Chronic Pain Coping Inventory Research Articles

Translation and validation of the simplified Chinese version of the Chronic Pain Coping Inventory-42

BackgroundThe Chronic Pain Coping Inventory-42(CPCI-42) is mainly used for chronic pain management project, its original version is written in English and has been widely used in western countries. Therefore, the purpose of our study is to apply the CPCI-42 to Chinese patients and evaluate its responsiveness, reliability, and validity for Chinese patients with lumbar disc herniation (LDH).MethodsTranslation and adaptation were carried out in accordance with the guidelines of the American Academy of Orthopedic Surgeons Outcome Committee. A total of 133 patients who were diagnosed with LDH were included in this study. Psychometric evaluations were then performed and included score distribution, internal consistency, test–retest reliability, construct validity, and responsiveness.ResultsCPCI-42 is well adapted to the assessment of the cognitive and behavioral strategies of patients with LDH, and the scores of score distribution, internal consistency, test–retest reliability, construct validity, and responsiveness are excellent. Forward and reverse translation of the CPCI-42 to English from Chinese worked smoothly.ConclusionIt is applicable to the assessment of quality of life of the cognitive and behavioral strategies of patients with LDH, and the scores of all indicators are excellent.

A Rasch Analysis of the Chronic Pain Coping Inventory-Brazilian Version.

The Rasch model has not yet been used to evaluate the Chronic Pain Coping Inventory (CPCI), a tool used worldwide to measure coping with chronic pain. Analyze the adjustment of the CPCI-Brazilian version and its scales to the Rasch model. CPCI Rasch analysis with 705 outpatients from a Brazilian hospital. The set of Illness-Focused coping strategies presented as a one-dimensional scale. The Rasch reliability of the person item ranged between 0.33 and 0.89, and 0.29 and 0.99, respectively. There were misfits for items 35 (MNSQOutfit = 2.12) and 54 (MNSQOutfit = 2.92), and DIF of one item regarding gender. The Wright map revealed some gaps in coping measurement. The scales of CPCIBrazilian Version fitted to the Rasch model after adjustments in the categories of response and exclusion of items 35 and 54.

Structural validity of the Chronic Pain Coping Inventory-Brazilian version.

BackgroundThe Chronic Pain Coping Inventory (CPCI) has been widely used to measure coping with pain, however, the psychometric properties of the Brazilian CPCI are unknown.AimTo verify the validity and reliability of the CPCI-Brazilian version.Materials and methodsA sample of 705 outpatients with chronic pain participated in the study. Cronbach’s alpha, corrected item-total correlations, and confirmatory factor analysis were performed, using the method of Diagonally Weighted Least Squares.ResultsConstruct validity was supported with a factor loading range of 0.36–0.90 (9 factors) corroborating original loads. The final model had adequate fit with items 42 and 54 excluded, D.F = 2174, TLI = 0.96; CFI = 0.96 and RMSEA = 0.051(p = 0.067). Eight of the nine CPCI scales showed satisfactory reliability (Cronbach’s alpha ranged from 0.70 to 0.92). The Relaxation scale obtained a low alpha value (0.53).ConclusionThe CPCI-Brazilian version, after exclusion of items 42 and 54, is valid to measure chronic pain coping in Brazilian adults.

Quality of life in chronic pain patients: Illness- and wellness-focused coping as moderators.

Chronic pain is a health problem that significantly influences patients' lives, causing functional, social, socioeconomic, and emotional changes that impact quality of life (QoL). The aim of this study was to evaluate which variables (e.g., psychological morbidity, illness representations, pain, and coping) contribute to QoL and to analyse the moderating role of illness- and wellness-focused coping in the relationship between pain interference and Qol, in chronic pain patients. A sociodemographic and clinical questionnaire, the Brief Illness Perception Questionnaire, the Pain Catastrophizing Scale, the Hospital Anxiety and Depression Scale, the Chronic Pain Coping Inventory, the Short Form Health Survey, and the Brief Pain Inventory were completed by 103 patients with chronic pain. Greater use of wellness-focused coping and being professionally active were associated with better physical QoL. Cognitive representations and illness-focused coping contributed to physical QoL, and psychological morbidity contributed to mental QoL. Illness-focused coping and wellness-focused coping moderated the relationship between pain interference and physical QoL, but not with mental QoL. Since pain interference was positively related to psychological morbidity, and the latter was negatively related to QoL, it is extremely important to evaluate and promote patients' coping strategies that are focused on well-being to improve QoL. Results from this study underline the relevance of a multidisciplinary approach to chronic pain and the need to account for psychological morbidity and coping strategies in intervention programs to promote QoL in chronic pain patients.

