Pain Attitudes Research Articles

The relationship between electronic health literacy and individual factors among adults with chronic pain: A cross-sectional study

Introduction: Chronic pain requires individuals to develop self-management skills that rely on health literacy and, more recently, eHealth literacy. Very few studies have investigated potential predictors of eHealth literacy in chronic pain patients. Therefore, the purpose of this study is to explore potential predictors of eHealth literacy among individual characteristics and pain-related clinical factors, as a preliminary step to understanding the multi-variable relationships that could be examined in a larger study. Methods: A cross-sectional online survey was distributed to adults living in the United States with various chronic pain conditions using Amazon’s Mechanical Turk. A convenience sample of 196 participants was recruited. The independent variables of interest regarding their relationship with eHealth literacy (dependent variable) included demographics, health literacy, chronic pain severity, pain attitudes and coping skills. Chi square tests of association, and independent samples t-tests were used to examine the bivariate relationships. Results: The majority of the sample suffered from chronic pain for more than 2 years with 48% suffering from chronic back pain. Most of the sample (n=184, 93.9%) had high eHealth literacy. Significant relationships were found between eHealth literacy and the following variables: marital status, education level, and age, as well as health literacy, chronic pain interference with activities and chronic pain attitudes. These warrant further exploration in a larger study using logistic regression. Conclusions: our findings provide new information on the relationship between eHealth literacy levels, pain-related individual factors such as attitudes toward pain, and clinical outcomes, i.e., pain interference with physical and psychological function. Although further research is needed to investigate eHealth literacy predictors and mediators, these findings promote the evidence-based development and evaluation of interventions enhancing eHealth literacy skills, as well as self-management skills of chronic pain patients.

Attitudes and beliefs towards low back pain (LBP) among physiotherapists in Spain

BackgroundThe aim of this study is to investigate the attitudes and beliefs of Spanish physiotherapists towards the diagnosis and management of low back pain (LBP). A descriptive, cross-sectional study was conducted according to STROBE guidelines from December 18, 2021, to May 2022. An online survey was developed based on Pain Attitudes and Beliefs Scale for Physiotherapists (PABS-PT), a reliable and validated self-administered instrument developed to assess the strength of two possible treatment orientations of physiotherapists towards the diagnosis and management of LBP. Respondents were selected through a non-probabilistic convenience sampling technique, and the selection criteria were (1) active physiotherapists with no restrictions on gender and length of service, (2) physical therapists who have worked in both public and private environments, and (3) physiotherapists who have been officially registered with no restriction on the place of practice in Spain. Survey data was obtained and analyzed using the SPSS Statistic 28 (IBM®) statistical software.ResultsThree hundred eighty-one questionnaires were finally included (F;n=151, M;n=230). In relation to the diagnosis, the respondents indicated that the tissue damage was sufficient to explain widespread and lasting pain, but rather that it was due to psychological factors. In addition, for those surveyed, the diagnosis should not focus exclusively on imaging tests but on clinical symptoms and signs. However, the weak relationship between objective damage and perceived pain intensity, as well as the weak relationship between posture and the development or worsening of LBP, did not seem to be clear to physiotherapists. From the point of view of treatment, we can indicate that professionals are committed to maintaining adequate and individualized physical activity as a first-line treatment in pain management.ConclusionsMost physiotherapists in Spain have up-to-date knowledge of the biopsychosocial model of pain care. However, regarding attitudes and beliefs towards LBP, there are still contents and behaviors based on spine protective paradigms that are not conducive to active pain management.

