking treatment for chronic pain, women differed from men in their type of pain, had greater pain intensity and interference, and had greater prevalence and higher levels of many known biopsychosocial contributors to pain. Results point to the need for pain treatment that addresses the comprehensive needs of women Veterans. Clinical Trial Registration Number: NCT04526158. Patient enrollment began on December 4, 2020.
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Affiliation(s)
- Diana J. Burgess
- VA HSR&D Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, Minnesota, USA
- Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Emily M. Hagel Campbell
- VA HSR&D Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, Minnesota, USA
| | - Mariah Branson
- VA HSR&D Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, Minnesota, USA
| | - Collin Calvert
- VA HSR&D Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, Minnesota, USA
- Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Roni Evans
- Integrative Health and Wellbeing Research Program, Center for Spirituality and Healing, School of Nursing, University of Minnesota, Minneapolis, Minnesota, USA
| | - Kelli D. Allen
- VA HSR&D Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, North Carolina, USA
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, North Carolina, USA
| | - Ann Bangerter
- VA HSR&D Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, Minnesota, USA
| | - Lee J.S. Cross
- VA HSR&D Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, Minnesota, USA
| | - Mary A. Driscoll
- Pain Research, Informatics, Multimorbidities, and Education (PRIME) Center, VA Connecticut Health Care System, West Haven, Connecticut, USA
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - Sierra Hennessy
- VA HSR&D Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, Minnesota, USA
| | - John E. Ferguson
- Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Jessica K. Friedman
- VA HSR&D Center for the Study of Health Care Innovation, Implementation and Policy, Greater Los Angeles VA Health Care System, Los Angeles, California, USA
| | - Marianne S. Matthias
- VA HSR&D Center for Health Information and Communication, Roudebush VA Medical Center, Indianapolis, Indiana, USA
- Regenstrief Institute, Indianapolis, Indiana, USA
- Department of Medicine, School of Medicine, Indiana University, Indianapolis, Indiana, USA
| | - Laura A. Meis
- VA HSR&D Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, Minnesota, USA
- Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Melissa A. Polusny
- VA HSR&D Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, Minnesota, USA
- Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Stephanie L. Taylor
- VA HSR&D Center for the Study of Health Care Innovation, Implementation and Policy, Greater Los Angeles VA Health Care System, Los Angeles, California, USA
- Department of Health Policy and Management, UCLA School of Public Health, Los Angeles, California, USA
- Department of Medicine, UCLA School of Medicine, Los Angeles, California, USA
| | - Brent C. Taylor
- VA HSR&D Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, Minneapolis, Minnesota, USA
- Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA
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Franqueiro AR, Yoon J, Crago MA, Curiel M, Wilson JM. The Interconnection Between Social Support and Emotional Distress Among Individuals with Chronic Pain: A Narrative Review. Psychol Res Behav Manag 2023; 16:4389-4399. [PMID: 37915959 PMCID: PMC10617401 DOI: 10.2147/prbm.s410606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 10/21/2023] [Indexed: 11/03/2023] Open
Abstract
Chronic pain is a public health concern affecting over 100 million U.S. adults. Because chronic pain is multifactorial, it requires a biopsychosocial approach to understand how biological, psychological, and social factors contribute to both the development and maintenance of pain. On average, individuals with chronic pain report higher levels of emotional distress compared to pain-free individuals. Research has demonstrated that social support is associated with better pain outcomes and less emotional distress. It has been proposed that social support may improve pain outcomes by reducing the influence of stressors. However, the majority of research exploring the relationships between social support and pain-related outcomes has focused on the direct relationship between these variables, largely overlooking the process by which social support has a positive influence on pain. This narrative review synthesizes research on how chronic pain, emotional distress, and social support are highly interconnected, yet research investigating chronic pain and emotional distress within a social context is limited. We then highlight disparities in chronic pain, such that the burden of chronic pain is unequal between demographic groups. Next, we discuss existing evidence for the use of group-based interventions to address pain-related outcomes. Lastly, we summarize limitations of prior research studies and highlight gaps in the current literature. Overall, longitudinal research comprehensively investigating the distinct nuances in the measurement of social support and how these nuances relate to emotional distress and pain outcomes is needed and may provide insight into the unique needs of individuals or subgroups. Further, demographically diverse randomized controlled trials are needed to identify the process by which group-based interventions improve pain outcomes and whether these interventions are more effective for particular groups in order to personalize treatment approaches and address inequities in pain care.
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Affiliation(s)
- Angelina R Franqueiro
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Boston, MA, 02115, USA
| | - JiHee Yoon
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Boston, MA, 02115, USA
| | - Madelyn A Crago
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Boston, MA, 02115, USA
| | - Marie Curiel
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Boston, MA, 02115, USA
| | - Jenna M Wilson
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Boston, MA, 02115, USA
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Cheung CK, Tsang EYH. Conditions for Social Exclusion Leading to Distress Change in Chinese Lesbian, Gay, and Bisexual (LGB) People. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20105911. [PMID: 37239639 DOI: 10.3390/ijerph20105911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 05/15/2023] [Accepted: 05/20/2023] [Indexed: 05/28/2023]
Abstract
Lesbian, gay, and bisexual (LGB) people are likely to be at risk of distress because of social exclusion, including the feelings of resentment, resistance, and rejection they might experience from society. Nevertheless, the conditions for social exclusion leading to changes in distress are empirically unclear, especially in Chinese LGB people. To examine these conditions, this study surveyed 303 Chinese LGB people in Taiwan, Hong Kong, and various places in Mainland China. For comparability with other LGB studies, the study did not explicitly identify asexual, demisexual, or pansexual people in the LGB group. Results show that the retrospective reporting of social exclusion in 2016 did not significantly and unconditionally predict levels of distress in 2017. However, the reporting of exclusion significantly predicted current distress when the retrospective report of distress in 2016 was high. These results from the stress-vulnerability model indicate that prior distress is a vulnerability condition that allows social exclusion to exert its stressful effect. This study implies the need to prevent the social exclusion of highly distressed LGB people.
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Affiliation(s)
- Chau-Kiu Cheung
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong 518000, China
| | - Eileen Yuk-Ha Tsang
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong 518000, China
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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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The association of resilience, social connections, and internal locus of control with pain outcomes among older adults. Geriatr Nurs 2022; 48:43-50. [PMID: 36122517 DOI: 10.1016/j.gerinurse.2022.08.011] [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: 07/22/2022] [Revised: 08/18/2022] [Accepted: 08/22/2022] [Indexed: 12/14/2022]
Abstract
Our objective was to investigate the hypothesis that psychological resources, including resilience, social connections, and internal locus of control, separately and in additive combinations, would be associated with selected pain outcomes: 1) days of opioid use and 2) medical/drug expenditures over 2 years. A mailed survey was sent to a stratified sample of older adults age≥65 with diagnosed back pain, osteoarthritis, and/or rheumatoid arthritis. Each of the resources was dichotomized as high/low and/or counted with equal weighting. Among respondents (N=3,131), the prevalence of mild/no and moderate/severe pain severity was 59% and 41%, respectively. As hypothesized, each resource was associated with lower levels of pain; additively, reported pain severity decreased as the number of resources increased. For moderate/severe pain, there was reduced opioid use among those with more resources; and, for mild/no pain, decreased medical/drug expenditures among those with ≥2 resources. Interventions that integrate psychological resources may enhance their effectiveness.
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Do Men and Women Have a Different Association between Fear-Avoidance and Pain Intensity in Chronic Pain? An Experience Sampling Method Cohort-Study. J Clin Med 2022; 11:jcm11195515. [PMID: 36233383 PMCID: PMC9572454 DOI: 10.3390/jcm11195515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 09/15/2022] [Accepted: 09/16/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Fear-avoidance is one of the factors associated with chronic pain. However, it remains unclear whether the association between fear-avoidance and pain depends on sex. The present study aimed to investigate whether the association between fear-avoidance and pain intensity differed between men and women in chronic pain patients. Additionally, the potential confounding effect of affective experiences on the association between fear-avoidance and pain intensity was analyzed. Method: This cohort study included hospital referred chronic pain patients (n = 45). Short momentary assessment questions according to the experience sampling method (ESM) were used to repeatedly assess patients’ pain intensity, level of fear-avoidance and positive as well as negative affect during their daily life. Linear mixed-effects models were applied in the statistical analysis. Unadjusted and adjusted models were made, in which the latter corrected for statistically significant affective experiences and baseline variables, taking the Aikake Information Criterion into account to assess a better model of fit. Results: The results demonstrated an association between fear-avoidance and pain intensity that differed for men and women. In men (n = 13), no association between these variables was found (−0.04 (95% CI: −0.14, 0.06) with a p-value of 0.48), whereas in women (n = 32), an increase in fear-avoidance was associated with a (slight) increase in pain intensity (0.18 (95% CI 0.06, 0.30) with a p-value of 0.003). Affect did not confound the above-mentioned findings. Conclusion: Our data supports previous research highlighting the importance of sex differences in pain experience. These findings may be relevant for clinicians to consider more personalized (i.e., gender specific) pain management in chronic pain patients.
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Segning CM, Harvey J, Ezzaidi H, Fernandes KBP, da Silva RA, Ngomo S. Towards the Objective Identification of the Presence of Pain Based on Electroencephalography Signals' Analysis: A Proof-of-Concept. SENSORS (BASEL, SWITZERLAND) 2022; 22:6272. [PMID: 36016032 PMCID: PMC9413583 DOI: 10.3390/s22166272] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 08/17/2022] [Accepted: 08/18/2022] [Indexed: 06/15/2023]
Abstract
This proof-of-concept study explores the potential of developing objective pain identification based on the analysis of electroencephalography (EEG) signals. Data were collected from participants living with chronic fibromyalgia pain (n = 4) and from healthy volunteers (n = 7) submitted to experimental pain by the application of capsaicin cream (1%) on the right upper trapezius. This data collection was conducted in two parts: (1) baseline measures including pain intensity and EEG signals, with the participant at rest; (2) active measures collected under the execution of a visuo-motor task, including EEG signals and the task performance index. The main measure for the objective identification of the presence of pain was the coefficient of variation of the upper envelope (CVUE) of the EEG signal from left fronto-central (FC5) and left temporal (T7) electrodes, in alpha (8-12 Hz), beta (12-30 Hz) and gamma (30-43 Hz) frequency bands. The task performance index was also calculated. CVUE (%) was compared between groups: those with chronic fibromyalgia pain, healthy volunteers with "No pain" and healthy volunteers with experimentally-induced pain. The identification of the presence of pain was determined by an increased CVUE in beta (CVUEβ) from the EEG signals captured at the left FC5 electrode. More specifically, CVUEβ increased up to 20% in the pain condition at rest. In addition, no correlation was found between CVUEβ and pain intensity or the task performance index. These results support the objective identification of the presence of pain based on the quantification of the coefficient of variation of the upper envelope of the EEG signal.
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Affiliation(s)
- Colince Meli Segning
- Department of Applied Sciences, Université du Québec à Chicoutimi (UQAC), Saguenay, QC G7H 2B1, Canada
- Laboratoire de Recherche Biomécanique et Neurophysiologique en Réadaptation Neuro-Musculo-Squelettique (Lab BioNR), Université du Québec à Chicoutimi (UQAC), Saguenay, QC G7H 2B1, Canada
| | | | - Hassan Ezzaidi
- Department of Applied Sciences, Université du Québec à Chicoutimi (UQAC), Saguenay, QC G7H 2B1, Canada
| | - Karen Barros Parron Fernandes
- Department of Health Sciences, Université du Québec à Chicoutimi (UQAC), Saguenay, QC G7H 2B1, Canada
- School of Medicine, Pontifical Catholic University of Parana (PUCPR), 485-Hipica, Londrina 86072-360, PR, Brazil
| | - Rubens A. da Silva
- Laboratoire de Recherche Biomécanique et Neurophysiologique en Réadaptation Neuro-Musculo-Squelettique (Lab BioNR), Université du Québec à Chicoutimi (UQAC), Saguenay, QC G7H 2B1, Canada
- Department of Health Sciences, Université du Québec à Chicoutimi (UQAC), Saguenay, QC G7H 2B1, Canada
- Centre Intégré de Santé et Services Sociaux du Saguenay-Lac-Saint-Jean (CIUSSS SLSJ), Specialized Geriatrics, Services-Hôpital de La Baie, Saguenay, QC G7H 7K9, Canada
| | - Suzy Ngomo
- Laboratoire de Recherche Biomécanique et Neurophysiologique en Réadaptation Neuro-Musculo-Squelettique (Lab BioNR), Université du Québec à Chicoutimi (UQAC), Saguenay, QC G7H 2B1, Canada
- Department of Health Sciences, Université du Québec à Chicoutimi (UQAC), Saguenay, QC G7H 2B1, Canada
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Chng Z, Yeo JJ, Joshi A. Resilience as a protective factor in face of pain symptomatology, disability and psychological outcomes in adult chronic pain populations: a scoping review. Scand J Pain 2022; 23:228-250. [PMID: 35946872 DOI: 10.1515/sjpain-2021-0190] [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: 10/19/2021] [Accepted: 06/28/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Patients suffering from chronic pain experience significant disability and disease burden. Resilience has been understood to be a protective factor in face of adversity, eventually contributing to positive outcomes. As such, the current review sought to summarize the existing literature focusing on the roles of resilience in relation to pain phenomenology, pain outcomes (including function and mental health), amongst relevant clinical correlates in a bid to promote holistic management of debilitating chronic pain conditions from a resilience-oriented psychotherapeutic approach as an adjunct to pharmacological treatment. METHODS A scoping review was conducted on empirical studies surrounding the theme of resilience in adult chronic pain populations published before 9th May 2021. The following main inclusion criteria was applied; (a) adults diagnosed with chronic pain disorders, (b) use of quantifiable pain measures, (c) use of quantifiable resilience measures. A total of 32 studies were then selected for the review. RESULTS First, higher levels of resilience were associated with a reduced likelihood of experiencing any chronic pain, fewer pain sites, better psychological response towards nociception and reduced need for analgesia. Second, higher levels of resilience correlated with better daily and physical function, quality of life, psychosocial functioning and lower likelihood of co-morbid mental health disorders. Third, resilience was an intermediary variable in the pathways from pain phenomenology leading to pain interference, depression and post-traumatic growth. CONCLUSIONS The findings were contextualized using pain-disability and resilience frameworks (The Pain and Disability Drivers Model, O'Leary's Resilience models) with suggestions to enhance resilience and contextual factors in the holistic management of adult chronic pain conditions. Future research should examine the differences in resilience between pain types as well as evaluate the efficacy of streamlined resilience-oriented interventions.
