Meaningful coping with chronic pain: Exploring the interplay between goal violation, meaningful coping strategies and life satisfaction in chronic pain patients

Depression and life satisfaction after Kahramanmaraş earthquakes: The serial mediation roles of life meaning and coping with earthquake stress

This study aims to examine the meaning of life, and the mediating effect of strategies for coping with earthquake stress in the relationship between depression, and life satisfaction in survivors of the 2023 Kahramanmaraş centered earthquakes. The participants of this study were 472 adults (31.1% male, 68.9% female; Mage = 24.52) who were affected by earthquakes. The data of the study were tested with the bootstrapping-based PROCESS macro program (Model-81). The results showed that depression negatively predicted life satisfaction. Meaning of life mediated the relationship between depression and life satisfaction. However, problem solving and cognitive avoidance coping strategies reduced the effects of depression and the meaning of life on life satisfaction. These results can be a resource for mental health services for earthquake victims. At the same time, the study provides evidence that protecting personal resources in disaster situations positively affects life satisfaction in terms of conservation of resources theory (COR).

Turkish cross-cultural adaptation, construct validity, and reliability of the treatment expectations in chronic pain scale

BACKGROUND

Measuring treatment expectations using the Treatment Expectations in Chronic Pain (TEC) scale has the potential to help clinicians and researchers better understand the role that treatment expectations play within the framework of multimodal pain management settings.

OBJECTIVE

The purpose of this study is to determine the cross-cultural adaptation, construct validity and reliability of the TEC Scale in the Turkish language.

METHODS

The study included 191 volunteers aged 22-65 with chronic musculoskeletal diseases. This study composed of a six-stage cross-cultural adaptation process, which included translation, translation synthesis, back-translation, expert committee review, pre-testing and documentation submission. The Positivity Scale and Illness Cognition Questionnaire were used to measure convergent validity while the Hospital Anxiety and Depression Scale was used to test divergent validity. The psychometric properties of the Turkish version of the TEC scale was examined by confirmatory factor analysis (CFA). Scale's internal consistency was examined using Cronbach's alpha. Pearson correlation coefficients were utilized to evaluate both convergent and divergent validity. The significance level was set at p < .05.

RESULTS

The results of the CFA showed that factor structure of predicted subscale fitted well the data (x2/df = 3,07;CFI = 0,91,IFI = 0,91 TLI = 0,87,RMSEA = 0,10). The results of the CFA indicated that factor structure of ideal subscale fitted well with the data (x2/df = 2,38;CFI = 0,92,IFI = 0,93,TLI = 0,90,RMSEA = 0,08). Both subscales of the TEC were strongly correlated. The predicted subscale had moderate relationships to depression, anxiety, and positivity (r = -0.37 to r = 0.55) but poor correlations with measures of acceptance, perceived benefits and helplessness (r = -0.24 to 0.35). The ideal subscale had moderate correlations with measures of positivity (r = 0.36) and depression (r = -0.38) but poor correlations with measures of acceptance, perceived benefits helplessness and anxiety (r = 0.14).

CONCLUSIONS

The Turkish version of the TEC scale is acceptable, valid, and reliable for use in Turkish patients with chronic musculoskeletal pain in physiotherapy outpatient practice.

Divine resilience: Unveiling the impact of religious coping mechanisms on pain endurance in arab older adults battling chronic pain

BACKGROUND

Chronic pain diminishes the quality of life for many Older Adults individuals. Identifying effective coping methods to enhance pain resilience is imperative as populations age. Older Adults commonly use religious faith and spiritual practices to endure pain, yet little research has explored their impact on pain tolerance.

METHODS

This cross-sectional study examined relationships between positive/negative religious coping styles and pain endurance in 200 Arab elders with chronic pain. Participants completed the Brief Arab Religious Coping Scale, Numeric Pain Rating Scale, WHOQOL-BREF, and demographic/medical history questionnaires.

RESULTS

Quantitative analysis demonstrated significant positive associations between positive religious reappraisal and active spiritual coping with higher self-reported pain endurance (p<.05). Negative religious coping styles lacked meaningful relationships with pain tolerance. Multiple regression confirmed the unique effects of reappraisal and spiritual practice on improving pain resilience, controlling for covariates.