Pain Attitudes in Adults with Sickle Cell Disease: A Mixed Methods Study

Background: Sickle cell disease (SCD) affects over 100,000 people in the United States and about 20 million people worldwide. It is complicated by a spectrum of micro- and macrovascular complications, most commonly pain or a vaso-occlusive crisis. The episodic pain can be unpredictable and debilitating, affecting quality of life. In both pediatric and adult patients with SCD, those with more frequent chronic pain report more frequent depressive symptoms, more frequent hospital admission, and more significant functional disability. A crucial factor that affects quality of life is self-efficacy defined as one's ability to engage in behaviors resulting in improve health outcomes and quality of life (Al Raqaishi, et.al.; 2022). Prior research has shown poor self-efficacy was negatively correlated with the number of sickle cell crises per year. A major influencer of self-efficacy among SCD patients is stigma, a social concept that leaves a person with SCD vulnerable to negative evaluation from others. Studies have suggested that stigma might cause a delay in health seeking behavior resulting in lower self-efficacy and poorer quality of life in patients with SCD. This mixed methods pilot study sought to further explore attitudes and beliefs about the relationship between pain, discrimination, and stigma in adults with sickle cell disease. Additionally, participants were asked to evaluate a group intervention curriculum currently used for adults with chronic pain. After adapting this curriculum to be SCD specific, we plan to test its efficacy for chronic pain in adults with SCD. Methods: Thirteen adult participants with SCD were recruited from the Center for the Special Health Care Needs at ChristianaCare Wilmington, DE during a routine clinic visit. After informed consent was obtained, participants were interviewed by the research assistant over Zoom, using a standardized interview script. Interviews were recorded and stored securely. Surveys were completed via a secure RedCap link. Survey responses were analyzed, and descriptive statistics were performed. Interviews were transcribed using Microsoft Word transcription tool and reviewed for accuracy. Analysis was done using the Rapid and Rigorous qualitative Data Analysis (RADAR) technique; three coders were involved in the process to assure intercoder-reliability. Results: After analysis with RADAR, five themes and twenty-six codes were developed; thematic saturation was reached (Table 1). Representative quotes from the key informant interviews were identified for each theme and code. Survey responses were tabulated (Table 2- in progress). Discussion: Review of the codes identified in the Key Informant interviews revealed most participants endorsed a connection between their emotions and pain. Most described at least one experience of racism or discrimination in the health care setting and identified perceived lack of clinician knowledge about SCD as a barrier to appropriate care. These data and participant evaluation of the current chronic pain curriculum will be used to develop a SCD-specific curriculum that will be piloted in future work. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

Self-Efficacy and Stigma in Adults with Sickle Cell Disease: An Import Study Analysis

Background: Sickle cell disease (SCD) causes significant morbidity across the lifespan. Finding ways to manage the most common and debilitating complications, including chronic pain, is of utmost importance to restoring quality of life and decreasing health care utilization. Several studies have estimated that chronic daily pain affects 30-50% of adult patients with SCD (1) (2). Furthermore, in both pediatric and adult patients with SCD, those with more frequent chronic pain report more frequent depressive symptoms, more frequent hospital admission, and more significant functional disability (2) (3). Discrimination is associated with poor mental health and decreased self-efficacy. The Improving Patient Outcomes with Respect and Trust (IMPORT) study demonstrates that patients with SCD report higher rates of race-based discrimination compared to other Black patients (10). Disease-based discrimination was associated with more significant self-reported pain. Because virtually all patients with SCD identify as Black or other racial and ethnic minorities, it is important to understand how discrimination as experiences of bias, racism, and disease-related stigma interact to affect health and functioning. This study explores the relationship between SCD stigma, self-efficacy, and other factors in the IMPORT data set. Methods: We first analyzed the relationship between variables including trust in doctor (trust1), institutional trust (trust2), and depressive symptoms (depress) with a network analysis (NA). The weighted partial correlation network structure of these factors and self-care (care), self-efficacy (effic), bias, interpersonal communication-compassionate(ipc_c) and discrimination (ipc_d), pain attitudes (spa) and pain catastrophizing score (pcs) among SCD patients is shown in the figure (n= 245). The stronger a connection between two nodes, the thicker and more saturated the line. Positive and negative connections are denoted by blue and red edges, respectively. After identifying significant relationships by NA, Additional analysis explored the effect of provider and institution trust, perception of bias and stigma on pain catastrophizing score, self-care, and self-efficacy. We fit multivariable linear regression models of the three outcomes (pain catastrophizing score, self-care, and self-efficacy) with trust, perception, and stigma as covariates. We further adjusted for age, sex, income category, and education level in the regression models. Results:Figure 1- Network analysisTable 1- Multivariate Regression Model Trust in doctors, stigma and education level were significantly associated with the PCS score. Each unit increase in stigma was associated with increase in the PCS score by 1 (p<0.001). The higher the education level, the lower the PCS. Increase in trust in doctors was associated with increased PCS score. Trust in institutions and age were significantly associated with self-care behaviors. Higher trust in institution is associated with higher self-care. Also, older age is associated with increased self-care. Trust in institution and education level are positively associated with self-efficacy. Stigma is negatively associated with self-efficacy. Discussion: This novel analysis of self-efficacy and experiences of stigma in adults with SCD reveals a significant association between sigma and self-efficacy. Additionally, our network analysis demonstrates the centrality of self-efficacy and pain catastrophizing, 2 promising targets for future intervention. The centrality of compassionate interpersonal communication also underscores the importance of the bidirectional relationship between patients and clinicians. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