Typology of pain coping and associations with physical health, mental health, and pain profiles in Hong Kong Chinese older adults

Objectives To identify typology of pain coping in older adults and to see whether the coping types or patterns were associated with pain, physical health, and mental health outcomes. Methods Six hundred and fifty six Chinese older adults were recruited on a convenience basis from social centers in Hong Kong. A 14-item Brief Pain Coping Scale (BPCS) was constructed on the basis of the Chronic Pain Coping Inventory. Outcome measures included pain intensity, pain disability, pain-related cognitions, depressive symptoms, health-related quality of life, and health and physical functioning (in terms of chronic illnesses, basic and instrumental activities of daily living, and self-rated health). Coping typology was identified using latent class analysis. Results A 3-class solution based on BPCS provided the best fit to data. Class 1 used almost all coping strategies on a daily basis, Class 2 used the strategies less frequently, whereas Class 3 adopted few strategies. Yet, Class 3 was basically indistinguishable from Class 1 across the outcome variables, even though the participants had more chronic illnesses and poorer instrumental activities of daily living than those in Class 1. Class 2, however, had the poorest outcome profiles, reporting more pain, disability, depression, and health-related quality of life than the other two classes. The differences in coping could not be explained by the differential effectiveness of coping strategies across groups. Conclusion The way coping was used, and the way it was related to pain, mood, health and functioning outcomes, varied substantially across individuals. Implications for coping skills interventions are discussed.

Adaptive and maladaptive coping strategies in older adults with chronic pain after lumbar surgery.

This study investigated whether adaptive and maladaptive coping strategies mediate the association between chronic pain and health-related quality of life among older adults experiencing chronic pain after lumbar surgery. Participants were 103 older adults with either or both of chronic lower back pain and leg pain after lumbar surgery (median age = 75 years, men = 44, women = 59). Intensity of chronic lower back and leg pain (11-point numerical rating scale), physical activities (Physical Activity Scale for the Elderly) as an adaptive coping strategy, maladaptive coping strategies (e.g. guarding, resting; Chronic Pain Coping Inventory), and health-related quality of life (12-item Short-Form Health Survey) were measured. Hypothetical models with adaptive and maladaptive coping strategies as mediators of pain intensity and health-related quality of life were tested using structural equation modeling. Model fitness was acceptable (adjusted goodness of fit index: 0.94-0.98, comparative fit index: 1.00, root mean square error of approximation: 0.00). The results showed that (1) the adaptive coping strategy of physical activity positively mediated the association between lower back and leg pain, and physical health but not mental and social health; (2) maladaptive coping strategies negatively mediated the association between pain and physical, mental, and social health; (3) physical activities were negatively associated with maladaptive coping strategies. This study demonstrated that adaptive and maladaptive coping strategies serve as mediators of the relationship between chronic pain and health-related quality of life in older adults after lumbar surgery.

<p>Chronic Pain, Mood Disorders and Substance Use: Outcomes of Interdisciplinary Care in a Residential Psychiatric Hospital</p>

PurposeThe objective is to report outcomes of an interdisciplinary group-based residential chronic pain recovery program (CPRC), located in a private non-profit psychiatric hospital. The chronic pain program was aimed at treatment and engagement in self-care of both pain and co-occurring disorders in a residential facility that also offered treatment for specific psychiatric disorders.Patients and MethodsA retrospective chart review was conducted that included a convenience sample of 131 patients admitted from March 2012 through August 2017 who completed treatment. An interdisciplinary team of professionals provided psycho-behavioral therapy, movement therapies and medication management. Patients completed a battery of psycho-social and demographic questionnaires on admission and before discharge of the program.ResultsSignificant differences were noted in pain severity, pain interference, depression and anxiety (p<.01) between admission and discharge, and the Chronic Pain Coping Inventory demonstrated significant differences in guarding (p <.001), asking (p =.018), exercise (p <.001), relaxation (p <.001), and pacing (p=.024). Of patients using opioids on admission, at discharge, 37% had tapered and remained off all opioids, 43% were using buprenorphine for opioid use disorder, and 20% continued on analgesic opioids.ConclusionTreatment was associated with reductions in pain severity and interference, in anxiety and in depression as well as improvements in pain coping. Additionally, there was a reduction in reliance on opioids for pain relief.

