Pain Endurance Research Articles

McKenzie neck exercise versus cranio-cervical flexion exercise on strength and endurance of deep neck flexor muscles, pain, disability, and craniovertebral angle in individuals with chronic neck pain: a randomized clinical trial

ABSTRACT Purpose To compare the effectiveness of McKenzie neck exercise and cranio-cervical flexion (CCF) exercise on strength and endurance of deep neck flexor (DNF) muscles, pain, disability, and craniovertebral angle (CVA) in individuals with chronic neck pain. Methods Forty individuals with chronic neck pain were randomly allocated to the McKenzie neck or CCF exercise group. Each group performed exercises at home daily. The strength and endurance of DNF muscles were measured at baseline, immediately after the first exercise session, and each week follow-up for six weeks. Average pain over the past week was measured at baseline and each week follow-up for six weeks. Disability and CVA were measured at baseline and the end of six weeks. Results At six weeks, both groups exhibited significant improvements across all outcome variables (p < 0.001) but there were no differences between groups (p > 0.05). The significant difference from baseline in the strength of DNF muscles was observed as early as the second week of each intervention (p ≤ 0.001). The significant difference from baseline in the endurance of DNF muscles was observed as early as the first week in the CCF exercise group (p < 0.05) and the second week in the McKenzie neck exercise group (p < 0.05). A significant decrease in pain intensity from baseline was observed after the first week in the McKenzie neck exercise group (p < 0.001) while it was after the second week in the CCF exercise group (p < 0.05). Conclusion Both the McKenzie neck exercise and CCF exercise produced similar effects in enhancing the strength and endurance of the DNF muscles, decreasing pain, alleviating neck disability, and improving the CVA.

Exploring the association of gender role expectations of pain and measures of pain sensitization in people with knee osteoarthritis: A cross-sectional study

ObjectivesFirst, we explored the association between Gender Role Expectations of Pain (GREP), and psychophysical measures of sensitization in people with knee osteoarthritis (OA). Second, we explored whether the association differed by level of GREP items (high vs low scores). DesignWe conducted secondary analyses of a cohort study. Those who were (i) age of ≥ 40, English or French speaking, ii) diagnosed with knee OA using American College of Rheumatology criteria and iii) consulting with an orthopedic surgeon were included. GREP items pertaining to pain sensitivity and pain endurance of the typical man or woman were rated by males and females respectively. Psychophysical tests consisted of pressure pain thresholds (PPTs), Temporal Summation (TS), and Conditioned Pain Modulation (CPM). Multiple linear regression models for males and females were run with GREP scores (independent variables) and psychophysical tests (dependent variables). Next models stratified on the median split of GREP scores were run. Models were adjusted for age, BMI, pain catastrophizing, anxio-depressive symptoms, and radiographic severity. Results280 participants (57% females; age (SD): 63.9 (9.6) and BMI (SD): 31.3 (8.40)) were included. GREP pain sensitivity scores in males were associated with CPM values (β: 95% CI: 0.09 (0.01 to 0.17)). Males with low GREP pain sensitivity or pain endurance had very small to small positive associations with PPT and CPM values. ConclusionThis first exploration of gendered pain sensitivity and pain endurance by males and females has small and clinically unimportant associations with measures of pain sensitization requiring further validation.

Gender-based differential management of acute low back pain in the emergency department: A survey based on a clinical vignette.