Cross-sectional analysis of generational differences in pain attitudes and beliefs of patients receiving physical therapy care in outpatient clinics

BackgroundMusculoskeletal pain is a common reason to seek outpatient physical therapy care. Generational differences regarding attitudes and beliefs have been found in many areas, but it has not been explored regarding pain. ObjectivesThis study aimed to examine generational differences in attitudes and beliefs regarding pain and the potential differences between beneficial and non-beneficial treatment options in patients receiving care in outpatient physical therapy clinics. DesignCross-sectional descriptive survey. MethodA survey was developed to explore attitudes, beliefs, and treatment preferences. The survey was emailed out to past and current physical therapy patients as part of the customer satisfaction survey over a four-month period. Results/findings2260 surveys were completed during the collection period. Generational differences were found between the different generational groups. Younger generations were more in line with current pain neuroscience, understanding that pain is normal and part of the survival mechanism and less likely to believe that pain meant something wrong with one's tissues. Younger generations also reported more agreeance to the ability to cope without medication. However, significant variations existed in treatment choices that were most beneficial and least beneficial between respondents. ConclusionGenerational differences do exist in some areas of pain attitudes and beliefs. Less variation was noted in treatment options between generations, but there were significant variations within all patient respondents.

The knowledge and attitudes of South African-based runners regarding the use of analgesics during training and competition.

The use of analgesics is prevalent in runners, with the associated potential for serious harm. However, there is limited information regarding runners' knowledge and attitudes towards the use of analgesics in relation to running. To describe South African-based runners' knowledge and attitudes regarding running-related analgesic use. This study has a descriptive, cross-sectional design. South African-based runners, over the age of 18 who ran at least one race in the year preceding the study were included in this study. Participants completed an online questionnaire, including sections on demographic information, training and competition history, pain medication use, and knowledge and attitudes regarding running-related analgesic use. Data from 332 participants were analysed. Attitudes regarding the use of analgesics in relation to running were generally positive; however, knowledge was poor, with only 20% of participants achieving adequate knowledge scores (75% or above). Very few (n=49; 15%) had both adequate knowledge and positive attitudes, with most respondents (n=188; 58%) having inadequate knowledge and negative attitudes. Negative attitudes towards the use of analgesics were found to increase the odds of running-related analgesic use (OR 2.32; 95% CI:1.31-4.11). Knowledge regarding running-related use of analgesics was inadequate. Despite a lack of knowledge, attitudes were positive. Participants displayed positive attitudes towards safe practice regarding running-related analgesic use, but these did not translate into good practice. Targeted interventions are required to educate runners and improve their knowledge of all the effects associated with running-related analgesic use.

A survey study on knowledge and attitude towards pain management and associated factors among emergency Nurses,2021. Multi-center cross-sectional study