Efficacy of two brief cognitive-behavioral rehabilitation programs for chronic neck pain: results of a randomized controlled pilot study.

Current models of pain behavior suggest that kinesiophobia prevents the reacquisition of normal function, promotes the development of maladaptive coping strategies, and contributes to the disability associated with chronic neck pain (NP). Comparing two brief cognitive-behavioral programs aimed at managing kinesiophobia to understand which one induces better short-term improvements in disability, fear of movement, catastrophizing, adaptive coping strategies, quality of life (QoL), and pain intensity of chronic NP. Pilot, randomized, controlled trial, 3-months follow-up. Outpatients. Subjects with chronic NP. The population was randomized into two groups: group A (N.=15) underwent four sessions of cognitive-behavioral therapy (CBT) based on the NeckPix© (1-week duration); group B (N.=15) received four sessions of CBT based on the Tampa Scale of Kinesiophobia (TSK) (1-week duration). Afterwards, both groups attended 10 sessions of multimodal exercises (5-week duration). Primary measure: Neck Disability Index (NDI). Secondary measures: NeckPix©, TSK, Pain Catastrophizing Scale, Chronic Pain Coping Inventory, EuroQol-Five Dimensions, and pain intensity Numerical Rating Scale. Linear mixed model analyses for repeated measures for each outcome measure to evaluate changes over time and between group. A significant effect of time was found for all outcomes, while no outcomes showed group and/or interaction effects. No changes were found in terms of NDI at the end of CBT, while a significant improvement of about 13 points was found for both groups at the end of the motor training (P=0.001). Similarly, in terms of quality of life there was no change after the CBT program, and a significant change at the end of the motor training, with a partial loss at follow-up. From CBT sessions to follow-up both groups showed a progressive reduction in kinesiophobia, with each group achieving a bigger change in the specific scale used for the CBT program. Two brief cognitive-behavioral rehabilitation programs based on different methodologies of managing fear-avoidance beliefs induced similar short-term improvements in subjects with chronic NP. Clinically significant changes in terms of disability were found in both groups only at the end of a 5-week motor training, regardless of the cognitive-behavioral rehabilitation program previously administrated. Treatment of chronic NP requires cognitive modifications closely linked to physical performances in order to achieve mental adjustments and guarantee cognitive-behavioral as well as motor lasting changes.

Cross-cultural adaptation of Chronic Pain Coping Inventory - Brazilian version

ABSTRACT BACKGROUND AND OBJECTIVES: The Chronic Pain Coping Inventory is a widely used instrument to evaluate pain coping, however, there are no Brazilian publications about this tool. The objective of the study was to adapt the Chronic Pain Coping Inventory to the Brazilian culture. METHODS: According to the international guidelines for cross-cultural adaptation of measurement instruments, the study was developed in the stages: planning, translation, synthesis, analysis by an expert committee, back-translation, evaluation by the original author, discussion with lay people, pre-test and final evaluation. RESULTS: A pre-test of the consensus version approved by the committee was conducted with 59 people, resulting in the Brazilian Version of the Chronic Pain Coping Inventory adapted according to the Brazilian culture. A preliminary reliability analysis showed adequate values for the subscale of protection, ask for help, seek social support, coping self-statements and exercise/stretch. Its use in clinical practice and research shows a promising future towards a multidisciplinary pain management in Brazil. CONCLUSION: Future research is needed to determine the psychometric properties of the Brazilian version of the Chronic Pain Coping Inventory and to confirm the need to include items related to religious practices, and the use of pharmacological methods and complementary therapies as coping strategies for chronic pain.

