Pain Beliefs Research Articles

Physiotherapists’ pain attitudes and beliefs towards chronic low back pain and their association with treatment selection: a cross-sectional study

ObjectivesThe main aim of this study was to investigate physiotherapists’ pain attitudes and beliefs towardss non-specific chronic low back pain (NSCLBP) and identify whether they are associated with treatment selection.DesignCross-sectional...

Confidence, attitudes, beliefs and determinants of implementation behaviours among physiotherapists towards clinical management of low back pain before and after implementation of the BetterBack model of care

BackgroundImplementing clinical guidelines is challenging. To facilitate uptake, we developed a model of care (BetterBack Model of Care) and an implementation strategy to support management of low back pain in primary care. The aim of this study was to evaluate physiotherapists´ confidence, attitudes and beliefs in managing patients with low back pain before and after a multifaceted implementation of the BetterBack Model of Care. A further aim was to evaluate determinants of implementation behaviours among physiotherapists.MethodsThis clinical trial was an experimental before and after study within a hybrid type 2 effectiveness-implementation trial. The primary outcome was Practitioner Self-Confidence Scale (PCS), secondary outcomes were the Pain Attitude and Beliefs Scale for Physiotherapists (PABS-PT) and Determinants of Implementation Behaviour Questionnaire (DIBQ). Data was analysed using repeated measures ANOVA and pairwise comparisons.ResultsOne hundred sixteen physiotherapists answered a questionnaire before, directly after, as well as 3 and 12 months after implementation of the Model of Care. PCS improved over time with a large effect size post implementation (ηp2 = 0.197, p < 0.001). Changes in PABS-PT were only significant after 12 months with higher biopsychosocial orientation, (ηp2 = 0.071, p < 0.01) and lower biomedical orientation, (ηp2 = 0.136, p < 0.001). Directly after the workshop, after 3 and 12 months, physiotherapists had high ratings on all DIBQ domains, (scores > 50) implying that all were potential facilitators of the implementation. However, after 3 months, all domains had significantly decreased except for organisation, social influence and patient expectation domains. However, after 12 months, organisation and social influence domains had significantly decreased while domains such as knowledge, skills and beliefs about capabilities returned to initial levels.ConclusionsPhysiotherapists´ confidence and biopsychosocial orientation increased after implementation and may have the potential to improve management of low back pain in primary care. The implementation behaviour showed mostly facilitating patterns but changed over time, pinpointing a need to repeatedly monitor these changes. This can inform the need for changes of implementation efforts in different phases and support sustainability strategies.Trail registrationClinicalTrials.gov NCT03147300 3 May 2017, prospectivly registered.

Transcutaneous electrical nerve stimulation and heat to reduce pain in a chronic low back pain population: a randomized controlled clinical trial

BackgroundLow back pain is the leading cause of disability worldwide. The therapeutic management of patients with chronic LBP is challenging. ObjectivesThe aim of this study is to evaluate the effects of heat and transcutaneous electrical nerve stimulation combined on pain relief in participants with chronic low back pain. MethodsFifty participants with chronic (≥3 months) low back pain were randomly assigned to two groups: HeatTens (n=25) and control group (n=25). Primary outcome was pain. Secondary outcomes were pressure pain thresholds, temporal summation, conditioned pain modulation, fear-avoidance and beliefs questionnaire, central sensitization inventory, quality of life, and medication use. The control group received no treatment and continued usual care. After four weeks of treatment, all measurements were repeated. ResultsFifty individuals participated in this study. Significant higher pressure pain threshold measures after both 30min and 4 weeks for the lower back region and the second plantar toe were found only in the experimental group. ConclusionThe combination of heat and transcutaneous electrical nerve stimulation does not reduce pain scores in patients with chronic low back pain. Pressure pain threshold values significantly improved, showing beneficial effects of the experimental treatment.ClinicalTrials.gov: NCT03643731 (https://clinicaltrials.gov/ct2/show/NCT03643731).

Physiotherapistś pain attitudes and beliefs, and their influence on the treatment selection for patients with chronic non-specific low back pain

Key-Words: Physiotherapist, Low Back Pain, Saudi Arabia

Can the Pain Attitudes and Beliefs Scales be adapted for use in the context of osteoarthritis with general practitioners and physiotherapists?

