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Yıldız NG, Aydin HZ, Sambo G, Aydın K, Yıldız H, Santri IN, Wardani Y, Mwamulima B, Isni K, Phiri YVA. The mediating role of depressive symptoms among Turkish population related to gender and low back pain: evidence from a national health survey. BMC Public Health 2024; 24:1136. [PMID: 38654220 DOI: 10.1186/s12889-024-18612-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 04/15/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Low back pain (LBP), though non-life-threatening, burdens healthcare with treatment expenses and work hours lost. Globally, 70-84% experience it, with risk factors tied to societal structure, income, and living conditions, making it a leading cause of disability. METHODS This study utilized data from the 2019 Türkiye Health Survey, which consisted of 17,084 individuals aged 15 and above. Our study focused on investigating the factors related to low back pain through a cross-sectional analysis. To analyze these factors, we employed binary multivariate logistic regression. Additionally, we conducted post-hoc analyses to assess the potential mediating effect of depressive symptoms on the relationship between low back pain and gender. RESULTS We found that 31.9% of the population experienced low back pain, with women being 58% more likely [aOR = 1.58; 95% CI (1.45-1.73)] than men to report symptoms. Individuals aged 55 + years old had a 90% [aOR = 1.90; 95% CI (1.61-2.23)] chance of experiencing low back pain, indicating an age-related increase. In the general population, having depressive symptoms was 2.49 [95% CI (2.23-2.78)] times more likely associated with low back pain. Our mediation analysis showed that gender (i.e., women vs. men), indicated by direct effects with β-estimates e = 0.78, predicted the likelihood of low back pain. Additionally, the relationship between gender and low back pain, mediated through a history of depressive symptoms, had a significant total indirect effect (i.e., β-estimate given as e = 0.49). Specifically, a history of depressive symptoms accounted for 17.86% [95% CI (9.67-20.10)] of the association between women having a higher likelihood of low back pain compared to men. CONCLUSION We observed that a higher likelihood of low back pain associated with gender and aging. Additionally, BMI served as a significant predictor, particularly in adults. Depression mediated the association between gender and low back pain. Acknowledging these associations may help identify and address contributing factors to LBP, potentially increasing awareness and alleviating the burden. Policymakers and healthcare professionals may consider these findings when developing prevention and treatment programs for low back pain.
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Affiliation(s)
- Nadire Gülçin Yıldız
- Faculty of Education, Department of Guidance and Counseling, Istanbul Medipol University, Istanbul, Turkey
| | - Halide Z Aydin
- Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Grace Sambo
- Chang Gung Medical Education Research Centre (CG-MERC), Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Kemal Aydın
- Faculty of Economics and Administrative Sciences, Amasya University, Amasya, Turkey
| | - Hatice Yıldız
- Health Sciences Institute, Istanbul Medipol University, Istanbul, Turkey
| | | | - Yuniar Wardani
- Faculty of Public Health, Universitas Ahmad Dahlan, Yogyakarta, Indonesia
| | - Bwanalori Mwamulima
- Directorate of Health and Social Services, Rumphi District Council, Rumphi, Malawi
| | - Khoiriyah Isni
- Faculty of Public Health, Universitas Ahmad Dahlan, Yogyakarta, Indonesia
| | - Yohane V A Phiri
- Department of Epidemiology and Environmental Health (EEH), University at Buffalo, Buffalo, NY, USA.
- Charis Professional and Academic Research Consultants (CPARC), C/O, Mchinji, P.O. Box 132, Malawi.
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Sirbu E, Onofrei RR, Szasz S, Susan M. Predictors of disability in patients with chronic low back pain. Arch Med Sci 2023; 19:94-100. [PMID: 36817655 PMCID: PMC9897078 DOI: 10.5114/aoms.2020.97057] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 12/12/2019] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Chronic low back pain (CLBP) is a common and disabling health problem. In this study, we aimed to assess the relationship between pain intensity, the components of catastrophizing, depression and disability in patients with chronic low back pain. MATERIAL AND METHODS Seventy-six patients diagnosed with CLBP (age range 25-77 years; 73.7% female) participated in the study. Participants' socio-demographic data were collected: age, gender, height, weight, and work status (employed or retired). All participants were asked to complete the Pain Catastrophizing Scale (PCS), the visual analogue scale (VAS), the Oswestry Disability Questionnaire (ODQ), and the Beck Depression Inventory (BDI). RESULTS The mean group scores revealed moderate CLBP complaints (VAS - 4 [3-6]), mild depression (BDI - 10 [5-16]), a moderate level of catastrophizing (PCS total score 20.5 [10-34]) and moderate disability (Oswestry Disability Index [ODI] - 31 [14-38]). Positive significant correlations were found between ODI and age, residence, work status, VAS, PCS-rumination, PCS-magnification, PCS-helplessness and BDI, and also between PCS subscales and VAS. Our multivariate linear regression analysis showed that age, pain intensity, PCS-helplessness and depression can predict disability in patients with CLBP, explaining 84% of the variance of disability (R2 = 0.851, adjusted R2 = 0.843). CONCLUSIONS A multidisciplinary approach is needed for patients with CLBP and should include physical, mental and social evaluation in order to offer an optimal treatment.