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Affiliation(s)
- Zanna Chng
- Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, Singapore, Singapore
| | - Jerry Jay Yeo
- Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, Singapore, Singapore
| | - Ashutosh Joshi
- Khoo Teck Puat Hospital, National Healthcare Group, 90 Yishun Central, Singapore, Singapore
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Abstract
Chronic pain affects 20% of adults and is one of the leading causes of disability worldwide. Women and girls are disproportionally affected by chronic pain. About half of chronic pain conditions are more common in women, with only 20% having a higher prevalence in men. There are also sex and gender differences in acute pain sensitivity. Pain is a subjective experience made up of sensory, cognitive, and emotional components. Consequently, there are multiple dimensions through which sex and gender can influence the pain experience. Historically, most preclinical pain research was conducted exclusively in male animals. However, recent studies that included females have revealed significant sex differences in the physiological mechanisms underlying pain, including sex specific involvement of different genes and proteins as well as distinct interactions between hormones and the immune system that influence the transmission of pain signals. Human neuroimaging has revealed sex and gender differences in the neural circuitry associated with pain, including sex specific brain alterations in chronic pain conditions. Clinical pain research suggests that gender can affect how an individual contextualizes and copes with pain. Gender may also influence the susceptibility to develop chronic pain. Sex and gender biases can impact how pain is perceived and treated clinically. Furthermore, the efficacy and side effects associated with different pain treatments can vary according to sex and gender. Therefore, preclinical and clinical research must include sex and gender analyses to understand basic mechanisms of pain and its relief, and to develop personalized pain treatment.
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Affiliation(s)
- Natalie R Osborne
- Krembil Brain Institute, Krembil Research Institute, University Health Network, Toronto, Canada; Institute of Medical Science, University of Toronto, Toronto, Canada
| | - Karen D Davis
- Krembil Brain Institute, Krembil Research Institute, University Health Network, Toronto, Canada; Institute of Medical Science, University of Toronto, Toronto, Canada; Department of Surgery, University of Toronto, Toronto, Canada.
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Prevalence of Musculoskeletal Disorders and Self-Reported Pain in Artisanal Fishermen from a Traditional Community in Todos-os-Santos Bay, Bahia, Brazil. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020908. [PMID: 35055729 PMCID: PMC8775945 DOI: 10.3390/ijerph19020908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 12/16/2021] [Accepted: 12/24/2021] [Indexed: 12/10/2022]
Abstract
Musculoskeletal disorders (MSDs) can be characterized from their occupational etiology and their occurrence; their chronicity generates negative repercussions for the health of workers, especially of artisanal fishing. To investigate the prevalence of generalized musculoskeletal disorders by body region and self-reported pain in a fishing population of northeastern Brazil, an epidemiological cross-sectional study was carried out in Santiago do Iguape, Bahia-Brazil, in 2017. The Brazilian version of the Nordic Musculoskeletal Questionnaire (NMQ), in addition to a questionnaire containing the socio-demographic and labor conditions were applied to a random stratified sample of 248 artisanal fisheries. There were 170 female shellfish gatherers and 78 fishermen, with a mean age of 36.7 years (SD = 10.5 years) and 43.3 years (SD = 11.8 years), respectively. The beginning of the labor activity was initiated at approximately 11 years of age. The average weekly income varied from 17.64 USD to 29.10 USD. The prevalence of MSD independent of occupation occurred in at least one body region in 93.5% and the presence of musculoskeletal pain/discomfort over the last seven days in 95.2% of the fishing workers. The highest prevalence of MSD was found in shellfish gatherers in: lower back (86.4%), wrist and hand (73.5%), and upper back (66.8%). In relation to the presence of pain in the last year, the frequency of pain was greater in the fishermen compared to the shellfish gatherers. The generalized severity of the MSD in 93.5% of this community of fishermen is evident, with emphasis in the following regions: lower back, wrist and hand and upper back in both groups, with occurrence of pain in more than one body region at the same time.
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Morales-Fernández Á, Jiménez Martín JM, Vergara-Romero M, Morales-Asencio JM, Mora-Bandera AM, Gomez-Ortigosa MI, Aranda-Gallardo M, Canca-Sánchez JC. Gender differences in perceived pain and health-related quality of life in people with chronic non-malignant pain: a cross-sectional study. Contemp Nurse 2021; 57:280-289. [PMID: 34709980 DOI: 10.1080/10376178.2021.1999836] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Chronic pain has a disproportionate impact on members of vulnerable population groups, and women are at substantially greater risk than men of suffering multiple chronic pain disorders. Moreover, one of the aspects most affected by the presence of chronic pain is that of health-related quality of life (HRQoL), worsening over time, as the disease persists. OBJECTIVES To describe the profile of patients who suffer non-malignant chronic pain, from a gender perspective, and to identify factors related to their HRQoL and mental health. DESIGN A cross-sectional study was carried out in patients with chronic non-cancer pain. METHODS Sociodemographic variables, pain intensity at rest and in motion, SF-36 health questionnaire, anxiety, and depression were evaluated. RESULTS The study population consisted of 531 subjects, of whom 64.2% were women. The mean age was 52.9 (SD: 10.4) years. The pain intensity recorded on the visual analogue scale was 6 (SD: 2.7) at rest and 8 (SD: 2) in motion. Physical component score and mental component score of quality of life were worse in women vs men: 33.73 (6.77) vs 32.33 (6.20), for the physical component; 36.89 (12.77) vs 32.91 (11.51), for mental component. Anxiety, depression and pain intensity, showed poorer results in women. CONCLUSION Gender is a factor that should be considered in assessing and managing chronic pain, due to its influence on the perception of pain, and HRQoL. IMPACT STATEMENT Gender is an important modifier of the perception of pain, and HRQoL. To achieve a patient-centred approach, nurses should incorporate gender as a differential factor to adapt and individualize pain management and patient education.
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Affiliation(s)
- Ángeles Morales-Fernández
- Agencia Sanitaria Costa del Sol, Marbella, Spain.,Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - José Manuel Jiménez Martín
- Agencia Sanitaria Costa del Sol, Marbella, Spain.,Department of Nursing, Universidad de Málaga, Faculty of Health Sciences, Málaga, Spain
| | | | - José Miguel Morales-Asencio
- Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain.,Department of Nursing, Universidad de Málaga, Faculty of Health Sciences, Málaga, Spain
| | - Ana María Mora-Bandera
- Agencia Sanitaria Costa del Sol, Marbella, Spain.,Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain.,Department of Nursing, Universidad de Málaga, Faculty of Health Sciences, Málaga, Spain
| | | | - Marta Aranda-Gallardo
- Agencia Sanitaria Costa del Sol, Marbella, Spain.,Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain
| | - José Carlos Canca-Sánchez
- Agencia Sanitaria Costa del Sol, Marbella, Spain.,Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, Spain.,Department of Nursing, Universidad de Málaga, Faculty of Health Sciences, Málaga, Spain
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14
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Ramírez-Maestre C, Esteve R, López-Martínez AE, Jensen MP, Miró J, de la Vega R. The Impairment and Functioning Inventory Revised-English version: A validation study in individuals with disabilities and bothersome pain. PM R 2021; 14:818-827. [PMID: 34181318 DOI: 10.1002/pmrj.12659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 05/14/2021] [Accepted: 06/11/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND Despite the relevance of daily function in individuals with chronic pain, few questionnaires have been designed to assess this domain in individuals with musculoskeletal pain. In addition, the Impairment and Functioning Inventory-Revised (IFI-R) is the only instrument that assesses perceived decreases in levels of daily activity after the onset of pain. OBJECTIVE To evaluate the psychometric properties of the English version of the IFI-R. DESIGN Cross-sectional study. SETTING A database of individuals with medical conditions commonly associated with chronic pain maintained by the University of Washington. PATIENTS A total of 470 individuals with chronic pain. METHODS Factorial validity was analyzed by conducting a confirmatory factor analysis via structural equation modeling. Internal consistency was evaluated by calculating Cronbach's α coefficients. Convergent validity was assessed by calculating Pearson correlation coefficients between the two scales of the IFI-R and the Patient Reported Outcome Measurement Information System (PROMIS) Pain Interference Scale. Criterion validity was analyzed by regression analysis via structural equation modeling. MAIN OUTCOME MEASURES The English version of the IFI-R (IFI-R-EV) for individuals with chronic pain. RESULTS The IFI-R-EV consists of 30 items with two related subscales: The Daily Function subscale (α = .86). and the Impairment subscale (α = .89). A significant correlation was found between these subscales and a measure of pain interference (r's = - .33, and .35 respectively; p's < .01). We also found statistically significant associations (p < .05) between daily function and depression (β = -.14) and pain intensity (β = -.13), between impairment and depression (β = .14) and pain intensity (β = .16), and between daily function and pain acceptance (β = .14). CONCLUSIONS The findings indicate that the IFI-R-EV provides valid and reliable measures of daily function and impairment in English-speaking individuals with a disability and chronic pain. These results are consistent with those obtained with the Spanish version.
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Affiliation(s)
- Carmen Ramírez-Maestre
- Faculty of Psychology, Andalucía Tech. Campus de Teatinos, Universidad de Málaga, Málaga, Spain.,Biomedical Research Institute of Málaga (IBIMA), Málaga, Spain
| | - Rosa Esteve
- Faculty of Psychology, Andalucía Tech. Campus de Teatinos, Universidad de Málaga, Málaga, Spain.,Biomedical Research Institute of Málaga (IBIMA), Málaga, Spain
| | - Alicia E López-Martínez
- Faculty of Psychology, Andalucía Tech. Campus de Teatinos, Universidad de Málaga, Málaga, Spain.,Biomedical Research Institute of Málaga (IBIMA), Málaga, Spain
| | - Mark P Jensen
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA
| | - Jordi Miró
- Department of Psychology, Unit for the Study and Treatment of Pain - ALGOS, Research Center for Behavior Assessment (CRAMC), Universitat Rovira i Virgili, Catalonia, Spain.,Institut d'Investigació Sanitària Pere Virgili, Catalonia, Spain
| | - Rocío de la Vega
- Faculty of Psychology, Andalucía Tech. Campus de Teatinos, Universidad de Málaga, Málaga, Spain
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15
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Shangguan F, Zhou C, Qian W, Zhang C, Liu Z, Zhang XY. A Conditional Process Model to Explain Somatization During Coronavirus Disease 2019 Epidemic: The Interaction Among Resilience, Perceived Stress, and Sex. Front Psychol 2021; 12:633433. [PMID: 34093314 PMCID: PMC8172608 DOI: 10.3389/fpsyg.2021.633433] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 03/29/2021] [Indexed: 01/15/2023] Open
Abstract
Background More than 15% of Chinese respondents reported somatic symptoms in the last week of January 2020. Promoting resilience is a possible target in crisis intervention that can alleviate somatization. Objectives This study aims to investigate the relationship between resilience and somatization, as well as the underlying possible mediating and moderating mechanism, in a large sample of Chinese participants receiving a crisis intervention during the coronavirus disease 2019 epidemic. Methods Participants were invited online to complete demographic information and questionnaires. The Symptom Checklist-90 somatization subscale, 10-item Connor–Davidson resilience scale, and 10-item Perceived Stress Scale were measured. Results A total of 2,557 participants were included. Spearman correlation analysis revealed that lower resilience was associated with more somatic symptoms (p < 0.001). The conditional process model was proved (indirect effect = −0.01, 95% confidence interval = [−0.015, −0.002]). The interaction effects between perceived stress and sex predicted somatization (b = 0.05, p = 0.006). Conclusion Resilience is a key predictor of somatization. The mediating effects of perceived stress between resilience and somatization work in the context of sex difference. Sex-specific intervention by enhancing resilience is of implication for alleviating somatization during the coronavirus disease 2019 epidemic.