BackgroundConservative, first-line treatments (exercise, education and weight-loss if appropriate) for hip and knee joint osteoarthritis are underused despite the known benefits. Clinicians’ beliefs can affect the advice and education given to patients, in turn, this can influence the uptake of treatment. In New Zealand, most conservative OA management is prescribed by general practitioners (GPs; primary care physicians) and physiotherapists. Few questionnaires have been designed to measure GPs’ and physiotherapists’ osteoarthritis-related health, illness and treatment beliefs. This study aimed to identify if a questionnaire about low back pain beliefs, the Pain Attitudes and Beliefs Scale for Physiotherapists (PABS-PT), can be adapted to assess GP and physiotherapists’ beliefs about osteoarthritis.MethodsThis study used a cross-sectional observational design. Data were collected anonymously from GPs and physiotherapists using an online survey. The survey included a study-specific demographic and occupational characteristics questionnaire and the PABS-PT questionnaire adapted for osteoarthritis. All data were analysed using descriptive statistics, and the PABS-PT data underwent principal factor analysis.ResultsIn total, 295 clinicians (87 GPs, 208 physiotherapists) participated in this study. The principal factor analysis identified two factors or subscales (categorised as biomedical and behavioural), with a Cronbach’s alpha of 0.84 and 0.44, respectively.ConclusionsThe biomedical subscale of the PABS-PT appears appropriate for adaptation for use in the context of osteoarthritis, but the low internal consistency of the behavioural subscale suggests this subscale is not currently suitable. Future research should consider the inclusion of additional items to the behavioural subscale to improve internal consistency or look to develop a new, osteoarthritis-specific questionnaire.Trial registrationThis trial was part of the primary author’s PhD, which began in 2012 and therefore this study was not registered.

Post-Traumatic Stress Disorder Symptoms Contribute to Worse Pain and Health Outcomes in Veterans With PTSD Compared to Those Without: A Systematic Review With Meta-Analysis.

Post-traumatic stress disorder (PTSD) and chronic pain are frequently co-morbid conditions in the U.S. veteran population. Although several theories about the cause of increased pain prevalence in individuals with PTSD have been presented, no synthesis of primary data informing the impact of co-morbid PTSD and pain has been completed. The purpose of this study was to systematically review the literature and quantify disability, function, and pain-related beliefs and outcomes in veterans with PTSD compared to veterans without PTSD. A systematic search of three electronic databases was conducted. Inclusion criteria required pain-related comparison of veterans with PTSD to those without PTSD. Primary outcome measures and standardized mean differences (SMDs) were assessed for pain, function, disability, pain beliefs, and healthcare utilization using a random effects model. 20 original research studies met inclusion criteria and were assessed for quality and outcomes of interest. The majority of studies were cross-sectional. Veterans with PTSD and pain demonstrated higher pain (SMD=0.58, 95% CI 0.28-0.89), disability (SMD=0.52, 95%CI 0.33-0.71), depression (SMD=1.40, 95%CI 1.2-1.6), catastrophizing beliefs (SMD=0.95, 95% CI 0.69-1.2), sleep disturbance (SMD=0.80, 95% CI 0.57-1.02), and healthcare utilization; they had lower function (SMD=0.41, 95% CI 0.25-0.56) and pain self-efficacy (SMD=0.77, 95% CI 0.55-0.99) compared to veterans without PTSD. In veterans with chronic pain, PTSD symptomology has a large effect for many negative health-related outcomes. This review supports the need for clinicians to screen and understand the effects of PTSD symptoms on patients with pain. Clinicians should recognize that veterans with PTSD and pain likely have elevated pain catastrophizing beliefs and decreased self-efficacy that should be targeted for intervention.

Development and evaluation of interprofessional patient simulation activity for physiotherapy and occupational therapy students to assess and manage patients with chronic pain

Background/aims Opportunities for interprofessional learning are a priority to prepare health professionals for the effective interprofessional assessment and management of patients with chronic pain, yet finding effective and sustainable approaches are a challenge for health professional programmes. The aim of this study was to develop and evaluate an ‘interprofessional management of pain’ learning activity using simulation for physiotherapy and occupational therapy students. Methods A total of 40 physiotherapy and 20 occupational therapy students undertook the interprofessional management of pain learning activity. Chronic pain attitudes and beliefs (HC-PAIRS) and perception of interprofessional practice (SPICE-R) were assessed before and following the intervention. A survey relating to content and format of the activity was completed following the intervention. Results There was a significant improvement in total HC-PAIRS and SPICE-R scores for both student groups. Both groups demonstrated satisfaction with the activity. Conclusions These findings support the use of an interprofessional simulated learning activity with facilitated planning and debriefing to enhance students’ attitudes to chronic pain and interprofessional practice.