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Affiliation(s)
- Elena Sirbu
- Department of Physical Therapy and Special Motility, West University of Timişoara, Timişoara, Romania
| | - Roxana Ramona Onofrei
- Department of Rehabilitation, Physical Medicine and Rheumatology, “Victor Babes” University of Medicine and Pharmacy Timisoara, Romania
| | - Simona Szasz
- Department of Rheumatology, The University of Medicine and Pharmacy Tg Mures, Romania
| | - Monica Susan
- Department of Internal Medicine I, “Victor Babes” University of Medicine and Pharmacy Timisoara, Romania
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Bernardes JM, Spröesser Alonso M, Gómez-Salgado J, Ruiz-Frutos C, García-Navarro EB, Dias A. The impact of manual patient handling on work ability: A cross-sectional study in a Brazilian hospital. Nurs Open 2022; 9:2304-2313. [PMID: 35609217 PMCID: PMC9374414 DOI: 10.1002/nop2.1228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 12/10/2021] [Accepted: 04/17/2022] [Indexed: 11/20/2022] Open
Abstract
Aim To investigate the level of self‐reported work ability and its association with manual patient handling in healthcare workers. Design Cross‐sectional study adhering to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Methods A total of 320 healthcare workers answered a self‐administered questionnaire regarding manual patient handling, work ability, occupational factors, occurrence of low back pain and sociodemographic and lifestyle factors from November 2016 to March 2017. The association between manual patient handling and low back pain was analysed with Poisson regression models. Results The prevalence ratio of inadequate work ability was 43.42%. Manual patient handling (PR 1.375, 95% CI 1.038–1.821), bachelor education (PR 2.150, 95% CI 1.272–3.632), less than bachelor education (PR 2.166, 95% CI 1.218–3.855), seniority (PR 1.049, 95% CI 1.024–1.086), poor sleep quality (PR 1.425, 95% CI 1.13–1.796) and presence of low back pain (PR 2.003, 95% CI 1.314–3.052) were all positively associated with an inadequate work ability.
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Affiliation(s)
- João Marcos Bernardes
- Graduate Program in Collective/Public Health, Botucatu Medical School, Universidade Estadual Paulista/UNESP, Botucatu, São Paulo, Brazil.,Department of Public Health, Botucatu Medical School, Universidade Estadual Paulista/UNESP, Botucatu, São Paulo, Brazil
| | - Melissa Spröesser Alonso
- Graduate Program in Collective/Public Health, Botucatu Medical School, Universidade Estadual Paulista/UNESP, Botucatu, São Paulo, Brazil
| | - Juan Gómez-Salgado
- Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, Huelva, Spain.,Safety and Health Postgraduate Programme, Universidad Espíritu Santo, Guayaquil, Ecuador
| | - Carlos Ruiz-Frutos
- Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, Huelva, Spain.,Safety and Health Postgraduate Programme, Universidad Espíritu Santo, Guayaquil, Ecuador
| | - Esperanza Begoña García-Navarro
- Department of Nursing and Health Sciences, University of Huelva, Huelva, Spain.,Research Group ESEIS, Social Studies and Social Intervention, Center for Research in Contemporary Thought and Innovation for Development (COIDESO), University of Huelva, Huelva, Spain
| | - Adriano Dias
- Graduate Program in Collective/Public Health, Botucatu Medical School, Universidade Estadual Paulista/UNESP, Botucatu, São Paulo, Brazil.,Department of Public Health, Botucatu Medical School, Universidade Estadual Paulista/UNESP, Botucatu, São Paulo, Brazil
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Louw A, Puentedura EJ, Denninger TR, Lutz AD, Cox T, Zimney K, Landers MR. The clinical impact of pain neuroscience continuing education on physical therapy outcomes for patients with low back and neck pain. PLoS One 2022; 17:e0267157. [PMID: 35482780 PMCID: PMC9049561 DOI: 10.1371/journal.pone.0267157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 04/03/2022] [Indexed: 11/18/2022] Open
Abstract
Objectives Research suggests that attendance by physical therapists at continuing education (CE) targeting the management of low back pain (LBP) and neck pain does not result in positive impacts on clinical outcomes. The aim of this study was to determine if therapists attending a self-paced 3-hour online Pain Neuroscience Education (PNE) program was associated with any observed changes to patient outcomes and also clinical practice. Methods Participants were 25 different physical therapists who treated 3,705 patients with low back pain (LBP) or neck pain before and after they had completed an online PNE CE course. Change in outcomes measures of pain and disability at discharge were compared for the patients treated before and after the therapist training. Clinical practice patterns of the therapists, including total treatment visits, duration of care, total units billed, average units billed per visit, percentage of ‘active’ billing units and percentage of ‘active and manual’ billing units, were also compared for the patient care episodes before and after the therapist training. Results There was no significant difference for change in pain scores at discharge for patients treated after therapist CE training compared to those treated before regardless of the condition (LBP or neck pain). However, patients with LBP who were treated after therapist CE training did report greater improvement in their disability scores. Also after CE training, for each episode of care, therapists tended to use less total visits, billed fewer units per visit, and billed a greater percentage of more ‘active’ and ‘active and manual’ billing units. Discussion Attending an online 3-hour CE course on PNE resulted in improved disability scores for patients with LBP, but not for those with neck pain. Changes in clinical behavior by the therapists included using less visits, billing fewer total units, and shifting to more active and manual therapy interventions. Further prospective studies with control groups should investigate the effect of therapist CE on patient outcomes and clinical practice.
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Affiliation(s)
- Adriaan Louw
- Evidence in Motion, Story City, Iowa, United States of America
| | - Emilio J. Puentedura
- Department of Physical Therapy, Robbins College of Health and Human Sciences, Baylor University, Waco, Texas, United States of America
- * E-mail:
| | | | - Adam D. Lutz
- ATI Physical Therapy, Greenville, South Carolina, United States of America
| | - Terry Cox
- Department of Physical Therapy, Southwest Baptist University, Bolivar, Missouri, United States of America
| | - Kory Zimney
- Department of Physical Therapy, School of Health Sciences, University of South Dakota, Vermillion, South Dakota, United States of America
| | - Merrill R. Landers
- Department of Physical Therapy, School of Integrated Health Sciences, University of Nevada Las Vegas, Las Vegas, Nevada, United States of America
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Xiong M, Johnson W. Perceived discrimination and relative deprivation in Chinese migrant adolescents: the mediating effect of locus of control and moderating effect of duration since migration. Child Adolesc Psychiatry Ment Health 2022; 16:1. [PMID: 34998401 PMCID: PMC8742458 DOI: 10.1186/s13034-021-00436-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 12/27/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Associations between perceived discrimination and relative deprivation have been observed among both general and migrant populations. However, it is unclear how, and under what conditions, perceived discrimination relates to relative deprivation, a subjective cognition and affective experience in which individuals or groups perceive themselves as disadvantaged, compared to their peers. Therefore, this study aimed to construct a moderated mediation model to examine the roles of locus of control and duration since migration in the relationship between perceived discrimination and relative deprivation among Chinese rural-to-urban migrant adolescents. METHODS We conducted a cross-sectional study using a convenience sampling method in three coastal cities in southeast China. We recruited 625 Chinese rural-to-urban migrant adolescents, who completed a battery of questionnaires assessing perceived discrimination, relative deprivation, locus of control, and demographic variables. Regression-based statistical mediation and moderation were conducted using the PROCESS macro for SPSS. RESULTS After controlling for sex and age, perceived discrimination was positively associated with migrant adolescents' relative deprivation, and external locus of control partially mediated this connection. Furthermore, the mediating effect was moderated by the duration of the migration. In relatively recently migrated adolescents, perceived discrimination was significantly related to relative deprivation through a greater external locus of control; however, this indirect association was not significant for adolescents with long-term migratory duration. CONCLUSION The results of our analysis expand our understanding of the link between perceived discrimination and relative deprivation. Moreover, these findings may provide practical guidance for interventions among Chinese rural-to-urban migrant adolescents to raise their social status and improve their mental health by addressing the macro-social psychological causes of relative deprivation.
