870 WHAT HELPS AND WHY? PREDICTING PATIENT OUTCOMES IN INTERSTITIAL CYSTITIS/BLADDER PAIN SYNDROME (IC/BPS) WITH PAIN APPRAISALS AND BEHAVIOURAL COPING STRATEGIES

Abstract

You have accessJournal of UrologyInfections/Inflammation of the Genitourinary Tract: Interstitial Cystitis1 Apr 2013870 WHAT HELPS AND WHY? PREDICTING PATIENT OUTCOMES IN INTERSTITIAL CYSTITIS/BLADDER PAIN SYNDROME (IC/BPS) WITH PAIN APPRAISALS AND BEHAVIOURAL COPING STRATEGIES Dean A. Tripp, J. Curtis Nickel, Jillian Mulroy, Laura Katz, Michel Pontari, Robert Moldwin, Mayer Robert, Lesley Carr, Ragi Doggweiler, Claire Yang, Nagendra Mishra, and Jorgen Nordling Dean A. TrippDean A. Tripp Kingston, Canada More articles by this author , J. Curtis NickelJ. Curtis Nickel Kingston, Canada More articles by this author , Jillian MulroyJillian Mulroy Kingston, Canada More articles by this author , Laura KatzLaura Katz Kingston, Canada More articles by this author , Michel PontariMichel Pontari Philadelphia, PA More articles by this author , Robert MoldwinRobert Moldwin New York, NY More articles by this author , Mayer RobertMayer Robert Rochester, NY More articles by this author , Lesley CarrLesley Carr Toronto, Canada More articles by this author , Ragi DoggweilerRagi Doggweiler Knoxville, TN More articles by this author , Claire YangClaire Yang Seattle, WA More articles by this author , Nagendra MishraNagendra Mishra Ahmedabad, India More articles by this author , and Jorgen NordlingJorgen Nordling Herlev, Denmark More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.439AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES IC/BPS is a chronic pelvic pain syndrome. Our previous IC/BPS analysis correlated pain, quality of life (QoL), and psychosocial adjustments with other associated conditions[1], and catastrophizing and behavioural coping strategies (sedentary resting in reaction to pain) have been found to predict pelvic pain outcomes for men and women.[2-5] However, no study has examined a comprehensive list of pain appraisal and behavioural coping strategies as mechanisms in the relationship between pain and QoL in these patients. From a self-regulation perspective, appraisals and coping responses of patients suffering from IC/BPS are important in advancing patient management. METHODS Female patients with IC/BPS (n=190) were recruited from tertiary care urology clinics and completed questionnaires (demographics, O'Leary Sant, McGill Pain Questionnaire, SF12, Chronic Pain Coping Inventory, Pain Catastrophizing Scale). The data was examined for univariate and multivariate normality, and a missing values analysis was conducted. Associations of validated pain appraisals (e.g., catastrophizing) and behavioural coping strategies (e.g., illness focused coping) with outcomes of pain and QoL in IC/BPS were examined. Factor reduction was conducted and resulting variables were input into multivariable mediation models. RESULTS Patients ranged in age from 21-89 years (M=49.8, SD=14.83), were predominantly White (93.7%), with the majority (73%) in a relationship (married or living with partner). Factor analytic analyses revealed a 4-factor solution for these variables (catastrophizing, illness-focused behavioural coping, cognitive coping, and depression), which were used for subsequent mediation analyses. Multivariable mediation analyses for mental QoL showed catastrophizing (P<.0001) was a full and unique mediator of the effect of pain on mental QoL. For physical QoL, illness-focused behavioural coping (i.e., rest/avoidance, seeking assistance)(P<.0001) was a partial and unique mediator between patient pain and physical QoL. CONCLUSIONS These results suggest that catastrophic appraisals and illness-focused behavioural coping act as mechanisms driving the negative association between pain and QoL indices. In fact, the catastrophizing mediation effect supports the hypothesis that symptoms may become mentally disabling through the cognitive mechanisms. These results further support an expanding science emphasizing the importance of biopsychosocial pain/QoL models in Urology. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e359 Peer Review Report Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Dean A. Tripp Kingston, Canada More articles by this author J. Curtis Nickel Kingston, Canada More articles by this author Jillian Mulroy Kingston, Canada More articles by this author Laura Katz Kingston, Canada More articles by this author Michel Pontari Philadelphia, PA More articles by this author Robert Moldwin New York, NY More articles by this author Mayer Robert Rochester, NY More articles by this author Lesley Carr Toronto, Canada More articles by this author Ragi Doggweiler Knoxville, TN More articles by this author Claire Yang Seattle, WA More articles by this author Nagendra Mishra Ahmedabad, India More articles by this author Jorgen Nordling Herlev, Denmark More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...