Association Between Low Back Pain and Biomedical Beliefs in Academics of Physiotherapy.

Observational cross-sectional study. To analyze the association between low back pain and biomedical beliefs in physiotherapy students of the first and last year. There is a hypothesis that the presence of low back pain may be a risk factor for biomedical beliefs in physiotherapy academics. Three hundred sixty-five students of first and last year of the physiotherapy course from three universities in city of Fortaleza completed a questionnaire with sociodemographic factors and a Pain Attitude and Beliefs Scale used to determine the orientation (biopsychosocial or biomedical approach) of practitioners to the management of people with low back pain. The mean age of participants was 23.57 ± 4.77 years, with a predominance of females (80.27%, n = 239). Approximately 23.84% reported low back pain, 18.9% had undergone imaging tests at the site, and 36.71% reported that family members with low back pain also underwent these examinations. The means of the biopsychosocial subscale of the Pain Attitude and Belief Scale corresponded to 20.19 and 20.63 in the first and last year academics, respectively, whereas the biomedical subscale corresponded to 32.10 and 32.73 in the first and last year academics, respectively. There was no statistical difference between the scores of the first and last year students. Linear regression analyses showed that low back pain was associated with lower levels of biomedical beliefs in the students of the last year (beta coefficient = -2.17, 95% confidence interval = -3.95 to -0.3, P = 0.02). We did not find association between low back pain and levels of biomedical beliefs in academics of both years and with academics of the first year. Also, we did not find association between low back pain and levels of biopsychosocial beliefs. First and last year physical therapy students did not present a difference between biomedical and biopsychosocial beliefs. Although biomedical beliefs were prevalent in both groups, the academics of the last year who had low back pain presented lower levels of biomedical beliefs than the academics of the last year without low back symptoms. 4.

Ontario Musculoskeletal Physiotherapists' Attitudes toward and Beliefs about Managing Chronic Low Back Pain.

Purpose: The purpose of this study was to explore Ontario musculoskeletal physiotherapists' attitudes toward and beliefs about managing chronic low back pain (CLBP), and their biomedical (BM) and bio-psychosocial (BPS) treatment orientation. Method: Through a link in the Ontario Physiotherapy Association newsletter, we administered an electronic survey to registered physiotherapists via SurveyMonkey. We used a modified three-step Dillman approach to encourage participation. The questionnaire included the Pain Attitudes and Beliefs Scale for Physiotherapists (PABS-PT) measure, and demographic-practice items. Results: A total of 99 physiotherapists met the eligibility criteria and completed the PABS-PT (72.7% women; mean 17 years of experience). Respondents scored a mean of 26.98 (SD 7.69) on the BM sub-scale and 34.43 (SD 4.84) on the BPS sub-scale. Physiotherapists in public practice had a stronger BPS orientation (mean 36.52) than those in private practice (33.80; p=0.01). Less experienced physiotherapists (<10 y) had a higher BM sub-scale score (mean 29.33) than more experienced physiotherapists (25.24, p=0.013), and 78.8% of physiotherapists reported an awareness of clinical practice guidelines. Conclusions: Our preliminary findings suggest that Ontario physiotherapists' attitudes and beliefs align with a BPS orientation. Future studies should explore the impact of education that promotes a BPS approach to the management of CLBP.

Individuals perspectives related to acceptance, values and mindfulness following participation in an acceptance-based pain management programme

There is a growing body of evidence supporting the effectiveness of Acceptance and Commitment Therapy (ACT) for chronic pain. However, individuals' experiences and opinions of ACT and the underlying processes have rarely been examined. The aim of this study was to explore patients’ views, in relation to the processes acceptance and values, in addition to mindfulness, which is a core construct of ACT. A qualitative study was conducted with individuals, following attendance of a multidisciplinary pain management programme that included education, exercise and ACT-based psychology sessions. The study comprised of four semi-structured focus group interviews with eleven participants. Focus groups were audio-recorded and transcribed verbatim. A thematic analysis was performed and five main themes were identified: (1) Acceptance, with three sub-themes noted in relation to the process of acceptance: (i) an initial strong emotional reaction, (ii) evolving perspectives (iii) non-acceptance; (2) chronic pain beliefs; (3) empathy and validation; (4) values, with three sub-themes including (i) family and self-care, (ii) social activity, (iii) work and (5) being in the moment. This study provides new insights into the perspectives of individuals who have taken part in a multidisciplinary pain management programme, which included ACT-based psychology sessions. Factors which influenced engagement with the core processes underlying this therapeutic model are discussed.