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Affiliation(s)
- Meng Xiong
- Department of Psychology, Yangtze University, Jingzhou, 434023, Hubei, China. .,Department of Psychology, University of Edinburgh, Edinburgh, UK.
| | - Wendy Johnson
- grid.4305.20000 0004 1936 7988Department of Psychology, University of Edinburgh, Edinburgh, UK
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Pain and functional disability after lumbar microdiscectomy and their correlations with gender, depression and recovery expectations. VOJNOSANIT PREGL 2022. [DOI: 10.2298/vsp210328049p] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background/Aim. Among the various factors that can influence continued postoperative back pain and/or leg pain, and functional disability after lumbar microdiscectomy are gender, depression, and pessimism. The aim of this study was to determine the correlations between these factors. Methods. The research was conducted after microdiscectomy on 198 patients (95 men and 103 women), with a mean age of 50.20 ? 10.26 years. The following questionnaires were used for examinations: for assessment of pain and its intensity and character ? PainDETECT Test; for functional disability ? Oswestry Low Back Pain Disability Questionnaire; for the presence and degree of depression ? Beck Depression Inventory-II; and questionnaire for the assessment of personal expectations (pessimistic/optimistic) about the treatment results. These assessments were carried out after microdiscectomy ? just before rehabilitation treatment, one month later, and then 3 and 6 months after a microdiscectomy. Results. Depression (p < 0.01) and pessimism (p < 0.01) had significant negative influences on the pain and functional disability. The subjective sensation of pain was significantly higher in women than in men (p < 0.01), while men had a greater degree of functional disability (p < 0.01) than women. Conclusion. Pain and functional disability of the patients after lumbar microdiscectomy are significantly interconnected with gender, depression, and pessimism. The sensation of pain was higher in women, while men had a greater degree of functional disability. Globally, the intensity of pain and functional disability were significantly greater in patients with a higher degree of depression and pessimism, and, by registering mentioned factors, it is possible to predict the postoperative results.
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7
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Does the use of telephone reminders to increase survey response rates affect outcome estimates? An ancillary analysis of a prospective cohort study of patients with low back pain. BMC Musculoskelet Disord 2021; 22:893. [PMID: 34670521 PMCID: PMC8529745 DOI: 10.1186/s12891-021-04787-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 10/12/2021] [Indexed: 11/15/2022] Open
Abstract
Background Research is often undertaken using patient-reported outcomes from questionnaires. Achieving a high response rate demands expensive and time-consuming methods like telephone reminders. However, it is unknown whether telephone reminders change outcome estimates or only affect the response rate in research of populations with low back pain (LBP). The aim is to compare baseline characteristics and the change in outcome between patients responding before and after receiving a telephone reminder. Methods This is an ancillary analysis of data from a prospective cohort study employing questionnaires from 812 adults with LBP lasting more than 3 months. Patients not responding to the 52-week questionnaire were sent reminder emails after two and 3 weeks and delivered postal reminders after 4 weeks. Patients still not responding were contacted by telephone, with a maximum of two attempts. Patients were categorised into three groups: 1) patients responding before a telephone reminder was performed; 2) patients responding after the telephone reminder and 3) patients not responding at all. A positive outcome was defined as a 30% improvement on the Roland Morris Disability Questionnaire after 52 weeks. Results A total of 695 patients (85.2%) responded. Of these, 643 patients were classified in Group 1 and 52 patients were classified in Group 2. One hundred seventeen were classified in Group 3. No differences in outcome or baseline characteristics was found. In Group 1, 41.3% had a positive outcome, and in Group 2 48.9% had a positive outcome (P = 0.297). In group 3, non-respondents were younger, more often unemployed, more often smokers, more often reported co-morbidity, and reported higher depression scores than respondents. Conclusions Using a telephone reminder had no consequence on outcome estimates nor were there any differences in baseline characteristics between patients who responded before or after the telephone reminder. Trial registration The initial trial was registered in Clinicaltrials.gov (NCT03058315).
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A Brief Survey of the COVID-19 Pandemic's Impact on the Chronic Pain Experience. Pain Manag Nurs 2021; 23:3-8. [PMID: 34772607 PMCID: PMC8790052 DOI: 10.1016/j.pmn.2021.10.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 08/26/2021] [Accepted: 10/05/2021] [Indexed: 12/23/2022]
Abstract
Background The COVID-19 pandemic has forced sweeping social and behavioral changes that have adversely affected the general population. Many changes, such as business closures, working from home, increased psychological distress, and delayed access to health care, could have unique adverse effects on patients diagnosed with chronic pain (CP). The present study sought to examine perceived changes in the CP experience brought about by the COVID-19 pandemic. Design Participants included 487 self-reported patients with musculoskeletal, neuropathic, or postsurgical pain recruited using CloudResearch. A 53-item survey was created to assess changes in perceived pain, mood, control over pain, physical activity, employment, and medical access since the onset of the pandemic. Results Results suggested a worsening of the pain experience, particularly for women, with greater pain, negative affect, sedentary functioning, perceived decline in treatment quality, and increased treatment delays. Of note, pandemic-related declines in control over pain, which represents an important clinical target, are associated with other pandemic-related declines and also mediates relevant associations. Conclusions For frontline treatment providers, particularly primary care nurses and physicians, these findings may be relevant in order to reduce the likelihood of a worsening of symptoms, loss of self-efficacy regarding management of pain and/or potential maladaptive increase in the use of pain medications.