BackgroundPoor knowledge and attitude of nurses regarding pain may contribute to inadequate pain management. Nurses, as the primary caregivers in the emergency department, should have adequate knowledge and a good attitude towards pain management. The aim of this study was to determine the level of knowledge and attitude towards pain management and other factors among emergency nurses. MethodsA multi-center, institutional based, cross-sectional study was conducted on 153 nurses from May 01 to May 30, Ethiopia, 2021. Self–completed survey questionnaires were distributed using a modified and validated ‘Knowledge and Attitudes Survey Regarding Pain (KASRP)’ tool and analyses were performed using SPSS version 20. Descriptive statistics were used to summarize the characteristics of the participants, and the results were prepared using narrations, percentages, and tables. To demonstrate the strength of the association, the crude odds ratio and adjusted odds ratio with the corresponding 95% CI were calculated. Variables with a p-value of <0.05 were considered statistically significant after multivariate analysis. ResultThe mean percentage score of knowledge and attitude towards pain management was 52.8% (SD = 13). Prior pain management, training, and years of work experience as an emergency nurse were associated with good pain management knowledge and attitude. Conclusion and recommendationsThe level of knowledge and attitude of emergency nurses toward pain management were poor. So, we suggest all stakeholders who participate in nursing education work together to educate nurses to a higher level of education and deliver pain management training to enhance their knowledge and attitude towards pain management.

Osteoarticular and musculoskeletal disorders, chronic pain, quality of life and physical activity level distributed by age and gender in elderly people participating in a water aerobics program

The study aims to describe osteoarticular and musculoskeletal disorders, chronic pain, quality of life (QOL) and physical activity level (PAL) distributed by age group and gender in the elderly. The design was quantitative, descriptive and cross-sectional. The non-probabilistic sample, for convenience, comprised 101 elderly people, over 60 years old, who regularly participate in water aerobics activities in the municipality of Dois Irmãos, RS. The instruments used were: Multidimensional Pain Assessment Scale, Survey of Pain Attitudes, IPAQ and EUROHIS-QOL. Descriptive frequency analyzes were performed, which showed the predominance of women in water aerobics activities, most frequently in the age group of 70 years. Similarly, the presence of osteoarticular and musculoskeletal disorders and chronic pain intensity (moderate and severe) were more expressive in females and in the age group of 70 years. The distribution of QOL and pain intensity in relation to age, gender and PAL shows in the age group of 60 years, the male, irregularly active with higher average, with higher occurrence of pain (moderate) in the active elderly. Active females, on the other hand, show better QOL scores and higher pain intensity in irregularly active aspect. In conclusion, the actions promoted by the municipality have a positive impact on QOL. However, there is a need for greater involvement of participants to achieve more adequate levels of regular physical activity, taking into account the significant presence of pain complaints in females and in the age group of 70 years.

Knowledge and Attitude of Sciatica Pain and Treatment Methods among Adults in Saudi Arabia.

Background Sciatica is a relatively common condition, with a lifetime incidence varying from 13% to 40%. The corresponding annual incidence of an episode of sciatica ranges from 1% to 5%. The exact cause of sciatica is unknown to this day; treatment methods and practices differ between individuals based on their cultural background, socioeconomic status, and religious beliefs. This study aimed to assess the knowledge and attitude toward sciatica pain among adults in Saudi Arabia. Methods A cross-sectional study was conducted among the adult population in Saudi Arabia. A self-administered questionnaire was distributed among the study population using an online survey. Questions were divided into four groups, each containing multiple questions covering the following aspects: demographic data, past medical history, and the assessment of knowledge and attitudes regarding sciatica. Results A total of 3,764 respondents were involved in this study, with an age range of 18–65 years old (females 59.8%). The mean knowledge score was 3.8 (SD 2.1), with the majority having poor knowledge (60.1%). The most common source of sciatica information was an orthopedic or a neurosurgeon, while the most common self-treatment used was painkiller medications (30.8%). The mean attitude score was 35.8 (SD 5.3), with most respondents having a neutral attitude (80.3%). The factors correlated with an increase in knowledge and attitude were having a bachelor's or higher degree and living in an urban area. Conclusion While the attitude of the adult population toward sciatica pain seems adequate, their knowledge was shown to be deficient. Furthermore, when comparing diagnosed individuals living in cities with those in rural areas, both knowledge and attitudes were shown to be better in individuals living in cities. Awareness programs by health institutions and healthcare professionals are needed to enhance patients knowledge. Various media can be utilized to enhance patients knowledge including social media platforms.

The Impact of Nurses' Beliefs, Attitudes, and Cultural Sensitivity on the Management of Patient Pain.