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Affiliation(s)
- Fangfang Shangguan
- Beijing Key Laboratory of Learning and Cognition, School of Psychology, Capital Normal University, Beijing, China
| | - Chenhao Zhou
- Beijing Key Laboratory of Learning and Cognition, School of Psychology, Capital Normal University, Beijing, China
| | - Wei Qian
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Chen Zhang
- Beijing Key Laboratory of Learning and Cognition, School of Psychology, Capital Normal University, Beijing, China
| | - Zhengkui Liu
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Xiang Yang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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16
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Midavaine É, Côté J, Marchand S, Sarret P. Glial and neuroimmune cell choreography in sexually dimorphic pain signaling. Neurosci Biobehav Rev 2021; 125:168-192. [PMID: 33582232 DOI: 10.1016/j.neubiorev.2021.01.023] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 11/03/2020] [Accepted: 01/25/2021] [Indexed: 12/17/2022]
Abstract
Chronic pain is a major global health issue that affects all populations regardless of sex, age, ethnicity/race, or country of origin, leading to persistent physical and emotional distress and to the loss of patients' autonomy and quality of life. Despite tremendous efforts in the elucidation of the mechanisms contributing to the pathogenesis of chronic pain, the identification of new potential pain targets, and the development of novel analgesics, the pharmacological treatment options available for pain management remain limited, and most novel pain medications have failed to achieve advanced clinical development, leaving many patients with unbearable and undermanaged pain. Sex-specific susceptibility to chronic pain conditions as well as sex differences in pain sensitivity, pain tolerance and analgesic efficacy are increasingly recognized in the literature and have thus prompted scientists to seek mechanistic explanations. Hence, recent findings have highlighted that the signaling mechanisms underlying pain hypersensitivity are sexually dimorphic, which sheds light on the importance of conducting preclinical and clinical pain research on both sexes and of developing sex-specific pain medications. This review thus focuses on the clinical and preclinical evidence supporting the existence of sex differences in pain neurobiology. Attention is drawn to the sexually dimorphic role of glial and immune cells, which are both recognized as key players in neuroglial maladaptive plasticity at the origin of the transition from acute pain to chronic pathological pain. Growing evidence notably attributes to microglial cells a pivotal role in the sexually dimorphic pain phenotype and in the sexually dimorphic analgesic efficacy of opioids. This review also summarizes the recent advances in understanding the pathobiology underpinning the development of pain hypersensitivity in both males and females in different types of pain conditions, with particular emphasis on the mechanistic signaling pathways driving sexually dimorphic pain responses.
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Affiliation(s)
- Élora Midavaine
- Department of Pharmacology-Physiology, Institut de pharmacologie de Sherbrooke, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Québec, Canada; Centre de recherche du Centre hospitalier universitaire de Sherbrooke, CIUSSS de l'Estrie - CHUS, Sherbrooke, Québec, Canada.
| | - Jérôme Côté
- Department of Pharmacology-Physiology, Institut de pharmacologie de Sherbrooke, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Québec, Canada; Centre de recherche du Centre hospitalier universitaire de Sherbrooke, CIUSSS de l'Estrie - CHUS, Sherbrooke, Québec, Canada
| | - Serge Marchand
- Department of Pharmacology-Physiology, Institut de pharmacologie de Sherbrooke, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Québec, Canada; Centre de recherche du Centre hospitalier universitaire de Sherbrooke, CIUSSS de l'Estrie - CHUS, Sherbrooke, Québec, Canada
| | - Philippe Sarret
- Department of Pharmacology-Physiology, Institut de pharmacologie de Sherbrooke, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Québec, Canada; Centre de recherche du Centre hospitalier universitaire de Sherbrooke, CIUSSS de l'Estrie - CHUS, Sherbrooke, Québec, Canada.
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17
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Finlay J, Lind C, Dela Cruz AM. Concept analysis: Resilience in young women with chronic pain. Nurs Forum 2020; 56:389-395. [PMID: 33345367 DOI: 10.1111/nuf.12543] [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: 09/11/2020] [Revised: 10/29/2020] [Accepted: 12/04/2020] [Indexed: 11/26/2022]
Abstract
The aim of this article is to define the concept of resilience in the context of chronic pain, while presenting a historical background of resilience. Resilience in young women with chronic pain is discussed where findings exist. Chronic pain places a considerable burden on individual and societal health; resilience is critical to chronic pain management. Enhancing understanding of the concept of resilience can promote resilience and aid in early recognition of impaired coping. Rodgers's evolutionary method of concept analysis was used. Using CINAHL, PubMed, and Google Scholar databases, articles published from 1979 to 2020 were analyzed to identify conceptual components of resilience. We reviewed included articles to determine surrogate terms, relevant uses of the concept, attributes, references of the concept, antecedents, consequences, and related concepts. Resilience in the context of chronic pain is a lifelong process of positive adaption and thriving despite adversity. Components of Rodgers's evolutionary method are identified for the concept. Further research on resilience in young women with chronic pain is needed, given the current lack of literature. Developing nursing interventions to foster resilience is important to promote long-term, effective self-management of individuals living with chronic pain.
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Affiliation(s)
- Jenise Finlay
- Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada
| | - Candace Lind
- Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada
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18
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Williams MW, Rapport LJ, Sander AM, Parker HA. Pain anxiety and rehabilitation outcomes after acquired brain injury. Brain Inj 2020; 35:32-40. [PMID: 33347375 DOI: 10.1080/02699052.2020.1859614] [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: 10/22/2022]
Abstract
Purpose: The purpose of this study was to examine pain anxiety after acquired brain injury (ABI) and its relationship to rehabilitation outcomes.Materials and Method: Participants consisted of 89 adults with an ABI participating in outpatient rehabilitation therapy. They completed a battery of neuropsychological tests at baseline along with surveys of mood, health-related self-efficacy, and pain anxiety. Separately, occupational therapists assessed basic and instrumental activities of daily living (ADLs) as well as therapy engagement across treatment after the sixth session.Results: Individuals who reported high pain anxiety had fewer years of formal education, lower self-efficacy, and more emotional distress than those with low pain anxiety. Although Blacks were about half (56%) of the study sample, they comprised the majority (73.1%) of individuals in the high pain anxiety group. Pain anxiety was negatively related to therapy engagement. Moderation analysis using linear regression indicated that pain anxiety moderated the influence of self-efficacy on basic ADLs.Conclusions: Pain anxiety, particularly when high, is negatively associated with rehabilitation outcomes for individuals with ABI. Among those with high pain anxiety, health-related self-efficacy is an important resilience characteristic to improve functional outcomes. In rehabilitation therapy, pain anxiety provides a novel intervention target to enhance ABI recovery.
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Affiliation(s)
- Michael W Williams
- Department of Psychology, Wayne State University, Detroit, MI, USA.,Department of Psychology, University of Houston, Houston, TX, USA
| | - Lisa J Rapport
- Department of Psychology, Wayne State University, Detroit, MI, USA
| | - Angelle M Sander
- Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA.,Brain Injury Research Center, TIRR Memorial Hermann, Houston, TX, USA
| | - Hillary A Parker
- Department of Psychology, Wayne State University, Detroit, MI, USA.,Neurology, Mount Carmel Health System, Columbus, OH, USA
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19
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Occurrence and Severity of Pain in Patients with Venous Leg Ulcers: A 12-Week Longitudinal Study. J Clin Med 2020; 9:jcm9113399. [PMID: 33114118 PMCID: PMC7690800 DOI: 10.3390/jcm9113399] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 10/19/2020] [Accepted: 10/21/2020] [Indexed: 11/16/2022] Open
Abstract
Background: The aim of the study was to analyze the dynamics of pain severity and its predictors in a group of patients with chronic venous leg ulcers. Methods: A 12-week longitudinal study included 754 patients with chronic venous leg ulcers. Subjective severity of pain was measured at weekly intervals with an 11-point visual analogue scale (VAS). Results: A significant decrease in VAS scores has been observed throughout the entire analyzed period. Higher severity of pain during follow-up was independently predicted by the presence of pus and/or unpleasant smell from the ulceration during the first visit, as well as by the occurrence of posterior and/or circumferential ulcers. The presence of ulcer redness during the first visit was associated with lesser pain severity; also, a significant interaction effect between the ulceration redness and warmth was observed. Conclusions: Implementation of complex holistic care may contribute to a substantial decrease in the occurrence and severity of pain in a patient with venous leg ulcers. Pain control seems to depend primarily on clinical parameters and topography of venous ulcers. The predictors of pain severity identified in this study might be considered during the planning of tailored care for patients with venous leg ulcers.
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20
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You B, Jackson T. Factor Structure and Construct Validity of the Pain Resilience Scale Within Chinese Adult Chronic Musculoskeletal Pain Samples. J Pers Assess 2020; 103:685-694. [DOI: 10.1080/00223891.2020.1801700] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Beibei You
- Key Laboratory of Cognition & Personality, Southwest University, Chongqing, China
- Qiannan Preschool Education College, Guizhou, China
| | - Todd Jackson
- Key Laboratory of Cognition & Personality, Southwest University, Chongqing, China
- Department of Psychology, University of Macau, Taipa, Macau, S.A.R
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21
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Koller J, Bismarck C, Krebs S, Hitzl W, Mayer M, Koller H. Coexistence of Neck and Shoulder Disability: Results of a Population-Based Cross-Sectional Study on Normative Scores and Multifactorial Risk Factors for Neck and Shoulder Problems. Asian Spine J 2020; 15:180-191. [PMID: 32718131 PMCID: PMC8055464 DOI: 10.31616/asj.2019.0397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 03/24/2020] [Indexed: 11/28/2022] Open
Abstract
Study Design Cross-sectional population-based study. Purpose The study objective was to evaluate the coexistence of neck- and shoulder-disability, to establish normative scores for Neck Disability Index (NDI), Visual Analog Scale (VAS)-neck, VAS-arm, Quick Disability of Shoulder and Hand (Quick-DASH), and modified Constant score (mConstant score), and to determine the influence of psychological distress (Hospital Anxiety and Depression Scale [HADS]) on the disability measures. The authors also investigated the distribution of dysphagia across the population and its relation to the NDI scores. Overview of Literature Several factors can adversely influence the clinical outcomes after cervical surgeries. The interaction of neck and shoulder disability in the perspective of psychological distress is not well understood. Methods Prospective questionnaire-based assessment was performed for 1,000 participants. Questionnaires consisted of validated generic and disease-specific queries and specific questions. The survey included patients without pathologies of cervical spine/shoulders/upper extremities. Results Mean age of participants was 39 years. The average neck VAS score was 1.2, NDI% was 7.3, arm VAS score was 0.8, Quick-DASH was 6.2, mConstant score was 70.7, HADS-A score was 4.9, and HADS-D score was 3.2. The psychological scores showed a significant correlation with neck- and shoulder-disability (p<0.0001, r=0.3 to r=0.5). However, correlations between neck (NDI%, neck VAS score) and shoulder disability (mConstant score, arm VAS score, Quick-DASH) were stronger (p<0.0001, r=0.5 to r=0.6). A body mass index >35 kg/m2 influenced shoulder-disability (p<0.005) and psychological distress (HADS-D score, p<0.00001). Limited neck rotation was present in those with higher age, psychological distress, neck and shoulder disability (p<0.001). Conclusions Normative scores for neck and shoulder disability were established. The outcomes of cervical spine surgery can be normalized to these results. A better understanding of the interdependencies of neck and shoulder disability and psychological distress would enable superior decision-making and patient counseling.