Comparison of Vaginal Penetration Cognitions and Metacognitions Between Women With Genito-Pelvic Pain and Penetration Disorder and Healthy Controls

BackgroundInvestigation of vaginal penetration cognitions and metacognitive beliefs in genito-pelvic pain and penetration disorder (GPPPD) could be important for understanding the underlying mechanisms of sexual disorders. AimThe aim of this study was to compare healthy controls and GPPPD women for vaginal penetration cognitions and metacognitions. MethodsOutpatients with GPPPD (n = 135) and healthy controls (n = 136) were evaluated with Sociodemographic Data Form, Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders IV (SCID-I), SCID nonpatient version, Golombok-Rust Inventory of Sexual Satisfaction Female Form (GRISS), Vaginal Penetration Cognition Questionnaire, Metacognitions Questionnaire (MQ), Hamilton Anxiety Rating Scale (HAM-A), SCID and Hamilton Depression Rating Scale (HAM-D). OutcomesThe relationship between metacognitions and vaginal penetration cognitions was detected, and patients with GPPPD and healthy controls were compared for metacognitions. ResultsThe MQ total score and all MQ subdimension scores other than positive beliefs about worry of GPPPD were found to be significantly higher in the GPPPD group than in controls. All Vaginal Penetration Cognition Questionnaire subdimension scores except positive cognitions for penetration score were significantly higher in patients with GPPPD than in controls. The total and frequency of sexuality, sexual communication between partners, avoidance of sexuality, nonsensuality, vaginismus, satisfaction, and anorgasmia subscores of the GRISS were significantly higher in the GPPPD group. Cognitive self-consciousness, need for controlling thoughts, and HAM-D values had a significant and independent effect on distinguishing the patients with GPPPD from the controls. Clinical ImplicationsOur results may be important to address the metacognitions in the treatment of women with GPPPD. Strengths & LimitationsThe strengths are large-sample case and control groups, comparison with the control group using both clinical interviews and scale evaluations, diagnosis of GPPPD using clinical interviews and with 2 validated scales, exclusion of patients with depression and anxiety disorders, and evaluation of metacognitions not affected by concomitant disorders. The cross-sectional nature of our study and the fact that it was performed only in treatment-seeking groups and recruitment of hospital workers' relatives as a control group were limitations of the study. ConclusionIn addition to the behavioral components of GPPPD treatment, the emphasis on metacognitions especially in the treatment process may have a positive effect on treatment.Teksin Ünal G, Şahmelikoğlu Onur Ö, Erten E. Comparison of Vaginal Penetration Cognitions and Metacognitions Between Women With Genito-Pelvic Pain and Penetration Disorder and Healthy Controls. J Sex Med 2020;17:964–974.

The Effect of Surgical Decompression and Fusion on Functional Balance in Patients With Degenerative Lumbar Spondylolisthesis.

Prospective cohort study. To quantify the effect of lumbar decompression and fusion surgery on balance and stability in patients with degenerative lumbar spondylolisthesis (DLS) and compare them to controls. DLS is a condition in which one vertebra subluxates relative to an adjacent vertebra in the absence of a disruption in the neural arch. While the existing literature demonstrates that decompression and fusion can successfully alleviate pain and reduce disability in patients with DLS, no studies to date have used quantitative dynamic testing to determine the effect of surgery on cone of economy (CoE) measures in this patient population. Forty-five DLS patients performed a series of functional balance tests a week before and 3 months after surgery and were compared to 28 controls. The outcome measures included range of sway (RoS) and total sway for the center of mass (CoM) and head in the sagittal, coronal, and axial planes, along with leg and back Visual Analog Scale (VAS), Oswestry Disability Index (ODI), Fear/Avoidance Behavior Questionnaire (FABQ), Tampa Scale of Kinesophobia (TSK), and Demoralization scale. RoS for the CoM (P < 0.005) and head (P < 0.017) decreased in all planes postoperatively. Reductions in CoM (P = 0.001) and head total sway (P = 0.001) were also observed after surgery. Furthermore, patients with DLS reported strong improvements in VAS low back (P = 0.001), VAS leg (P = 0.001), ODI (P = 0.001), FABQ Physical (P = 0.003), TSK (P = 0.001), and demoralization (P = 0.044) with surgical intervention. Although total sway was reduced after surgery, it did not return to the level of normal controls as demonstrated with more total sway of their CoM (P = 0.002) and head (P = 0.001) as well as more sagittal head RoS (P = 0.048). This study confirms that surgical intervention for degenerative spondylolisthesis is effective at reducing disability, back and leg pain, demoralization, kinesiophobia, and fear-avoidance beliefs related to physical activity in patients with DLS. Furthermore, such patients exhibit a significantly more stable stance after surgery. However, balance parameters did not completely normalize by 3 months postoperatively. 3.

