1,165 results on '"Pain Interference"'
Search Results
202. Psychophysiological Disorders
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Molton, Ivan R., Raichle, Katherine A., Segal, Daniel L., editor, and Hersen, Michel, editor
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- 2010
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203. Adaptation to Amputation and Prosthesis Use
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Schaffalitzky, Elisabeth, Gallagher, Pamela, Desmond, Deirdre, MacLachlan, Malcolm, and Murray, Craig, editor
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- 2010
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204. Pain Catastrophizing Mediates the Effects of Psychological Distress on Pain Interference in Patients with Orofacial Pain: A Cross-Sectional Study.
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Hoon-Ho Jang, Mee-Eun Kim, and Hye-Kyoung Kim
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TREATMENT of psychological stress ,COGNITIVE therapy ,HELPLESSNESS (Psychology) ,PATH analysis (Statistics) ,QUESTIONNAIRES ,TEMPOROMANDIBULAR disorders ,PAIN measurement ,CROSS-sectional method ,RETROSPECTIVE studies ,PAIN catastrophizing ,BRIEF Pain Inventory ,SYMPTOM Checklist-90-Revised - Abstract
Aims: To investigate whether pain catastrophizing has not only direct effects as a predictor of pain-related interference but also indirect effects as a mediator in the relationship between psychological distress and pain interference and to examine the mediating roles of subtypes of catastrophizing (magnification, rumination, and helplessness) between psychological distress and interference. Methods: This retrospective study included 815 patients with orofacial pain aged 18 to 81 years. All participants completed a set of self-administered questionnaires concerning pain interference (Brief Pain Inventory), psychological distress (Symptom Checklist-90-Revised), and pain catastrophizing (Pain Catastrophizing Scale) at the first consultation. The associations between these three variables were calculated using mediation path analysis. Results: Pain catastrophizing predicted pain interference. In addition, 34% of the variance in pain interference attributable to psychological distress was mediated by catastrophizing when controlling for pain duration and severity. The greatest portion of the mediating effect of catastrophizing was attributable to the helplessness component. Conclusion: Within the limitations of cross-sectional studies, this study demonstrated that pain catastrophizing mediates the effects of psychological distress on pain interference in patients with orofacial pain. Most of the mediating effects were attributable to the helplessness component of pain catastrophizing. Cognitive behavioral therapy targeting pain catastrophizing, specifically helplessness, could potentially reduce pain-related disability in orofacial pain patients. [ABSTRACT FROM AUTHOR]
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- 2018
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205. The Relationship of PROMIS Pain Interference and Physical Function Scales.
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Kendall, Richard, Wagner, Bill, Brodke, Darrel, Bounsanga, Jerry, Voss, Maren, Gu, Yushan, Spiker, Ryan, Lawrence, Brandon, and Hung, Man
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ACADEMIC medical centers , *AGE distribution , *BACKACHE , *STATISTICAL correlation , *LIFE skills , *LONGITUDINAL method , *MENTAL health , *HEALTH outcome assessment , *RACE , *REGRESSION analysis , *SELF-evaluation , *SEX distribution , *PAIN measurement , *RETROSPECTIVE studies - Abstract
Objectives To examine the relationship between the Patient Reported Outcome Measurement Information System (PROMIS) Pain Interference (PI) and PROMIS Physical Function (PF) scales in patients with spinal pain at a university spine center. Design Retrospective analysis of prospectively collected patient-reported outcome data at a university spine clinic. Pearson correlation was done to examine the relationship of the PROMIS PF and PROMIS PI scores. Age, gender, and race were analyzed by subgroups on the PROMIS Physical Function and Pain Interference score. Linear regression analyzed predictive relationships. Statistical significance was set at P < 0.05. Results A total of 1,992 participants completed an assessment, with 1,923 completing the PF CAT and 1,927 the PI CAT. Participants’ mean age was 52.8 years (range = 18–94 years, SD = 6.5 years). Correlation analysis of the PROMIS PF with the PROMIS PI showed a Pearson correlation value of –0.717 (P < 0.05). There was a strong linear relationship with a high negative correlation between PF CAT and PI CAT. The PI CAT predicted PF CAT scores (β = –0.707, P < 0.001). Conclusions For patients with pain from spinal origin, there is a strong negative correlation between self-reported physical function and pain interference related to physical, social, and mental health. The predictive relationship of function from pain scores supports the PROMIS PI being used as an important adjunct measure of physical function in patients with spinal pain. [ABSTRACT FROM AUTHOR]
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- 2018
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206. Prevalence and Correlates of Low Pain Interference Among Patients With High Pain Intensity Who Are Prescribed Long-Term Opioid Therapy.
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Adams, Melissa H., Dobscha, Steven K., Smith, Ning X., Yarborough, Bobbi Jo, Deyo, Richard A., and Morasco, Benjamin J.
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The pain experience may vary greatly among individuals reporting equally high levels of pain. We sought to examine the demographic and clinical characteristics associated with pain interference in patients with high pain intensity. Among patients with chronic musculoskeletal pain who were prescribed long-term opioid therapy and who were recruited from 2 health care systems, we identified a subset who reported high pain intensity (n = 189). All individuals completed self-report assessments of clinical and demographic factors. Analyses examined characteristics associated with pain interference. Within this group of patients with high reported pain intensity, 16.4% (n = 31) had low pain interference, 39.2% (n = 74) had moderate pain interference, and 44.4% (n = 84) had high pain interference. In bivariate analyses, patients with lower pain interference had fewer symptoms of depression and anxiety, less pain catastrophizing, a better quality of life, and greater self-efficacy for managing pain. In multivariate analyses, variables most strongly associated with low pain interference, relative to high interference, were depression severity (odds ratio 0.90; 95% confidence interval 0.82-0.99) and pain self-efficacy (odds ratio 1.07; 95% confidence interval 1.02-1.12). Study results suggest that chronic pain treatments that address symptoms of depression and enhance pain self-efficacy may be prioritized, particularly among patients who are prescribed long-term opioid therapy.
Perspective: This article describes the prevalence and correlates of pain interference categories (low, medium, and high) among patients with high pain intensity who are prescribed long-term opioid therapy. Findings reveal that 16.4% of participants with high pain intensity had low impairment. Multivariate analyses indicate that variables significantly associated with low pain interference were lower depression scores and greater pain self-efficacy. [ABSTRACT FROM AUTHOR]- Published
- 2018
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207. The Recovery Curve for the Patient-Reported Outcomes Measurement Information System Patient-Reported Physical Function and Pain Interference Computerized Adaptive Tests After Primary Total Knee Arthroplasty.
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Kagan, Ryland, Anderson, Mike B., Christensen, Jesse C., Peters, Christopher L., Gililland, Jeremy M., and Pelt, Christopher E.
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Background: We sought to characterize the typical recovery in physical function (PF) and pain interference (PI) after TKA using Patient-Reported Outcomes Measurement Information System (PROMIS) patient-reported outcome (PRO) measures.Methods: Ninety-one patients were enrolled into an institutional review board -approved prospective observational study. PROs were obtained preoperatively and postoperatively at 6 weeks, 3 months, 6 months, and 1 year. PROs included the PROMIS PF computerized adaptive test (CAT) and the PROMIS PI CAT. Generalized estimating equations were used to evaluate outcomes over time.Results: There was no difference in the preoperative and 6-week postoperative T-scores for the PF CAT (P = .410). However, all subsequent postoperative T-scores were greater than the preoperative T-score (all, P < 0.05). There was a significant reduction in PI CAT T-scores between the preoperative and all subsequent postoperative T-scores (all, P < .05). A clinically important difference in PF CAT T-scores (β = 5.44, 95% confidence interval 4.10-6.80; P < .001) and PI CAT T-scores (β = -7.46, 95% confidence interval -9.52 to -5.40; P < 0.001) was seen between the preoperative and 3-month postoperative visits. Sixty-three percent of the improvement in PF occurred by 3 months, and 89% had occurred by 6 months. The majority of reduction in PI (68%) occurred by 3 months and 90% had occurred by 6 months.Conclusion: The greatest magnitude of improvement in both PF and PI occurred within the first 3 months. After 6 months, patients might expect modest improvements in PF and mild reductions of PI. Patients and surgeons should use this information for setting expectations, planning for recovery, and improving care. [ABSTRACT FROM AUTHOR]- Published
- 2018
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208. Chronic Pain and Attention in Older Community‐Dwelling Adults.
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van der Leeuw, Guusje, Leveille, Suzanne G., Dong, Zhiyong, Shi, Ling, Habtemariam, Daniel, Milberg, William, Hausdorff, Jeffrey M., Grande, Laura, Gagnon, Peggy, McLean, Robert R., and Bean, Jonathan F.
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COGNITION in old age , *CHRONIC pain , *ATTENTION , *COGNITIVE ability , *NEUROPSYCHOLOGY - Abstract
OBJECTIVES: To examine the cross‐sectional relationship between chronic pain and complex attention in a population of community‐living older adults. DESIGN: Prospective cross‐sectional cohort study. SETTING: Population‐based Maintenance of Balance, Independent Living, Intellect, and Zest in the Elderly of Boston Study II. PARTICIPANTS: Individuals aged 71 to 101 (N=354). MEASUREMENTS: Chronic pain was measured using the pain severity and interference subscales of the Brief Pain Inventory. Four subscales of the Test of Everyday Attention were used to measure domains of attention switching and selective, sustained, and divided attention. RESULTS: Before and after multivariable adjustment, pain severity was associated with poorer scores on measures of selective and sustained attention. Pain interference scores also were significantly inversely associated with selective attention. CONCLUSION: Chronic pain is associated with poorer performance in selective and sustained attention in community‐dwelling older adults. Further research is needed to determine whether effective pain management could lead to better attentional performance in older adults. Older adults who live with chronic pain, often undertreated, are potentially at risk of cognitive difficulties and related functional consequences. [ABSTRACT FROM AUTHOR]
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- 2018
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209. Pain interference and alcohol, nicotine, and cannabis use disorder in a national sample of substance users.
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McDermott, Katherine A., Joyner, Keanan J., Hakes, Jahn K., Okey, Sarah A., and Cougle, Jesse R.