Nurses' attitudes and beliefs may impact pain management. This study investigated nurses' perceptions regarding their own and patients' pain experiences by examining relationships between pain cautiousness and stoicism, cultural sensitivity, and personal pain attitudes. A correlational methodology examined nursing staff in a Midwestern private hospital. The sample included 102 primarily female (95.1%), Caucasian (97%), and married (66%) nursing staff. Measures included the Intercultural Sensitivity Scale, Pain Attitudes Questionnaire to Assess Stoicism and Cautiousness, and the Pain Management: Nurses' Knowledge and Attitude Survey. Cultural sensitivity was a significant predictor of pain knowledge and attitudes total score (R2 = .081, β = .244, p = .040), while pain stoicism and pain cautiousness were not predictive. Findings highlight the importance of nurses being aware of personal attitudes, beliefs, and cultural sensitivity in pain management. Results also demonstrate a gap between the knowledge and utilization of nonpharmacologic pain management interventions among nursing staff.

International, multi-disciplinary, cross-section study of pain knowledge and attitudes in nursing, midwifery and allied health professions students

BackgroundPersistent pain is a highly prevalent, global cause of disability. Research suggests that many healthcare professionals are not well equipped to manage pain, and this may be attributable at least in part to undergraduate education. The primary aim of this study was to quantify and compare first and final year nursing, midwifery and allied health professional (NMAHP) students’ pain related knowledge and attitudes. The secondary aim was to explore what factors influence students’ pain related knowledge and attitudes.MethodsIn this cross-sectional study, 1154 first and final year healthcare students, from 12 universities in five different countries completed the Revised Neurophysiology of Pain Quiz (RNPQ) [knowledge] and the Health Care Providers Pain and Impairment Relationship Scale (HC-PAIRS) [attitudes].ResultsPhysiotherapy was the only student group with statistically and clinically improved pain related knowledge [mean difference, 95% CI] (3.4, 3.0 to 3.9, p = 0.01) and attitudes (-17.2, -19.2 to 15.2, p = 0.01) between first and final year. Pain education teaching varied considerably from course to course (0 to 40 h), with greater levels of pain related knowledge and attitudes associated with higher volumes of pain specific teaching.ConclusionsThere was little difference in pain knowledge and attitudes between all first and final year NMAHP students other than physiotherapy. This suggests that for most NMAHP disciplines, undergraduate teaching has little or no impact on students’ understanding of pain. There is an urgent need to enhance pain education provision at the undergraduate level in NMAHPs.Trial RegistrationThe study protocol was prospectively registered at ClinicalTrials.Gov NCT03522857.

Comparison of attitudes and beliefs of physical therapists and primary care physicians regarding low back pain management: A cross-sectional study.

BACKGROUND: The first-line contact for patients seeking care for low back pain (LBP) can potentially change the disease course. The beliefs and attitudes of healthcare providers (HCPs) can influence LBP management. Although referring patients with LBP to physical therapy is common, the first-line contact for patients with LBP in Saudi Arabia is the primary care physician (PCP). Physical therapy will soon be integrated into primary care; therefore, it is rational to compare physical therapists’ (PTs) beliefs and attitudes regarding LBP with those of PCPs.OBJECTIVE: We compared PCPs’ and PTs’ attitudes and beliefs regarding LBP management.METHODS: We employed a cross-sectional, voluntary response sample research design using the Pain Attitudes and Beliefs Scale (PABS). Participants were PTs and PCPs practicing in Saudi Arabia.RESULTS:In total, 153 participants completed the PABS (111 PTs and 52 PCPs). PCPs demonstrated significantly higher PABS biomedical subscale scores than did the PTs.CONCLUSIONS: HCPs in Saudi Arabia should receive additional training to adopt a biopsychosocial approach to managing LBP. In this study, the HCPs’ treatment recommendations may not correspond with contemporary clinical guidelines. Research to facilitate the implementation of optimal professional education and training to adopt a biopsychosocial approach is an urgent priority.