Group Differences Between Countries and Between Languages in Pain-Related Beliefs, Coping, and Catastrophizing in Chronic Pain: A Systematic Review.

ObjectiveTo evaluate the extent to which pain-related beliefs, appraisals, coping, and catastrophizing differ between countries, language groups, and country economy. DesignSystematic review. MethodsTwo independent reviewers searched 15 databases without restriction for date or language of publication. Studies comparing pain beliefs/appraisals, coping, or catastrophizing across two or more countries or language groups in adults with chronic pain (pain for longer than three months) were included. Two independent reviewers extracted data and performed the quality appraisal. Study quality was rated as low, moderate, or high using a 10-item modified STROBE checklist. Effect sizes were reported as small (0.20–0.49), medium (0.50–0.79), or large (≥0.80). ResultsWe retrieved 1,365 articles, read 42 potential full texts, and included 10 (four moderate-quality, six low-quality) studies. A total of 6,797 adults with chronic pain (33% with chronic low back pain) were included from 16 countries. Meta-analysis was not performed because of heterogeneity in the studies. A total of 103 effect sizes were computed for individual studies, some of which indicated between-country differences in pain beliefs, coping, and catastrophizing. Of these, the majority of effect sizes for pain beliefs/appraisal (60%; eight large, eight medium, and eight small), for coping (60%; seven large, 11 medium, and 16 small), and for catastrophizing (50%; two medium, one small) evidenced statistically significant between-country differences, although study quality was low to moderate. ConclusionsIn 50% or more of the studies, mean scores in the measures of pain beliefs and appraisals, coping responses, and catastrophizing were significantly different between people from different countries.

P039 CLINICAL HYPNOSIS IN PEDIATRIC CROHN’S DISEASE: A RANDOMIZED CONTROLLED TRIAL

Abstract Background Crohn’s disease (CD) is a chronic, immune-mediated condition associated with abdominal pain, psychological comorbidities, and reduced quality of life (QoL), even in remission. Clinical hypnosis, involving focused relaxation and therapeutic suggestion, is helpful for irritable bowel syndrome, pain, and anxiety, and may have anti-inflammatory effects. Study Aims: To implement hypnosis as an adjunctive therapy for adolescents with CD. To assess the impact on QoL, abdominal pain, psychosocial measures, and disease activity compared to standard care. Methods Forty 12–18 year-olds with CD diagnosed &amp;gt;3 months prior randomized to hypnosis intervention (HI) or waitlist control (WC). HI receive one in-person hypnosis session focused on enhancing comfort, calm, and energy; education on self-hypnosis; audio recordings for 8 weeks home practice. Assessments at 8 and 16 weeks. Primary outcome: disease-specific health-related (HR) QoL Impact III, single-item QoL modified Cantril Scale, parent-proxy HRQoL PedsQL 4.0. Secondary outcomes: Anxiety, Depressive Symptoms, Sleep Disturbance (PROMIS pediatric short forms); abdominal pain frequency and intensity; Pain Beliefs Questionnaire short form (PBQ-SF); school absences; healthcare utilization; Physician’s Global Assessment (PGA); Pediatric Crohn’s Disease Activity Index. With n=40, 80% power to detect 13-point difference in Impact III. Two-sided Wilcoxon test used to compare differences from baseline to follow up and between groups. Results Demographics: 40 participants enrolled February-May 2019. 50% female. 15.8 y ± 2. PGA: 28 quiescent, 6 mild, 3 moderate, 3 not documented. 18, 8, and 13 of 40 with moderate-severe depressive symptoms, anxiety, and sleep disturbance, respectively. 25 of 40 with abdominal pain in the past week. WC with poorer systemic symptom-related QoL by Impact III (p=0.01) and greater depressive symptoms (p=0.03) compared to HI. Post-Intervention (8 Weeks): In HI and not in WC, significant improvement was noted in parent-reported QoL (p=0.006; Figure 1), maximum abdominal pain intensity (p=0.01, Figure 2), PBQ-SF subdomain emotion-focused coping efficacy (p=0.04), and school absences (p=0.03). 50% of HI participants used self-hypnosis at least 3–4 times per week and tended to have greater QoL improvement than those who practiced less. Participants described improvement in stress, anxiety, and sleep, though corresponding measures were unchanged. 16-week outcomes and disease activity pending. Conclusions Adolescents with CD have pain, reduced QoL, and psychological impairment despite inactive disease. Hypnosis is an acceptable, feasible, and promising complementary therapy in CD and may improve QoL, abdominal pain, coping efficacy, and school attendance. Additional RCTs with longer follow up, objective disease activity assessment, and measures to improve compliance are warranted.