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Non-Preferred Work and the Incidence of Spinal Pain and Psychological Distress-A Prospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910051. [PMID: 34639355 PMCID: PMC8508031 DOI: 10.3390/ijerph181910051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 09/21/2021] [Accepted: 09/22/2021] [Indexed: 12/24/2022]
Abstract
Mental illness and psychological distress are global concerns. This study aimed to investigate the association between having non-preferred work and the incidence of spinal pain, psychological distress, and spinal pain with concurrent psychological distress, and if associations are modified by sleep disturbance. A prospective study of 4285 participants 23-62 years old was conducted, from years 2007 to 2010. Participants reported their work situation as preferred/non-preferred regarding profession/workplace with a high/low possibility to change. Psychological distress was measured with the General Health Questionnaire 12 and spinal pain with questions about neck/back pain. Binominal regression analyses calculated relative risk (RR) with 95% confidence interval (CI). Non-preferred work with a low possibility to change was associated with a higher incidence of spinal pain (RR 1.8; 95% CI 1.2-2.6) and psychological distress (RR 1.8; 95% CI 1.4-2.4) compared to preferred work. The RR was 1.4 (95% CI 0.9-2.1) for spinal pain and 1.3 (95% CI 1.0-1.7) for psychological distress among those with a high possibility to change. Non-preferred work yielded a higher incidence of spinal pain with concurrent psychological distress (RR 1.9; 95% CI 1.0-3.7). Sleep disturbance did not modify associations. A replication based on newer data is needed to confirm the results. In conclusion, non-preferred work is associated with a higher incidence of spinal pain and psychological distress, especially if the possibility to change job is low.
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Craig KD, MacKenzie NE. What is pain: Are cognitive and social features core components? PAEDIATRIC AND NEONATAL PAIN 2021; 3:106-118. [PMID: 35547951 PMCID: PMC8975232 DOI: 10.1002/pne2.12046] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 02/04/2021] [Accepted: 02/19/2021] [Indexed: 01/29/2023]
Abstract
Pain is a universal experience, but it has been challenging to adequately define. The revised definition of pain recently published by the International Association for the Study of Pain addressed important shortcomings of the previous version; however, it remains narrow in its focus on sensory and emotional features of pain, failing to capture the substantial roles of cognitive and social core components of the experience and their importance to advances in pain management. This paper reviews evidence and theoretical models for the significant role social and cognitive factors play in pain experience and we argue that without explicit recognition of these core components in the definition, significant nuances are lost at a cost to understanding and clinical management of pain. A focus on sensory and emotional features perpetuates biomedical interventions and research, whereas recognition of cognitive and social features supports a multidimensional model of pain, advances in interdisciplinary care, and the benefits of cognitive behavioral therapy and self‐management interventions. We also explore the six Key Notes that accompany the new definition of pain, discuss their application to the understanding of pain in childhood, and, in doing so, further explore social and cognitive implications. Considerations are also described for assessment and treatment of pain in pediatric populations.
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Affiliation(s)
- Kenneth D. Craig
- Department of Psychology University of British Columbia Vancouver BC Canada
| | - Nicole E. MacKenzie
- Department of Psychology and Neuroscience Dalhousie University Halifax NS Canada
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11
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Aroke EN, Overstreet DS, Penn TM, Crossman DK, Jackson P, Tollefsbol TO, Quinn TL, Yi N, Goodin BR. Identification of DNA methylation associated enrichment pathways in adults with non-specific chronic low back pain. Mol Pain 2021; 16:1744806920972889. [PMID: 33169629 PMCID: PMC7658508 DOI: 10.1177/1744806920972889] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Chronic low back pain (cLBP) that cannot be attributable to a specific pathoanatomical change is associated with high personal and societal costs. Still, the underlying mechanism that causes and sustains such a phenotype is largely unknown. Emerging evidence suggests that epigenetic changes play a role in chronic pain conditions. Using reduced representation bisulfite sequencing (RRBS), we evaluated DNA methylation profiles of adults with non-specific cLBP (n = 50) and pain-free controls (n = 48). We identified 28,325 hypermethylated and 36,936 hypomethylated CpG sites (p < 0.05). After correcting for multiple testing, we identified 159 DMRs (q < 0.01and methylation difference > 10%), the majority of which were located in CpG island (50%) and promoter regions (48%) on the associated genes. The genes associated with the differentially methylated regions were highly enriched in biological processes that have previously been implicated in immune signaling, endochondral ossification, and G-protein coupled transmissions. Our findings support inflammatory alterations and the role of bone maturation in cLBP. This study suggests that epigenetic regulation has an important role in the pathophysiology of non-specific cLBP and a basis for future studies in biomarker development and targeted interventions.