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Affiliation(s)
- Juliane Koller
- Department of General Surgery and Traumatology, Hospital zum Heiligen Geist Fritzlar, Fritzlar, Germany.,Center for Spine and Scoliosis Surgery, Schoen-Klinik Vogtareuth, Vogtareuth, Germany
| | - Carsten Bismarck
- Department of General Surgery and Traumatology, Hospital zum Heiligen Geist Fritzlar, Fritzlar, Germany
| | - Sona Krebs
- Department of General Surgery and Traumatology, Hospital zum Heiligen Geist Fritzlar, Fritzlar, Germany
| | - Wolfgang Hitzl
- Research Office for Biostatistics, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Michael Mayer
- Center for Spine and Scoliosis Surgery, Schoen-Klinik Vogtareuth, Vogtareuth, Germany.,Department for Orthopedic Surgery and Traumatology, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Heiko Koller
- Department for Orthopedic Surgery and Traumatology, Paracelsus Medical University Salzburg, Salzburg, Austria.,Department of Neurosurgery, Klinikum Rechts der Isar, Technical University of Munich, München, Germany
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22
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Liesto S, Sipilä R, Aho T, Harno H, Hietanen M, Kalso E. Psychological resilience associates with pain experience in women treated for breast cancer. Scand J Pain 2020; 20:545-553. [PMID: 32335540 DOI: 10.1515/sjpain-2019-0137] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 03/21/2020] [Indexed: 11/15/2022]
Abstract
Background and aims Psychological resilience refers to successful adaptation or a positive outcome in the context of significant life adversity, such as chronic pain. On the other hand, anxiety closely associates with pain. The aim of this study was to explore how anxiety and psychological resilience together associate with persistent and experimental pain. Methods In a cross-sectional design, we studied 160 patients who had previously been treated for breast cancer and who now reported at least moderate pain (NRS ≥ 4) in any area of the body. Psychological resilience was measured on the Resilience Scale-14, anxiety on the Hospital Anxiety and Depression Scale, and intensity and interference of persistent pain by means of the Brief Pain Inventory. The cold pressor test was conducted to assess sensitivity to experimental cold pain. Results The results showed that resilience associated with pain interference in persistent pain, and that anxiety moderated this effect. Higher psychological resilience was associated with lower pain interference and this association was stronger in patients with low anxiety than among patients with high anxiety. These effects were visible with regard to persistent pain but not in experimental cold pain. Conclusions These results indicate that chronic pain and experimental pain as well as pain severity and pain interference are psychologically different phenomena. Psychological resilience protects against pain interference but effectively only in patients with low anxiety. It is necessary also to consider protective factors in addition to vulnerability factors in cases of persistent pain. Implications Resilience has been considered a potential target for intervention in chronic pain. However, high levels of anxiety might diminish the protective effect of psychological resilience in clinical settings. Therefore, it is important to treat anxiety in addition to resilience enhancing interventions. Patients with low psychological distress might be more suitable for resilience enhancing interventions than patients with high anxiety.
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Affiliation(s)
- Sanna Liesto
- Division of Pain Medicine, Department of Anaesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Clinical Neurosciences, Neuropsychology, University of Helsinki and Neurocenter, Helsinki University Hospital, Helsinki, Finland
| | - Reetta Sipilä
- Division of Pain Medicine, Department of Anaesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Tommi Aho
- Division of Pain Medicine, Department of Anaesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Hanna Harno
- Division of Pain Medicine, Department of Anaesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Clinical Neurosciences, Neurology, University of Helsinki and Neurocenter, Helsinki University Hospital, Helsinki, Finland
| | - Marja Hietanen
- Clinical Neurosciences, Neuropsychology, University of Helsinki and Neurocenter, Helsinki University Hospital, Helsinki, Finland
| | - Eija Kalso
- Division of Pain Medicine, Department of Anaesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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Lentz TA, Rhon DI, George SZ. Predicting Opioid Use, Increased Health Care Utilization and High Costs for Musculoskeletal Pain: What Factors Mediate Pain Intensity and Disability? THE JOURNAL OF PAIN 2020; 21:135-145. [PMID: 31201989 PMCID: PMC6908782 DOI: 10.1016/j.jpain.2019.06.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 05/29/2019] [Accepted: 06/01/2019] [Indexed: 12/28/2022]
Abstract
This study determined the predictive capabilities of pain intensity and disability on health care utilization (number of condition-specific health care visits, incident, and chronic opioid use) and costs (total condition-specific and overall medical costs) in the year following an initial evaluation for musculoskeletal pain. We explored pain catastrophizing and spatial distribution of symptoms (ie, body diagram symptom score) as mediators of these relationships. Two hundred eighty-three military service members receiving initial care for a musculoskeletal injury completed a region-specific disability measure, numeric pain rating scale, Pain Catastrophizing Scale, and body pain diagram. Pain intensity predicted all outcomes, while disability predicted incident opioid use only. No mediation effects were observed for either opioid use outcome, while pain catastrophizing partially mediated the relationship between pain intensity and number of health care visits. Pain catastrophizing and spatial distribution of symptoms fully mediated the relationship between pain intensity and both cost outcomes. The mediation effects of pain catastrophizing and spatial distribution of symptoms are outcome specific, and more consistently observed for cost outcomes. Higher pain intensity may drive more condition-specific health care utilization and use of opioids, while higher catastrophizing and larger spatial distribution of symptoms may drive higher costs for services received. PERSPECTIVE: This article examines underlying characteristics that help explain relationships between pain intensity and disability, and the outcomes of health care utilization and costs. Health care systems can use these findings to refine value-based prediction models by considering factors that differentially influence outcomes for health care use and cost of services.
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Affiliation(s)
- Trevor A Lentz
- Department of Orthopaedic Surgery Duke University, Duke Clinical Research Institute, Duke University, Durham, North Carolina.
| | - Daniel I Rhon
- Department of Orthopaedic Surgery Duke University, Duke Clinical Research Institute, Duke University, Durham, North Carolina; Brooke Army Medical Center, San Antonio, Texas; Physical Performance Service Line, G3/5/7, Army Office of the Surgeon General, Falls Church, Virginia
| | - Steven Z George
- Department of Orthopaedic Surgery Duke University, Duke Clinical Research Institute, Duke University, Durham, North Carolina; Department of Orthopeadic Surgery, Duke University, Durham, North Carolina
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Abstract
PURPOSE Women have a higher dry eye disease prevalence compared with men, although only relatively minor differences in the ocular surface have been observed. Interestingly, a sex difference in pain sensitivity is known, and recent research suggests that pain sensitivity is associated with dry eye symptoms. This study attempts to discern whether the association between pain sensitivity and dry eye symptoms varies between women and men. METHODS In this prospective cross-sectional study, subjects were seen for one visit where they were asked to fill out a set of questionnaires consisting of the Pain Sensitivity Questionnaire, Ocular Surface Disease Index (OSDI), and other dry eye questionnaires. This was followed by an ocular surface assessment on both eyes. RESULTS Two hundred eighty-seven subjects (194 women, 93 men) completed the study. Intersex differences in the ocular surface were noted. Even after accounting for these differences, an interaction effect between sex and Pain Sensitivity Questionnaire-minor score on dry eye symptoms was observed, with only women noting increased symptoms on the OSDI (P < 0.005) and other dry eye questionnaires (P values ranging from 0.01 to <0.005) with greater pain sensitivity. After controlling for other variables, women with the highest pain sensitivity had a 17-point higher OSDI score and greater symptoms, as reported by all the other dry questionnaires compared with their male counterparts. CONCLUSIONS The role of pain sensitivity on dry eye symptoms appears to vary between women and men. This difference provides insight into why women have a significantly higher dry eye disease prevalence than men.
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Ruiz-Montero PJ, Ruiz-Rico Ruiz GJ, Martín-Moya R, González-Matarín PJ. Do Health-Related Quality of Life and Pain-Coping Strategies Explain the Relationship between Older Women Participants in a Pilates-Aerobic Program and Bodily Pain? A Multiple Mediation Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16183249. [PMID: 31487929 PMCID: PMC6765881 DOI: 10.3390/ijerph16183249] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 09/02/2019] [Accepted: 09/03/2019] [Indexed: 12/31/2022]
Abstract
This study (1) analyzes the differences between non-participating and participating older women in terms of clinical characteristics, pain coping strategies, health-related quality of life and physical activity (PA); (2) studies the associations between non-participants and participants, clinical characteristics, pain coping strategies, HRQoL and bodily pain and PA; and (3) determines whether catastrophizing, physical role, behavioural coping, social functioning and emotional role are significant mediators in the link between participating in a Pilates-aerobic program (or not) and bodily pain. The sample comprised 340 older women over 60 years old. Participants of the present cross-sectional study completed measures of clinical characteristics: HRQoL using the SF-36 Health Survey, pain-coping strategies using the Vanderbilt Pain Management Inventory (VPMI) and PA using the International Physical Activity Questionnaire (IPAQ). Significant differences between non-participants and participants, were found in clinical characteristics, pain-coping strategies (both, p < 0.05), HRQoL (p < 0.01), and PA (p < 0.001). Moreover, catastrophizing support mediated the link between non-participants and participants and bodily pain by 95.9% of the total effect; 42.9% was mediated by PA and 39.6% was mediated by behavioural coping. These results contribute to a better understanding of the link between PA and bodily pain.
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Affiliation(s)
- Pedro Jesús Ruiz-Montero
- Department of Physical Education and Sport, Faculty of Education and Social Sciences, Campus of Melilla, University of Granada, 52071 Melilla, Spain.
| | | | - Ricardo Martín-Moya
- Body Expression area, Education School, University of Granada, 18011 Granada, Spain
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Racine M, Solé E, Sánchez-Rodríguez E, Tomé-Pires C, Roy R, Jensen MP, Miró J, Moulin DE, Cane D. An Evaluation of Sex Differences in Patients With Chronic Pain Undergoing an Interdisciplinary Pain Treatment Program. Pain Pract 2019; 20:62-74. [PMID: 31376331 DOI: 10.1111/papr.12827] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 07/02/2019] [Accepted: 07/27/2019] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To determine if there are sex differences in a sample of patients participating in a 4-week interdisciplinary pain treatment program in (1) pretreatment pain intensity, physical function, psychological function, pain beliefs, kinesiophobia, pain catastrophizing, and activity management patterns; and (2) treatment response. METHODS Seventy-two men and 130 women with chronic pain completed study measures. Analyses of covariance (ANCOVAs) were performed to compare men and women on pretreatment measures. Repeated-measures ANCOVAs were used to compare both sexes on 3 treatment outcomes (pain intensity, physical function, and depressive symptoms). RESULTS Before treatment, compared to women, men reported higher levels of kinesiophobia, were more likely to view their pain as being harmful, and used more activity pacing when doing daily activities. Women were more likely to use an overdoing activity pattern than men. No sex differences emerged for pretreatment pain intensity, physical function, psychological function, catastrophizing, activity avoidance, or measures of other pain-related beliefs. At posttreatment, women reported more improvements in pain intensity and physical function compared to men, while both sexes reported similar reductions in depressive symptoms. All effect sizes for statistically significant findings were of small to moderate magnitude. DISCUSSION The results of this study suggest that men and women have a comparable profile with respect to the overall burden of chronic pain. Nevertheless, sex differences were found for certain pain beliefs and coping styles. Women appear to reap more benefits from the interdisciplinary pain management program than men. These findings indicate that further research to develop sex-specific assessment procedures and tailored pain treatments may be warranted.