The Portuguese osteopaths' attitudes towards a biomechanical or biopsychosocial model in the approach of chronic low back pain – A cross-sectional questionnaire-based survey

ObjectiveThis study investigated the Portuguese Osteopaths attitudes towards a biomechanical or biopsychosocial approach of care in patients with chronic low back pain (cLBP). MethodsA cross-sectional questionnaire-based survey of Portuguese registered osteopaths was composed using sociodemographic determinants, the Health Care Providers' Pain and Impairment Relationship Scale (HC-PAIRS) and Pain Attitudes and Beliefs for Physiotherapists (PABS-PT). The HC-PAIRS assesses the attitudes and beliefs about the functional expectations of patients with cLBP, and the PABS-PT assesses the dominant model of care. ResultsPortuguese registered osteopaths (n = 103) had mean PABS-PT subscale scores of 29.6 ± 7.7 [CI95% 28.12–31.14] (biomechanical) and 22.9 ± 5.3 [CI95% 21.88–23.94] (biopsychosocial). The mean HC-PAIRS total score was 52.4 ± 9.0 [CI95% 50.66–54.16]. There was a strong and positive correlation between the HC-PAIRS and the PABS-PT biomechanical subscale (n (103) = 0.55, p < 0.001, and in PABS-PT a negative correlation between the biomechanical and biopsychosocial subscale scores (n(103) = -0.21, p = 0.028). ConclusionsPortuguese osteopaths tend to adopt a biomechanical model of care instead of a biopsychosocial model in the management of patients with chronic low back pain. They seem to agree that chronic low back pain was due entirely to tissue damage, indicating strong biomechanical beliefs about the pain that may ultimately influence their clinical decisions.

Antidepressant treatment in premenstrual dysphoric disorder, case report

IntroductionPremenstrual dysphoric disorder (PMDD) is included for the first time in the last edition of DSM within affective disorders. It is necessary that 5 of a list of 11 symptoms (lability, irritability, depressed mood, anxiety, lethargy, being out of control or physical symptoms among others) appear in the majority of menstrual cycles but must be only present during the week before menstruation improving after its onset. It has a prevalence of 1,8-5,8% and it is associated to significant functional impairment. SSRIs are indicated as first-line treatment in severe symptoms.ObjectivesTo review about premenstrual dysphoric disorder and its psychopharmacological treatment.MethodsWe carry out a literature review about premenstrual dysphoric disorder, accompanied by a clinical description of one patient treated with sertraline.Results44 years old female referred to our outpatient mental health service due to anxious and depressive symptoms. She had presented abdominal pain, anxiety, obsessive thoughts, sadness, emotional lability, apahty, anergy, uncontrolled impulse, irritability and vociferous attitude with verbal agressiveness only the week before menstruation during several years. These symptoms interfered negatively in her relationships. We started sertraline treatment with ad integrum clinical recovery after two menstrual cycles. 6 months later we indicated to take sertraline only the week before menstruation, maintaining stability.Conclusions1) It is important to consider premenstrual dysphoric disorder as a possible diagnosis in women with premenstrual discomfort symptoms. 2) It might be consider as a depressive disorder. 3) Antidepressant treatment should be considered in women with disabling symptoms.DisclosureNo significant relationships.

The Relationship between Work Attitude and Weight Load with Complaints of Low Back Pain (LBP) in Transporting Workers of Catched Fish at Fish Auction Sites (TPI)

Occupational diseases are one of the diseases that can be experienced by workers in their work, which are at risk of causing occupational diseases, namely, work equipment, work environment, and the process of their work. Occupational diseases caused by work attitudes can be influenced by non-ergonomic positions and activities that are carried out incorrectly, such as the wrong position when lifting heavy loads are also the cause of low back pain.The purpose of this study is to explain the relationship between work attitude and weight with complaints of low back pain (LBP) in workers transporting the catch.This study uses a descriptive analytic method using a cross sectional design. The population in this study were all workers transporting fish catches totaling 52 workers with a sample of 34 workers who were taken using purposive sampling technique. The instrument used is a questionnaire. Data analysis was carried out univariate and bivariate using the Spearman rank test with = 0.05. The results of the analysis show that there is a relationship between work attitude and complaints of low back pain (p value = 0.000) &lt; 0.05 and there is a relationship between the weight of the load and complaints of low back pain (p value = 0.036) &lt; 0.05. This happens because the way of lifting when lifting weights is not right and lifting excessive loads so that it causes injury to the spine which results in low back pain. Based on the results of the research above, for workers to use tools such as hand trucks in transporting fish catches.