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Affiliation(s)
- Edwin N Aroke
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Demario S Overstreet
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Terence M Penn
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - David K Crossman
- Department of Genetics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Pamela Jackson
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Trygve O Tollefsbol
- Department of Biology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Tammie L Quinn
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Nengjun Yi
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Burel R Goodin
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA.,Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
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12
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Race, Social Status, and Depressive Symptoms: A Moderated Mediation Analysis of Chronic Low Back Pain Interference and Severity. Clin J Pain 2021; 36:658-666. [PMID: 32487870 DOI: 10.1097/ajp.0000000000000849] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Chronic low back pain (cLBP) is the leading cause of disability, with a significant societal cost. It disproportionately affects non-Hispanic blacks and individuals of lower socioeconomic status. The biopsychosocial framework has been used to study and manage cLBP, yet disparities persist. OBJECTIVE The objective of this study was to assess whether self-identified race moderated the relationship between perceived social status and cLBP outcomes (pain interference and pain severity) and investigate whether race moderated the indirect relationship between perceived social status and pain outcomes via depressive symptoms. METHODS Fifty-seven blacks and 48 whites with cLBP were recruited as part of a large ongoing study. Depressive symptoms, objective and subjective measures of socioeconomic status, and pain outcomes were measured. Hayes' moderated mediation model was used to estimate conditional direct and indirect relationship between these variables. RESULT On average black participants reported significantly more pain interference (4.12 [SD=2.65] vs. 2.95 [SD=2.13]) and severity (5.57 [SD=2.27] vs. 3.99 [SD=1.99]) than white participants, (P<0.05). Race moderated the association between perceived social status and pain interference: higher social status decreases pain interference for white participants, but that trend was not observed in black participants. Moreover, race moderated association of perceived social status with depressive symptoms (P<0.001); which mediates the effects of perceived social status on pain outcomes. CONCLUSION Higher perceived social status is associated with less severe depressive symptoms, which in turn is associated with less pain severity and less pain interference for whites but not for blacks with cLBP.
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13
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Bazargan M, Loeza M, Ekwegh T, Adinkrah EK, Kibe LW, Cobb S, Assari S, Bazargan-Hejazi S. Multi-Dimensional Impact of Chronic Low Back Pain among Underserved African American and Latino Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7246. [PMID: 34299695 PMCID: PMC8306928 DOI: 10.3390/ijerph18147246] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 06/23/2021] [Accepted: 07/02/2021] [Indexed: 12/25/2022]
Abstract
Chronic low back pain is one of the most common, poorly understood, and potentially disabling chronic pain conditions from which older adults suffer. The existing low back pain research has relied almost exclusively on White/Caucasian participant samples. This study examines the correlates of chronic low back pain among a sample of underserved urban African American and Latino older adults. Controlling for age, gender, race/ethnicity, education, living arrangement, and number of major chronic conditions, associations between low back pain and the following outcome variables are examined: (1) healthcare utilization, (2) health-related quality of life (HR-QoL) and self-rated quality of health; and (3) physical and mental health outcomes. METHODS We recruited nine hundred and five (905) African American and Latino older adults from the South Los Angeles community using convenience and snowball sampling. In addition to standard items that measure demographic variables, our survey included validated instruments to document HR-QoL health status, the Short-Form McGill Pain Questionnaire-2, Geriatric Depression Scale, sleep disorder, and healthcare access. Data analysis includes bivariate and 17 independent multivariate models. RESULTS Almost 55% and 48% of the Latino and African American older adults who participated in our study reported chronic low back pain. Our data revealed that having low back pain was associated with three categories of outcomes including: (1) a higher level of healthcare utilization measured by (i) physician visits, (ii) emergency department visits, (iii) number of Rx used, (iv) a higher level of medication complexity, (v) a lower level of adherence to medication regimens, and (vi) a lower level of satisfaction with medical care; (2) a lower level of HR-QoL and self-assessment of health measured by (i) physical health QoL, (ii) mental health QoL, and (iii) a lower level of self-rated health; and (3) worse physical and mental health outcomes measured by (i) a higher number of depressive symptoms, (ii) a higher level of pain, (iii) falls, (iv) sleep disorders, (v) and being overweight/obese. DISCUSSION Low back pain remains a public health concern and significantly impacts the quality of life, health care utilization, and health outcomes of underserved minority older adults. Multi-faceted and culturally sensitive interventional studies are needed to ensure the timely diagnosis and treatment of low back pain among underserved minority older adults. Many barriers and challenges that affect underserved African American and Latino older adults with low back pain simply cannot be addressed in over-crowded EDs. Our study contributes to and raises the awareness of healthcare providers and health policymakers on the necessity for prevention, early diagnosis, proper medical management, and rehabilitation policies to minimize the burdens associated with chronic low back pain among underserved older African American and Latino patients in an under-resourced community such as South Los Angeles.
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Affiliation(s)
- Mohsen Bazargan
- Department of Family Medicine, Charles R Drew University of Medicine and Science (CDU), Los Angeles, CA 90059, USA; (M.B.); (M.L.); (S.A.)
- Department of Public Health, CDU, Los Angeles, CA 90059, USA;
- Physician Assistant Program, CDU, Los Angeles, CA 90059, USA;
- Department of Family Medicine, UCLA, Los Angeles, CA 90095, USA
| | - Margarita Loeza
- Department of Family Medicine, Charles R Drew University of Medicine and Science (CDU), Los Angeles, CA 90059, USA; (M.B.); (M.L.); (S.A.)
- Department of Family Medicine, UCLA, Los Angeles, CA 90095, USA
| | - Tavonia Ekwegh
- School of Nursing, CDU, Los Angeles, CA 90059, USA; (T.E.); (S.C.)
| | | | - Lucy W. Kibe
- Physician Assistant Program, CDU, Los Angeles, CA 90059, USA;
| | - Sharon Cobb
- School of Nursing, CDU, Los Angeles, CA 90059, USA; (T.E.); (S.C.)
| | - Shervin Assari
- Department of Family Medicine, Charles R Drew University of Medicine and Science (CDU), Los Angeles, CA 90059, USA; (M.B.); (M.L.); (S.A.)