Chronic Pain and Pain Belief in Active Military Personnel: a Cross-sectional Study.

Background:Chronic pain (CP) and mental disorders are common among active military personnel (AMP) due to their potential exposure to various physical and psychological stressors.Aim:The aim of this study was to evaluate pain perception and beliefs regarding their pain among AMP suffering from CP using self-reported measures, and to understand the development and persistence of pain in AMP.Methods:Sixty male AMP outpatients suffering CP were included. All participants completed the following forms and questionnaires: Oswestry Disability Index(ODI), Visual Analogue Scale(VAS), Neck Disability Index(NDI), Bournemouth Questionnaire for neck(BQN), International Physical Activity Questionnaire(IPAQ), Hospital Anxiety and Depression Index(HADS), 36-item Short Form Survey(SF-36), Automatic Thoughts Questionnaire(ATQ), and Pain Belief Questionnaire(PBQ).Results:The mean age of the participants was 22.85±3.50 years, the median duration and frequency of pain were 12 months and 14.5 days in a month, respectively. The median of ODI scores was 26; three of patients were evaluated as crippled while 8 patients had severe disability. The HADS and PBQ-psychological scores were high in the patient group. Positive correlations were found between pain frequency and the ODI, VAS, NDI and PBQ-psychological scores. Relationships were also shown between PBQ-psychological and the VAS and ATQ scores. Correlations between ODI scores and ATQ scores were also revealed.Conclusions:Our results suggest that, in addition to the organic basis of pain, there is strong evidence for significant contribution from the psychological characteristics and pain-related beliefs of the patients. Physicians may choose a multi-dimensional perspective in the diagnosis and treatment of pain, especially in patients suffering from CP.

Evaluation of Pain as a Fifth Vital Sign: Nurses' Opinions and Beliefs

Objective:After the American Pain Society recognized pain as a fifth vital sign, many countries adopted similar pain screening approaches. The routine evaluation of pain has recently come to the agenda in Turkey, along with the important role played by nurses in pain evaluation, and hence, this study focuses on the opinions of nurses on the evaluation of pain as a fifth vital sign, their pain beliefs, and how their pain beliefs influence their opinions.Methods:This descriptive study was conducted in a City Hospital with the involvement of 223 nurses. A questionnaire and a Pain Beliefs Questionnaire were used for the collection of data, and the data were analyzed using descriptive statistics, and Mann–Whitney U-test, analysis of variance, and Kruskal–Wallis tests.Results:Of the respondent nurses, 31.8% of the nurses were working in medical inpatient clinics, and 56.5% stated that pain should not be evaluated as a fifth vital sign, giving the following reasons: if patients are in pain, they already report it (40.5%), and overwork and the lack of sufficient nurses (34.9%). There was no difference in the pain beliefs scores of the nurses who stated that pain should not be evaluated as a fifth vital sign (56.5%) and the scores of those who stated the opposite (43.5%) (P > 0.05).Conclusions:Most of the nurses do not think that pain should be evaluated as a fifth vital sign. Furthermore, the pain beliefs of nurses do not influence their opinions regarding the assessment of pain as a fifth vital sign.