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Affiliation(s)
- Mélanie Racine
- Department of Clinical Neurological Sciences, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Ester Solé
- Unit for the Study and Treatment of Pain-ALGOS, Department of Psychology, Research Center for Behavior Assessment (CRAMC), Universitat Rovira i Virgili, Catalonia, Spain.,Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Catalonia, Spain
| | - Elisabet Sánchez-Rodríguez
- Unit for the Study and Treatment of Pain-ALGOS, Department of Psychology, Research Center for Behavior Assessment (CRAMC), Universitat Rovira i Virgili, Catalonia, Spain.,Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Catalonia, Spain
| | - Catarina Tomé-Pires
- Unit for the Study and Treatment of Pain-ALGOS, Department of Psychology, Research Center for Behavior Assessment (CRAMC), Universitat Rovira i Virgili, Catalonia, Spain.,Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Catalonia, Spain
| | - Rubén Roy
- Unit for the Study and Treatment of Pain-ALGOS, Department of Psychology, Research Center for Behavior Assessment (CRAMC), Universitat Rovira i Virgili, Catalonia, Spain.,Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Catalonia, Spain
| | - Mark P Jensen
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, U.S.A
| | - Jordi Miró
- Unit for the Study and Treatment of Pain-ALGOS, Department of Psychology, Research Center for Behavior Assessment (CRAMC), Universitat Rovira i Virgili, Catalonia, Spain.,Institut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Catalonia, Spain
| | - Dwight E Moulin
- Department of Clinical Neurological Sciences, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Douglas Cane
- Pain Management Unit, Nova Scotia Health Authority, Halifax, Nova Scotia, Canada
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Naamany E, Reis D, Zuker-Herman R, Drescher M, Glezerman M, Shiber S. Is There Gender Discrimination in Acute Renal Colic Pain Management? A Retrospective Analysis in an Emergency Department Setting. Pain Manag Nurs 2019; 20:633-638. [PMID: 31175043 DOI: 10.1016/j.pmn.2019.03.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 03/02/2019] [Accepted: 03/31/2019] [Indexed: 02/08/2023]
Abstract
BACKGROUND Pain is a widespread problem, affecting both men and women; studies have found that women in the emergency department receive analgesic medication and opioids less often compared with men. AIMS The aim of this study was to examine the administration and management of analgesics by the medical/paramedical staff in relation to the patients' gender, and thereby to examine the extent of gender discrimination in treating pain. DESIGN This is a single-center retrospective cohort study that included 824 patients. SETTINGS Emergency department of tertiary hospital in Israel. PARTICIPANTS/SUBJECTS The patients stratified by gender to compare pain treatments and waiting times between men and women in renal colic complaint. METHODS As an acute pain model, we used renal colic with a nephrolithiasis diagnosis confirmed by imaging. We recorded pain level by Visual Analog Scale (VAS) scores and number of VAS examinations. Time intervals were calculated between admissions to different stations in the emergency department. We recorded the number of analgesic drugs administered, type of drugs prescribed, and drug class (opioids or others). RESULTS A total of 824 patients (414 women and 410 men) participated. There were no significant differences in age, ethnicity, and laboratory findings. VAS assessments were higher in men than in women (6.43 versus 5.90, p = .001, respectively). More men than women received analgesics (68.8% versus 62.1%, p = .04, respectively) and opioids were prescribed more often for men than for women (48.3 versus 35.7%, p = .001). The number of drugs prescribed per patient was also higher in men compared with women (1.06 versus 0.93, p = .03). A significant difference was found in waiting time length from admission to medical examination between non-Jewish women and Jewish women. CONCLUSIONS We found differences in pain management between genders, which could be interpreted as gender discrimination. Yet these differences could also be attributed to other factors not based on gender discrimination but rather on gender differences.
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Affiliation(s)
- Eviatar Naamany
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Daniel Reis
- Department of Emergency Medicine, Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel
| | - Rona Zuker-Herman
- Department of Emergency Medicine, Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel
| | - Michael Drescher
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Emergency Medicine, Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel
| | - Marek Glezerman
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Research Institute for Gender Medicine, Rabin Medical Center, Beilinson Campus, Petach Tikva, Israel
| | - Shachaf Shiber
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Emergency Medicine, Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel.
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O'Loughlin I, Newton-John TRO. 'Dis-comfort eating': An investigation into the use of food as a coping strategy for the management of chronic pain. Appetite 2019; 140:288-297. [PMID: 31145944 DOI: 10.1016/j.appet.2019.05.027] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 04/18/2019] [Accepted: 05/21/2019] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Chronic pain and obesity are major public health concerns. Animal and human models have demonstrated that eating high-sugar nutrient-dense foods confers analgesic effects. Moreover, recent research suggests that people with chronic pain may "comfort eat" to cope with their pain. Given the harmful impact of obesity on chronic pain, it is critical to determine whether pain elicits comfort eating amongst individuals with chronic pain to ensure that this potentially maladaptive pain coping strategy is not overlooked in chronic pain treatment. Therefore, this study aimed to: determine whether chronic pain intensity predicts pain-induced comfort eating and identify mediators of this relationship; to determine whether pain-induced comfort eating predicts elevated BMI; and to establish whether BMI predicts chronic pain interference. METHODS This study utilised a cross-sectional online survey design and a sample of 151 adults with chronic pain. RESULTS Over three-quarters of this chronic pain sample reported engaging in pain-induced comfort eating. Chronic pain intensity did not significantly predict pain-induced comfort eating. However, there was a significant indirect effect of chronic pain intensity on pain-induced comfort eating through stress-but not experiential avoidance or pain catastrophising. As predicted, pain-induced comfort eating significantly predicted increased BMI, and BMI in turn significantly predicted greater chronic pain interference. DISCUSSION This study indicates that pain-induced comfort eating is both common and harmful amongst individuals with chronic pain, across the entire BMI spectrum. Pain-induced comfort eating and stress have emerged as promising chronic pain treatment targets. The findings are discussed and interpreted in light of extant research and theory, as well as limitations of the current study. Future research directions and clinical implications are also considered.
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Affiliation(s)
- Imogen O'Loughlin
- Graduate School of Health, University of Technology Sydney, Australia
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Musich S, Wang SS, Slindee L, Kraemer S, Yeh CS. The association of pain locus of control with pain outcomes among older adults. Geriatr Nurs 2019; 41:521-529. [PMID: 31078323 DOI: 10.1016/j.gerinurse.2019.04.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 04/24/2019] [Accepted: 04/26/2019] [Indexed: 11/30/2022]
Abstract
Our primary objective was to 1) determine the prevalence of pain locus of control (LOC) subscales in a population of older adults with pain conditions, and 2) estimate their associated protective effects on pain outcomes. A mailed survey was sent to a stratified sample of older adults age≥65 with diagnosed back pain, osteoarthritis and/or rheumatoid arthritis. Multivariate logistic regression modeling was used to determine the relative protective associations of positive resources, including LOC, resilience and social networks, on pain outcomes. Among respondents (N = 3,824), 31% were identified as internal; 34% as powerful others; and 35% as chance. In adjusted models, internal was associated with outcomes of lower pain severity, reduced chronic opioid use and increased physical functionality. Powerful others was partially protective; chance was associated with the poorest outcomes. Multidimensional pain programs should incorporate the enhancement of positive resources, including LOC, to maximize the effectiveness of pain management strategies.
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Affiliation(s)
- Shirley Musich
- Research for Aging Populations, Optum, 315 E. Eisenhower Parkway, Suite 305, Ann Arbor, MI 48108, United States.
| | - Shaohung S Wang
- Research for Aging Populations, Optum, 315 E. Eisenhower Parkway, Suite 305, Ann Arbor, MI 48108, United States.
| | - Luke Slindee
- Informatics & Data Science, Optum, 12700 Whitewater Drive, Minnetonka, MN 55343, United States.
| | - Sandra Kraemer
- Medicare & Retirement, UnitedHealthcare Alliances, PO Box 9472, Minneapolis, MN 55440, United States.
| | - Charlotte S Yeh
- AARP Services, Inc., 601 E. Street, N.W., Washington, DC 20049, United States.
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Musich S, Wang SS, Slindee L, Kraemer S, Yeh CS. Association of Resilience and Social Networks with Pain Outcomes Among Older Adults. Popul Health Manag 2019; 22:511-521. [PMID: 30801238 PMCID: PMC6885755 DOI: 10.1089/pop.2018.0199] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Depression, stress, and poor sleep have been associated with increased pain among older adults; positive resources, such as resilience and social networks, may help to buffer the impacts of these negative attributes on pain outcomes. The primary objective was to determine the relative effects of positive resources and negative attributes on pain outcomes among older adults with diagnosed back pain, osteoarthritis, and rheumatoid arthritis. The stratified study sample was identified from older adults ages ≥65 years. Members received a survey assessing positive resources (resilience, social networks), negative attributes (depression, stress, poor sleep), and pain outcomes (severity, interference). Opioid and other medication use was determined from pharmaceutical claims. After weighting to representative distributions of pain conditions and adjusting for survey response bias, multinomial logistic regressions were used to determine the relative associations of positive and negative attributes on pain outcomes. Among survey respondents (N = 4161), prevalence of self-reported pain severity and interference for no/mild, moderate, and severe categories was 61%, 21%, and 18%, and 67%, 16%, and 17%, respectively. In bivariate models, negative attributes of depression, stress, and poor sleep had stronger associations with pain severity and interference than the moderating effects of positive resources of high resilience and diverse social networks. In fully adjusted multivariate models, the strongest associations with moderate and severe pain severity and interference remained depression, stress, and poor sleep. Based on these results, multidimensional pain management strategies should include management of negative attributes along with enhancement of positive resources for effective management of chronic pain.
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Affiliation(s)
- Shirley Musich
- Research for Aging Populations, Optum, Ann Arbor, Michigan
| | | | - Luke Slindee
- Informatics & Data Science, Optum, Minnetonka, Minnesota
| | - Sandra Kraemer
- UnitedHealthcare Medicare & Retirement, Minneapolis, Minnesota
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Salman Roghani R, Delbari A, Asadi-Lari M, Rashedi V, Lökk J. Neuropathic Pain Prevalence of Older Adults in an Urban Area of Iran: A Population-Based Study. PAIN RESEARCH AND TREATMENT 2019; 2019:9015695. [PMID: 30719350 PMCID: PMC6334371 DOI: 10.1155/2019/9015695] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 11/02/2018] [Accepted: 11/22/2018] [Indexed: 11/17/2022]
Abstract
BACKGROUND Pain prevalence would increase as the population grows older, but the exact prevalence rate is not apparent in Iran. OBJECTIVES This study, therefore, set out to reveal the prevalence of pain, especially neuropathic type and explore its associated comorbidities among Iranian older adults in a large urban population-based survey. METHODS 5326 older people, aged ≥ 60 years, were randomly chosen by a multistage, cluster sampling method. The selected people then were interviewed by using the following instruments: a standard questionnaire about pain, questions of interview part of Douleur Neuropathique 4 Questions (DN4) and its comorbidities, GHQ-28, and a sociodemographic checklist. Descriptive statistics and multiple regression analysis were conducted to analyze the gathered data. RESULTS The average of the participants' age was 68.92 ± 7.02 years. Of 5326 participants, 2529 (47.5%) of participants were male. About one-third of this population had chronic pain. Chronic neuropathic pain prevalence was 13.7% and nociceptive in 30%. Knee pain (20.6%) and feet dysesthesia (7.8%) were the most common sites of nociceptive and neuropathic pain, respectively. Results of multiple regression analysis revealed that the major comorbidities of chronic pain were osteoporosis, disability, diabetes mellitus, and stroke. Neuropathic pain experiences were significantly associated with GHQ-28 scores (t=-11.42, P<0.001). CONCLUSIONS In addition to neuropathic pain, other subtypes of pain prevalence and the comorbidities are determined in the community-dwelling elder adults. This study highlights the importance of neuropathic pain and its adverse consequences and can be used to manage this populations' needs in Iran effectively.
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Affiliation(s)
- Reza Salman Roghani
- Department of Neurobiology, Care Sciences and Society, Division of Clinical Geriatrics, Karolinska Institute, Stockholm, Sweden
- Physical Medicine and Rehabilitation Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ahmad Delbari
- Department of Neurobiology, Care Sciences and Society, Division of Clinical Geriatrics, Karolinska Institute, Stockholm, Sweden
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mohsen Asadi-Lari
- Department of Epidemiology, School of Public Health, Oncopathology Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Vahid Rashedi
- School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
| | - Johan Lökk
- Department of Neurobiology, Care Sciences and Society, Division of Clinical Geriatrics, Karolinska Institute, Stockholm, Sweden
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Garaud T, Gervais C, Szekely B, Michel-Cherqui M, Dreyfus JF, Fischler M. Randomized study of the impact of a therapeutic education program on patients suffering from chronic low-back pain who are treated with transcutaneous electrical nerve stimulation. Medicine (Baltimore) 2018; 97:e13782. [PMID: 30593158 PMCID: PMC6314771 DOI: 10.1097/md.0000000000013782] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Transcutaneous electrical nerve stimulation (TENS) is often used for the treatment of low-back pain (LBP). However, its effectiveness is controversial. OBJECTIVE To determine the efficacy of TENS in the treatment LBP when associated to a therapeutic education program (TEP). DESIGN Open randomized monocentric study. SETTING University hospital between 2010 and 2014. PATIENTS A total of 97 patients suffering from LBP. INTERVENTIONS Routine care (TENS group) or routine care plus a therapeutic education program (TENS-TEP group) based on consultation support by a pain resource nurse. MAIN OUTCOME MEASURES EIFEL and Dallas Pain Questionnaire scores. RESULTS Twenty-two patients (44%) were still assessable at the end-of-study visit, whereas 33 (70%) were assessable at the same time point in the TENS-TEP group (P = .013). The EIFEL score and the Dallas score had a similar evolution over time between groups (P = .18 and P = .50 respectively). Similarly, there were no significant differences between the groups with respect to resting pain scores (P = .94 for back pain and P = .16 for leg pain) and movement pain scores (P = .52 for back pain and P = .56 for leg pain). At Month 6, there was no significant difference between the groups (P = .85) with regard to analgesics and social impact. Two patients presented a serious adverse event during the study (one in each group) but non-attributable to the treatment studied. CONCLUSION This study does not support the use of TENS in the treatment of patients with chronic LBP even though patients benefited from a therapeutic education program by a pain resource nurse. However, the higher number of premature withdrawals in the TENS group may be due to early withdrawal of patients who did not experience improvement of their symptoms.