CONCLUSIONS

Outcomes align with perspectives highlighting multidimensional neurocognitive, emotional, and psychosocial pain relief from religious coping. Findings underscore integrating positive faith-based resources in biopsychosocial paradigms for Older Adult's pain management. Additional research should investigate causal pathways and contextual factors influencing religious coping effects on diverse Older Adult subgroups.

Chronic pain self-management interventions in primary care - does it make any difference? A qualitative study

BACKGROUND

Total recovery from chronic pain is difficult. It is therefore important for those who are suffering from chronic pain to find ways to self-manage their pain in daily life. Several chronic pain self-management interventions have been established, but more knowledge is needed to find out what and how it works. This study aimed to explore how the participants in two chronic pain self-management interventions in primary health care experienced the different components of the interventions, and whether the interventions induced any positive changes in the participants' everyday lives.

METHODS

A qualitative study nested within a randomized controlled study using semi-structured individual face-to-face interviews with 17 informants were conducted three months after the interventions. The data were analysed thematically using Systematic Text Condensation.

RESULTS

The main finding was that the informants, from both interventions, self-managed their chronic pain differently in a positive way after they had participated in the self-management interventions. The participants gained new insight from lectures, learning from peers by sharing experiences and belonging to a group, and by recognizing the importance of being physically active.

CONCLUSION

This study shows that chronic pain self-management interventions consisting of components that learn the participants about chronic pain and include physical activity in a socially supportive environment, may contribute to a positive change in the lives of people living with chronic pain.

The experience of meaningful rehabilitation as perceived by people with chronic pain: A phenomenological study

BACKGROUND: People with chronic pain may seek rehabilitation to reduce pain and restore productivity and valued roles. Theoretically, a biopsychosocial approach makes rehabilitation more meaningful, however, the limited research on meaningful rehabilitation predominantly describes the perspective of therapists and researchers. The client’s perspective of meaningfulness in rehabilitation is lacking. OBJECTIVE: To investigate the experience of meaningfulness in rehabilitation from the perspective of people with chronic pain. METHOD: Qualitative, semi-structured interviews were conducted with Australian adults who had chronic pain and recent experience of occupational therapy or physiotherapy. Sampling continued until thematic saturation occurred. Transcripts were coded and analyzed using theory-driven and data-driven thematic analysis. RESULTS: Ten participants (four males; six females) were interviewed. Pain histories ranged from nine months to 20+ years, with conditions such as fibromyalgia or trauma. Three themes from a prior concept analysis were upheld, and a further three data-driven themes emerged. Results indicate that people with chronic pain seek a “genuine connection”; from a therapist who is “credible”; and can become a “guiding partner”, and they find rehabilitation meaningful when it holds “personal value”; is “self-defined”; and relevant to their sense of “self-identity”. CONCLUSIONS: The genuine connection and guiding partnership with a credible therapist, that is sought by people with chronic pain, may be at odds with aspects of contemporary rehabilitation. Client-defined meaningfulness is an important construct to engage clients in treatment and improve work and other occupational outcomes for people with chronic pain.

A Single-blind, randomized, pilot study of a brief Mindfulness-Based Intervention for the endometriosis-related pain management

BACKGROUND

Women with endometriosis suffer from frequent symptoms despite multiple treatments in tertiary care. Although there is a need for a biopsychosocial perspective on endometriosis treatment, few conservative treatments have been investigated. We aimed to investigate the effects of a brief Mindfulness-Based Intervention (bMBI) in women with deep endometriosis who remain symptomatic despite undergoing conventional medical treatment.

METHODS

A randomized controlled trial was performed with 2 groups: a standard medical treatment plus bMBI program and only standard medical treatment as a control. A total of 63 eligible participants were randomized to bMBI and control group. The primary outcome was endometriosis-related pain, and secondary outcomes were quality of life and stress perception posttreatment. Analyses were carried out using multiple regression models.