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NICOTINE addiction , *SUBSTANCE-induced disorders , *EPIDEMIOLOGY , *REGRESSION analysis , *LONGITUDINAL method , *HEALTH surveys - Abstract
Background: Pain interference is associated with substance use, but has yet to be considered as a potential indicator of SUDs among substance users. We sought to examine whether moderate and high pain interference would confer risk for SUDs in ever and weekly users.Methods: Using data from the National Epidemiologic Survey on Alcohol and Related Conditions, logistic regression analyses were conducted to examine the association between pain interference and concurrent and prospective alcohol and nicotine dependence, as well as concurrent cannabis use disorder. Those with no/low pain were used as the reference group. Gender was examined as a moderator.Results: Controlling for relevant covariates, moderate pain interference was associated with past year alcohol (odds ratio [OR] = 1.33, 95% CI, 1.16-1.52, p < .001) and nicotine (OR = 1.41, 95% CI 1.27-1.56, p < .001) dependence among ever users. In prospective analyses, moderate pain interference predicted the development of alcohol (Moderate: OR = 1.56, 95% CI, 1.39-1.75, p < .001) and nicotine (OR = 1.37, 95% CI, 1.14-1.65, p < .001) dependence. Similar results were found with high pain and for weekly users. Both moderate and high pain interference were associated with past-year occurrence of cannabis use disorder for women but not men. High pain predicted the development of nicotine dependence exclusively among males.Conclusion: Pain interference may confer risk for the occurrence of cannabis use disorder among female cannabis users and the occurrence and development of alcohol and nicotine dependence among users of both genders. Pain interference may be an important factor to monitor in these populations. [ABSTRACT FROM AUTHOR]- Published
- 2018
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210. Sleep Disturbance Mediates the Association of Post-Traumatic Stress Disorder Symptoms and Pain in Patients With Cancer.
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Lillis, Teresa A., Gerhart, James, Bouchard, Laura C., Cvengros, Jamie, O’Mahony, Sean, Kopkash, Katherine, Kabaker, Katherine B., and Burns, John
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Background: Sleep disturbance is a common complaint of patients with cancer and is well established in both pain conditions and post-traumatic stress disorder (PTSD). An estimated one-third of patients with cancer develop symptoms of PTSD at some point in their treatment. However, few studies have evaluated the contributions of PTSD and sleep disturbance to pain processes in cancer populations. The current study used mediation models to test the hypothesis that sleep disturbance would mediate the relationships between PTSD symptoms and pain intensity and PTSD symptoms and pain interference in a sample of patients with cancer. Methods: A cross-sectional, retrospective chart review was conducted of the electronic medical records of 85 adult patients with cancer (89.4% female; 59% white; 42% metastatic) who sought individual psychosocial support services at our institution. Results: Post-traumatic stress disorder symptoms, sleep disturbance, pain intensity, and pain interference were all positively correlated (P < .01). Clinical levels of PTSD symptoms were reported by 30% to 60% of the sample. Even after controlling for metastatic disease, race, and cancer type, sleep disturbance mediated the relationships between PTSD symptoms and pain intensity (B = 0.27; 95% CI: 0.10-0.44) and PTSD symptoms and pain-related interference (B = 0.58; 95% CI: 0.28-0.87). Conclusions: The relationships among PTSD symptoms, pain intensity, and pain interference could be explained by co-occurring sleep disturbance. Given the high frequency of PTSD symptoms among patients with cancer and PTSD’s known links to sleep problems and pain, clinicians should be attentive to the role that traumatogenic processes may play in eliciting sleep and pain-related complaints among patients with cancer. [ABSTRACT FROM AUTHOR]
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- 2018
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211. Estimating minimally important differences for the PROMIS pain interference scales: results from 3 randomized clinical trials.
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Chen, Chen X., Kroenke, Kurt, Stump, Timothy E., Kean, Jacob, Carpenter, Janet S., Krebs, Erin E., Bair, Matthew J., Damush, Teresa M., and Monahan, Patrick O.
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PAIN management , *CLINICAL trials , *COGNITIVE interference , *LUMBAR pain , *CHRONIC pain - Abstract
Minimally important difference (MID) refers to the smallest meaningful difference that carries implications for patient care. Minimally important differences are necessary to help interpret patient-reported pain outcomes in research and clinical practice. The PROMIS pain interference scales were validated across diverse samples; however, more information about their MIDs could improve their interpretability. The purpose of this study was to estimate MIDs for 4 fixed-length PROMIS pain interference scales, including the 6-item Pain Short Form and the 4-, 6-, and 8-item pain interference scales used in the PROMIS profile instruments. Data were analyzed from 3 randomized controlled trials (N = 759). The 3 samples, respectively, consisted of patients with chronic low back pain (n = 261), chronic back pain or hip/knee osteoarthritis pain (n = 240), and a history of stroke (n = 258). For each sample, anchor- and distribution-based approaches were used to estimate MIDs. Standard error of measurement and effect sizes were used as distribution-based MID estimates. Anchor-based MID estimates were established by mapping PROMIS pain interference scores onto established anchor measures, including the Brief Pain Inventory, and retrospective and prospective global ratings of change. The distribution- and anchor-based MID estimates showed convergence. For the pain samples, MID estimates ranged from 2 to 3 T-score points. For the nonpain sample, MID estimates ranged from 3.5 to 4.5 T-score points. The MID estimates were comparable across the 4 fixed-length scales. These MIDs can be used to evaluate treatment effects in research and clinical care and to calculate estimates for powering clinical trials. [ABSTRACT FROM AUTHOR]
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- 2018
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212. Psychological flexibility moderates the relation between PTSD symptoms and daily pain interference.
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Berghoff, Christopher R., McDermott, Michael J., and Dixon-Gordon, Katherine L.
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TREATMENT of post-traumatic stress disorder , *CHRONIC pain , *SYMPTOMS , *SEVERITY of illness index , *PSYCHOSOCIAL factors - Abstract
Posttraumatic stress disorder (PTSD) symptoms are associated with increased physical health problems, including chronic pain. Although researchers have identified several risk factors that partially account for the co-occurrence of PTSD symptoms and pain, a substantial amount of variance remains unexplained in these models. The present study evaluated psychological flexibility (PF) as a potential moderator of the relation between probable PTSD diagnosis and pain interference in daily life. Probable PTSD participants reported significantly greater daily pain severity and interference, and greater daily pain interference when controlling for pain severity, relative to non-PTSD participants. PF emerged as a significant moderator of the relation of PTSD and pain interference. Participants with probable PTSD reported greater pain interference only in conjunction with low levels of PF. Results suggest psychosocial treatments that target PF as a means of improving functioning may improve outcomes for patients with co-occurring PTSD and chronic pain. [ABSTRACT FROM AUTHOR]
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- 2018
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213. Satisfaction With Life Moderates the Indirect Effect of Pain Intensity on Pain Interference Through Pain Catastrophizing.
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Talaei-Khoei, Mojtaba, Chen, Neal, Ring, David, and Vranceanu, Ana-Maria
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PSYCHOLOGICAL stress , *HEALTH , *PAIN - Abstract
Objective: Satisfaction with life buffers the effect of stress on health, but its role in the mechanism through which pain may impact engagement in activities of daily living is not known. We tested whether satisfaction with life protects against engaging in pain catastrophizing and through this explains individual differences in the extent to which pain interferes with activities of daily living. Method: One-hundred and 42 patients with upper extremity musculoskeletal illness participated in this cross-sectional study and completed the PROMIS pain intensity. PROMIS pain interference, pain catastrophizing scale (PCS), satisfaction with life scale (SWLS), and demographic variables. Results: A simple mediation model confirmed that the indirect effect of pain intensity on pain interference through PCS was 35.9% of the total effect. A moderated mediation analysis showed that the indirect effect of pain intensity on pain interference through PCS was differentially moderated by SWLS after controlling for relevant covariates. As satisfaction with life increased from low to moderate to high, a smaller proportion of the effect of pain intensity on pain interference (41.6%, 26.1%, and 10.5%) was carried through PCS, such that at the highest satisfaction with life, the indirect effect becomes completely nonsignificant. Conclusions: Satisfaction with life appears to buffer the effect of pain in individuals with upper extremity musculoskeletal illness. If replicated through longitudinal designs, results suggest that clinical interventions focused on increasing satisfaction with life, such as acceptance and commitment therapy, mindfulness training, gratitude, and other positive psychology skills, may improve outcomes in this population. [ABSTRACT FROM AUTHOR]
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- 2018
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214. Nurse practitioner led pain management the day after caesarean section: A randomised controlled trial and follow-up study.
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Schoenwald, Anthony, Windsor, Carol, Gosden, Edward, and Douglas, Clint
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CHRONIC pain , *CESAREAN section , *CONFIDENCE intervals , *LONGITUDINAL method , *NURSE practitioners , *POSTOPERATIVE pain , *PAIN management , *OXYCODONE , *PAIN measurement , *RANDOMIZED controlled trials , *DATA analysis software , *DESCRIPTIVE statistics , *ODDS ratio , *NURSING interventions ,PAIN risk factors - Abstract
Background Pain on the day after caesarean section is often treated with controlled-release oxycodone to supplement the decline in analgesia from intrathecal opioids. Evidence suggests that caesarean birth is a biopsychosocial experience where a comprehensive approach is needed that promotes control and participation in pain management. Objectives This study compared immediate-release oxycodone integrated with supportive educational strategies to controlled-release oxycodone. A follow-up phase aimed to explore pain over three months. Design This study was a two-group parallel randomised controlled trial. Setting A metropolitan hospital in Australia with a birthing suite, operating rooms, and a postnatal unit. Participants English-speaking women scheduled for elective caesarean section were mailed trial information. Exclusion criteria included contraindications to intrathecal analgesia, herpes simplex infection, a history of chronic pain, opioid tolerance, or substance abuse. A total of 131 participants were recruited and randomised out of 298 eligible participants. Methods Group allocation was undertaken using sequentially numbered opaque sealed envelopes. The nurse practitioner intervention commenced on the day after surgery with immediate-release oxycodone alongside supportive strategies. The control group received scheduled doses of controlled-release oxycodone. All participants could request additional oxycodone or tramadol. Primary outcomes were pain intensity and secondary outcomes included patient global impression of change, pain interference, opioid consumption, and maternal perception of control. A follow-up phase evaluated pain outcomes over three months. Results The final sample size was 122, with 61 participants in each group. Pain intensity scores were analysed by linear mixed regression models. There were no statistical differences over 24 h between the control and intervention groups at rest ( p = 0.40, 95% CI – 4.8 mm, 11.9 mm) or on sitting or moving ( p = 0.561, 95% CI –15.2 mm, 8.3 mm). Patient global impression of change was significant over three hours ( p = 0.014, OR = 2.5, 95% CI 1.2, 5.3). The intervention group reported less pain interference while consuming less oxycodone ( p < 0.05). There was no difference between groups in terms of perceived control over pain management ( p = 0.273, 95% CI –16.2 mm, 4.6 mm). The follow-up analysis graded 5.9% of participants as experiencing severe pain interference. Chronic pain following caesarean was associated with postnatal depression ( p < 0.001). Conclusions The research showed that a nurse practitioner intervention can improve pain management following caesarean section. The results underscore the influence of biological, psychological, and social factors on acute pain. Hence, this study reinforces the need for a biopsychosocial approach to acute pain management following caesarean delivery. [ABSTRACT FROM AUTHOR]
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- 2018
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215. Do patient perceptions of provider communication relate to experiences of physical pain?