Women may receive suboptimal pain management compared with men, and this disparity might be related to gender stereotypes. To assess the influence of patient gender on the management of acute low back pain. We assessed pain management by 231 physicians using an online clinical vignette describing a consultation for acute low back pain in a female or male patient. The vignette was followed by a questionnaire that assessed physicians' management decisions and their gender stereotypes. We created an online clinical vignette presenting a patient with acute low back pain and assessed the influence of a patient's gender on pain management. We investigated gender-related stereotyping regarding pain care by emergency physicians using the Gender Role Expectation of Pain questionnaire. Both male and female physicians tended to consider that a typical man was more sensitive to pain, had less pain endurance, and was more willing to report pain than a typical woman. These stereotypes did not translate into significant differences in pain management between men and women. However, women tended to be referred less often for imaging examinations than men and were also prescribed lower doses of ibuprofen and opioids. The physician's gender had a modest influence on management decisions, female physicians being more likely to prescribe ancillary examinations. We observed gender stereotypes among physicians. Our findings support the hypothesis that social characteristics attributed to men and women influence pain management. Prospective clinical studies are needed to provide a deeper understanding of gender stereotypes and their impact on clinical management.

The effect of additional transcutaneous auricular vagus nerve stimulation on back muscle endurance of chronic low back pain

Background: This study aims to investigate the effects of adding transcutaneous auricular vagus nerve stimulation (tVNS) to exercise therapy on back extensor muscle endurance of patients with mechanical chronic low back pain (CLBP). Methods: A randomized controlled group study was conducted on 22 patients with mechanical CLBP aged 16-55. Participants were randomized into an exercise group (control) and an exercise with a tVNS group (experimental). The outcome was back extensor muscle endurance measured by the Biering Sorensen Test (BST), evaluated before and after 2 weeks of intervention Results: There was a significant improvement in pre-post evaluation in the intervention group (before: 40.30± 31.20 and after: 66.49±45.87, p&lt;0.05), with a large effect size (Cohen’s d=0.918). No difference in pre-post evaluation in the control group (before: 58.18±50.75; after: 66.82±38.56; p&gt;0.05) with a small effect size (Cohen’s d=0.414). There was no significant difference between the delta BST of the two groups (p=0.418). Conclusion: Our results suggest that no difference was found between the two groups. However, tVNS addition to exercise therapy showed beneficial effects potency on back muscle endurance of the experimental group in CLBP patients during a relatively short period in two weeks of intervention. Further research is needed to confirm the potential of tVNS therapy in CLBP.

The effect of recorded music on pain endurance (CRESCENDo) – A randomized controlled trial

IntroductionClarifying the effect of music on pain endurance in an experimental design could aid in how music should be applied during both surgical and non-surgical interventions. This study aims to investigate the effect of music on pain endurance and the involvement of the sympathetic adrenomedullary axis (SAM) and the hypothalamic-pituitary-adrenocortical axis (HPA). Materials and methodsIn this randomized controlled trial all participants received increasing electric stimuli through their non-dominant index finger. Participants were randomly assigned to the music group (M) receiving a 20-minute music intervention or control group (C) receiving a 20-minute resting period. The primary outcome was pain endurance, defined as amount milliampere tolerated. Secondary outcomes included anxiety level, SAM-axis based on heart rate variability (HRV) and salivary alpha-amylase, and HPA-axis activity based on salivary cortisol. ResultsIn the intention-to-treat analysis, the effect of music on pain tolerance did not statistically differ between the M and C group. A significant positive effect of music on pain endurance was noted after excluding participants with a high skin impedance (p = 0.013, CI 0.35; 2.85). Increased HRV was observed in the M-group compared to the C-group for SDNN (B/95%CI:13.80/2.22;25.39, p = 0.022), RMSSD (B/95%CI:15.97/1.64;30.31, p = 0.032), VLF (B/95%CI:212.08/60.49;363.67, p = 0.008) and HF (B/95%CI:821.15/150.78;1491.52, p = 0.0190). No statistical significance was observed in other secondary outcomes. ConclusionsThe effect of the music intervention on pain endurance was not statistically significant in the intention-to-treat analysis. The subgroup analyses revealed an increase in pain endurance in the music group after correcting for skin impedance, which could be attributed to increased parasympathetic activation.