RESULTS

The results show that bMBI significantly improved pain unpleasantness (Cohen's f2 = 0.67, NNT = 3.2), pelvic pain (Cohen's f2 = 0.16, NNT = 5.3), and dyschezia (Cohen's f2 = 0.23, NNT = 2.9) immediately posttreatment and decreased all endometriosis-related pain (Cohen's f2 ranging from 0.20 to 0.60 and NNT ranging from 5 to -9) after the follow-up. We found an extensive positive effect of bMBI on the mental health dimension in the two time-point measures (Cohen's f2 = 0.34 and 0.25, NNT = 3.5 and 2.3) and vitality (Cohen's f2 = 0.22, NNT = 2.1) after the follow-up.

CONCLUSIONS

Our study suggests that bMBI is useful for managing endometriosis-related pain and restoring women's psychological well-being.

Leisure-time physical activity, coping and life satisfaction among Korean individuals with physical disabilities

A few studies explored the relationships among leisure-time physical activity (LTPA), coping, and life satisfaction among individuals with physical disabilities. This study aims to investigate how LPTA contributes to coping and life satisfaction among Korean individuals with physical disabilities. Using a purposive sampling strategy, a total of 351 people with physical disabilities participated in this study. The results of this study find that participation in LTPA leads to the development of active coping strategies that contribute to increased life satisfaction. This study suggests that encouraging LTPA participation can be a critical task to healthcare providers working with individuals with physical disabilities.

Spiritual Well-Being in People Living with Persistent Non-Cancer and Cancer-Related Pain

CONTEXT

Existential and spiritual factors are known to play an important role in how people cope with disability and life-threatening illnesses such as cancer. However, comparatively little is known about the impact of pain on factors such as meaning and purpose in one's life and their potential roles in coping with pain.

OBJECTIVES

The aim of this study was to determine spiritual well-being scores in people with persistent pain and to compare these with people with cancer and healthy controls.

METHODS

We assessed 132 people with chronic pain, 74 people with cancer (49 with pain and 25 without pain) and 68 control participants using standardised measures of pain-related variables including pain intensity, physical function, mood and cognitions. Spiritual well-being was also assessed using a validated and widely used questionnaire, the Functional Assessment of Chronic Illness Therapy - Spirituality Scale (FACIT-Sp).

RESULTS

Spiritual well-being scores were significantly lower in people with persistent pain when compared with controls and were no different when compared with people with cancer, including those who had cancer and pain. In addition, low levels of meaning and purpose were significant predictors of depression, anxiety, and stress across all groups.

CONCLUSION

The findings demonstrate that persistent pain is associated with spiritual distress that is equal to those observed in people who have cancer. Furthermore, those who have higher levels of meaning and purpose are less likely to develop mood dysfunction when experiencing pain, indicating they may have a protective role.

Using a Narrative Practice Approach to Understand In-Depth Experiences of Individuals Coping with Chronic Pain

OBJECTIVE

Current psychological interventions to enhance management of chronic pain report small to moderate effects. There is a need to explore the experiences and coping of individuals with chronic pain in depth and expand beyond current knowledge paradigms to enhance psychological interventions. The current literature recommends narrative practice as a qualitative approach in a group to facilitate sharing of knowledge on coping with chronic pain. Therefore, we conducted group sessions incorporating narrative practice to explore the experiences of individuals coping with chronic pain.

DESIGN

We explored the experiences of 11 individuals coping with chronic pain from two group sessions that incorporated narrative practice. Themes emerging from participants' sharing were triangulated from interview transcripts, field notes, and participants' response worksheets. Data analysis adopted thematic analysis and narrative practice approaches.

RESULTS

Themes on coping found include "refocusing," "distraction," "inspiration and perspective taking," and "acknowledgement of skills, knowledge, and attitude." "Distraction" and "refocusing" complimented one another. This provided a new perspective, in contrast to current research that views both as mutually exclusive. Social environmental factors were found to help participants share existing coping methods of "connection," "deepen perspective," "inspiration and perspective taking," and "acknowledgement of skill, knowledge and attitude." The possible relationships between the themes also provided support to the theoretical foundations of Acceptance and Commitment Therapy. Results suggest that adopting a narrative practice sequence helped individuals to acknowledge chronic pain experiences and facilitated their identification of ways to cope.