Symptoms of chronic fatigue syndrome/myalgic encephalopathy are not determined by activity pacing when measured using the chronic pain coping inventory

Symptoms of chronic fatigue syndrome/myalgic encephalopathy are not determined by activity pacing when measured using the chronic pain coping inventory

Symptoms of chronic fatigue syndrome/myalgic encephalopathy are not determined by activity pacing when measured by the chronic pain coping inventory

ObjectivesChronic fatigue syndrome/myalgic encephalopathy (CFS/ME) is a chronic illness which can cause significant fatigue, pain and disability. Activity pacing is frequently advocated as a beneficial coping strategy, however, it is unclear whether pacing is significantly associated with symptoms in people with CFS/ME. The first aim of this study was therefore to explore the cross-sectional associations between pacing and levels of pain, disability and fatigue. The second aim was to explore whether changes in activity pacing following participation in a symptom management programme were related to changes in clinical outcomes. DesignCross-sectional study exploring the relationships between pacing, pain, disability and fatigue (n=114) and pre–post treatment longitudinal study of a cohort of patients participating in a symptom management programme (n=35). SettingOut-patient physiotherapy CFS/ME service. ParticipantsOne-hundred and fourteen adult patients with CFS/ME. Main outcome measuresPacing was assessed using the chronic pain coping inventory. Pain was measured using a Numeric Pain Rating Scale, fatigue with the Chalder Fatigue Scale and disability with the Fibromyalgia Impact Questionnaire. ResultsNo significant associations were observed between activity pacing and levels of pain, disability or fatigue. Likewise, changes in pacing were not significantly associated with changes in pain, disability or fatigue following treatment. ConclusionsActivity pacing does not appear to be a significant determinant of pain, fatigue or disability in people with CFS/ME when measured with the chronic pain coping index. Consequently, the utility and measurement of pacing require further investigation.

Validation of the French Version of the "Patterns of Activity Measure" in Patients with Chronic Musculoskeletal Pain.

Background. The “Patterns of Activity Measure” (POAM-P) is a self-administered questionnaire that assesses “avoidance”, “pacing” and “overdoing” activity patterns in chronic pain patients. Objectives. To adapt the POAM-P to French (“POAM-P/F”) and test its validity and reliability in Chronic Musculo-Skeletal Pain patients (CMSP). Methods. We followed the recommended procedure for translation of questionnaires. Five hundred and ninety five inpatients, admitted to a tertiary rehab center in the French-speaking part of Switzerland for chronic pain after orthopedic trauma, were included (sex ratio M/F = 4.36, mean age 43 ± 12). Face, content and criterion validities, internal consistency and reliability were assessed. Data included: TAMPA Scale for Kinesiophobia (TSK), Chronic Pain Coping Inventory (CPCI), Pain Catastrophizing Scale (PCS), Brief Pain Inventory (BPI), Hospital Anxiety and Depression Scale (HADS). Results. Face and content validities were checked during the translation process. Correlations between POAM-P/F-avoidance and TSK, POAM-P/F-pacing and CPCI-pacing, POAM-P/F-overdoing and CPCI-task persistence were highly significant (r > 0.3, p < 10−2). The three subscales demonstrated excellent homogeneity (Cronbach's alpha coefficients > 0.8) and test-retest reliability (Intraclass Correlation Coefficients > 0.8). They correlated very differently with the other scales. Discussion and Conclusion. The three POAM-P/F subscales clearly assess different behaviors in CMSP. The POAM-P/F is a suitable questionnaire for classifying French speaking CMSP into avoiders, pacers or overdoers.

Companion-Animals’ Effectiveness in Managing Chronic Pain in Adult Community Members

ABSTRACTTherapy animals have been found to alleviate pain in healthcare settings, but companion-animal owners report greater discomfort and use more analgesics than people who do not own one or more companion animals. To investigate this anomaly, 173 adults completed an online survey that included questions about themselves and any companion animal they owned, the Depression Anxiety and Stress Scales, the Numeric Pain Rating Scale, and a modified version of the Chronic Pain Coping Inventory-42. Participants were also invited to contact the researchers to expand on their responses in a semi-structured interview, to which seven owners responded. There was no significant difference between reported pain levels in owners versus non-owners. However, companion-animal owners who reported actively using human–animal interactions to manage their pain rated this as moderately helpful and reported lower pain levels than other owners. There were also no significant differences between owners’ and non-owners’ anxiety or stress levels. Companion-animal owners reported more depressive symptoms than non-owners, but owners with animals perceived as more friendly reported fewer depressive symptoms. Dog owners comprised most of the sample and, for these participants, there was a negative association between perceived dog friendliness and levels of depression and anxiety. Those with more disobedient dogs also experienced greater stress. Interviewees reported that their companion animals helped them cope with pain in many ways, including provision of social and emotional support and by providing a sense of purpose in life. These findings indicate that some, but not all, companion animals may be beneficial for participants with chronic pain. Since the benefits appear to be associated with the species and personality of the animal, and with whether the person actively uses human–animal interactions as a pain-coping mechanism, care should be taken before recommending companion-animal ownership to persons suffering from chronic pain.