Muscular endurance and its association with neck pain, disability, neck awareness, and kinesiophobia in patients with chronic neck pain

Background Recent studies revealed the connection between the endurance of neck muscles and pain, neck awareness, and fear of movement in patients with chronic neck pain in literature. Objectives To investigate the association between cervical, scapular, trunk, and upper extremity muscles’ endurance and neck pain, disability, neck awareness, and kinesiophobia in patients with chronic neck pain. Design Cross-sectional, observational study. Methods Thirty-six patients with chronic neck pain (aged 18–65 years) were included in the study. Endurance tests were performed for 9 muscles/muscle groups in the cervical and scapular region, upper limb, and trunk. Pain severity, neck disability, neck awareness, and fear of movement were measured by Visual Analog Scale (VAS), Neck Disability Index (NDI), Fremantle Neck Awareness Questionnaire (FreNAQ), and Tampa Scale of Kinesiophobia (TSK), respectively. Results Negative, weak-to-moderate relations were found between VAS (at rest and during activity) and the endurance of muscles evaluated in the cervical and scapular regions, upper extremity, and trunk as well as between NDI and endurance of the same muscles, similar to the relations between FreNAQ scores and the endurance of the cervical flexor, anterior trunk flexor, and upper extremity muscles (p < 0.05). No relation was found between the endurance of the muscles and TSK (p > 0.05). Conclusions Since the decrease in upper extremity, scapular region, and trunk muscles’ endurance may contribute to neck pain and disability, and decrease neck awareness in patients with chronic neck pain; the evaluation of muscular endurance of upper body and trunk should also be considered. Clinical Trials NCT05121467

Resting-state neural mechanisms of capability for suicide and their interaction with pain – A CAN-BIND-05 Study

BackgroundSuicidal ideation is highly prevalent in Major Depressive Disorder (MDD). However, the factors determining who will transition from ideation to attempt are not established. Emerging research points to suicide capability (SC), which reflects fearlessness of death and increased pain tolerance, as a construct mediating this transition. This Canadian Biomarker Integration Network in Depression study (CANBIND-5) aimed to identify the neural basis of SC and its interaction with pain as a marker of suicide attempt. MethodsMDD patients (n = 20) with suicide risk and healthy controls (n = 21) completed a self-report SC scale and a cold pressor task measuring pain threshold, tolerance, endurance, and intensity at threshold and tolerance. All participants underwent a resting-state brain scan and functional connectivity was examined for 4 regions: anterior insula (aIC), posterior insula (pIC), anterior mid-cingulate cortex (aMCC) and subgenual anterior cingulate cortex (sgACC). ResultsIn MDD, SC correlated positively with pain endurance and negatively with threshold intensity. Furthermore, SC correlated with the connectivity of aIC to the supramarginal gyrus, pIC to the paracingulate gyrus, aMCC to the paracingulate gyrus, and sgACC to the dorsolateral prefrontal cortex. These correlations were stronger in MDD compared to controls. Only threshold intensity mediated the correlation between SC and connectivity strength. LimitationsResting-state scans provided an indirect assessment of SC and the pain network. ConclusionsThese findings highlight point to a neural network underlying SC that is associated with pain processing. This supports the potential clinical utility of pain response measurement as a method to investigate markers of suicide risk.

Thinking abstractly about one’s physical pain: can abstraction reduce sensitivity to painful stimuli?

Whether people think less abstractly when they experience physical pain has been examined in previous research. However, the reverse causal possibility—that abstraction reduces sensitivity to painful stimuli—does not appear to have been empirically tested. The aim of this study was to investigate whether abstraction reduces sensitivity to painful stimuli. Using the cold pressor method, university students (N = 205) were exposed to experimental pain. Participants were randomly assigned to an abstract mindset, concrete mindset, cognitive distraction (control task), or no task (control) condition. As a manipulation of abstraction, participants focused on why they felt pain (abstract condition) versus how they felt pain (concrete condition). Pain endurance and pain intensity were evaluated. The abstract mindset condition did not show significantly lower pain sensitivity compared with the other experimental conditions. We found no evidence suggesting that abstract thinking would reduce pain sensitivity. The effectiveness of other techniques that induce abstraction, such as third-person (versus first-person) self-talk should be examined in future research. Since experimentally induced pain in healthy participants differs from clinical pain, whether abstract thinking may reduce pain sensitivity in chronic pain patients should also be examined.