CONCLUSIONS

Narrative practice identified themes of coping that can inform clinical practice. Narrative practice is indicated as a feasible and acceptable research and clinical approach for individuals with chronic pain.

The Mediating Effect of Coping Strategies on Religious/Spiritual Struggles and Life Satisfaction

A growing number of researchers are testing potential problematic forms of religiousness that denote anxieties regarding sacred matters. However, only a few studies have assessed how religious/spiritual struggle is associated with positive outcomes. Because people’s coping responses to stressors are key determinants of their well-being, we expected that different coping strategies could be potential mediators between religious problems/tensions and life satisfaction. The research was conducted on a group of 744 Roman Catholics. We used the Religious Comfort and Strain Scale, Satisfaction with Life Scale, and Brief Coping Orientation to Problems Experienced (COPE) questionnaire. The outcomes show that religious comfort correlated positively with life satisfaction, while fear/guilt, negative emotions toward God, and negative social interactions surrounding religion correlated negatively with life satisfaction. Our research amplifies the understanding of the religious/spiritual struggles and life satisfaction relationship, mediated by “secular” coping strategies. It confirms that both religious and secular methods of experiencing different strains seem to coexist with multiple other strategies in the context of broadly understood life satisfaction.

Improving spiritual well-being among cancer patients: implications for clinical care

PURPOSE

This study aimed to explore the associated factors of spiritual well-being among cancer patients and the relationship between spiritual well-being (SWB) and quality of life (QOL).

METHODS

This cross-sectional study was conducted in 200 Chinese cancer patients in a tertiary cancer hospital. Functional Assessment of Cancer Therapy-General (FACT-G) and the Functional Assessment of Chronic Illness Therapy-Spiritual Well-being (FACIT-Sp) were used to measure SWB and QOL levels of participants. Multiple regression analyses were performed to determine the relationship between SWB and QOL.

RESULTS

The mean score of QOL was 59.8 (SD 13.1) with a range of 27-106. The mean score of SWB was 24.4 (SD 6.5), with a range of 8-48. Hospitalization frequency was the only variable associated with SWB. In terms of the relationship between SWB and QOL, the meaning and peace subscales were significantly related to overall QOL. It was also observed that the meaning subscale was positively related to social/family well-being, emotional well-being, and functional well-being. The peace subscale was related to the physical well-being, social/family well-being, and functional well-being. Faith was negatively related to physical and emotional well-being, but it had a positive effect on functional well-being.

CONCLUSIONS

Given that the meaning and peace subscales are related to a higher QOL level, it is important to find ways to improve these dimensions of spiritual well-being among cancer inpatients during treatment.

Short-term effect of a chronic pain self-management intervention delivered by an easily accessible primary healthcare service: a randomised controlled trial

OBJECTIVES

To investigate the effects on persons with chronic pain after 3 months of a group-based chronic pain self-management course compared with a drop-in, low-impact outdoor physical group activity on patient activation and a range of secondary outcomes.

DESIGN

An open, pragmatic, parallel group randomised controlled trial. Analyses were performed using a two-level linear mixed model.

SETTING

An easily accessible healthcare service provided by Norwegian public primary healthcare.

PARTICIPANTS

A total of 121 participants with self-reported chronic pain for 3 months or more were randomised with 60 participants placed in the intervention group and 61 placed in the control group (mean age 53 years, 88% women, 63% pain for 10 years or more).

INTERVENTIONS

The intervention group was offered a group-based chronic pain self-management course with 2.5-hour weekly sessions for a period of 6 weeks. The sessions consisted of education, movement exercises and emphasised group discussions. The control group was offered a low-impact outdoor group physical activity in 1-hour weekly sessions that consisted of walking and simple strength exercises for a period of 6 weeks.

MAIN OUTCOMES

The primary outcome was patient activation assessed using the Patient Activation Measure. Secondary outcomes measured included assessments of pain, anxiety and depression, pain self-efficacy, sense of coherence, health-related quality of life, well-being and the 30 s chair to stand test.