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Affiliation(s)
- Thomas Garaud
- Department of Anesthesiology, Hôpital Foch, Suresnes, France and Université Versailles Saint-Quentin en Yvelines
| | | | - Barbara Szekely
- Department of Anesthesiology, Hôpital Foch, Suresnes, France and Université Versailles Saint-Quentin en Yvelines
- Pain Management Unit, Hôpital Foch
| | - Mireille Michel-Cherqui
- Department of Anesthesiology, Hôpital Foch, Suresnes, France and Université Versailles Saint-Quentin en Yvelines
- Pain Management Unit, Hôpital Foch
| | | | - Marc Fischler
- Department of Anesthesiology, Hôpital Foch, Suresnes, France and Université Versailles Saint-Quentin en Yvelines
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Delaruelle Z, Ivanova TA, Khan S, Negro A, Ornello R, Raffaelli B, Terrin A, Mitsikostas DD, Reuter U. Male and female sex hormones in primary headaches. J Headache Pain 2018; 19:117. [PMID: 30497379 PMCID: PMC6755575 DOI: 10.1186/s10194-018-0922-7] [Citation(s) in RCA: 85] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 09/20/2018] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The three primary headaches, tension-type headache, migraine and cluster headache, occur in both genders, but all seem to have a sex-specific prevalence. These gender differences suggest that both male and female sex hormones could have an influence on the course of primary headaches. This review aims to summarise the most relevant and recent literature on this topic. METHODS Two independent reviewers searched PUBMED in a systematic manner. Search strings were composed using the terms LH, FSH, progesteron*, estrogen*, DHEA*, prolactin, testosterone, androgen*, headach*, migrain*, "tension type" or cluster. A timeframe was set limiting the search to articles published in the last 20 years, after January 1st 1997. RESULTS Migraine tends to follow a classic temporal pattern throughout a woman's life corresponding to the fluctuation of estrogen in the different reproductive stages. The estrogen withdrawal hypothesis forms the basis for most of the assumptions made on this behalf. The role of other hormones as well as the importance of sex hormones in other primary headaches is far less studied. CONCLUSION The available literature mainly covers the role of sex hormones in migraine in women. Detailed studies especially in the elderly of both sexes and in cluster headache and tension-type headache are warranted to fully elucidate the role of these hormones in all primary headaches.
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Affiliation(s)
- Zoë Delaruelle
- Department of Neurology, University Hospital Ghent, Corneel Heymanslaan 10, 9000 Ghent, Belgium
| | | | - Sabrina Khan
- Danish Headache Center, Glostrup Hospital, Copenhagen, Denmark
| | - Andrea Negro
- Dipartimento di Medicina Clinica e Molecolare, Universita degli Studi di Roma La Sapienza, Rome, Italy
| | - Raffaele Ornello
- Department of Neurology, University of La’Aquila, L’Aquila, Italy
| | - Bianca Raffaelli
- Departmentt of Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Alberto Terrin
- Department of Neurosciences, Headache Center, University of Padua, Padua, Italy
| | - Dimos D. Mitsikostas
- Neurology Department, Aeginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Uwe Reuter
- Charite Universitatsmedizin Berlin, Berlin, Germany
| | - on behalf of the European Headache Federation School of Advanced Studies (EHF-SAS)
- Department of Neurology, University Hospital Ghent, Corneel Heymanslaan 10, 9000 Ghent, Belgium
- First Moscow State Medical University, Moscow, Russia
- Danish Headache Center, Glostrup Hospital, Copenhagen, Denmark
- Dipartimento di Medicina Clinica e Molecolare, Universita degli Studi di Roma La Sapienza, Rome, Italy
- Department of Neurology, University of La’Aquila, L’Aquila, Italy
- Departmentt of Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany
- Department of Neurosciences, Headache Center, University of Padua, Padua, Italy
- Neurology Department, Aeginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
- Charite Universitatsmedizin Berlin, Berlin, Germany
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Hirani SS, Lasiuk G, Van Vliet KJ, Van Zanten SV, Karmaliani R, Norris CM. Comparison of Urdu Versions of the Resilience Scale and the Resilience Scale for Adults. J Nurs Meas 2018; 26:106-120. [PMID: 29724282 DOI: 10.1891/1061-3749.26.1.106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE Several methodological challenges are associated with measuring resilience in women. This study compares the 14-item Resilience Scale (RS-14) and the Resilience Scale for Adults (RSA) in a community sample of women. METHODS Data were collected from 120 women residing in low socioeconomic areas of Karachi, Pakistan. Construct validity, internal consistency, and responsiveness were calculated. RESULTS Both scales demonstrated satisfactory psychometric characteristics. The total RS-14 score was significantly associated with all subscales of the RSA. However, two items of the RS-14 did not show any association with any of the subscales of the RSA. Medium effect size was noted on the "structured style"subscale of the RSA. CONCLUSION Differences between the scales concluded that the Urdu version the of RSA yielded improved results in this sample.
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Bylinka J, Oniszczenko W. Temperament, Beliefs About Pain Control, and Pain Intensity in Endometriosis Patients. J Clin Psychol Med Settings 2018; 23:410-419. [PMID: 27738846 PMCID: PMC5131087 DOI: 10.1007/s10880-016-9473-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This correlational study investigated the relationships between temperament, beliefs about pain control, and pain intensity ratings in a group of 103 women diagnosed with endometriosis. Temperament traits were assessed using the Formal Characteristics of Behaviour-Temperament Inventory. Beliefs about pain control were measured using the Polish version of the Beliefs about Pain Control Questionnaire. The Numerical Rating Scale (NRS-11) was used to measure pain intensity. There was a high negative correlation between the temperament trait of endurance and pain intensity ratings. Moderate negative correlations with pain intensity were found for internal beliefs about pain control. Hierarchical multiple regression analysis indicated that the endurance trait and internal beliefs about pain control accounted for 33 % of the variance in pain intensity ratings in women with endometriosis.
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Affiliation(s)
- Joanna Bylinka
- Faculty of Psychology, University of Warsaw, Stawki 5/7, 00-183, Warsaw, Poland
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Myers L, Trobliger R, Bortnik K, Lancman M. Are there gender differences in those diagnosed with psychogenic nonepileptic seizures? Epilepsy Behav 2018; 78:161-165. [PMID: 29183659 DOI: 10.1016/j.yebeh.2017.10.019] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2017] [Revised: 10/13/2017] [Accepted: 10/15/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVE The objective of the study was to determine whether male and female populations of patients with psychogenic nonepileptic seizures (PNES) differ, in terms of demographic, social/clinical, and etiological factors as well as psychological measures. BACKGROUND Psychogenic nonepileptic seizures are overrepresented by females; therefore, information about PNES in males is limited. Only a handful of studies have examined PNES and gender, and of those, one was a literature review and with the exception of two, most have had small sample sizes. Of the existing literature, differences in abuse type, psychiatric diagnoses, and psychometric results have been observed in the two genders. METHODS This is a retrospective study of 51 consecutive males and 97 consecutive females with video-electroencephalogram (video-EEG) confirmed diagnosis of PNES. Patients were examined on demographics (age, education, working status), clinical (seizure frequency, trauma type: sexual, nonsexual, age of first trauma), and psychometric measures. The latter included the State Trait Anger Expression Inventory-2 (STAXI-2), Trauma Symptom Inventory-2 (TSI-2), the Coping Inventory for Stressful Situations (CISS), and the Quality of Life Inventory in Epilepsy-31 (QOLIE-31). RESULTS Women reported experiencing significantly more sexual traumas (p=0.007) than men. Women also endorsed significantly higher levels of dissociation (p=0.012) and sexual disturbances (p=0.46). In contrast, men reported significantly greater use of avoidance (p=0.001) as a stress coping strategy and higher levels of depression (p=0.006). CONCLUSIONS Gender differences were identified with males reporting a significantly higher use of avoidance (cognitive and behavioral avoidance of stress) and depressive symptoms. Women exhibited significantly higher rates of sexual trauma compared with male counterparts. Consequently, women also had significantly higher rates of trauma symptomatology (dissociation and sexual disturbances) which are often observed in those who have been traumatized sexually. These gender distinctions may support different first-line treatment approaches (e.g., trauma-focused; more traditional cognitive behavioral therapy) depending on the most prominent symptomatology.
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Affiliation(s)
- Lorna Myers
- Northeast Regional Epilepsy Group, New York, NY, United States.
| | | | - Kirsty Bortnik
- Northeast Regional Epilepsy Group, New York, NY, United States
| | - Marcelo Lancman
- Northeast Regional Epilepsy Group, New York, NY, United States
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Cimas M, Ayala A, Sanz B, Agulló-Tomás MS, Escobar A, Forjaz MJ. Chronic musculoskeletal pain in European older adults: Cross-national and gender differences. Eur J Pain 2017; 22:333-345. [PMID: 29235193 DOI: 10.1002/ejp.1123] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2017] [Indexed: 11/08/2022]
Abstract
BACKGROUND In an ageing Europe, chronic pain is a major public health problem, but robust epidemiological data are scarce. This study aimed to analyse the prevalence of and factors associated with chronic musculoskeletal pain by gender in older adults of 14 European countries. METHODS A cross-sectional study was performed from wave 5 of the Survey of Health, Ageing and Retirement in Europe (SHARE). The study included people ≥50 years residing in Austria, Belgium, Czech Republic, Denmark, Estonia, France, Germany, Italy, Luxembourg, the Netherlands, Slovenia, Spain, Sweden and Switzerland. Chronic pain was defined as being bothered by joint and/or back pain for the previous 6 months. Multivariable Poisson regression models with robust variance were performed to analyse prevalence ratio by covariates, stratified by sex. RESULTS A total of 61,157 participants were included. Overall prevalence of chronic musculoskeletal pain was 35.7% (28.8-31.7), ranging from 18.6% (17.1-20.1) for Switzerland to 45.6% (43.3-47.8) for France. Prevalence was higher in women than in men: 41.3% (40.2-42.4) versus 29.1% (28.0-30.3). Chronic musculoskeletal pain was lower in men aged >75 years (PR = 0.82; 0.72-0.92) than the younger (50-59) group. Separated/divorced status presented opposite effects among men (PR = 0.85; 0.76-0.96) and women (PR = 1.12; 1.03-1.21) compared with married, and unemployment was a significant factor in men (PR = 1.21; 95% CI 1.02-1.43) compared with employed. CONCLUSIONS Musculoskeletal pain in older European adults is very frequent, especially in women, with large differences depending on the country of residence. Health policy makers should prioritize strategies aimed at improving the prevention and management of chronic musculoskeletal pain in Europe. SIGNIFICANCE This study provides epidemiological data of chronic musculoskeletal pain in older adults. Reported differences contribute to highlight the relevance of considering a gender perspective in chronic musculoskeletal pain research. Cross-national comparison also offers a map of differences that improves the knowledge of this chronic condition in Europe.
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Affiliation(s)
- M Cimas
- National School of Health, Institute of Health Carlos III, Madrid, Spain
| | - A Ayala
- National School of Health, Institute of Health Carlos III, Madrid, Spain.,Red de Investigación en Servicios, Red de Servicios de Salud Orientados a Enfermedades Crónicas (REDISECC), Madrid, Spain
| | - B Sanz
- National School of Health, Institute of Health Carlos III, Madrid, Spain
| | - M S Agulló-Tomás
- Instituto Universitario de Estudios de Género y Departamento de Análisis Social, Universidad Carlos III, Madrid, Spain
| | - A Escobar
- Red de Investigación en Servicios, Red de Servicios de Salud Orientados a Enfermedades Crónicas (REDISECC), Madrid, Spain
| | - M J Forjaz
- National School of Health, Institute of Health Carlos III, Madrid, Spain.,Red de Investigación en Servicios, Red de Servicios de Salud Orientados a Enfermedades Crónicas (REDISECC), Madrid, Spain
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Cabrera-Leon A, Cantero-Braojos MÁ. [Impact of disabling chronic pain: results of a cross-sectional population study with face-to-face interview]. Aten Primaria 2017; 50:527-538. [PMID: 29102446 PMCID: PMC6839206 DOI: 10.1016/j.aprim.2017.03.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Revised: 02/22/2017] [Accepted: 03/20/2017] [Indexed: 11/28/2022] Open
Abstract
Objetivo Conocer el impacto del dolor crónico discapacitante (DCD) en la calidad de vida, el trabajo, el consumo de medicamentos y la utilización de servicios sanitarios. Diseño Estudio poblacional transversal con entrevista cara a cara y diseño muestral complejo. Emplazamiento Encuesta Andaluza de Salud (edición 2011). Participantes Un total de 6.507 personas ≥ 16 años (p = q = 0,5; nivel confianza = 95%; error muestral = 1,49; efecto diseño = 1,52). Intervenciones Se trata de un estudio observacional, por lo que no se realizó intervención alguna. Mediciones principales Variable dependiente: DCD, definido como población que afirmó verse limitada en su actividad por alguno de los dolores crónicos (DC) recogidos en el estudio. Variables independientes: calidad de vida, consumo de medicamentos, utilización de servicios sanitarios y ausencia laboral. Resultados Comparado con la población sin dolor crónico (nDC), la población con DCD tiene 6 puntos menos en calidad de vida mental y 12 en la física, consume el triple de medicamentos, utiliza casi el doble los servicios sanitarios, y su ausencia laboral prolongada es el triple. Además, la población con DC no discapacitante (DCnD) no difiere significativamente de aquella nDC en cuanto a las variables de estudio. Conclusiones Hemos considerado DCD como otra categoría del DC por su gran impacto en las variables de estudio. Por el contrario, la población con DCnD no obtiene diferencias de impacto significativas con respecto a la población nDC. Así pues, creemos que Atención Primaria y Salud Pública deberían liderar diferentes estrategias de prevención para el DCD así como la identificación de la población con DCnD para disminuir su posible deterioro hacia el DCD.