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Ruben, Mollie A., Meterko, Mark, and Bokhour, Barbara G.
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PATIENT satisfaction , *CHRONIC diseases , *PATIENT safety , *MEDICAL communication , *HEALTH education , *PAIN & psychology , *COMMUNICATION , *VETERANS , *EVALUATION of medical care , *PHYSICIAN-patient relations , *SELF-efficacy , *PATIENTS' attitudes - Abstract
Objectives: Patient-provider communication is an important component of the medical interaction yet little research has examined the relationships between perceptions of communication and health outcomes or the mechanisms by which communication may ameliorate the pain experience. This is the first study to examine the relationships between patients' perceptions of provider communication, pain intensity and self-efficacy for managing chronic disease.Methods: The total sample contained 1027 (85.8% male) Veteran patients. Patients responded to surveys about their experiences and outcomes of care, including measures of patient-provider communication, self-efficacy and pain outcomes including pain intensity and pain interference.Results: Results showed more positive perceptions of provider communication were related to lower levels of pain intensity and pain interference and that this relationship was significantly mediated by higher levels of self-efficacy for managing chronic disease.Conclusion: More positive provider communication was related to higher levels of self-efficacy, which in turn was related to lower levels of pain intensity and pain interference. Findings suggest that providers may be able to elicit higher levels of self-efficacy in their patients by providing patient-centered communication, which in turn will reduce pain intensity and interference in their patient's lives. [ABSTRACT FROM AUTHOR]- Published
- 2018
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216. Construct validity of the G-CPAQ and its mediating role in pain interference and adjustment.
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Vasiliou, Vasilis S., Karekla, Maria, Michaelides, Michalis P., and Kasinopoulos, Orestis
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CHRONIC pain & psychology , *TEST validity , *CHRONIC pain , *PSYCHOSOCIAL factors , *SOCIAL adjustment , *DIAGNOSIS - Abstract
The Chronic Pain Acceptance Questionnaire (CPAQ) is a measure of pain acceptance comprised of pain willingness (PW) and activity engagement (AE; McCracken et al., 2004). Concerns about the factorial structure of the CPAQ exist, as it is not yet clear whether PW and AE constitute 2 independent constructs or 1, pain acceptance. Concerns also exist about the internal and predictive validity of test score interpretations of this measure. This study also presents that the choice of predictor variables has contributed to theoretical confusion regarding the impact of pain acceptance on pain-related adjustment. The purpose of this study was: (a) to examine the psychometric properties of both the long (20 items) and short (8 items) versions of the Greek-Chronic Pain Acceptance Questionnaire (G-CPAQ); (b) to examine the utility of a 2-factor solution in predicting psychosocial adjustment to pain using confirmatory factor analysis; and (c) to explore the mediating effects of pain acceptance and cognitive defusion, comprising the "open" response style to pain, between pain interference and pain related outcomes. One hundred and sixty chronic pain patients completed a questionnaire packet including pain indexes, pain acceptance, cognitive fusion, avoidance, and emotional distress. Confirmatory factor analyses supported the 2-factor solution, though a general good model fit was achieved only for the short G-CPAQ version. Structural equation modeling showed that PW and AE coupled with cognitive defusion partially mediated the influence of pain interference on pain severity, emotional distress, and avoidance of pain. (PsycINFO Database Record [ABSTRACT FROM AUTHOR]
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- 2018
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217. A systematic review of the effectiveness of patient-based educational interventions to improve cancer-related pain.
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Oldenmenger, Wendy H., Geerling, Jenske I., Mostovaya, Irina, Vissers, Kris C.P., de Graeff, Alexander, Reyners, Anna K.L., and van der Linden, Yvette M.
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Background: Despite existing guidelines to assess and manage pain, the management of cancer-related pain is often suboptimal with patients often being undertreated. Inadequate pain management may be due to patient-related barriers. Educating patients may decrease these barriers. However, the effect of pain education on patient-related outcomes is still unclear. This review aimed to study the effect of educational interventions on cancer-related pain.Design: We performed a systematic review of randomized controlled trials (RCTs) identified from Medline and Cinahl, from 1995 to May 2017. Two reviewers independently selected trials comparing educational intervention to usual care or an active control intervention. The methodological quality was assessed and data extraction was done independently. Primary outcome measures were pain intensity and interference. Secondary outcome measures were knowledge/barriers, medication adherence and self-efficacy.Results: Twenty-six RCTs totaling 4735 patients met our inclusion criteria. Compared to the control group, 31% of the studies (including 19% of all patients) reported a significant difference in pain intensity in favor of the intervention group. Twelve studies measured pain interference and four (30%) found a significant improvement. With regard to secondary endpoints, significant differences in favor of the experimental arms were found for pain knowledge or barriers (15/22 studies; 68%), medication adherence (3/6 studies; 50%) and self-efficacy (1/2 studies).Conclusions: Patient-based pain educational programs may result in improvements of relevant patient-reported outcomes. However, the interventions are heterogeneous and improvement of pain was only seen in less than one third of the studies and in less than 20% of all included patients. [ABSTRACT FROM AUTHOR]- Published
- 2018
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218. Type D personality in patients with upper extremity musculoskeletal illness: Internal consistency, structural validity and relationship to pain interference.
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Talaei-Khoei, Mojtaba, Mohamadi, Amin, Fischerauer, Stefan F., Ring, David, and Vranceanu, Ana-Maria
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PAIN & psychology , *AFFECT (Psychology) , *DEFENSE mechanisms (Psychology) , *EVALUATION of medical care , *MUSCULOSKELETAL system diseases , *PERSONALITY , *SYMPTOMS , *PSYCHOLOGY - Abstract
Objective Type D personality – the joint tendency toward negative affectivity (NA) and social inhibition (SI) – is associated with greater symptom perception and negative health outcomes among various patient populations. We investigated Type D personality among patients with upper extremity musculoskeletal illness. Method In cross-sectional design, we estimated the prevalence of Type D personality in this population and explored the associations of two different Type D conceptualizations (i.e., categorical and dimensional as the NA × SI interaction) and the individual NA and SI traits with pain interference as well as structural-internal validity of DS14. Results The categorical Type D personality and greater NA and SI were associated with pain interference above and beyond descriptive variables, but the interaction term between NA and SI was not. NA explained a larger proportion of the variance in pain interference than SI. DS14 showed a two-factor structure and high internal consistency in this sample. Conclusions The categorical Type D allows for identifying individuals who struggle with recovery from musculoskeletal injury. Although the dimensional conceptualization didn't prove to be associated with pain interference, NA and SI appear to have individual effects on pain interference, with most variance being accounted for by NA. Implications for clinical care are discussed. [ABSTRACT FROM AUTHOR]
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- 2018
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219. Examining HIV-Related stigma in relation to pain interference and psychological inflexibility among persons living with HIV/AIDS: The role of anxiety sensitivity.
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Wong, Celia C. Y., Paulus, Daniel J., Lemaire, Chad, Leonard, Amy, Sharp, Carla, Neighbors, Clayton, Brandt, Charles P., Lu, Qian, and Zvolensky, Michael J.
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ANXIETY , *CONFIDENCE intervals , *FEAR , *MATHEMATICAL models , *PAIN , *RESEARCH funding , *SOCIAL stigma , *THEORY , *EFFECT sizes (Statistics) , *DATA analysis software , *DESCRIPTIVE statistics ,HIV infections & psychology - Abstract
Pain is highly prevalent among people living with HIV (PLHIV). Although the association between stigma and pain among stigmatized individuals has been well-established in the non-HIV chronic pain literature, little is known about the association between stigma and pain among PLHIV and the mechanisms that underlie this association. The present study examined the indirect effect of HIV stigma and pain via anxiety sensitivity (fear of anxiety symptoms). The sample included 97 PLHIV (60.2% male,
M age = 48.40,SD = 7.75). Results indicated significant and medium-sized indirect effects of HIV stigma on pain severity, pain interference, and psychological inflexibility in pain via anxiety sensitivity. Alternative models did not yield significant indirect effects. The results suggest anxiety sensitivity may explain the association between stigma and pain among PLHIV. These findings provide novel empirical insight into the nature of stigma-pain relation among PLHIV and could be used to guide pain-based intervention development for this population. [ABSTRACT FROM AUTHOR]- Published
- 2018
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220. Reduction of opioid use and improvement in chronic pain in opioid-experienced patients after topical analgesic treatment: an exploratory analysis.