Overactivity in daily life: a crucial step in understanding how to tailor treatments.

Overactivity in daily life: a crucial step in understanding how to tailor treatments.

Integrating virtual reality with activity management for the treatment of fibromyalgia: acceptability and preliminary efficacy.

Cognitive-behavioral therapies (CBT) for fibromyalgia syndrome (FMS) are important interventions in the management of this condition. Empirical evidence reports that although the results are promising, further research is needed to respond more appropriately to these patients. This study focuses on exploring the use of Virtual Reality (VR) as an adjunct to the activity management component. The aim of this study is to present the results of a small-sized randomized controlled trial to test the preliminary efficacy and acceptability of this component. The final sample was composed of 61 women diagnosed with FMS according to the American College of Rheumatology. The sample was randomly allocated to 2 conditions: VR treatment and treatment as usual. Participants in the VR condition achieved significant improvements in the primary outcome: disability measured with the FIQ. The improvement was also significant in secondary outcomes, such as perceived quality of life and some of the coping strategies included in the Chronic Pain Coping Inventory: task persistence and exercise. There were no differences in other secondary outcome measures like pain intensity and interference and depression. Participants reported high satisfaction with the VR component. The effects were related to the psychological aspects targeted in the treatment. The component was well accepted by FMS patients referred from a public hospital. These findings show that the VR component could be useful in the CBT treatment of FMS and encourage us to continue exploring the use of integrating VR with CBT interventions for the treatment of FMS.

The effect of pain on quality of life before and after the surgical treatment of lumbar vertebral canal stenosis

To evaluate the efficacy of surgical treatment of lumbar vertebral canal stenosis based on the study of patient's pain and emotional status, quality of life and level of disability before and after surgical treatment. A complex examination of 163 patients with lumbar vertebral canal stenosis was carried out. The visual analogous scale, Paindetect (PD) and Douleur neuropathique 4 (DN4), the Chronic Pain Coping Inventory, the Oswestry low back pain disability questionnaire were used. Affective disorders were measured using Beck depression scale. Blood serum and thrombocytic serotonin were determined with ELISA. Patients were examined at admission before the surgery, at discharge from the hospital after surgical treatment and one year after the surgery. Before surgery, the patients had chronic pain syndrome of mixed etiology (nociceptive and neurotic type) and neurological disorders that significantly affected quality of life and work capacity. Neuropathic pain and depression, reduced quality of life and daily activities were more pronounced in patients with central canal stenosis compared to patients with lateral stenosis. The timely surgical treatment of lumbar vertebral canal stenosis promoted the decompression of nervous structures. A significant reduction of pain syndrome and the level of depression as well as the improvement of quality of life were observed.

The Italian version of the Pain Beliefs and Perceptions Inventory: cross-cultural adaptation, factor analysis, reliability and validity

To create an Italian version of the Pain Beliefs and Perceptions Inventory (PBAPI-I) and evaluate its psychometric properties. The PBAPI was culturally adapted in accordance with international standards. The psychometric testing included factor analysis, investigating reliability by internal consistency (Cronbach's alpha) and test/retest stability (intraclass correlation coefficient, ICC), and exploring construct validity by comparing the PBAPI-I with a pain numerical rating scale (NRS), the Roland Morris Disability Questionnaire (RMDQ), the Pain Catastrophizing Scale (PCS), the Tampa Scale of Kinesiophobia (TSK), the Hospital Anxiety and Depression Score (HADS) and the Chronic Pain Coping Inventory (Pearson's correlation). One hundred and sixty-seven subjects with chronic low back pain (83% compliance) completed the tool. Factor analysis revealed a three-factor (Time, Mystery and Self-Blame), 16-item solution (explained variance: 80%). The questionnaire was internally consistent (α=0.91-0.96), and its stability was good (ICCs=0.73-0.82). As expected, the construct validity estimates indicated that the Time and Mystery subscales moderately correlated with the NRS (r=0.33-0.54), RMDQ (r=0.34-0.47), PCS (r=0.37-0.49) and TSK (r=0.30-0.43), whereas the correlations between the Self-Blame subscale and the same measures were poorer. The correlations with the HADS were moderate and poor (anxiety: r=0.37-0.05; depression: r=0.39-0.07). Maladaptive coping strategies were more related to pain beliefs than adaptive strategies. The PBAPI-I has good psychometric properties that replicate those of other versions.