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Affiliation(s)
- Andrés Cabrera-Leon
- Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria, ibs.GRANADA, Hospitales Universitarios de Granada/Universidad de Granada, Granada, España; Centro de Investigación Biomédica en Red de Salud Pública y Epidemiología (CIBERESP), Madrid, España
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Aguiar ARSA, Ribeiro-Samora GA, Pereira LSM, Godinho LB, Assis MG. Disability in older adults with acute low back pain: the study Back Complaints in the Elderly - (Brazil). Braz J Phys Ther 2017; 21:365-371. [PMID: 28941958 PMCID: PMC5628373 DOI: 10.1016/j.bjpt.2017.06.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 09/21/2016] [Accepted: 11/21/2016] [Indexed: 12/19/2022] Open
Abstract
Older adults reported moderate to severe acute low back pain. Irrelevant association between acute pain intensity with disability was observed. There is interaction between age groups and marital status with disability.
Background The increase in the older adult and oldest old population in Brazil is growing. This phenomenon may be accompanied by an increase in musculoskeletal symptoms such as low back pain. This condition is usually associated with disability. Objective To verify the association between pain intensity and disability in older adults with acute low back pain and assess whether these variables differ depending on the age group and marital status. Methods This is a cross-sectional study conducted with 532 older adults with acute low back pain episodes. Pain intensity was assessed through the Numeric Pain Scale and disability through the Late Life Function and Disability Instrument, which shows two dimensions: “frequency” and “limitation” in performing activities. The association between pain and disability was analyzed. Results For the interaction effect between age groups and marital status, we found that the oldest old living with a partner performed activities of the personal domain less often compared to the oldest old living alone. The oldest old group living with a partner had a lower frequency of performing activities, but did not report feeling limited. The association of pain with disability was minimal (rho < 0.20) and thus considered irrelevant. Conclusion Disability in older adults with acute low back pain was influenced by the interaction between age groups and marital status and is not associated with pain intensity.
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Affiliation(s)
| | | | | | - Larissa Birro Godinho
- Programa de Pós-Graduação em Ciência da Reabilitação da Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Marcella Guimarães Assis
- Departamento de Terapia Ocupacional, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.
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Bendayan R, Ramírez-Maestre C, Ferrer E, López A, Esteve R. From acute to chronic back pain: Using linear mixed models to explore changes in pain intensity, disability, and depression. Scand J Pain 2017; 16:45-51. [PMID: 28850411 DOI: 10.1016/j.sjpain.2017.02.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2016] [Revised: 02/03/2017] [Accepted: 02/21/2017] [Indexed: 02/05/2023]
Abstract
Abstract
Background/aims
This longitudinal study investigated the pattern of change in pain intensity, disability, and depression in 232 chronic pain patients who were followed up for 2 years since pain onset. Most studies that have investigated changes in these variables over time have used participants who had already been in pain for more than 3 months. Few studies have followed up individuals from the acute phase onward and such studies used traditional statistical methods that cannot identify transition points over time or measure inter-individual variability.
Methods
We followed up individuals with chronic pain from pain onset up to 18 months and we examined their pain intensity, disability and depression trajectories using a modelling approach that allows to account for between and within-individual variability. We compared three patterns of change based on theoretical criterions: a simple linear growth model; a spline model with a 3-month transition point; and a spline model with a 6-month transition point. Time with pain was selected as time metric to characterise the change in these variables in the transition from acute to chronic pain. Sex and age differences were also examined.
Results
The results showed that the pain intensity trajectory was best represented by the spline model with a 3-month transition point, whereas disability and depression were best explained by linear growth models. There were sex differences at intercept level in all the models. There were age differences at baseline for pain intensity. No sex or age differences were found for the slope.
Conclusions
Pain intensity decreased in the first 3 months but underwent no further change. Disability and depression slightly but constantly decreased over time. Although women and older individuals are more likely to report higher pain intensity or pain-related disability in the first three months with pain, no differences by sex or age appear to be associated with the changes in pain intensity, depression and disability through the process of chronification.
Implications
Our findings suggest that pain chronification could be considered a continuous process and contribute to the ongoing discussion on the utility of standard classifications of pain as acute or chronic from a clinical point of view. Clinical and intervention decisions based in these standard classifications should consider the differences in the trajectories of pain related variables over time. In addition, this article illustrates a statistical procedure that can be of utility to pain researchers.
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Affiliation(s)
- Rebecca Bendayan
- Department of Psychobiology and Methodology of Behavioural Sciences, University of Malaga, Facultad de Psicologia, Campus de Teatinos s/n, Malaga 29071, Spain; MRC Unit for Lifelong Health and Ageing at UCL, 33 Bedford Place, London WC1B 5JU, United Kingdom.
| | - Carmen Ramírez-Maestre
- Department of Personality, Assessment and Psychological Treatment, University of Malaga, Facultad de Psicologia, Campus de Teatinos s/n, Malaga 29071, Spain
| | - Emilio Ferrer
- Department of Psychology, University of California, Davis, One Shields Ave., Davis, CA 95616-8686, United States
| | - Alicia López
- Department of Personality, Assessment and Psychological Treatment, University of Malaga, Facultad de Psicologia, Campus de Teatinos s/n, Malaga 29071, Spain
| | - Rosa Esteve
- Department of Personality, Assessment and Psychological Treatment, University of Malaga, Facultad de Psicologia, Campus de Teatinos s/n, Malaga 29071, Spain
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A Preliminary Genome-Wide Association Study of Pain-Related Fear: Implications for Orofacial Pain. Pain Res Manag 2017; 2017:7375468. [PMID: 28701861 PMCID: PMC5494109 DOI: 10.1155/2017/7375468] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Revised: 03/16/2017] [Accepted: 04/18/2017] [Indexed: 12/14/2022]
Abstract
Background Acute and chronic orofacial pain can significantly impact overall health and functioning. Associations between fear of pain and the experience of orofacial pain are well-documented, and environmental, behavioral, and cognitive components of fear of pain have been elucidated. Little is known, however, regarding the specific genes contributing to fear of pain. Methods A genome-wide association study (GWAS; N = 990) was performed to identify plausible genes that may predispose individuals to various levels of fear of pain. The total score and three subscales (fear of minor, severe, and medical/dental pain) of the Fear of Pain Questionnaire-9 (FPQ-9) were modeled in a variance components modeling framework to test for genetic association with 8.5 M genetic variants across the genome, while adjusting for sex, age, education, and income. Results Three genetic loci were significantly associated with fear of minor pain (8q24.13, 8p21.2, and 6q26; p < 5 × 10−8 for all) near the genes TMEM65, NEFM, NEFL, AGPAT4, and PARK2. Other suggestive loci were found for the fear of pain total score and each of the FPQ-9 subscales. Conclusions Multiple genes were identified as possible candidates contributing to fear of pain. The findings may have implications for understanding and treating chronic orofacial pain.
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Nortvedt L, Kumar BN, Lohne V. A qualitative study of immigrant women on long-term sick leave and their experience of dignity. Disabil Rehabil 2017; 40:2242-2249. [PMID: 28549409 DOI: 10.1080/09638288.2017.1331379] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE The purpose of this study was to explore if and how immigrant women suffering from chronic pain experience and maintain their dignity, during rehabilitation. METHODS The study was designed as a field study, with participant observation and in-depth interviews. Participant observations were carried out during a rehabilitation course for 14 immigrant women on an outpatient clinic at a rehabilitation hospital in southern Norway. In-depth interviews were performed after the rehabilitation period. Hermeneutic analysis was applied to interpret the data. RESULTS Findings show that the immigrant women experienced dignity by being seen, respected and believed by family-members, healthcare personnel and other patients at the outpatient clinic. Moreover, they maintained their dignity through a sense of their own value, integrity, religious faith and hope for the future. CONCLUSIONS The immigrant women maintained and protected their dignity by finding strength, pride, and self-worth in their religion and through their family-members' affection. Taking responsibility for themselves and others and experiencing fellowship and equality with other women, they enhanced their dignity during their rehabilitation process. The caring attitudes and behavior of some healthcare personnel promoted patient dignity. They also gained hope and dignity by experiencing goodness, cultural competence, and sensitivity from healthcare personnel. Implications for rehabilitation This study shows that the family role is more important for the immigrant women than the role as an employee, although financial independence and being able to help relatives financially also were central. Fellowship and equality with other patients, together with a rehabilitation program, which is facilitated for different language levels, were understood as important factors for an effective recovery. Enough time to get to know the patients and cultural competence seems to be central components for the health care personnel to give efficient help to immigrants in rehabilitation. Immigrants from low/middle-income countries appear to apply their religiousness as a resource in their lives to a greater extent than native Norwegians do, and should be taken into consideration when planning and implementing rehabilitation programs for immigrants.
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Affiliation(s)
- Line Nortvedt
- a Department of Nursing and Health Promotion , Oslo & Akershus University College of Applied Sciences , Oslo , Norway
| | - Bernadette Nirmal Kumar
- b Faculty of Medicine , Oslo University Hospital, Norwegian Center for Minority Health Research, University of Oslo , Oslo , Norway
| | - Vibeke Lohne
- a Department of Nursing and Health Promotion , Oslo & Akershus University College of Applied Sciences , Oslo , Norway
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Shim M, Johnson RB, Gasson S, Goodill S, Jermyn R, Bradt J. A model of dance/movement therapy for resilience-building in people living with chronic pain. Eur J Integr Med 2017. [DOI: 10.1016/j.eujim.2017.01.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Feinstein AB, Sturgeon JA, Darnall BD, Dunn AL, Rico T, Kao MC, Bhandari RP. The Effect of Pain Catastrophizing on Outcomes: A Developmental Perspective Across Children, Adolescents, and Young Adults With Chronic Pain. THE JOURNAL OF PAIN 2016; 18:144-154. [PMID: 27825857 DOI: 10.1016/j.jpain.2016.10.009] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 08/29/2016] [Accepted: 10/16/2016] [Indexed: 11/15/2022]
Abstract
Pain catastrophizing is one of the most powerful predictors of poor outcomes in youth and adults with pain; however, little is known about differential effects of pain catastrophizing on outcomes as a function of age. The current study examined the predictive value of pain catastrophizing on pain interference and pain intensity across children, adolescents, and 2 age groups of young adults with chronic pain. Cross-sectional data are presented from the adult and pediatric Collaborative Health Outcomes Information Registry (CHOIR), including measures of pain catastrophizing, pain intensity, pain interference, and emotional distress from 1,028 individuals with chronic pain. Results revealed that age moderated the relation between pain catastrophizing and pain interference, with the strength of these effects declining with age. The effect of pain catastrophizing on pain interference was strongest in adolescents and relatively weak in all 3 other groups. Emotional distress was the strongest predictor of pain interference for children, whereas pain intensity was the strongest predictor for both adult groups. Pain catastrophizing was found to predict pain intensity and, although age was a significant moderator, statistical findings were weak. Developmental considerations and clinical implications regarding the utility of the construct of pain catastrophizing across age groups are discussed. PERSPECTIVE This article explores differences in pain catastrophizing as predictors of pain interference and pain intensity across cohorts of children, adolescents, and 2 age groups of young adults. This work may stimulate further research on chronic pain from a developmental perceptive and inform developmentally tailored treatment interventions that target catastrophizing, emotional distress, and pain intensity.