- Department of Public Health, CDU, Los Angeles, CA 90059, USA;
| | - Shahrzad Bazargan-Hejazi
- Department of Psychiatry, UCLA, Los Angeles, CA 90095, USA
- Department of Psychiatry, CDU, Los Angeles, CA 90059, USA
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14
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Observational Study of Qigong as a Complementary Self-Care Practice at a Tertiary-Care Pain Management Unit. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:6621069. [PMID: 34239585 PMCID: PMC8235984 DOI: 10.1155/2021/6621069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 06/01/2021] [Indexed: 11/18/2022]
Abstract
Qigong, which can be characterized in many different ways, is offered as a complementary self-care practice at a tertiary-care pain management unit in Halifax, Nova Scotia. This report provides a quantitative and qualitative assessment of two groups engaged in qigong practice in this context as part of two Research in Medicine (RIM) projects (2014-15, 2016-17). It includes assessments of pain, mood, quality of life, sleep, and fatigue, considers outcomes in relation to the amount of practice, and considers whether health attitudes would help determine who might benefit from the practice. There were 43 participants (28 ongoing practitioners, 15 new to qigong). The ongoing practice group in RIM2 had significant benefits over time in pain, mood, quality of life, and fatigue in quantitative scores, but changes were not significant in RIM 1. There were no differences in any measures in those new to qigong. Qualitative comments in core and other domains reflected good or better outcomes in 16 subjects in the ongoing group who practiced consistently. In those who practiced less, results were more variable. In most of those new to qigong, the practice was limited and comments indicate minimal changes. Those engaged in qigong have a stronger internal health locus of control than control subjects. Diligent qigong practice provides multiple health benefits for those with chronic pain, and qualitative assessments are essential for documenting these effects. For those new to qigong, factors needed to effectively engage practice need to be explored further to optimize program delivery. The trial is registered with http://www.clinicaltrials.gov (NCT04279639).
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15
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Della Villa F, Straub RK, Mandelbaum B, Powers CM. Confidence to Return to Play After Anterior Cruciate Ligament Reconstruction Is Influenced by Quadriceps Strength Symmetry and Injury Mechanism. Sports Health 2021; 13:304-309. [PMID: 33530847 DOI: 10.1177/1941738120976377] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Although the restoration of quadriceps strength symmetry is a primary rehabilitation goal after anterior cruciate ligament reconstruction (ACLR), little is known about the potential relationship between quadriceps strength symmetry and psychological readiness to return to play (RTP). HYPOTHESIS Quadriceps strength symmetry will be associated with psychological readiness to RTP after ACLR. Secondarily, injury mechanism will influence the association between quadriceps strength and psychological readiness to RTP. STUDY DESIGN Retrospective cohort. LEVEL OF EVIDENCE Level 3 (cohort study). METHODS A total of 78 female patients completed strength testing and the Injury-Psychological Readiness to Return to Sport (I-PRRS) scale at an outpatient clinical facility as part of return to sport testing after ACLR. Linear regression analysis was used to assess the relationship between the I-PRRS and the independent variables of interest (quadriceps strength symmetry and injury mechanism). RESULTS For all patients combined, a significant symmetry × mechanism interaction was found. When split by injury mechanism, a significant linear relationship was found between quadriceps strength symmetry and the I-PRRS score in patients who experienced a noncontact injury (n = 55; P = 0.01; R2 = 0.24). No such relationship was found for those who experienced a contact injury (n = 23; P = 0.97; R2 = 0.01). CONCLUSION Greater quadriceps strength symmetry was associated with greater psychological readiness to RTP in female athletes after ACLR. This relationship, however, was present only in those who experienced a noncontact injury. CLINICAL RELEVANCE Clinicians should consider both the physical and the psychological factors in assessing a patient's readiness to RTP. This may be particularly important for those who have experienced an ACL tear through a noncontact mechanism.
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Affiliation(s)
- Francesco Della Villa
- Education and Research Department, Isokinetic Medical Group FIFA Medical Centre of Excellence, Bologna, Italy
| | - Rachel K Straub
- Division of Biokinesiology & Physical Therapy, University of Southern California, Los Angeles, California
| | - Bert Mandelbaum
- Cedars Sinai Kerlan Jobe Institute, Santa Monica, California
| | - Christopher M Powers
- Division of Biokinesiology & Physical Therapy, University of Southern California, Los Angeles, California
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16
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Osma J, Peris-Baquero O, Suso-Ribera C, Sauer-Zavala S, Barlow DH. Predicting and Moderating the Response to the Unified Protocol: Do Baseline Personality and Affective Profiles Matter? COGNITIVE THERAPY AND RESEARCH 2021. [DOI: 10.1007/s10608-021-10208-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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17
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Kietrys D, Myezwa H, Galantino ML, Parrott JS, Davis T, Levin T, O'Brien K, Hanass-Hancock J. Functional Limitations and Disability in Persons Living with HIV in South Africa and United States: Similarities and Differences. J Int Assoc Provid AIDS Care 2020; 18:2325958219850558. [PMID: 31109225 PMCID: PMC6748470 DOI: 10.1177/2325958219850558] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Persons living with HIV (PLHIV) may experience disability. We compared disability among
PLHIV in the United States and South Africa and investigated associations with health and
demographic characteristics. Secondary analysis of cross-sectional data using medical
records and questionnaires including the World Health Organization Disability Assessment
Schedule (WHO-DAS) 2.0 12-item version (range: 0-36, with higher scores indicative of more
severe disability). Between-country differences for the presence of disability were
assessed with logistic regression and differences in severity using multiple regression.
Eighty-six percent of US participants reported disability, compared to 51.3% in South
Africa. The mean WHO-DAS score was higher in the United States (12.09 ± 6.96) compared to
South Africa (8.3 ± 6.27). Participants with muscle pain, depression, or more years since
HIV diagnosis were more likely to report disability. Being female or depressed was
associated with more severity. Being adherent to anti-retroviral therapy (ART) and
employed were associated with less severity. Because muscle pain and depression were
predictive factors for disability, treatment of those problems may help mitigate
disability in PLHIV.