Review: Pop Masculinities: The Politics of Gender in the Twenty-First Century Popular Music, by Kai Arne Hansen

Review: <i>Pop Masculinities: The Politics of Gender in the Twenty-First Century Popular Music</i>, by Kai Arne Hansen

Assessing the experience of dyspareunia in the endometriosis population: the Subjective Impact of Dyspareunia Inventory (SIDI).

Is the Subjective Impact of Dyspareunia Inventory (SIDI) a reliable tool to examine the experience of dyspareunia in the context of endometriosis? In this study, the SIDI showed good structural and psychometric properties, and thus can be used as a reliable questionnaire to assess the impact of endometriosis-related dyspareunia on multiple dimensions, such as sexuality and intimate relationships. In the endometriosis population, dyspareunia has a tremendous negative impact on psychological health, overall sexual function and couple relationships. However, there is a paucity of tools that can be effectively used in either research or clinical practice to assess the subjective components of the dyspareunia experience, including coping strategies to deal with the pain. In this cross-sectional study, the validity of the SIDI was examined by considering the responses provided by 638 participants with endometriosis and dyspareunia, who participated in an online survey conducted between 8 November and 21 December 2021. Participants were recruited using snowball sampling that involved posting the invitation to participate in the study on the social media of a patient association. Participants were women aged ≥18 with clinical or surgical diagnosis of endometriosis. The SIDI measures the subjective impact of dyspareunia and is composed of 16 items focused on the frequency of dyspareunia-related experiences in the last 6 months, rated on a 5-point Likert scale. Sexuality was assessed using the Female Sexual Function Index. Psychological health was measured using the Hospital Anxiety and Depression Scale and the Rosenberg Self-Esteem Scale. Sociodemographic and endometriosis-related information was collected using a researcher-made questionnaire. Statistical significance was set at P < 0.05. Factor analysis revealed that the SIDI has a four-factor structure and allows for examining the impact of dyspareunia in terms of Sexual Concerns (Factor 1), Relationship Concerns (Factor 2), Partner Support (Factor 3) and Endurance of Pain (Factor 4). The SIDI showed good structural and psychometric properties (including internal consistency), was associated with sexual function and psychological health and was able to discriminate between participants with and without sexual dysfunction. Reasons for caution are related to the risk of self-selection bias depending on the study population and recruitment strategy. Moreover, all the information provided by the participants was self-reported, which may have affected the accuracy of the data collected, especially with regards to endometriosis-specific information. This study may provide a new brief tool that can be used by clinicians and researchers to assess the impact of dyspareunia from a multidimensional perspective and to consider subjective aspects that can be usefully integrated with information about pain severity, timing and localization. There was no funding for this study. A.F. is the President of APE-Odv (Associazione Progetto Endometriosi-Organizzazione di volontariato (Endometriosis Project Association-Volunteer Organization)), the largest nonprofit endometriosis patient association in Italy. The other authors have no conflicts of interest. N/A.

