Profile Of Chronic Pain Research Articles

GS02 **INGUINAL HERNIA REPAIR WITH UHS – A SINGLE SURGEON REVIEW

Purpose: Inguinal hernia repair is a common operation with much focus in recent times on improving morbidity. The use of mesh repair has greatly decreased reoccurrence rates and focus turns towards improving postoperative groin pain. This review examines the use of UHS in inguinal hernia repair and relation with postoperative groin pain.Methods: A retrospective audit of consecutive cases over one year (telephone and mailed questionnaires) was conducted. The recently validated IPQ (inguinal pain score) was used. A review of files and operative reports was also undertaken. Cases undergoing bilateral repair, or other operations simultaneously were excluded.Results: 59 patients (61%) participated in the audit, with a mean follow up of 11 months (range 5–16). 4 minor wound complications occurred. Higher pain scores appeared to correlate preoperatively with age and workers compensation status. Postoperative pain scores and limitation to functional status were low, and trended towards lower values in the UHS (ultrapro hernia system) repair group compared to the group who underwent repair with PHS (preceding week pain scores respectively –UHS repair, mean 1.22, (95%CI 1.07–1.38); PHS 1.76, (95%CI 1.11–2.43)). The average time until pain disappeared in the groin was within one month (IPQ score of 1.27). For those patients still experiencing any pain, (14 of 59; 23.7%) it occurred on average, once per week for minutes to hours and was at a level that could be ignored.Conclusion: Inguinal hernia repair with UHS appears to be a safe procedure with minimal complications and a favourable postoperative chronic pain profile.

Perceptions of Chronic Pain’s Interference with Sexual Functioning: The Role of Gender, Treatment Status, and Psychosocial Factors

The relation between self-reported pain and sexual functioning was investigated in a national sample of adults between the ages of 25–80. Although it is believed that pain generally has a deleterious effect on sexual functioning, relatively little data are available about the psychosocial correlates of the pain-sexuality link, the pain-sexuality relation among persons not in treatment for pain, or the role of gender as a potential moderator of the relation between psychosocial factors and pain-related interference. The present study involved the screening of chronic pain via the Profile of Chronic Pain: Screen (PCP: S) and the assessment of psychosocial correlates of pain’s interfering effects on sexual performance by means of responses on the Profile of Chronic Pain: Extended Assessment Battery (PCP: EA). Results revealed that, although pain did not interfere with sexual functioning in 37% of the respondents, several psychosocial variables from the PCP: EA were linked to pain’s interference with sexual activity controlling for the effects of pain severity. Pain-induced fear, impatience, and tangible support all yielded significant main effects. Moreover, the effects of five variables (ignoring, self-talk, task persistence, belief in a medical cure, and control) varied significantly by gender, and the effects of two PCP: EA dimensions (catastrophizing and belief in a medical cure) varied by treatment status. The assessment and treatment implications of the present findings were considered.

Psychosocial Aspects of Pain-Related Life Task Interference: An Exploratory Analysis in a General Population Sample

To assess perceptions of the interfering effects of chronic pain upon the frequency of eight activities of daily living, and to examine the psychosocial correlates of these perceptions. The areas assessed included social life, recreation, sleep, household chores, working at a paid job, self-care, exercise, and routine physical activities. A telephone survey of U.S. English-speaking adults was conducted using a random digit dialing recruitment procedure. The data are cross-sectional. A national sample of adult men and women aged 25-80 years was recruited. A total of 9,759 persons were screened for the presence of chronic pain. Of the 3,050 found eligible, a total of 2,407 adults with chronic pain completed measures of pain interference and its psychosocial correlates. Participants provided responses to the Profile of Chronic Pain: Screen (PCP: S) and to the Profile of Chronic Pain: Extended Assessment (PCP: EA) battery. The PCP: S measures key aspects of chronic pain, and the PCP: EA assesses pain attitudes and beliefs, coping, and positive and negative social responses to pain. Regression analyses revealed that pain severity, along with factors assessed by the PCP: EA (including catastrophizing, fear of pain, guarding, and control beliefs), accounts for 16-40% of the variance in perceptions of functional task interference. Although pain severity is consistently related to life task interference, several psychosocial variables make incremental contributions to the perception of pain's deleterious influence on daily task functioning.

Evaluating Chronic Pain Impact among Patients in Primary Care: Further Validation of a Brief Assessment Instrument

To evaluate the psychometric properties of the Profile of Chronic Pain: Screen (PCP:S) in primary care. The PCP:S is a brief assessment device designed to gauge pain severity, interference, and emotional burden. Questionnaire survey with short-term reliability and validity follow-up. Two hundred and forty-four outpatients (52% female) with chronic pain recruited from five primary care settings completed the 15-item PCP:S at an initial testing session. Approximately 1 week later, two subgroups participated in a retest reliability and validity follow-up. The battery of follow-up questionnaires included a measure of social desirability response bias and several instruments designed to provide convergent validity for the PCP:S. Retest reliability, internal consistency, factor structure, and social desirability bias were all found to be acceptable. Likewise, preliminary evidence suggests that, by virtue of its correlation with established measures of pain adjustment, the PCP:S is a valid pain assessment device. Although the PCP:S was initially developed and validated using a national community sample of adults with chronic pain who provided data via telephone interviews, the present findings support its use as a brief and psychometrically sound paper-and-pencil measure for the assessment of three key components of chronic pain in primary care.