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Gudin, Jeffrey A, Brennan, Michael J, Harris, E. Dennis, Hurwitz, Peter L, Dietze, Derek T, and Strader, James D
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CHRONIC pain ,DRUG therapy ,OPIOIDS ,ANALGESICS ,FOLLOW-up studies (Medicine) ,SEVERITY of illness index ,PREVENTION ,SUBSTANCE abuse prevention ,THERAPEUTIC use of narcotics ,COMBINED modality therapy ,DRUG administration ,LONGITUDINAL method ,PATIENT satisfaction ,SELF-evaluation ,CUTANEOUS therapeutics ,PAIN measurement ,TREATMENT effectiveness ,DIAGNOSIS - Abstract
Objective: There is a need to identify safe and effective opioid-sparing multimodal alternative treatment strategies and approaches, including topical analgesics, for opioid-experienced chronic pain patients to mitigate the risk of addiction, misuse, and abuse of opioids.Methods: This subset analysis from a prospective, observational study evaluated changes in opioid use, other concurrent medication use, and pain severity and interference in opioid-experienced patients (OEP) treated with topical analgesics for chronic pain with measures obtained at baseline and 3- and 6- month follow-up.Results: The 3-month opioid-experienced patient (3-month OEP) group included 121 patients who completed baseline and 3-month follow-up assessments; 27 opioid-experienced patients completed baseline and 6-month follow-up assessments (6-month OEP). Demographic characteristics, and mean pain severity and interference scores were similar between groups at baseline. After treatment with topical analgesics, 49% of patients in the 3-month and 56% of patients in the 6-month group reported they had completely discontinued use of opioids. In addition, 31% of patients at the 3-month assessment and 30% at the 6-month assessment reported that they were no longer taking any pain medication. Other concurrent medications decreased by 65% after 3 months, and 74% after 6 months. There were statistically significant decreases from baseline in pain severity and interference scores within the 3- (CI:0.7-1.4, 1.4-2.2) and 6-month (CI:0.7-2.4 (severity); CI:1.2-3.5 (interference)) OEP groups.Conclusions: Opioid use and other concurrent medications decreased among opioid-experienced chronic pain patients after 3- and 6- months of treatment with topical analgesics. Pain severity and interference scores also decreased. The topical analgesics were reported to be effective and safe for the treatment of chronic pain, with randomized controlled trials needed to confirm these findings. [ABSTRACT FROM AUTHOR]- Published
- 2018
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221. The impact of experiential avoidance on the relations between illness representations, pain catastrophising and pain interference in chronic pain.
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Karademas, Evangelos C., Karekla, Maria, Flouri, Magdalini, Vasiliou, Vasilis S., Kasinopoulos, Orestis, and Papacostas, Savvas S.
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CHRONIC pain & psychology , *PSYCHOLOGICAL adaptation , *AVOIDANCE (Psychology) , *SELF-management (Psychology) , *DATA analysis software - Abstract
Objective:The aim of this study was to examine the effects of experiential avoidance (EA) on the indirect relationship of chronic pain patients’ illness representations to pain interference, through pain catastrophising Design and main outcome measure:The sample consisted of 162 patients diagnosed with an arthritis-related or a musculoskeletal disorder. The effects of EA on the pathway between illness representations, pain catastrophising and pain interference were examined with PROCESS, a computational tool for SPSS Results:After controlling for patient and illness-related variables and pain severity, the ‘illness representations–pain catastrophising–pain interference’ pathway was interrupted at the higher levels of EA. The reason was that, at the high levels of EA, either the relation of illness representations to pain catastrophising or the relation of pain catastrophising to pain interference was not statistically significant. Conclusion:The findings indicate that EA is not a generalised negative response to highly aversive conditions, at least as far as the factors examined in this study are concerned. EA may rather reflect a coping reaction, the impact of which depends on its specific interactions with the other aspects of the self-regulation mechanism. At least in chronic pain, EA should become the focus of potential intervention only when its interaction with the illness-related self-regulation mechanism results in negative outcomes. [ABSTRACT FROM PUBLISHER]
- Published
- 2017
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222. Multidisciplinary Approach and Chronic Pain
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Roy, Ranjan and Roy, Ranjan
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- 2008
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223. Racial-ethnic Disparities in Pain Intensity and Interference Among Middle-aged and Older U.S. Adults
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Hanna Grol-Prokopczyk, Karl Pillemer, M. Carrington Reid, and Yulin Yang
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Aging ,Multivariate analysis ,business.industry ,THE JOURNAL OF GERONTOLOGY: Medical Sciences ,Psychological intervention ,Ethnic group ,Black People ,Pain Interference ,Health Status Disparities ,Hispanic or Latino ,Middle Aged ,Health and Retirement Study ,United States ,Health equity ,Racial ethnic ,Social Class ,Ethnicity ,Humans ,Medicine ,Geriatrics and Gerontology ,business ,Socioeconomic status ,Aged ,Pain Measurement ,Clinical psychology - Abstract
Background This study aims to better understand differing pain experiences across U.S. racial/ethnic subgroups by estimating racial-ethnic disparities in both pain intensity and domain-specific pain-related interference. To address this issue, we use a nationally representative sample of non-Hispanic White, non-Hispanic Black, and Hispanic adults ages 50+ who report recently experiencing pain. Methods Using data from the 2010 wave of the Health and Retirement Study (HRS; N = 684), we conducted a series of multivariate analyses to assess possible racial/ethnic disparities in pain intensity and 7 domains of pain interference, controlling for relevant sociodemographic variables and other health problems. Results Black and Hispanic participants reported higher pain intensity than White participants after controlling for socioeconomic status (SES) and other health conditions. Both Black and Hispanic individuals reported more domain-specific pain interference in bivariate analyses. In multivariate analyses, Black (vs White) participants reported significantly higher levels of pain interference with family–home responsibilities, occupation, sexual behavior, and daily self-care. We did not find significant Hispanic-White differences in the 7 pain interference domains, nor did we find Black-White differences in 3 domains (recreation, social activities, and essential activities). Conclusions Our findings highlight the need for using multidimensional measures of pain when assessing for possible pain disparities with respect to race/ethnicity. Future studies on pain interventions should consider contextualizing the pain experience across different racial subgroups to help pain patients with diverse needs, with the ultimate goal of reducing racial/ethnic disparities in pain.
- Published
- 2021
224. Can PROMIS measures be used to create subgroups for patients seeking orthopaedic care?
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Emily K. Reinke, Steven Z. George, Maggie E. Horn, Sheng Luo, Xiaofang Yan, Steven A. Olson, and Michael P. Bolognesi
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General Orthopaedics ,medicine.medical_specialty ,Complications ,Pain Interference ,Glycemic Control ,Physical function ,Prognostic ,03 medical and health sciences ,0302 clinical medicine ,Information system ,Medicine ,030212 general & internal medicine ,Routine care ,Orthopedic surgery ,030222 orthopedics ,Patient-reported outcomes ,business.industry ,General Engineering ,Outcome measures ,Glycated Haemoglobin ,Pain interference ,Phenotypes ,Glucose ,Physical therapy ,business ,Glucose Variability ,RD701-811 - Abstract
Aims Patient-reported outcome measures have become an important part of routine care. The aim of this study was to determine if Patient-Reported Outcomes Measurement Information System (PROMIS) measures can be used to create patient subgroups for individuals seeking orthopaedic care. Methods This was a cross-sectional study of patients from Duke University Department of Orthopaedic Surgery clinics (14 ambulatory and four hospital-based). There were two separate cohorts recruited by convenience sampling (i.e. patients were included in the analysis only if they completed PROMIS measures during a new patient visit). Cohort #1 (n = 12,141; December 2017 to December 2018,) included PROMIS short forms for eight domains (Physical Function, Pain Interference, Pain Intensity, Depression, Anxiety, Sleep Quality, Participation in Social Roles, and Fatigue) and Cohort #2 (n = 4,638; January 2019 to August 2019) included PROMIS Computer Adaptive Testing instruments for four domains (Physical Function, Pain Interference, Depression, and Sleep Quality). Cluster analysis (K-means method) empirically derived subgroups and subgroup differences in clinical and sociodemographic factors were identified with one-way analysis of variance. Results Cluster analysis yielded four subgroups with similar clinical characteristics in Cohort #1 and #2. The subgroups were: 1) Normal Function: within normal limits in Physical Function, Pain Interference, Depression, and Sleep Quality; 2) Mild Impairment: mild deficits in Physical Function, Pain Interference, and Sleep Quality but with Depression within normal limits; 3) Impaired Function, Not Distressed: moderate deficits in Physical Function and Pain Interference, but within normal limits for Depression and Sleep Quality; and 4) Impaired Function, Distressed: moderate (Physical Function, Pain Interference, and Sleep Quality) and mild (Depression) deficits. Conclusion These findings suggest orthopaedic patient subgroups differing in physical function, pain, and psychosocial distress can be created from as few as four different PROMIS measures. Longitudinal research is necessary to determine whether these subgroups have prognostic validity. Cite this article: Bone Jt Open 2021;2(7):493–502.
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- 2021
225. Cannabis use, pain interference, and prescription opioid receipt among persons with HIV: a target trial emulation study
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Rachel Vickers-Smith, E. Jennifer Edelman, Yu Li, William C. Becker, Ellen C. Caniglia, Termeh M. Feinberg, and Brandon D.L. Marshall
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Male ,medicine.medical_specialty ,Health (social science) ,Social Psychology ,Pain Interference ,HIV Infections ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,030212 general & internal medicine ,Cannabis ,030505 public health ,biology ,business.industry ,Public Health, Environmental and Occupational Health ,Chronic pain ,Middle Aged ,Cannabis use ,medicine.disease ,biology.organism_classification ,Analgesics, Opioid ,Prescriptions ,Opioid ,Concomitant ,Physical therapy ,Female ,Observational study ,Chronic Pain ,0305 other medical science ,business ,medicine.drug ,Cohort study - Abstract
Concomitant with expanded legalization, cannabis is increasingly used to treat chronic pain among persons with HIV (PWH), despite equivocal benefit in research limited by small sample sizes and short duration of follow-up. To address these limitations, among a sample of PWH with pain interference enrolled in the Veterans Aging Cohort Study, we performed a target trial emulation study to compare the impact of four cannabis use strategies on pain interference. Among those receiving long-term opioid therapy (LTOT), we also explored impact of these strategies on ≥ 25% LTOT dose reduction. Among the analytic sample (N = 1284), the majority were men with a mean age of 50. Approximately 31% used cannabis and 12% received LTOT at baseline. Adjusting for demographic and clinical factors, cannabis use in any of 4 longitudinal patterns was not associated with resolved pain interference over 12- to 24-month follow-up. Among 153 participants receiving LTOT at baseline, cannabis use at both baseline and follow-up was negatively associated with LTOT dose reduction compared to no use at both baseline and follow-up. These findings support other observational studies finding no association between cannabis use and improved chronic pain or LTOT reduction among PWH.