The Effect of Different Physiotherapy Programs on Pain, Balance and Trunk Functional Capacity in Adolescents with Low Back Pain

Background. Low back pain is a common problem, adversely affecting balance and strategy for controlling the trunk muscles. There are various methods to treat low back pain, therefore, studies comparing the effectiveness of different programs can help improve the rehabilitation program for patients with low back pain.&#x0D; The aim. To evaluate the effect of trunk stabilization and balance exercises performed with different devices on pain, balance and trunk functional capacity in adolescents with low back pain.&#x0D; Methods. 12 adolescents with low back pain participated in this study. They were divided into two groups. The first group received 20 minutes of stabilization exercises and 10 minutes of balance training using the Biodex balance system. The second group received 20 minutes of stabilization exercises and 10 minutes of balance training using a vibration platform. All subjects were evaluated before and after 10 physiotherapy procedures. Self-reported pain, balance and static endurance of trunk muscles were assessed before and after the interventions.&#x0D; Results. Both programs significantly reduced pain, improved control of the center of gravity within the base of support, reduced the time required to shift weight in different paths, reduced sway index in conditions of eyes open or eyes closed on a firm or foam surface, improved dynamic and static overall postural stability and increased static endurance of trunk muscles. Improvement in control of the center of gravity within the base of support, and reduction in the time required to shift weight in different paths, were more significant in the group that received balance training using the Biodex balance system compared with that in the group that received balance training using a vibration platform.&#x0D; Conclusions. Balance training using the Biodex balance system was more effective in improving control of the center of gravity within the base of support and reducing the time required to shift weight in different paths than balance training using a vibration platform.&#x0D; Keywords: low back pain, balance, trunk stability, Biodex balance system, vibration platform.&#x0D; &#x0D;

Effect of Forefoot–Rearfoot and Pelvic–Scapular Weight Shifts on Lower-Limb and Lumbar Muscle Activity during Static Wall-Squat Exercises

(1) Background: The static body-weight wall-squat (SBWS) exercise is often included in the early rehabilitation stages of the lower limb. To establish its effectiveness and optimise its application, it is important to precisely quantify the muscle contribution to different versions of this exercise. (2) Methods: We analysed the electromyographic activity of lower limb and lumbar muscles during the SBWS with knees flexed at 45° by manipulating three different variables: horizontal distance of the ankles from the wall; scapular or pelvic location of the centre of pressure Cwall of the force exerted by the wall on the back; rearfoot or forefoot location of the centre of pressure CGR of the ground reaction force. (3) Results: The forefoot-to-rearfoot CGR shift significantly increased the vastus medialis, vastus lateralis, and tibialis anterior activity up to 23%, 26%, and 44% of the maximum voluntary isometric contraction (MVIC). The lumbar muscle activity was maximised (23% MVIC) shifting CGR at the forefoot, Cwall at the scapular zone, and placing the feet far from the wall. (4) Conclusions: These SBWS methods might be effective for quadriceps, tibialis anterior, and lumbar muscles strengthening in the early phase of rehabilitation intervention as soon as the patient can tolerate partial weight-bearing. The exercise appears suitable for patients with low back pain and limited lumbar muscle endurance, or quadriceps weakness and inhibition secondary to a knee injury.

A one-week online self-compassion training reduces self-criticism and pain endurance in adults with non-suicidal self-injury ideation: A randomized-waitlist controlled study

A one-week online self-compassion training reduces self-criticism and pain endurance in adults with non-suicidal self-injury ideation: A randomized-waitlist controlled study

Yi Jin Bang exercise versus usual exercise therapy to treat subacromial pain syndrome: a pilot randomised controlled trial

ABSTRACT To evaluate the effect of Yi Jin Bang (YJB) exercise on pain, disability, flexibility, and muscular endurance in individuals with subacromial pain syndrome (SAPS). Fifty-four adults with SAPS were randomly allocated into either a YJB (n = 18), a usual exercise therapy (UET; n = 18), or a control group (n = 18). YJB and UET interventions involved 10 weeks of home-based exercise training, with four sessions per week. The control group received no treatment. Outcome measures included Shoulder Pain and Disability Index (SPADI), pain at rest and during activity, flexion and abduction range of motion (ROM), back scratch test, and shoulder abduction endurance test. These measures were assessed at baseline, immediately after a single face-to-face session (acute effects), and after 10 weeks of intervention (chronic effects). For acute effects, significant group-by-time interactions were observed for flexion ROM, abduction ROM, and the back scratch test (all p < 0.05). For chronic effects, significant group-by-time interactions were found for pain during activity, the SPADI score, and the back scratch test (all p < 0.05). Home-based YJB exercise is comparable to home-based UET in reducing pain and disability and improving flexibility.