Psychological “resilience” and its correlates in chronic pain: Findings from a national community sample

The display of effective functioning despite exposure to stressful circumstances and/or internal distress is often termed ‘resilience’. The study of resilience is believed to provide information about the nature of illness adaptation that is distinct from that obtained via the analysis of clinically impaired groups. In recent years, the concept of resilience has seen only limited exploration in the chronic pain literature. This article describes a multi-step procedure that first identifies resilience among chronic pain sufferers selected from a national sample of adults and then examines a set of its psychological correlates. Using the Profile of Chronic Pain:Screen (PCP:S), administered to a national sample of adults with chronic pain, a resilient subsample was identified on the basis of high scores on a Severity scale (at least 1 SD above the mean) combined with low scores (at least 1 SD below the mean) on scales assessing Interference and Emotional Burden. An age- and gender-matched non-resilient subsample was then selected who scored high (at least one standard deviation above the mean) on Severity, Interference, and Emotional Burden. The results of a series of comparisons between the resilient and non-resilient groups revealed significant differences favoring resilient individuals in coping style, pain attitudes and beliefs, catastrophizing tendencies, positive and negative social responses to pain, and health care and medication utilization patterns. The findings provide a preliminary foundation for further research aimed at understanding the nature and causal underpinnings of resilience in persons with chronic pain.

The development and preliminary validation of the Profile of Chronic Pain: Extended Assessment Battery

The aim of the present research was the development and validation of a set of instruments, collectively called the Profile of Chronic Pain: Extended Assessment Battery (PCP:EA), designed to be administered to adults (between the ages of 25 to 80) after establishing the existence of a chronic pain problem. The final 86-item version of the PCP:EA consisted of 33 single items assessing: pain location and severity, pain characteristics (e.g. worst daily pain), medication use, health care status, the identity of the most important person in the patient's life, and functional limitations in 10 areas of daily living. In addition, the PCP:EA includes 13 multi-item subscales addressing aspects of coping (guarding, ignoring, task persistence, and positive self-talk), catastrophizing, pain attitudes and beliefs (including disability beliefs, belief in a medical cure for pain, belief in pain control, and pain-induced fear), and positive (tangible and emotional) and negative (insensitivity and impatience) social responses. Data were obtained from two national samples which were recruited and screened via a random-digit dialing telephone interview procedure. Stratified sampling was employed to assure equal gender and age group representation across three age groupings (25–44; 45–64; 65–80). Two survey studies provided strong evidence for the hypothesized factor structure, internal consistency, independence from response bias, and validity of the PCP:EA. Moreover, the presence of normative data enhance the diagnostic and prescriptive utility of the instrument.

The development and preliminary validation of a brief measure of chronic pain impact for use in the general population

From a biopsychosocial perspective, assessing chronic pain's psychological impact should involve at minimum the measurement of pain severity, functional interference, and pain-related emotional burden. This article details the development of a brief instrument, the 15-item Profile of Chronic Pain: Screen (PCP:S), designed to address these three key elements in a national (US) sample of over 2400 individuals recruited via random digit dialing. Retest reliability, internal consistency, and preliminary validity were excellent. The scales also demonstrated minimal social desirability response bias. A series of confirmatory factor analyses on several distinct samples revealed a stable, 3-factor solution reflecting pain severity, interference, and emotional burden. Finally, national norms were developed by gender and three age groups. In view of its strong psychometric properties, the PCP:S has the potential to serve as a brief, cost-effective assessment tool for identifying individuals whose chronic pain merits more detailed psychosocial evaluation.

Music Therapy for Children with Severe Burn Injury

Music Therapy for Children with Severe Burn Injury

Psychological factors associated with primary fibromyalgia syndrome.

Forty-five ambulatory patients with primary fibromyalgia syndrome (PFS), 30 with rheumatoid arthritis, and 32 normal controls were administered 3 psychological tests: the Minnesota Multiphasic Personality Inventory (MMPI), the Life Events Inventory, and the Assertiveness-Aggressiveness Inventory. The PFS patients scored significantly higher on 8 MMPI scales when compared with the normal control group and on 4 MMPI scales when compared with the rheumatoid arthritis group. Further subgrouping of PFS patients according to MMPI scores showed that only 31% were "psychologically disturbed," 33% had a typical chronic pain profile, and 36% were within the normal range. The PFS patients scored higher than the rheumatoid arthritis and normal control groups on the Life Events Inventory but not the Assertiveness-Aggressiveness Inventory.