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- 2021
226. Pain experience in an aging adult population during a 10-year follow-up
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Hanna Vuorimaa, Hannu Kautiainen, Maiju K Marttinen, and Markku Kauppi
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Adult ,Aging ,medicine.medical_specialty ,Adult population ,Pain ,Pain Interference ,Affect (psychology) ,Logistic regression ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Humans ,Medicine ,030212 general & internal medicine ,Child ,Pain Measurement ,Pain experience ,business.industry ,10 year follow up ,medicine.disease ,Intensity (physics) ,Anesthesiology and Pain Medicine ,Neurology (clinical) ,Metabolic syndrome ,business ,030217 neurology & neurosurgery ,Follow-Up Studies - Abstract
Objectives This 10-year follow-up study aimed to examine the persistence of SF-36 pain intensity and pain-related interference and to identify baseline factors that may relate to pain experience among community-dwelling aging adults. Methods Questionnaire and clinical data on a total of 1,954 participants (mean age at baseline 63 years) were collected in 2002, 2005, 2008, and 2012. Based on pain reports, four pain intensity, pain interference (PIPI) groups were formed at each time point: PIPI group I: none to mild pain intensity and interference; II: moderate to extreme pain intensity, none to mild pain-related interference; III: None to mild pain intensity, moderate to extreme pain-related interference, IV: Moderate to extreme pain intensity and interference. Results Participants with the most pain at baseline improved their pain situation the most during the follow-up. Higher BMI was associated with pain interference, and metabolic syndrome (MetS) and musculoskeletal diseases with both pain intensity and interference (p Conclusions Multiple factors may affect pain persistence in late adulthood with varying effect on pain intensity and pain-related interference. Pain situation of even those with most pain may be improved.
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- 2021
227. Evaluation of PROMIS’ Ability to Detect Immediate Postoperative Symptom Improvement Following Carpal Tunnel Release
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Calvin H. Englert, David N. Bernstein, and Warren C. Hammert
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medicine.medical_specialty ,Pain Interference ,030230 surgery ,Upper Extremity ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Carpal tunnel release ,Humans ,Orthopedics and Sports Medicine ,Clinical significance ,Carpal tunnel ,Patient Reported Outcome Measures ,Postoperative Period ,Hand clinic ,Carpal tunnel syndrome ,Depression (differential diagnoses) ,030222 orthopedics ,business.industry ,medicine.disease ,Carpal Tunnel Syndrome ,medicine.anatomical_structure ,Symptom improvement ,Physical therapy ,Surgery ,business ,Boston - Abstract
Purpose We sought to determine whether subjective clinical improvement immediately after carpal tunnel release (CTR) was captured by Patient-Reported Outcomes Measurement Information System (PROMIS) Upper Extremity (UE), Physical Function (PF), Pain Interference (PI), and Depression. Methods Between September 2018 and January 2020, patients presenting to a single academic medical center hand clinic were asked to complete PROMIS UE, PF, PI, and Depression computer adaptive tests. In addition, patients who had CTR were asked to answer the following at their first postoperative clinic visit: “Since my last clinic visit, my condition is: (1) much better; (2) mildly better; (3) no change; (4) mildly worse; (5) much worse.” For each patient, the last clinic visit was the final preoperative visit. The PROMIS domain scores were compared before and after surgery using paired t tests. The percentage of patients subjectively reporting better symptoms was calculated. Results A total of 156 patients fit our inclusion criteria. The average number of days between the final preoperative visit and CTR was 7 (range, 0–30), and the average number of days between CTR and the first postoperative visit was 9 (range, 3–21). A total of 116 patients (74%) reported their carpal tunnel syndrome was better at their first postoperative visit. However, PROMIS UE, PF, and PI scores were significantly worse at the first postoperative visit, although not at clinically appreciable levels. There was no statistical or clinical difference in PROMIS Depression scores from pre- to postoperative time points. Conclusions Nearly 75% of patients subjectively report their carpal tunnel syndrome is better at their first follow-up visit within 3 weeks of CTR; however, PROMIS does not capture this improvement. Clinical relevance Hand surgeons evaluating patients shortly following CTR should be aware of the potential limitation of PROMIS to accurately capture immediate postoperative clinical outcomes. Disease-specific Patient-Reported Outcome Measures, such as the Boston Carpal Tunnel Questionnaire , may be preferred during this immediate postoperative timeframe.
- Published
- 2021
228. Physical Function and Pain Interference Levels of Hallux Rigidus Patients Before and After Synthetic Cartilage Implant vs Arthrodesis Surgery
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Jessica M Kohring, Peter Y Joo, John P. Ketz, Judith F. Baumhauer, A. Samuel Flemister, Jeff Houck, Benedict F. DiGiovanni, Samantha L. Hoffman, Irvin Oh, and Olivia Waldman
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medicine.medical_specialty ,Arthrodesis ,medicine.medical_treatment ,Pain ,Pain Interference ,Arthritis ,Physical function ,Prosthesis Design ,03 medical and health sciences ,Hallux rigidus ,0302 clinical medicine ,Quality of life ,Hallux Rigidus ,medicine ,Humans ,Orthopedics and Sports Medicine ,030222 orthopedics ,business.industry ,Cartilage ,030229 sport sciences ,Middle Aged ,medicine.disease ,Surgery ,medicine.anatomical_structure ,Quality of Life ,Implant ,business - Abstract
Background: Hallux rigidus is a common and painful degenerative condition of the great toe limiting a patient’s physical function and quality of life. The purpose of this study was to investigate pre- and postoperative physical function (PF) and pain interference (PI) levels of patients undergoing synthetic cartilage implant hemiarthroplasty (SCI) vs arthrodesis (AD) for treatment of hallux rigidus using the Patient-Reported Outcomes Measurement Information System (PROMIS). Methods: PROMIS PF and PI t scores were analyzed for patients who underwent either SCI or AD. Postoperative final PROMIS t scores were obtained via phone survey. Linear mixed model analysis was used to assess differences in PF and PI at each follow-up point. Final follow-up scores were analyzed using independent sample t tests. Results: Total 181 (59 SCI, 122 AD) operatively managed patients were included for analysis of PROMIS scores. Final phone survey was performed at a minimum of 14 (mean 33, range, 14-59) months postoperatively, with 101 patients (40 SCI, 61 AD) successfully contacted. The mean final follow-up was significantly different for SCI and AD: 27 vs 38 months, respectively ( P < .01). The mean age of the SCI cohort was lower than the AD cohort (57.5 vs 61.5 years old, P = .01). Average PF t scores were higher in the SCI cohort at baseline (47.1 and 43.9, respectively, P = .01) and at final follow-up (51.4 vs 45.9, respectively, P < .01). A main effect of superior improvement in PF was noted in the SCI group (+4.3) vs the AD group (+2) across time intervals ( P < .01). PI t scores were similar between the 2 procedures across time points. Conclusion: The SCI cohort reported slightly superior PF t scores preoperatively and at most follow-up time points compared with the arthrodesis group. No differences were found for PI or complication rates between the 2 treatment groups during this study time frame. Level of Evidence: Level IV, case series.
- Published
- 2021
229. Determinants of pain interference and headache impact in patients who have chronic migraine with medication overuse: Results from the MOTS trial
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John J. Wald, Judy Lane, Nicole M. Spare, Vincent T. Martin, Justin DeLange, Marius Birlea, FM Cutrer, Howard Schecht, Kristina Lopez, Maike Tiede Blaya, Mots Investigators, Kathleen B. Digre, Natalia Murinova, Joseph G. Hentz, Karly Pippitt, David W. Dodick, Melissa M. Cortez, Paul Rizzoli, Teri Robert, Todd J. Schwedt, William Mullally, Zubair Ahmed, and Soma Sahai-Srivastava
- Subjects
Adult ,medicine.medical_specialty ,Migraine Disorders ,Headache impact ,Pain Interference ,Anxiety ,03 medical and health sciences ,0302 clinical medicine ,Chronic Migraine ,Headache Disorders, Secondary ,Humans ,Medicine ,In patient ,030212 general & internal medicine ,Prescription Drug Overuse ,Pain Measurement ,Analgesics ,business.industry ,Headache ,General Medicine ,medicine.disease ,Migraine ,Physical therapy ,Neurology (clinical) ,business ,Medication overuse ,030217 neurology & neurosurgery - Abstract
Objective “Pain interference” and “headache impact” refer to negative consequences that pain and headache have on one’s life. This study investigated determinants of these negative impacts in a large patient cohort who have chronic migraine with medication overuse. Methods Six hundred and eleven adults were enrolled from 34 headache, neurology, and primary care clinics. Negative consequences of chronic migraine with medication overuse were determined using the Patient-Reported Outcomes Measurement Information System (PROMIS) Pain Interference 6b questionnaire and the Headache Impact Test 6. Relationships between PROMIS-6b and Headache Impact Test 6 scores with demographics, headache characteristics, medication use, anxiety symptoms, and depression symptoms were assessed with linear regression. Elastic Net regression was used to develop a multiple regression model. Results PROMIS-6b T-Scores averaged 65.2 (SD 5.4) and Headache Impact Test 6 scores averaged 65.0 (SD 5.3), indicating severe negative consequences of chronic migraine with medication overuse. Chronic migraine with medication overuse interfered with enjoyment of life, concentration, daily activities, doing tasks away from home, and socializing. Depression symptom severity had the strongest relationship with pain interference and headache impact. Moderate-to-severe headache frequency, headache intensity, and anxiety symptoms were also associated with pain interference and headache impact. Conclusions Chronic migraine with medication overuse is associated with substantial negative consequences, the extent of which is most strongly related to depression symptoms.