Effects of stabilization exercises on disability, pain, and core stability in patients with non-specific low back pain: A randomized controlled trial

BACKGROUND: Many studies have emphasized the importance of stabilization exercises (SE) for the management of non-specific low back pain (NSLBP), yet there is no study assessing all aspects of core stability in comparing SE and other exercises. OBJECTIVE: To investigate the effects of SE on pain and core stability by using core stability tests that focus on all aspects of core stability in patients with NSLBP. METHODS: Thirty-seven individuals with chronic NSLBP were randomly divided into two groups as SE and conventional exercises (CE). Both groups underwent the progressive exercise program three days per week for six weeks. The assessments were conducted before and after the exercise programs. The outcome measures included pain, disability, trunk strength, trunk flexor, extensor and lateral flexor endurance, function, flexibility, and motor control during eyes open/closed. RESULTS: All assessment parameters except motor control during eyes open improved after SE (p &lt; 0.05). Also, all assessment parameters except motor control during eyes open/closed and lateral trunk endurance improved after CE (p &lt; 0.05). When comparing groups for gain scores, there were more significant improvements in pain during activity, endurance and function after SE (p &lt; 0.05). CONCLUSIONS: SE is more effective than CE in reducing pain during activity and improving core stability regarding functionality and endurance.

Acute Effects of a Combined Strength and Endurance Training Rehabilitation Protocol for Patients in Different Professions with Back Pain

Abstract Objective The purpose of this study was to investigate the effects of a combined strength and endurance training rehabilitation protocol for patients in different professions with back pain. Material and Methods 162 patients (craftsman n=56, preschool teachers n=45 and nurses n=61) were included into a prospective observational study. Peak force of trunk muscles (isometric testing), endurance (PWC130) and back pain dysfunction (ODI) were assessed before (t1) and after (t2) a 3-week-period of individually tailored but not professionally clustered rehabilitation training. Results The ODI (%) disability as well as all trunk muscle peak forces and aerobic endurence improved significantly in all subsamples (p&lt;0.01), with the exception of the preschool teachers. They showed unaltered PWC130 values (p=0.255), which was in turn accompanied by a significant weight gain (+1%, p&lt;0.001), while craftsmen and nurses demonstrated no changes in weight or waist circumference (p&gt;0.05). But all analyses revealed great interindividual variations. Pre-post changes did not differ significantly among the profession groups (p&gt;0.05). Conclusions Interindividual response variations should be considered as a typical finding well known in back pain rehabilitation studies. We did not reveal benefit differences between occupational subsamples after the present combined strength and endurance training protocol. Future research should apply a randomized study design to compare the regular rehabilitation program and enriched programs including specific occupational demands.

Feasibility and estimated efficacy of blood flow restricted training in female patients with rheumatoid arthritis: a randomized controlled pilot study

Objectives: The study aimed to evaluate the feasibility of a blood flow restriction (BFR) training regimen in patients with rheumatoid arthritis (RA); and to compare the effects of 4 weeks of BFR training with low-intensity strength training on muscle strength, muscle endurance, and joint pain in patients with RA. Method: In this non-blinded pilot randomized controlled trial, 18 women with RA aged 18–65 years performed low-intensity strength training for the lower limbs three times a week for 4 weeks, and were randomized to train with or without occlusion bands. The primary outcomes were registration of the recruitment process, compliance with training sessions, side effects, perceived pain, and a satisfaction survey. The secondary outcomes were changes in muscle strength, muscle endurance, and joint pain. Results: The findings of this pilot study included a challenging recruitment process, well tolerated training and test protocols, overall good patient satisfaction, no serious side effects, and high compliance. Both groups achieved significant improvements in knee extensor strength from baseline to follow-up, with a change of 11.5 kg [interquartile range (IQR) 9.8;13.0] in the intervention group and 8.4 kg (IQR 5.5;12.4) in the control group, and a significant between-group difference in favour of the intervention group (p = 0.0342). Conclusions: The feasibility results of this study indicated a challenging recruitment process, general satisfaction with the BFR and exercises, good compliance, and only expected non-serious side effects. BFR training may improve knee extensor strength in women with RA, compared low-intensity strength training without BFR.