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Affiliation(s)
- David Kietrys
- 1 Department of Rehabilitation and Movement Sciences, School of Health Professions, Rutgers - The State University of New Jersey, Blackwood, NJ, USA
| | - Hellen Myezwa
- 2 Department of Physiotherapy, School of Therapeutic Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Mary Lou Galantino
- 2 Department of Physiotherapy, School of Therapeutic Sciences, University of the Witwatersrand, Johannesburg, South Africa.,3 Physical Therapy Program, School of Health Sciences, Stockton University, Galloway, NJ, USA.,4 Clinical Center for Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - James Scott Parrott
- 1 Department of Rehabilitation and Movement Sciences, School of Health Professions, Rutgers - The State University of New Jersey, Blackwood, NJ, USA
| | - Tracy Davis
- 1 Department of Rehabilitation and Movement Sciences, School of Health Professions, Rutgers - The State University of New Jersey, Blackwood, NJ, USA
| | - Todd Levin
- 5 School of Osteopathic Medicine, Rowan University, Stratford, NJ, USA
| | - Kelly O'Brien
- 6 Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada.,7 Institute of Health Policy, Management and Evaluation (IHPME), University of Toronto, Toronto, Ontario, Canada.,8 Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
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18
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Dayanır IO, Birinci T, Kaya Mutlu E, Akcetin MA, Akdemir AO. Comparison of Three Manual Therapy Techniques as Trigger Point Therapy for Chronic Nonspecific Low Back Pain: A Randomized Controlled Pilot Trial. J Altern Complement Med 2020; 26:291-299. [DOI: 10.1089/acm.2019.0435] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Ismail Oguz Dayanır
- Neurosurgery Clinic, Ministry of Health Haseki Training and Research Hospital, Istanbul, Turkey
| | - Tansu Birinci
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul Medeniyet University, Istanbul, Turkey
| | - Ebru Kaya Mutlu
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Mustafa Ali Akcetin
- Neurosurgery Clinic, Ministry of Health Haseki Training and Research Hospital, Istanbul, Turkey
| | - Ali Osman Akdemir
- Neurosurgery Clinic, Ministry of Health Haseki Training and Research Hospital, Istanbul, Turkey
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19
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Pain-related Self-efficacy Among People With Back Pain: A Systematic Review of Assessment Tools. Clin J Pain 2020; 36:480-494. [PMID: 32080001 DOI: 10.1097/ajp.0000000000000818] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Before an intervention can be implemented to improve pain-related self-efficacy, assessment is required. The aim of the present study was to provide a systematic review on which self-efficacy scales are being used among patients with back pain and to evaluate their psychometric properties. METHODS A systematic search was executed in January 2019 and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2009 checklist served as a guide for conducting the study. Electronic databases included Cinahl, Medline, PubMed, PsycINFO, PSYNDEX, and SportDiscus. Publications in English or German language that focused on the adult patient population with back pain and which provided validation or reliability measures on pain-related self-efficacy were included. RESULTS A total of 3512 records were identified resulting in 671 documents after duplicates were removed. A total of 233 studies were screened full-text, and a total of 47 studies addressing 19 different measures of pain-related self-efficacy were included in the quality analysis. The most commonly used instruments were the Pain Self-Efficacy Questionnaire and the Chronic Pain Self-Efficacy Scale. All studies reported internal consistency, but many studies lacked other aspects of reliability and validity. CONCLUSIONS Further research should focus on assessing validity and interpretability of these questionnaires, especially in pain-related target groups. Researchers should select questionnaires that are most appropriate for their study aims and the back pain population and contribute to further validation of these scales to best predict future behavior and develop intervention programs. This systematic review aids selection of pain-related assessment tools in back pain both in research and practice.
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20
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Zuercher-Huerlimann E, Stewart JA, Egloff N, von Känel R, Studer M, Grosse Holtforth M. Internal health locus of control as a predictor of pain reduction in multidisciplinary inpatient treatment for chronic pain: a retrospective study. J Pain Res 2019; 12:2095-2099. [PMID: 31372026 PMCID: PMC6626892 DOI: 10.2147/jpr.s189442] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 05/28/2019] [Indexed: 12/14/2022] Open
Abstract
Purpose Chronic pain is a major health concern and its treatment requires physiological as well as psychological interventions. This study investigates the predictive value of health locus of control (HLOC) in pain intensity in chronic pain patients in an inpatient treatment setting. Patients and methods Data of 225 patients with a chronic pain condition were collected in a psychosomatic university clinic in Switzerland. Self-report assessment tools were used to measure pain intensity pre- and posttreatment and with a questionnaire dimensions of the HLOC were captured. Using hierarchic linear regression analysis, the predictive value of HLOC was investigated. Results A higher internal HLOC at pre-treatment was associated with a greater reduction in pain intensity from pre- to posttreatment (β = -0.151, p<0.05). For social-external and fatalistic-external HLOC no significant effects were observed. Conclusion Internal HLOC showed predictive value regarding the reduction in pain intensity in a multidisciplinary inpatient treatment for chronic pain, whereas social-external and fatalistic-external HLOC did not. Early interventions to strengthen internal beliefs of health control may be a promising component in multidisciplinary inpatient treatment for patients with chronic pain.