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- 2021
230. Predictors of postoperative pain using PROMIS pain interference two-years following knee surgery
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Michael J. Foster, Patrick M.J. Sajak, Matheus B. Schneider, Ali Aneizi, Moli Karsalia, Vidushan Nadarajah, Tina Zhang, R. Frank Henn rd, and Sean J. Meredith
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030222 orthopedics ,medicine.medical_specialty ,business.industry ,Postoperative pain ,Confounding ,Pain Interference ,030229 sport sciences ,Article ,03 medical and health sciences ,0302 clinical medicine ,Knee surgery ,Rating scale ,Physical therapy ,Medicine ,Anxiety ,Orthopedics and Sports Medicine ,Medical history ,medicine.symptom ,business ,Lower income - Abstract
Introduction The purpose of this study was to identify preoperative factors associated with worse PROMIS Pain Interference (PI) two years following knee surgery. Methods Participants completed surveys preoperatively and two years postoperatively. Data collected included demographics, medical history, and multiple patient-reported outcomes measures, including PROMIS PI. Results After controlling for confounders, lower income, smoking, worse PROMIS Anxiety, worse Numeric Pain Score body pain, and worse Marx Activity Rating Scale were independent predictors for worse PROMIS PI two years after surgery. Conclusion Worse PROMIS PI two years after elective knee surgery is associated with multiple socio-demographic patient identifiers.
- Published
- 2021
231. The Associations Between Sleep Disturbance, Psychological Dysfunction, Pain Intensity, and Pain Interference in Children with Chronic Pain
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Universitat Rovira i Virgili, Sole, Ester; Sharma, Saurab; Ferreira-Valente, Alexandra; Pathak, Anupa; Sanchez-Rodriguez, Elisabet; Jensen, Mark P.; Miro, Jordi, Universitat Rovira i Virgili, and Sole, Ester; Sharma, Saurab; Ferreira-Valente, Alexandra; Pathak, Anupa; Sanchez-Rodriguez, Elisabet; Jensen, Mark P.; Miro, Jordi
- Abstract
Objectives This study aimed to better understand the associations between both sleep disturbance and psychological dysfunction (i.e., anxiety and depressive symptoms, and anger), and pain intensity and pain interference, in a sample of children with chronic pain. Design Cross-sectional design. Methods Three hundred and forty-two children with chronic pain (8-18 years) completed measures assessing pain intensity, pain interference, sleep disturbance, anxiety, depressive symptoms, and anger. Regression analyses examined the direct, interaction (with sex), and mediation effects of sleep quality and psychological dysfunction on pain intensity and interference. Results Sleep disturbance was significantly associated with both pain intensity and pain interference. However, measures of psychological dysfunction were associated significantly only with pain interference. Sex did not moderate these associations. The measures of psychological dysfunction mediated the associations between sleep disturbance and pain interference but not those between sleep disturbance and pain intensity. Conclusions The results confirmed significant cross-sectional associations between both sleep disturbance and psychological dysfunction and pain outcomes in children with chronic pain. Future research to test for causal associations is warranted.
- Published
- 2022
232. Pain Interference, Resilience, and Perceived Well-Being During COVID-19: Differences Between Women With and Without Trauma Exposure Prior to the Pandemic
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Elena R. Serrano-Ibáñez, Carmen Ramírez-Maestre, Gema T. Ruiz-Párraga, Rosa Esteve, and Alicia E. López-Martínez
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Health (social science) ,Public Health, Environmental and Occupational Health ,COVID-19 ,pain interference ,Pain ,Resilience, Psychological ,trauma exposure ,well-being ,women health ,Communicable Disease Control ,Humans ,Female ,resilience ,Pandemics - Abstract
Objectives: The aim of this study was to investigate the consequences of the COVID-19 pandemic in women with non-malignant chronic pain, and to determine whether women exposed to traumatic situations prior to the outbreak would be at a higher risk of negative health impacts.Methods: A total of 365 women were divided into three subgroups according to whether or not they had experienced a traumatic event prior to COVID-19. They completed an online survey.Results: Significant differences were found between groups during lockdown: 1) more psychological abuse was experienced by the group of women who had experienced an interpersonal traumatic event prior to the pandemic than in the other subgroups; 2) physical activity levels were higher and scores on pain interference were lower in women in the non-traumatized subgroup than in the other subgroups; 3) pain interference was predicted by pain intensity, decreased social support, and resilience, whereas perceived well-being was predicted by pain interference.Conclusion: Women who had experienced a traumatic event prior to the pandemic suffered worse consequences of the COVID-19 lockdown, particularly greater pain interference, although resilience was shown to both mitigate pain interference and enhance perceived well-being.
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- 2022
233. More than Hurt Feelings: The Wear and Tear of Day-to-Day Discrimination in Adults with Chronic Pain
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Selin Goktas, Anthony D. Ong, and M. Carrington Reid
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Adult ,Male ,media_common.quotation_subject ,Emotions ,Pain Interference ,medicine ,Humans ,Social isolation ,media_common ,business.industry ,Chronic pain ,Cognition ,Loneliness ,General Medicine ,medicine.disease ,United States ,Pain & Aging Section ,Confidence interval ,Analgesics, Opioid ,Cross-Sectional Studies ,Anesthesiology and Pain Medicine ,Feeling ,Cohort ,Female ,Self Report ,Neurology (clinical) ,Chronic Pain ,medicine.symptom ,business ,Clinical psychology - Abstract
Objective To examine the extent to which self-reported experiences of discrimination are associated with pain interference among men and women with chronic non-cancer pain. Methods Data are from the Study of Midlife in the United States (MIDUS) Refresher Cohort. The analytic sample consisted of 207 adults with chronic pain (54.2 ± 12.8 years; 53.6% female) who completed the Major Experiences of Discrimination and Everyday Discrimination scales. Regression analyses examined cross-sectional relations between discrimination and pain interference. Results On average, the level of pain interference was moderate in the sample (mean = 3.46, standard deviation = 2.66; observed range 0–10). Approximately a third of respondents reported at least one major discriminatory event in their lifetime, while 22% reported three or more discriminatory lifetime events. Everyday discrimination scores averaged 14.19 ± 5.46 (observed range 0–33). With adjustment for sociodemographics, physical health, cognitive and psychological factors, social isolation, and loneliness, everyday discrimination was associated with increased pain interference (B = 0.099; 95% confidence interval [CI]: 0.02 to 0.17). Conclusion These findings add weight to the importance of day-to-day experiences of interpersonal discrimination by documenting independent associations with functional interference in adults with chronic pain.
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- 2021
234. Evaluating Immediate and Short-Term Postoperative Clinical Outcomes of Patients Undergoing Ulnar Shortening for Ulnar Impaction Syndrome Using PROMIS
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Warren C. Hammert, David N. Bernstein, and Richard D. Lander
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030222 orthopedics ,medicine.medical_specialty ,Ulnar impaction syndrome ,business.industry ,Minimal clinically important difference ,Pain Interference ,Physical function ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Orthopedics and Sports Medicine ,Functional status ,030212 general & internal medicine ,Level ii ,Ulnar shortening ,business ,Depression (differential diagnoses) - Abstract
Background The early recovery trajectory of patients undergoing ulnar shortening for ulnar impaction syndrome using the Patient-Reported Outcomes Measurement Information System (PROMIS) is unknown. Questions/Purposes Using PROMIS Upper Extremity (UE), Physical Function (PF), Pain Interference (PI), and Depression, we asked (1) do patients undergoing operative management for ulnar impaction syndrome present at their preoperative visit with notable impairment?; (2) At immediate follow-up, do patients present with a clinically appreciable change in symptom severity?; and (3) At short-term follow-up, do patients present with a clinically appreciable change in symptom severity? Materials and Methods We identified patients from 01/2017 to 12/2019 at our institution undergoing ulnar shortening for ulnar impaction syndrome who completed all PROMIS domains at a preoperative visit and at least one postoperative time point (i.e., less than 4 weeks and/or greater than 12 weeks). Distribution- and anchor-based minimal clinically important difference estimates were used to evaluate clinically appreciable changes in symptoms over time. Results A total of 38 patients met our inclusion criteria. The average change in PROMIS UE, PF, PI, and Depression scores from preoperative to immediate postoperative follow-up were –3.8, –4.3, 3.2, and 0.5, respectively. However, by short-term follow-up, the average change in PROMIS UE, PF, PI, and Depression scores were 3.7, 3.2, –4.7, and –3.9, respectively. Conclusions Patients have worsening function at the immediate postoperative follow-up. By short-term postoperative follow-up, functional status and PI levels improve. Our findings can help hand surgeons provide evidence-based guidance on expected initial recovery following operative management for ulnar impaction syndrome. Level of Evidence This is a level II, prognostic study.
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- 2021
235. Does Pain Acceptance Buffer the Negative Effects of Catastrophizing on Function in Individuals With Chronic Pain?
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Saurab Sharma, Alexandra Ferreira-Valente, Jordi Miró, Ester Solé, Mark P. Jensen, Rocio de la Vega, Elisabet Sánchez-Rodríguez, and Anupa Pathak
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medicine.medical_specialty ,business.industry ,Catastrophization ,Treatment outcome ,Chronic pain ,Pain Interference ,medicine.disease ,03 medical and health sciences ,0302 clinical medicine ,Anesthesiology and Pain Medicine ,Activity engagement ,030202 anesthesiology ,medicine ,Physical therapy ,Pain catastrophizing ,Neurology (clinical) ,business ,030217 neurology & neurosurgery ,Depression (differential diagnoses) - Abstract
Objectives Pain catastrophizing and pain acceptance are psychological factors that have been shown to be associated with pain-related outcomes and predict multidisciplinary pain treatment outcomes. However, they are rarely examined in the same study. This study aimed to: (1) assess the independent roles of pain catastrophizingand pain acceptance as predictors of pain intensity, pain interference, and depression; and (2) evaluate the potential moderating role of pain acceptance on the association between pain catastrophizing and both pain and function. Materials and methods A sample of 467 adults with chronic pain completed an online survey including measures of pain intensity, pain interference, depression, pain catastrophizing, and pain acceptance. Results Pain catastrophizing and pain acceptance were independent predictors of pain interference. Only pain catastrophizing and the activity engagement domain of pain acceptance were independent predictors of pain intensity and depression. Activity engagement moderated the association between pain catastrophizing and depression, indicating a buffering effect on the negative effects of catastrophizing on depression. Pain willingness moderated the association between pain catastrophizing and pain interference, such that endorsing low pain willingness may override any negative effects of pain catastrophizing. Discussion The findings suggest that pain catastrophizing and pain acceptance are independently important to adjustment to chronic pain. Research is needed to determine if treatments that target both for change are more effective than treatments that target only one.