Burns pain management: The role of nurse–patient communication

BackgroundNursing is an embodiment of knowledge, clinical work, and interpersonal communication. Effective nursing care has a distinct influence on the overall satisfaction and experience of the patient. Communication is said to be indispensable in the delivery of quality healthcare. Effective communication between nurses and patients has proven to yield better results with pain control and improved psychological status of patients. ObjectivesThe aim of the study is to explore nurses’ perceptions on the role of communication in the management of burns pain. MethodsA qualitative design with purposive sampling was carried out to recruit 11 registered nurses from a Reconstructive Plastic Surgery and Burns Center in Ghana. To identify the participants’ perception on the role of nurse–patient communication in the management of burns pain, a face to face semi-structured interviews were conducted using an interview guide to collect data. ResultsThematic analysis was done with various themes emerging. Helping patients manage pain, early detection of patient’s distress, improved patient participation in their care were some of the positive effects of nurse–patient communication whiles reduced level of cooperation during caregiving, and endurance of pain by the patient were the results of poor nurse–patient communication. Language and time factor were the barriers that were identified to hinder effective communication between nurses and patients. ConclusionsDue to the subjective nature of pain, the current study highlights the need for increased communication for an effective assessment and management of pain among patients with burns. It is, therefore, imperative that nurses be well trained in communication with an emphasis on patient-centered communication.

Relationship Between Adherence to Opioid Analgesics and Pain Beliefs Among Patients with Cancer Pain at Tertiary Care Hospitals in Malaysia.

ContextPain is a common and distressing symptom among cancer patients. Opioid analgesics are the mainstay of cancer pain management, and adequate adherence plays an important role in achieving good pain control.PurposeTo determine the level of adherence to opioid analgesics in patients with cancer pain and to identify factors that may influence the adherence.Patient and MethodsThis was a cross-sectional study conducted from March to June 2018 at two tertiary care hospitals in Malaysia. Study instruments consisted of a set of validated questionnaires; the Medication Compliance Questionnaire, Brief Pain Inventory and Pain Opioid Analgesic Beliefs─Cancer scale.ResultsA total of 134 patients participated in this study. The patients’ adherence scores ranged from 52–100%. Factors with a moderate, statistically significant negative correlation with adherence were negative effect beliefs (rs= −0.53, p<0.001), pain endurance beliefs (rs = −0.49, p<0.001) and the use of aqueous morphine (rs = −0.26, p=0.002). A multiple linear regression model on these predictors resulted in a final model which accounted for 47.0% of the total variance in adherence (R2 = 0.47, F (7, 126) = 15.75, p<0.001). After controlling for other variables, negative effect beliefs were the strongest contributor to the model (β = −0.39, p<0.001) and uniquely explained 12.3% of the total variance.ConclusionThe overall adherence to opioid analgesics among Malaysian patients with cancer pain was good. Negative effects beliefs regarding cancer pain and opioids strongly predicted adherence.

The Relationship between Middle‐aged Women’s Unstable Adult Attachment and Psychological Well-being: Mediating Effect of Pain Endurance and Active Coping

The Relationship between Middle‐aged Women’s Unstable Adult Attachment and Psychological Well-being: Mediating Effect of Pain Endurance and Active Coping