RESULTS

There was no effect after 3 months of the group-based chronic pain self-management course compared with the control group for the primary outcome, patient activation (estimated mean difference: -0.5, 95% CI -4.8 to 3.7, p=0.802).

CONCLUSIONS

There was no support for the self-management course having a better effect after 3 months than a low-impact outdoor physical activity offered the control group.

TRIAL REGISTRATION NUMBER

NCT02531282; Results.

Lab- and Field-Based Approaches to Meaning Threats and Restoration: Convergences and Divergences

Two distinct approaches to meaning—experimental lab-based research on meaning and its maintenance in response to situational cues and observational field research on meaning-focused coping following highly stressful or traumatic situations—have both produced important insights into the mechanics underlying responses to meaning-relevant threats. It has been suggested that although these 2 approaches focus on different, specific aspects of meaning, they converge on common underlying phenomena. The present article considers how lab-based and field-based approaches align and diverge on their answers to 4 questions: (1) How is meaning defined in the context of meaning violation and restoration? (2) What are threats to meaning? (3) How do people respond to these threats? and (4) Why does meaning restoration matter? Our comparison of these lab- and field-based approaches suggests that they share considerable commonalities in conceptualization, but they diverge in important ways in terms of emphasis and empirical considerations. We conclude that lab- and field-based approaches to meaning violation and restoration may be focusing on the same phenomena studied at different levels, but with some qualitative differences, and we offer suggestions for how lab- and field-based approaches can better inform one another. Considering these two approaches conjointly provides a more holistic and comprehensive understanding of the fundamental phenomena of meaning threat and restoration.

Expectations towards participation in easily accessible pain management interventions: a qualitative study

BACKGROUND

People with chronic pain use a range of healthcare services, but they also report a high degree of dissatisfaction with treatments. One reason for dissatisfaction might be participants' expectations towards treatments. The aim of this study was to explore expectations of people with chronic pain towards participation in easily accessible pain management interventions delivered in public primary care.

METHODS

A qualitative study using semi-structured individual face-to-face interviews with 21 informants. The informants were recruited among participants enrolled in a randomised controlled trial on the effect of an easily accessible self-management course for people with chronic pain. The data were analysed thematically using Systematic Text Condensation.

RESULTS

Having experienced pain for a long time, there was no specific expectation of a cure or a significant alleviation of the pain. The informants' expectations mainly concerned a hope that participation could lead to a better everyday life. The informants said that hope was important as it motivated them to keep going and continue self-care activities. The hope acted as a driving force towards trying new interventions and maintaining motivation to do activities they experienced as beneficial. Both concrete aspects of the current intervention and an understanding of what interventions in general could offer contributed to the informants hope. The expectations centred about the interventions being something new, as they had not previously tried this service, an opportunity to gain and reinforce skills, to help them continue to grow as a person, to meet others in similar situations, and to access professional support in an easy manner. Participating in interventions provided by healthcare services was seen by some as an act of self-care, where they did something active to manage their health.

CONCLUSIONS

Expectations towards the interventions were related to a hope for participation leading to a better everyday life. The role of hope for peoples' motivation to self-care implies that service providers should be aware of and help to maintain hope for a better everyday life. The importance of social support as part of self-care should be acknowledged when developing interventions targeting chronic pain.

TRIAL REGISTRATION

ClinicalTrials.gov: NCT02531282 . Registered on August 21 2015.

Narrative meaning making and integration: Toward a better understanding of the way falling ill influences quality of life

Falling seriously ill is often experienced as a life event that causes conflict with people’s personal goals and expectations in life and evokes existential questions. This article presents a new humanities approach to the way people make meaning of such events and how this influences their quality of life. Incorporating theories on contingency, narrative identity, and quality of life, we developed a theoretical model entailing the concepts life event, worldview, ultimate life goals, experience of contingency, narrative meaning making, narrative integration, and quality of life. We formulate testable hypotheses and describe the self-report questionnaire that was developed based on the model.