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Affiliation(s)
- Amanda B Feinstein
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, and Stanford Children's Health, Palo Alto, California.
| | - John A Sturgeon
- Department of Anesthesiology, Perioperative and Pain Medicine, Systems Neuroscience and Pain Laboratory, Stanford University School of Medicine, Palo Alto, California
| | - Beth D Darnall
- Department of Anesthesiology, Perioperative and Pain Medicine, Systems Neuroscience and Pain Laboratory, Stanford University School of Medicine, Palo Alto, California
| | - Ashley L Dunn
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, and Stanford Children's Health, Palo Alto, California
| | - Tom Rico
- Department of Anesthesiology, Perioperative and Pain Medicine, Systems Neuroscience and Pain Laboratory, Stanford University School of Medicine, Palo Alto, California
| | - Ming C Kao
- Department of Anesthesiology, Perioperative and Pain Medicine, Systems Neuroscience and Pain Laboratory, Stanford University School of Medicine, Palo Alto, California
| | - Rashmi P Bhandari
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, and Stanford Children's Health, Palo Alto, California
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Muscle Functions and Functional Performance among Older Persons with and without Low Back Pain. Curr Gerontol Geriatr Res 2016; 2016:8583963. [PMID: 27872641 PMCID: PMC5107865 DOI: 10.1155/2016/8583963] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2016] [Revised: 07/28/2016] [Accepted: 10/03/2016] [Indexed: 11/19/2022] Open
Abstract
This study aims to compare muscle functions and functional performances between older persons with and without low back pain (LBP) and to determine the association between muscle functions and functional performances. This is a cross-sectional study, involving 95 older persons (age = 70.27 ± 7.26 years). Anthropometric characteristics, muscle functions, and functional performances were measured. Data were analyzed using ANOVA, Pearson's correlation, and multiple linear regression. The functional performances showed no significant differences (females LBP versus non-LBP, males LBP versus non-LBP) (p < 0.05). For muscle functions, significant differences were found (females LBP versus non-LBP) for abdominal muscle strength (p = 0.006) and back muscle strength (p = 0.07). In the LBP group, significant correlations were found between back and abdominal muscle strength and hand grip strength (r = 0.377 and r = 0.396, resp.), multifidus control and lower limb function (r = 0.363) in females, and back muscle strength and lower limb function (r = 0.393) in males (all p < 0.05). Regression analysis showed that abdominal and back muscle strengths were significant predictors of hand grip strength (p = 0.041 and p = 0.049, resp.), and multifidus control was a significant predictor of lower limb function in females (p = 0.047). This study demonstrates that older women with LBP exhibit poorer muscle functions compared to older women without LBP.
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Kroska EB. A meta-analysis of fear-avoidance and pain intensity: The paradox of chronic pain. Scand J Pain 2016; 13:43-58. [DOI: 10.1016/j.sjpain.2016.06.011] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 06/24/2016] [Accepted: 06/27/2016] [Indexed: 01/14/2023]
Abstract
Abstract
Background
The fear-avoidance model of chronic pain has established avoidance as a predictor of negative outcomes in chronic pain patients. Avoidance, or deliberate attempts to suppress or prevent unwanted experiences (e.g., pain), has been studied extensively, with multiple reviews implicating this behavior as a predictor of disability, physical disuse, and depression. Despite hundreds of studies examining the associations between different components of this model (i.e., catastrophizing, fear, avoidance, depression), the association between fear-avoidance and pain intensity has remained unclear. The present study seeks to clarify this association across samples.
Method
The present analyses synthesize the literature (articles from PsycInfo, PubMed, and ProQuest) to determine if fear-avoidance and pain intensity are consistently correlated across studies, samples, and measures. Eligible studies measured pain intensity and fear-avoidance cross-sectionally in chronic pain patients. The search resulted in 118 studies eligible for inclusion. A random-effects model was used to estimate the weighted mean effect size. Comprehensive Meta-Analysis software was used for all analyses. Moderation analyses elucidate the variables that affect the strength of this association. Meta-regression and meta-ANOVA analyses were conducted to examine moderating variables. Moderator variables include demographic characteristics, pain characteristics, study characteristics, and national cultural characteristics (using Hofstede’s cultural dimensions). Publication bias was examined using the funnel plot and the p-curve.
Results
Results indicate a small-to-moderate positive association between fear-avoidance and pain intensity. The results were stable across characteristics of the sample, including mean age, gender distribution, marital status, and duration of pain. Moderation analyses indicate that the measures utilized and cultural differences affect the strength of this association. Weaker effect sizes were observed for studies that utilized measures of experiential avoidance when compared to studies that utilized pain-specific fear-avoidance measures. Studies that utilized multiple measures of fear-avoidance had stronger effect sizes than studies that utilized a single measure of fear-avoidance. Three of Hofstede’s cultural dimensions moderated the association, including Power Distance Index, Individualism versus Collectivism, and Indulgence versus Restraint.
Conclusions
The present meta-analysis synthesizes the results from studies examining the association between fear-avoidance and pain intensity among individuals with chronic pain. The positive association indicates that those with increased fear-avoidance have higher pain intensity, and those with higher pain intensity have increased fear-avoidance. Findings indicate that cultural differences and measurement instruments are important to consider in understanding the variables that affect this association. The significant cultural variations may indicate that it is important to consider the function of avoidance behavior in different cultures in an effort to better understand each patient’s cultural beliefs, as well as how these beliefs are related to pain and associated coping strategies.
Implications
The results from the current meta-analysis can be used to inform interventions for patients with chronic pain. In particular, those with more intense pain or increased fear-avoidance should be targeted for prevention and intervention work. Within the intervention itself, avoidance should be undermined and established as an ineffective strategy to manage pain in an effort to prevent disability, depression, and physical deconditioning.
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Affiliation(s)
- Emily B. Kroska
- University of Iowa , E11 Seashore Hall , Iowa City , IA 52242 , USA
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Wadley AL, Mitchell D, Kamerman PR. Resilience does not explain the dissociation between chronic pain and physical activity in South Africans living with HIV. PeerJ 2016; 4:e2464. [PMID: 27672513 PMCID: PMC5028784 DOI: 10.7717/peerj.2464] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Accepted: 08/19/2016] [Indexed: 01/20/2023] Open
Abstract
Pain burden is high in people living with HIV (PLWH), but the effect of this pain on functionality is equivocal. Resilience, the ability to cope with adversity, may promote adaptation to pain, so we hypothesised that higher resilience would correlate with less pain-related impairment of activity. We recruited 197 black South African PLWH, 99 with chronic pain (CP) and 98 patients without. We measured pain intensity and interference using the Brief Pain Inventory, and resilience using the Resilience Scale. Participants were generally highly resilient. Greater resilience correlated with better health-related quality of life, but not with pain intensity or interference. We also measured physical activity objectively, by actigraphy, in a subset of patients (37 with chronic pain and 31 without chronic pain), who wore accelerometers for two weeks. There was no difference in duration or intensity of activity between those with and without pain, and activity was not associated with resilience. In this sample, pain was not associated with altered physical activity. Resilience did not explain differences in pain intensity or pain interference but was associated with improved quality of life. Financial stresses and the fear of HIV stigma may have driven patients to conceal pain and to suppress its expected impairment of activity.
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Affiliation(s)
- Antonia L Wadley
- Brain Function Research Group, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand , Johannesburg , South Africa
| | - Duncan Mitchell
- Brain Function Research Group, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand , Johannesburg , South Africa
| | - Peter R Kamerman
- Brain Function Research Group, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand , Johannesburg , South Africa
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Liu F, Ma J, Liu P, Chu Z, Lei G, Jia X, Wang J, Dang Y. Hint1 gene deficiency enhances the supraspinal nociceptive sensitivity in mice. Brain Behav 2016; 6:e00496. [PMID: 27547499 PMCID: PMC4885746 DOI: 10.1002/brb3.496] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 04/07/2016] [Accepted: 04/16/2016] [Indexed: 01/17/2023] Open
Abstract
INTRODUCTION Previous studies have indicated a possible role of histidine triad nucleotide-binding protein 1 (HINT1) on sustaining the regulatory crosstalk of N-methyl-D-aspartate acid glutamate receptors (NMDARs) and G-protein-coupled receptors (GPCRs) such as the μ-opioid receptor (MOR). Both receptors are present in the midbrain periaqueductal gray neurons, an area that plays a central role in the supraspinal antinociceptive process. METHODS In the present study, a battery of pain-related behavioral experiments was applied to Hint1 knockout, heterozygous and wild-type mice. Both the male and female mice were investigated to assess the differences between genders. RESULTS Hint1-/- mice presented significant shorter latency at 50°C in both male and female in hot plate test while no significant difference was found in tail filck test. In Von Frey hairs test Hint1-/- mice were more sensitive than Hint1+/+ mice, presenting a lower withdrawal threshold and enhanced relative frequency of paw withdrawal. The average flinches and licking time of Hint1-/- mice were more than that of Hint1+/+ mice in formalin test. CONCLUSION The absence of Hint1 gene-enhanced supraspinal nociceptive sensitivity in mice, including thermal, mechanical and inflammatory hyperalgesia. Meanwhile, there was no certain evidence indicating the haploinsufficiency and gender differences of Hint1 gene in pain-related behaviors.
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Affiliation(s)
- Fei Liu
- College of Medicine & ForensicsXi'an Jiaotong University Health Science CenterXi'an710061ShaanxiChina
- Affiliated Stomatology Hospital of Xi'an Jiaotong University Health Science CenterXi'an710004ShaanxiChina
| | - Jing Ma
- Affiliated Stomatology Hospital of Xi'an Jiaotong University Health Science CenterXi'an710004ShaanxiChina
| | - Peng Liu
- College of Medicine & ForensicsXi'an Jiaotong University Health Science CenterXi'an710061ShaanxiChina
| | - Zheng Chu
- College of Medicine & ForensicsXi'an Jiaotong University Health Science CenterXi'an710061ShaanxiChina
| | - Gang Lei
- College of Medicine & ForensicsXi'an Jiaotong University Health Science CenterXi'an710061ShaanxiChina
| | - Xiao‐di Jia
- College of Medicine & ForensicsXi'an Jiaotong University Health Science CenterXi'an710061ShaanxiChina
- Key Laboratory of the Health Ministry for Forensic MedicineXi'an Jiaotong University Health Science CenterXi'an710061ShaanxiChina
- Key Laboratory of Forensic Medicine of Shaanxi ProvinceXi'an Jiaotong University Health Science CenterXi'an710061ShaanxiChina
| | - Jia‐bei Wang
- Department of Pharmaceutical SciencesUniversity of Maryland School of PharmacyBaltimoreMaryland21201
| | - Yong‐hui Dang
- College of Medicine & ForensicsXi'an Jiaotong University Health Science CenterXi'an710061ShaanxiChina
- Key Laboratory of the Health Ministry for Forensic MedicineXi'an Jiaotong University Health Science CenterXi'an710061ShaanxiChina
- Key Laboratory of Forensic Medicine of Shaanxi ProvinceXi'an Jiaotong University Health Science CenterXi'an710061ShaanxiChina
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Symptoms and function in patients with articular cartilage lesions in 1,000 knee arthroscopies. Knee Surg Sports Traumatol Arthrosc 2016; 24:1610-6. [PMID: 25502829 DOI: 10.1007/s00167-014-3472-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 12/04/2014] [Indexed: 02/08/2023]
Abstract
PURPOSE Focal chondral lesions of the knee are commonly occurring. A lot is known about their frequency, size and localisation in arthroscopic series, but less about the symptoms they elicit and little about how the arthroscopic findings and symptoms correlate. The purposes of the present study included to investigate the relationship between articular cartilage lesion factors and patient factors, and to compare the symptoms and function of cartilage lesion patients to those of patients with a deficient ACL. METHODS A prospective registration was conducted of preoperative data including Lysholm knee score and perioperative findings in 1,000 consecutive patients undergoing an arthroscopic procedure of the knee-including microfracture of articular cartilage defects and ACL reconstructions. RESULTS Chondral or osteochondral lesions were found in 57 % of the arthroscopies. The mean Lysholm score in this subgroup was 55. The mean Lysholm score was significantly lower in women (50, SD 19) compared to men (59, SD 18, p < 0.001). Among the chondral lesion factors, only kissing (vs. non-kissing) lesions and multiple (vs. single) lesions influenced symptoms and function to a more than negligible degree. Microfracture in one or two articular cartilage defects was performed in 187 patients. The microfracture group had a significant lower mean Lysholm score (54, SD 18) than a group of patients (N = 71) undergoing ACL reconstruction group (67, SD 17, p < 0.001). CONCLUSION The study confirms that articular cartilage lesions are both common and cumbersome. Women seem to have more problems than men, whereas chondral lesion factors-such as localisation and size-seem to influence symptoms and function to a small degree. These aspects should be addressed when designing outcome studies, and should also be of interest to the orthopaedic surgeon-in the day-by-day clinical work. When treating these patients, our prime focus need to be on knee function rather than the cartilage defect as the relationship between the latter and the former is unclear. LEVEL OF EVIDENCE Case-control study, Level III.
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