Psychometric properties of the Polish language version of the chronic pain coping inventory-42 for patients treated surgically due to herniated lumbar discs and spondylotic changes.

BackgroundThe development of a pain-management program tailored to the specific needs of patients with chronic low back pain (CLBP) requires the proper assessment of psychosocial factors affecting each individual. The Chronic Pain Coping Inventory-42 (CPCI-42) refers to coping strategies, which are commonly defined as the cognitive and behavioral techniques an individual may resort to in stressful or demanding situations. Evidence from a number of sources suggests that differences in pain coping strategies may significantly affect how an individual deals with chronic pain. We aimed to adapt the CPCI-42 to Polish cultural conditions (PL-CPCI-42) and then verify its psychometric properties based on a group of patients treated surgically due to herniated lumbar discs and coexisting spondylotic changes.Material/MethodsThe average age of the study participants (n=90) was 43.47 years (SD 10.21). The average duration of chronic low back pain (CLBP) was 49.37 months (SD 64.71). Lumbosacral spine X-rays and magnetic resonance imaging scans were performed and all patients completed the PL-CPCI-42 and the Polish versions of the Numeric Pain Rating Scale (NPRS-PL) twice. Internal consistency of the PL-CPCI-42, floor and ceiling effects, test-retest reliability, and criterion validity were analyzed.ResultsResting, guarding, and coping self-statements were frequently used as coping strategies both in the test and in the retest, in contrast to relaxation and exercise/stretch. The NPRS-PL result was 5.70 cm in the test and 5.66 in the retest. Cronbach’s alpha values were recorded for the asking for assistance, coping self-statements, and seeking social support domains (0.83, 0.80, 0.83, respectively). Test-retest reliability of the PL-CPCI-42 varied from 0.53 (relaxation domain) to 0.84 (asking for assistance and coping self-statements domains).ConclusionsThe present study provides evidence of the validity of the PL-CPCI-42 and supports its usefulness in assessing chronic pain coping strategies, which are especially important to pain adjustment and in the creation of multidisciplinary pain management programs for patients with severe CLBP.

The 27-item coping strategies questionnaire-revised: confirmatory factor analysis, reliability and validity in Italian-speaking subjects with chronic pain.

Increasing attention is being devoted to cognitive-behavioural measures to improve interventions for chronic pain. To develop an Italian version of the Coping Strategies Questionnaire - Revised (CSQ-R), and to validate it in a study involving 345 Italian subjects with chronic pain. The questionnaire was developed following international recommendations. The psychometric analyses included confirmatory factor analysis; reliability, assessed by internal consistency (Cronbach's alpha) and test-retest reliability (intraclass correlation coefficients); and construct validity, assessed by calculating the correlations between the subscales of the CSQ-R and measures of pain (numerical rating scale), disability (Sickness Impact Profile - Roland Scale), depression (Center for Epidemiological Studies - Depression Scale) and coping (Chronic Pain Coping Inventory) (Pearson's correlation). Confirmatory factor analysis revealed that the CSQ-R model had an acceptable data-model fit (comparative fit index and normed fit index ≥0.90, root mean square error of approximation ≤0.08). Cronbach's alpha was satisfactory (CSQ-R 0.914 to 0.961), and the intraclass correlation coefficients were good⁄excellent (CSQ-R 0.850 to 0.918). As expected, the correlations with the numerical rating scale, Sickness Impact Profile - Roland Scale, Center for Epidemiological Studies - Depression Scale and Chronic Pain Coping Inventory highlighted the adaptive and maladaptive properties of most of the CSQ-R subscales. The CSQ-R was successfully translated into Italian. The translation proved to have good factorial structure, and its psychometric properties are similar to those of the original and other adapted versions. Its use is recommended for clinical and research purposes in Italy and abroad.

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

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 ...