The Modified Back Beliefs Questionnaire as a tool to screen for incorrect beliefs regarding back pain: Cross-cultural adaptation and measurement properties

BackgroundThe Modified Back Beliefs Questionnaire (MBBQ) evaluates and screens for incorrect beliefs about low back pain (LBP). Although the MBBQ has been used to assess, its measurement properties remain unknown therefore, a rigorous cross-cultural validation is necessary. ObjectiveTo translate and cross-culturally adapt the MBBQ into Brazilian Portuguese and investigate its measurement properties. MethodsThe MBBQ was translated and cross-culturally adapted into Brazilian Portuguese. In the final stage of the cross-cultural adaptation process, the translated version was tested with 30 physical therapists to check the understanding of each item. Then, we evaluated the measurement properties in a sample of 100 physical therapists. We calculated test-retest reliability, internal consistency, standard error of the measurement (SEM) and minimal detectable change (MDC). The Pain Attitudes and Beliefs Scale for Physiotherapists (PABS.PT) was used in the construct validity analysis. ResultsThe reliability analysis showed high internal consistency, good to excellent test-retest reproducibility. Cronbach alpha coefficient for the MBBQ inevitability score was 0.80 and for the composite score 0.89. Intraclass correlation coefficient (ICC) for the Inevitability score was 0.67 (95%CI: 0.55 to 0.77) and 0.79 (95%CI: 0.70 to 0.86) for the composite score. The MBBQ inevitability and composite scores showed SEM of 1.9 and 2.4 points and minimal detectable change (MDC) of 5.1 and 6.7 points, respectively. Construct validity analyses showed moderate to excellent correlation of the MBBQ scores and the biomedical subscale of the PABS.PT. ConclusionsMBBQ showed acceptable measurement properties and may be considered a reliable and valid tool to assess physical therapists' beliefs about low back pain.

An exploration of primary care healthcare professionals\u2019 understanding of pain and pain management following a brief pain science education

BackgroundPersistent pain is a leading cause of disability worldwide yet implementation of clinical guidelines that recommend a biopsychosocial approach remains a challenge in clinical practise. Limited pain understanding amongst clinicians may be partly responsible for this.Purpose of the study1) Qualitatively explore the experience of receiving PSE, understanding of PSE and operationalisation of PSE-related principles in routine clinical practice. 2) Quantitatively explore pain knowledge, attitudes, and behaviours of general practitioners (GPs) and nurse practitioners (NPs) before and after pain science education (PSE).MethodsAn exploratory, single-site, mixed-methods study in north-east England. Fifteen NPs/GPs completed questionnaires and a case-vignette before and after a 70-min face-to-face PSE lecture. Qualitative data were thematically analysed from two focus groups after the intervention.ResultsClinicians’ relatively high prior levels of knowledge, attitudes, and behaviour were similar after PSE. Qualitative themes described facilitation of self-reflection on pain management behaviours, and difficulties in operationalising PSE principles in practise including: limited patient rapport; short appointment times; patients’ passive and often oppositional biomedical treatment expectations; and clinicians’ lack of readily understandable language to communicate with patients.ConclusionThe findings highlight the value of PSE perceived by these clinicians who were already favourably inclined towards biopsychosocial pain management. They sought more resources for their personal learning and for communication with patients. Even with such favourable disposition, the practicalities and environment of clinical practice impeded the operationalisation of PSE-related principles.Trial registrationThis study was prospectively registered at ClinicalTrials.Gov (NCT04587596) in October 2020.

Pain sensitivity is associated with general attitudes towards pain: Development and validation of a new instrument for pain research and clinical application.