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- 2021
236. Meaningful Change Thresholds for Patient-Reported Outcomes Measurement Information System (PROMIS) Fatigue and Pain Interference Scores in Patients With Rheumatoid Arthritis
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Elizabeth S. Davis, Huifeng Yun, Jeffrey R. Curtis, David Cella, and Jennifer L. Beaumont
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Patient-Reported Outcomes Measurement Information System ,medicine.medical_specialty ,Immunology ,A little better ,Pain ,Arthritis ,Pain Interference ,Arthritis, Rheumatoid ,03 medical and health sciences ,0302 clinical medicine ,Rheumatology ,medicine ,Humans ,Immunology and Allergy ,In patient ,Patient Reported Outcome Measures ,030212 general & internal medicine ,Fatigue ,Retrospective Studies ,030203 arthritis & rheumatology ,business.industry ,medicine.disease ,Rheumatoid arthritis ,Cohort ,Physical therapy ,business ,Rheumatism ,Information Systems - Abstract
ObjectiveWe estimated meaningful change thresholds (MCTs) for Patient-Reported Outcomes Measurement Information System (PROMIS) Fatigue and Pain Interference in rheumatoid arthritis (RA).MethodsThe responsiveness of several patient-reported outcomes (PROs) was assessed among 521 patients with RA in the Arthritis, Rheumatism, and Aging Medical Information Systems (ARAMIS) cohort. PROMIS Fatigue (7-item) and Pain Interference (6-item) short form instruments were administered at baseline, 6 months, and 12 months. Self-reported retrospective changes over the previous 6 months (a lot better/worse, a little better/worse, stayed the same) were obtained at 6 and 12 months’ follow-up. We estimated MCTs using the mean change in PROMIS scores for patients who rated their change “a little better” or “a little worse.”ResultsBaseline fatigue and pain interference scores were near normal (median 54 and 56, respectively). At 6 months, 7.9% of patients reported their fatigue was a little better compared to baseline (mean change [SD]: –2.6 [4.8]) and 22.8% a little worse (1.7 [5.6]). Pain was a little better for 11.5% of patients (–1.9 [6.1]) and a little worse for 24.2% of patients (0.6 [5.7]). At 12 months, results were similar. Thus, the MCT range was 1–2 points for both fatigue and pain interference. Correlations between change scores and retrospective ratings were low (0.13–0.29), indicating possible underestimation of MCT.ConclusionThe group-level MCT for PROMIS Fatigue and Pain Interference is roughly 2–3 points and corresponds to a small effect size, which is consistent with earlier work demonstrating an MCT of 2 points for PROMIS Physical Functioning.
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- 2021
237. The Relationships Between Self-reported Pain Intensity, Pain Interference, and Quality of Life Among Injured U.S. Service Members With and Without Low Back Pain
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Gretchen Jones, Michael R. Galarneau, Jessica R Watrous, Brad D. Hendershot, Susan L. Eskridge, Shawn Farrokhi, Brittney Mazzone, and Cameron T. McCabe
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050103 clinical psychology ,medicine.medical_specialty ,Active duty ,business.industry ,05 social sciences ,Pain Interference ,Service member ,Low back pain ,03 medical and health sciences ,Clinical Psychology ,Military personnel ,Health psychology ,0302 clinical medicine ,Quality of life (healthcare) ,Health care ,Physical therapy ,medicine ,0501 psychology and cognitive sciences ,030212 general & internal medicine ,medicine.symptom ,business ,human activities ,health care economics and organizations - Abstract
Low back pain is a prevalent military and veteran health problem and individuals injured on deployment may be at particularly high risk of pain conditions. Given that increasing numbers of active duty and veteran military personnel are seeking care in community settings, it is critical that health care providers are aware of military health issues. The current study examined the prevalence of low back pain among individuals with deployment-related injuries, compared their self-reported pain intensity and interference ratings, and assessed the relationship between low back pain, self-reported pain ratings, and quality of life. Almost half of participants had low back pain diagnoses, and individuals with low back pain reported significantly higher intensity and interference due to their pain than individuals without low back pain. Finally, the relationship between low back pain and quality of life was explained by self-reported pain indices, underscoring the importance of patient-centered metrics in pain treatment.
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- 2021
238. Patients and clinicians define symptom levels and meaningful change for PROMIS pain interference and fatigue in RA using bookmarking
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Susan J. Bartlett, Anne Lyddiatt, Clifton O. Bingham, Mary Suzanne Schrandt, Alessandra Butanis, Michelle Jones, Karon F. Cook, Ana Maria Orbai, Vivian P. Bykerk, and Victoria Ruffing
- Subjects
Adult ,Male ,medicine.medical_specialty ,Patient-Reported Outcomes Measurement Information System ,Pain Interference ,Severity of Illness Index ,Arthritis, Rheumatoid ,03 medical and health sciences ,0302 clinical medicine ,Rheumatology ,Internal medicine ,Humans ,Medicine ,Pharmacology (medical) ,Patient Reported Outcome Measures ,030212 general & internal medicine ,Fatigue ,Aged ,Pain Measurement ,030203 arthritis & rheumatology ,business.industry ,Bookmarking ,Lived experience ,Perspective (graphical) ,Middle Aged ,Clinical Science ,Social engagement ,Treatment efficacy ,Methotrexate ,Treatment Outcome ,Antirheumatic Agents ,Physical therapy ,Female ,Symptom Assessment ,business - Abstract
Objectives Using patient-reported outcomes to inform clinical decision-making depends on knowing how to interpret scores. Patient-Reported Outcome Measurement Information System® (PROMIS®) instruments are increasingly used in rheumatology research and care, but there is little information available to guide interpretation of scores. We sought to identify thresholds and meaningful change for PROMIS Pain Interference and Fatigue scores from the perspective of RA patients and clinicians. Methods We developed patient vignettes using the PROMIS item banks representing a continuum of Pain Interference and Fatigue levels. During a series of face-to-face ‘bookmarking’ sessions, patients and clinicians identified thresholds for mild, moderate and severe levels of symptoms and identified change deemed meaningful for making treatment decisions. Results In general, patients selected higher cut points to demarcate thresholds than clinicians. Patients and clinicians generally identified changes of 5–10 points as representing meaningful change. The thresholds and meaningful change scores of patients were grounded in their lived experiences having RA, approach to self-management, and the impacts on function, roles and social participation. Conclusion Results offer new information about how both patients and clinicians view RA symptoms and functional impacts. Results suggest that patients and providers may use different strategies to define and interpret RA symptoms, and select different thresholds when describing symptoms as mild, moderate or severe. The magnitude of symptom change selected by patients and clinicians as being clinically meaningful in interpreting treatment efficacy and loss of response may be greater than levels determined by external anchor and statistical methods.
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- 2021
239. Reducing Opioid Prescriptions Lowers Consumption Without Detriment to Patient-Reported Pain Interference Scores After Total Hip and Knee Arthroplasties
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Nathan Woody, Ryan H. Barnes, Daniel J. Del Gaizo, Joshua A. Shapiro, Christopher W. Olcott, and Fei Chen
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musculoskeletal diseases ,medicine.medical_specialty ,Total hip replacement ,Total knee arthroplasty ,Pain Interference ,03 medical and health sciences ,0302 clinical medicine ,lcsh:Orthopedic surgery ,medicine ,Orthopedics and Sports Medicine ,030212 general & internal medicine ,Medical prescription ,Original Research ,030222 orthopedics ,business.industry ,After discharge ,PROMIS 6B pain interference score ,lcsh:RD701-811 ,Opioid ,Patient-reported outcome measures ,Physical therapy ,Surgery ,Observational study ,Total hip arthroplasty ,business ,medicine.drug ,Standardized opioid-prescribing schedule - Abstract
Background Opioid addiction is endemic in the United States. We developed a standardized opioid-prescribing schedule (SOPS) after total hip arthroplasty (THA) and total knee arthroplasty (TKA) and evaluated opioid usage alongside Patient-Reported Outcomes Measurement Information System (PROMIS) pain interference scores. We hypothesized that opioid usage would be less than prescribed and reducing prescription would decrease consumption without negatively impacting the PROMIS scores. Methods A prospective observational study was performed on all patients undergoing primary THA and TKA from April 7, 2018, to August 10, 2019. Opioid consumption and pain interference were determined 2 weeks after discharge via telephone and email surveys. SOPSs were implemented during the study. Outcomes were compared in patients before and after the SOPS. Results A total of 715 patients met inclusion criteria; 201 patients completed surveys. Before the SOPS, the mean opioid prescription was 81.2 ± 15.3 tablets for THA and 82.9 ± 10.6 for TKA. The mean usage was 35.1 ± 29.4 tablets and 35.4 ± 33.4, respectively. After the SOPS, the mean usage decreased to 19.4 ± 16.8 (P = .04) and 31.6 ± 20.9 (P = .52), respectively. After implementation of a second SOPS for THA, the mean number of tablets consumed was 21.5 ± 18.6 (P = .05 compared with pre-SOPS). The PROMIS 6B responses in patients who underwent THA demonstrated no significant changes. PROMIS 6B responses for TKA showed an increase in interference with recreational activities (P = .04) and tasks away from home (P = .04), but otherwise had no significant impact on reported scores. Conclusions Implementation of the SOPS reduced postoperative opioid prescription and consumption without significantly impacting the reported pain interference, supporting the need to decrease opioid prescription after THA and TKA.