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Affiliation(s)
- Elian Zuercher-Huerlimann
- Division of Psychosomatic Medicine, Department of Neurology, Inselspital, Bern University Hospital, Bern, Switzerland.,Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Julian A Stewart
- Division of Psychosomatic Medicine, Department of Neurology, Inselspital, Bern University Hospital, Bern, Switzerland.,Department of Psychology, University of Bern, Bern, Switzerland
| | - Niklaus Egloff
- Division of Psychosomatic Medicine, Department of Neurology, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Roland von Känel
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, Zurich, Switzerland
| | - Martina Studer
- Division of Psychosomatic Medicine, Department of Neurology, Inselspital, Bern University Hospital, Bern, Switzerland.,Department of Psychology, University of Bern, Bern, Switzerland
| | - Martin Grosse Holtforth
- Division of Psychosomatic Medicine, Department of Neurology, Inselspital, Bern University Hospital, Bern, Switzerland.,Department of Psychology, University of Bern, Bern, Switzerland
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21
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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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22
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Pagé MG, Ziemianski D, Martel MO, Shir Y. Development and validation of the Treatment Expectations in Chronic Pain Scale. Br J Health Psychol 2019; 24:610-628. [PMID: 30989756 DOI: 10.1111/bjhp.12371] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 03/02/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To develop and examine the psychometric properties of the Treatment Expectations in Chronic Pain (TEC) scale, a brief measure of treatment expectations of chronic non-cancer pain treatment. DESIGN A cross-sectional study design was used. METHODS After conducting a literature review and expert discussions, a preliminary version of the TEC scale was developed. Cognitive interviews with 10 clinicians and 14 patients were conducted to examine the scale's face validity and item wording. Last, two hundred and five patients on the waitlist for a multidisciplinary pain treatment centre completed a battery of self-report questionnaires to examine the TEC scale's reliability and construct validity. Mokken scale analysis was conducted to select the final items. Reliability (Cronbach's alpha and Guttman's lambda2 ) and construct validity (Pearson correlations) were assessed. RESULTS The final scale was composed of nine items that each measured ideal and predicted expectations about process and outcome of treatment. Mokken scale analysis showed the presence of two subscales: ideal and predicted expectations. The TEC scale had good internal consistency (α = 0.876-0.869) and adequate discriminant validity as assessed by its low correlation with measures of depression, anxiety, and quality of life (r = -.038 to .114). The scale had however low correlation with a theoretically related measure of optimism (r = .240). CONCLUSION The TEC scale is a reliable scale measuring pain treatment expectation. Further evaluation of its psychometric properties is needed. The scale has the potential to deepen our understanding of the role treatment expectations play in chronic non-cancer pain treatment response. Statement of contribution What is already known on this subject? Expectations play a role in pain perception and the response to pain treatment Patients' expectations about pain and its management are associated with treatment satisfaction The absence of a validated tool to measure treatment expectations in chronic non-cancer pain prevents further exploration and understanding of the role of expectations in the context of multidisciplinary pain treatment . What does this study add? A new, reliable 9-item scale measuring treatment expectations among chronic non-cancer pain patients attending specialized multidisciplinary pain clinics .
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Affiliation(s)
- M Gabrielle Pagé
- Centre de Recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), QC, Canada.,Department of Anesthesiology and Pain Medicine, Faculty of Medicine, Université de Montréal, QC, Canada.,Alan Edwards Pain Management Unit, Montreal General Hospital, QC, Canada
| | - Daniel Ziemianski
- Alan Edwards Pain Management Unit, Montreal General Hospital, QC, Canada
| | - Marc Olivier Martel
- Alan Edwards Pain Management Unit, Montreal General Hospital, QC, Canada.,Faculty of Dentistry, McGill University, Montreal, QC, Canada.,Department of Anesthesia, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Yoram Shir
- Alan Edwards Pain Management Unit, Montreal General Hospital, QC, Canada.,Department of Anesthesia, Faculty of Medicine, McGill University, Montreal, QC, Canada
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23
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Wang C, Pu R, Ghose B, Tang S. Chronic Musculoskeletal Pain, Self-Reported Health and Quality of Life among Older Populations in South Africa and Uganda. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E2806. [PMID: 30544694 PMCID: PMC6313678 DOI: 10.3390/ijerph15122806] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 12/03/2018] [Accepted: 12/05/2018] [Indexed: 12/18/2022]
Abstract
Chronic musculoskeletal pain (CMP) is a serious health concern especially among the elderly population and has significant bearing on health and quality of life. Not much is known about the relationship between chronic pain with self-reported health and quality of life among older populations in low-resource settings. Based on sub-national data from South Africa and Uganda, the present study aimed to explore whether the older population living with CMP report health and quality of life differently compared to those with no CMP complaints. This study was based on cross-sectional data on 1495 South African and Ugandan men and women collected from the SAGE Well-Being of Older People Study. Outcome variables were self-reported physical and mental health and quality of life (QoL). Mental health was assessed by self-reported depressive symptoms during the last 12 months. CMP was assessed by self-reported generalised pain as well as back pain. Multivariable logistic regression models were used to measure the association between health and QoL with CMP by adjusting for potential demographic and environmental confounders. The prevalence of poor self-rated health (61.2%, 95% CI = 51.7, 70.0), depression (37.2%, 95% CI = 34.8, 39.6) and QoL (80.5%, 95% CI = 70.8, 87.5) was considerably high in the study population. Mild/moderate and Severe/extreme generalised pain were reported respectively by 34.5% (95% CI = 28.9, 40.5) and 15.7% (95% CI = 12.2, 19.9) of the respondents, while back pain was reported by 53.3% (95% CI = 45.8, 60.4). The prevalence of both types was significantly higher among women than in men (p < 0.001). In the multivariate analysis, both generalised pain and back pain significantly predicted poor health, depression and QoL, however, it varied between the two different populations. Back pain was associated with higher odds of poor self-rated health [OR = 1.813, 95% CI = 1.308, 2.512], depression [1.640, 95% CI = 1.425, 3.964] and poor QoL [1.505, 95% CI = 1.028, 2.202] in South Africa, but not in Uganda. Compared to having no generalised pain, having Mild/Moderate [OR = 2.309, 95% CI = 1.219, 7.438] and Severe/Extreme [OR = 2.271, 95% CI = 1.447, 4.143] generalised pain was associated with significantly higher odds of poor self-rated health in South Africa. An overwhelmingly high proportion of the sample population reported poor health, quality of life and depression. Among older individuals, health interventions that address CMP may help promote subjective health and quality and life and improve psychological health.
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Affiliation(s)
- Chao Wang
- School of Public Policy and Management, China University of Mining and Technology, Xuzhou 221116, China.
| | - Run Pu
- China National Center for Biotechnology Development, Beijing 100039, China.
| | - Bishwajit Ghose
- Faculty of Social Sciences, School of International Development and Global Studies, University of Ottawa, Ottawa, ON K1N 6N5, Canada.
| | - Shangfeng Tang
- School of Medicine and Health Management, Tongji medical college, Huazhong University of Science and Technology, Wuhan 430030, China.
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