YAŞLI BİREYLERİN AĞRI İNANÇLARI VE DEPRESYON DÜZEYLERİNİ ETKİLEYEN FAKTÖRLER

Aim: The aim of the study was to evaluate factors affecting pain beliefs and depression levels of elderly ındividuals who apply to the family health center Material and Methods: Sample of the study with cross-sectional qualities consisted of 413 elderly individuals who applied to Family Health Center between February-March 2020. Data were collected by Patient Information form, Pain Beliefs Scale (PBS) and Geriatric Depression Scale (GDS). Results: It has been determined that 72% of elderly individuals experience constant pain. “Organic Beliefs” sub-dimension average score of elderly individuals was found to be 2.91±0.74 while “Psychological Beliefs” sub-dimension average score was 2.86±0.83. The 'organic beliefs' sub-dimension mean scores of men, those who felt their general health well and who stated that they did not experience constant pain in the last 6 months were higher. The "psychological beliefs" sub-dimension point average of those with bad income level was found higher. 47.9% of the elderly individuals participating in the research are in definite depression. Among the elderly individuals, women, those who are single, those who have a fragmented family type, those who feel the health condition very badly and who have experienced constant pain in the last 6 months GDÖ levels are higher. A medium-level positive relationship was found between organic beliefs and GDÖ. Conclusion: It was found that the vast majority of elderly individuals experience constant pain. In addition, elderly individuals believe that pain has organic causes and almost half of them experience depression. It has been determined that as the organic pain beliefs increase in elderly individuals, their depression levels increase.

Pain beliefs of chronic headache patients

This study was designed to explore the origin of the pain beliefs of chronic headache patients.This qualitative research has been designed using a case study method. Selected using the criterion sampling method, patients consisted of a total of six chronic headache patients in algology outpatient clinic at a University Hospital in Turkey. The data were collected using focus group methods. Data were obtained using a semi-structured interview form composed of eight open-ended questions. Data were evaluated by analyzing both descriptive and content data.Chronic headache patients' views on why they have pain and which beliefs they have about origin of the pain have three subthemes: (1) Organic beliefs, (2) psychological beliefs, and (3) environmental beliefs. Patients' most frequently cited organic beliefs were genetics (familial) and physiological (tissue damage, surgery, and lifting of heavy objects). Patients' most frequently cited psychological beliefs were stress, sadness, and having a sensitive personality.It is suggested to take pain beliefs differences and qualitative research into consideration in the management of pain in nursing care.

Fibromyalji Sendromu Hastalarının Ağrı İnançları ile Psikiyatrik Belirtileri Arasındaki İlişki

Aim: This study was conducted to examine the relationship between the pain beliefs and psychiatric symptoms of the patients with fibromyalgia syndrome (FMS).Material and Methods: This cross-sectional study was conducted with 145 patients diagnosed with FMS between August 2018 and January 2019 in the Physical Therapy and Rehabilitation polyclinic of Aksaray University Training and Research Hospital. The sociodemographic data form prepared by authors, Pain Beliefs Scale (PBS), Depression Anxiety Stress Scale (DASS) and Visual Analogue Scale (VAS) were applied to the patients.Results: Mean age of FMS patients is 35.42±9.10 years, 57.9% (n=84) are female, 70.3% (n=102) are married and 95.9% (n=139) live in nuclear families. Of the patients, 46.9% (n=68) were reported that they perceived the pain at the severity of 9-10 (mean: 8.12±1.29) according to VAS. Mean score of organic beliefs was 4.87±0.77, and mean score of psychological beliefs was 5.17±0.52. It was found that depression (62.8%) and anxiety (33.1%) levels were very advanced, and stress (45.5%) levels were advanced. A statistically significant positive correlation was detected between the DASS total and the subscales of depression, anxiety and stress and both organic beliefs and psychological beliefs (all p values &amp;lt;0.001).Conclusion: The patients' pain beliefs and pain perception levels were found high and the rate of accompanying psychiatric symptoms was also high. While the patients' pain beliefs increase, their depression, anxiety and stress levels also increase. It is important to use holistic approaches to strengthen the response given to treatment in patients with FMS.

Chronic Whiplash Associated Disorders: Disability, Pain (Beliefs), Central Sensitization and Brain Activity

Chronic Whiplash Associated Disorders: Disability, Pain (Beliefs), Central Sensitization and Brain Activity