With regard to attitudes towards pain, many questionnaires have been developed. Although undoubtedly useful, they were specifically designed for the use in chronic pain and are less suitable for the assessment in the general population. The purpose of the present paper was to develop a measure for the assessment of general attitudes towards pain applicable in the general population, regardless of clinical condition, and to test its psychometric properties. We developed the General Attitudes Towards Pain Inventory and conducted two studies in order to provide psychometric data: In a general population sample (N=362, study one), participants were asked to complete a questionnaire battery. To assess test-retest reliability, participants were contacted again after 4weeks (retest sample: N=101). For the evaluation of criterion validity (study two), a sample with sadomasochistic sexual preference (N=68) was additionally recruited. Statistical analyses revealed, overall, acceptable internal consistencies and test-retest reliabilities. A 10-factor model showed acceptable fit and was superior to alternative models. The inventory demonstrated convergent and divergent validity. In this context, we found pain sensitivity to be associated with pain attitudes. Finally, compared to the general population sample, individuals with sadomasochistic sexual preference showed significantly higher scores on fascination-pleasure and challengesubscales. In the present paper, we introduce a new and comprehensive instrument for pain research and provide evidence for its reliability and validity. In addition, we present new insights into how interindividual differences in pain sensitivity relate to pain attitudes. Acknowledging the lack of basic research on pain attitudes in the general population, we have developed and validated the first psychometric instrument to measure ten general attitudes towards pain. The inventory is based on the literature and clinical expertise and has been demonstrated to be useful in pain sensitivity research. In the clinical context, general pain attitudes could be pivotal when a person who has only known everyday pain suddenly becomes a patient confronted with prolonged states of intense pain.

The attitudes and beliefs of physiotherapists, family physicians and physiatrists concerning chronic low back pain

Objective: To examine the chronic low back pain (CLBP)-related attitudes and beliefs of primary and secondary healthcare professionals responsible for the treatment of this condition.&#x0D; Material and Method: The study was conducted with 40 family physicians, 30 physiatrists, and 40 physiotherapists. The beliefs and attitudes of the participants concerning CLBP were evaluated using the Back Belief Questionnaire (BBQ), Health Care Providers’ Pain and Impairment Relationship Scale (HC-PAIRS), and Pain Attitudes and Beliefs Scale for Physiotherapists (PABS-PT).&#x0D; Results: Among all the participants, the rate of those with predominantly biomedical beliefs was 80.9%, while the rate of those with predominantly biopsychosocial beliefs was 15.5%. In addition, it was observed that the BBQ, HC-PAIRS and PABS-PT scores were not affected by educational status, number of patients with CLBP treated or examined in a week, and years of experience (p&gt;0.05). The BBQ and HC-PAIRS scores of the family physicians were statistically significantly lower compared to the physiotherapists and those of the physiotherapists were statistically significantly lower compared to the physiatrists (p0.05).&#x0D; Conclusion: This study revealed that family physicians, physiotherapists, and physiatrists in Turkey might have negative attitudes and beliefs concerning CLBP and the biopsychosocial approach should be further adopted among healthcare professionals.

No gain without pain education: Improving knowledge and biopsychosocial attitudes and beliefs in a predominantly non-health-related undergraduate target audience.

Chronic pain (CP) impacts individuals and society and is the leading cause of disability globally. Pain education interventions are often evaluated in patients and health professional students, but not in non-health student groups. Increasing knowledge of pain may facilitate shifts in attitudes and beliefs towards sufferers. We report on changes in pain knowledge, attitudes and beliefs of predominantly non-health-related tertiary degree students participating in online education. Quantitative cohort study design. Students reported demographics and completed the Chronic Pain Myth Scale and 12-item Neurophysiology of Pain Questionnaire (NPQ) before (T1) and after (T2) the 7-week online module at The University of Sydney in 2020. Twenty-two students undertaking predominantly non-health-related bachelor's degrees (16.5% response rate, 90.9% female, mean=19.5years) participated. NPQ scores increased from 47.3% to 62.9%. Attitudes and beliefs towards biopsychosocial impact improved (p<0.027) but not towards individuals suffering from CP or treatment of CP. A negative correlation was found between age and people suffering from CP (ρ=-0.437, p<0.042) and age and towards treatment of CP; ρ=-0.556, p<0.007) at T2. Completing the elective online module resulted in improved knowledge and biopsychosocial attitudes towards CP in this predominantly non-health cohort, as reported in health and patient cohorts.