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- 2020
240. Improving Veteran Access to Integrated Management of Back Pain (AIM-Back): Protocol for an Embedded Pragmatic Cluster-Randomized Trial
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Francis J. Keefe, Jennifer C. Naylor, Steven Z. George, Corey B. Simon, Heather A. King, Chad Cook, Aviel Alkon, Trevor A. Lentz, Kelli D. Allen, Adam P. Goode, Lindsay A. Ballengee, Cynthia J. Coffman, Janet M. Grubber, Susan N. Hastings, Catherine Stanwyck, and Ashley L. Choate
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medicine.medical_specialty ,Time Factors ,Best practice ,Nonpharmacologic ,03 medical and health sciences ,0302 clinical medicine ,Original Research Articles ,Surveys and Questionnaires ,Health care ,Back pain ,medicine ,Pain Management ,Humans ,Pain Interference ,030212 general & internal medicine ,Cluster randomised controlled trial ,Veterans Affairs ,health care economics and organizations ,Randomized Controlled Trials as Topic ,Veterans ,Protocol (science) ,business.industry ,General Medicine ,Low back pain ,Physical Function ,Anesthesiology and Pain Medicine ,Clinical research ,Physical therapy ,Care Pathways ,Neurology (clinical) ,medicine.symptom ,AcademicSubjects/MED00010 ,business ,Low Back Pain ,030217 neurology & neurosurgery ,EDITORIALS - Abstract
Background Coordinated efforts between the National Institutes of Health, the Department of Defense, and the Department of Veterans Affairs have built the capacity for large-scale clinical research investigating the effectiveness of nonpharmacologic pain treatments. This is an encouraging development; however, what constitutes best practice for nonpharmacologic management of low back pain (LBP) is largely unknown. Design The Improving Veteran Access to Integrated Management of Back Pain (AIM-Back) trial is an embedded pragmatic cluster-randomized trial that will examine the effectiveness of two different care pathways for LBP. Sixteen primary care clinics will be randomized 1:1 to receive training in delivery of 1) an integrated sequenced-care pathway or 2) a coordinated pain navigator pathway. Primary outcomes are pain interference and physical function (Patient-Reported Outcomes Measurement Information System Short Form [PROMIS-SF]) collected in the electronic health record at 3 months (n=1,680). A subset of veteran participants (n=848) have consented to complete additional surveys at baseline and at 3, 6, and 12 months for supplementary pain and other measures. Summary AIM-Back care pathways will be tested for effectiveness, and treatment heterogeneity will be investigated to identify which veterans may respond best to a given pathway. Health care utilization patterns (including opioid use) will also be compared between care pathways. Therefore, the AIM-Back trial will provide important information that can inform the future delivery of nonpharmacologic treatment of LBP.
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- 2020
241. Early Treatment Improvements in Depression Are Associated With Overall Improvements in Fatigue Impact and Pain Interference in Adults With Multiple Sclerosis
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Dawn M. Ehde, Kevin N. Alschuler, Anna L. Kratz, Lindsey M. Knowles, Anne Arewasikporn, and Aaron P. Turner
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Adult ,Male ,medicine.medical_specialty ,Multiple Sclerosis ,Pain Interference ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Patient Education as Topic ,Randomized controlled trial ,law ,medicine ,Humans ,030212 general & internal medicine ,Brief Pain Inventory ,Fatigue ,General Psychology ,Depression ,business.industry ,Self-Management ,Multiple sclerosis ,Chronic pain ,Chronic fatigue ,Middle Aged ,medicine.disease ,Fatigue impact scale ,Clinical trial ,Psychiatry and Mental health ,Physical therapy ,Female ,Chronic Pain ,business ,030217 neurology & neurosurgery - Abstract
Background Depression, fatigue, and pain commonly co-occur in multiple sclerosis (MS) and are positively associated with one another. However, it is unclear whether treatment-related improvement in one of these symptoms is associated with improvements in the other two symptoms. Purpose This study examined whether early improvements in depressive symptoms, fatigue impact, and pain interference during a multisymptom intervention in persons with MS were associated with overall improvements in the other two symptoms. Methods Secondary analysis of a randomized controlled trial in which both treatments improved depressive symptoms, fatigue, and pain interference. Adults with MS experiencing chronic pain, chronic fatigue, and/or moderate depressive symptoms (N = 154, 86% women) participated in an 8-week, telephone-delivered intervention: self-management (n = 69) or education (n = 85); intervention groups were combined for the current study. Outcome measures were depressive symptoms (PHQ-9), fatigue impact (Modified Fatigue Impact Scale), and pain interference (Brief Pain Inventory). Path analysis examined associations between pre-to-mid intervention improvement in one symptom (i.e., depression, fatigue, pain interference) and pre-to-post (overall) improvement in the other two symptoms. Results Early reduction in depressive symptoms was associated with an overall reduction in pain interference and fatigue impact (p’s < .01). Early reduction in fatigue impact was associated with an overall reduction in depressive symptom severity (p = .04) but not pain interference. Early reduction in pain interference was not associated with reductions in fatigue impact or depressive symptoms. Conclusions These findings suggest the potential importance of reducing depressive symptoms to overall improvement in fatigue and pain interference in persons with MS. Clinical Trial Registrations NCT00944190.
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- 2020
242. Are Physical Activity and Sedentary Behavior Associated With Cancer-Related Symptoms in Real Time?
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Raheem J. Paxton, Chuong Bui, John W Dubay, JoAnn S Oliver, Melinda R. Stolley, Kun Wang, Danielle Daniel, and Dottington Fullwood
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Male ,medicine.medical_specialty ,Oncology (nursing) ,business.industry ,Physical activity ,Symptom burden ,Cancer ,Pain Interference ,Mean age ,Sedentary behavior ,Middle Aged ,Daily diary ,medicine.disease ,Oncology ,Neoplasms ,medicine ,Physical therapy ,Humans ,Female ,Sedentary Behavior ,business ,Exercise ,Life Style ,Body mass index ,Fatigue - Abstract
Few studies have examined the real-time and dynamic relationship between lifestyle behaviors and treatment-related symptoms.The aim of this study was to examine the associations of daily physical activity and sedentary behavior with symptom burden, pain interference, and fatigue among patients who were undergoing active cancer treatment.A total of 22 (mean age = 57 years; 73% women; 55% Black) cancer patients were recruited from a local hospital and reported a daily diary of physical activity, sedentary behavior, symptom burden, pain interference, and fatigue over 10 days. Adjusted mixed-effects models were used to examine all associations.Body mass index moderated the relationship between physical activity and symptom burden (γ = 0.06, P.01) and physical activity and fatigue (γ = 0.09, P.05). On days where physical activity was higher than average, symptom burden and fatigue scores were lower among patients who had lower body mass index values. Also, age moderated the relationship between sedentary behavior and symptom burden (γ = -0.04, P.05); on days where patients sat more, symptom burden was lower among patients who were younger than the average age.Overall, these data indicate that treatment-related symptoms vary daily within cancer patients and that physical activity may alleviate treatment-related symptoms for leaner patients. Larger samples and objective assessments of physical activity and sedentary behavior are needed to validate our results.Oncology nurses may be in the best position to promote physical activity during treatment as a strategy to manage symptom burden.
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- 2020
243. Associations between Childhood Abuse and Chronic Pain in Adults with Substance Use Disorders
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Nadine R. Taghian, Roger D. Weiss, Alexandra R. Chase, Shelly F. Greenfield, Margaret L. Griffin, and R. Kathryn McHugh
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Adult ,medicine.medical_specialty ,Health (social science) ,Substance-Related Disorders ,030508 substance abuse ,Medicine (miscellaneous) ,Pain Interference ,03 medical and health sciences ,0302 clinical medicine ,Surveys and Questionnaires ,medicine ,Humans ,Child Abuse ,030212 general & internal medicine ,Child ,Psychiatry ,Childhood abuse ,business.industry ,Sex Offenses ,Public Health, Environmental and Occupational Health ,Chronic pain ,medicine.disease ,humanities ,Psychiatry and Mental health ,Pain severity ,Pain catastrophizing ,Chronic Pain ,Substance use ,0305 other medical science ,business - Abstract
Both childhood abuse and chronic pain are common in people with substance use disorders (SUDs). Studies have found that exposure to childhood abuse is associated with chronic pain in adulthood; however, few studies have examined this association in people with SUDs.
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- 2020
244. Patient-Reported Outcomes Measurements Information System (PROMIS) upper extremity and pain interference do not significantly predict rotator cuff tear dimensions
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Jonathan R. Warren, Gabriel B. Burdick, Alexander Pietroski, Sreten Franovic, and Stephanie Muh
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Rotator cuff ,medicine.medical_specialty ,Rotator cuff tear ,Pain Interference ,Tear size ,Diseases of the musculoskeletal system ,PROMIS ,medicine ,Rotator cuff repair ,Orthopedics and Sports Medicine ,Radiation treatment planning ,Orthopedic surgery ,Patient-reported outcomes ,medicine.diagnostic_test ,business.industry ,Magnetic resonance imaging ,Tendon ,Surgery ,medicine.anatomical_structure ,RC925-935 ,Cohort ,Tears ,business ,Body mass index ,RD701-811 - Abstract
Background Proper diagnosis of rotator cuff tears is typically established with magnetic resonance imaging (MRI); however, studies show that MRI-derived measurements of tear severity may not align with patient-reported pain and shoulder function. The purpose of this study is to investigate the capacity for the Patient-Reported Outcomes Measurements Information System (PROMIS) computer adaptive tests (CAT) to predict rotator cuff tear severity by correlating preoperative tear morphology observed on MRI with PROMIS Upper Extremity (UE) and Pain Interference (PI) scores. This is the first study to investigate the relationship between tear characteristics and preoperative patient-reported symptoms using PROMIS. Considering the essential roles MRI and patient-reported outcomes play in the management of rotator cuff tears, the findings of this study have important implications for both treatment planning and outcomes reporting. Methods Two PROMIS-CAT forms (PROMIS-UE and PROMIS-PI) were provided to all patients undergoing rotator cuff repair by one of three fellowship-trained surgeons at a single institution. Demographic information including age, sex, race, employment status, body mass index, smoking status, zip code, and preoperative PROMIS-UE and -PI scores were prospectively recorded. A retrospective chart review of small to large full- or partial-thickness rotator cuff tears between May 1, 2017 and February 27, 2019 was used to collect each patient’s MRI-derived tear dimensions and determine tendon involvement. Results Our cohort consisted of 180 patients (56.7% male, 43.3% female) with an average age of 58.9 years (standard deviation, 9.0). There was no significant difference in PROMIS-UE or -PI scores based on which rotator cuff tendons were involved in the tear (p > 0.05). Neither PROMIS-UE nor PROMIS-PI significantly correlated with tear length or retraction length of the supraspinatus tendon (p > 0.05). Sum of tear lengths in the anterior-posterior and medial-lateral directions was weakly correlated with PROMIS-UE (p = 0.042; r = -0.152, r2 = 0.031) and PROMIS-PI (p = 0.027; r = 0.165, r2 = 0.012). Conclusions Rotator cuff tear severity does not significantly relate to preoperative PROMIS-UE and -PI scores. This finding underscores the importance of obtaining a balanced preoperative assessment of rotator cuff tears that acknowledges the inconsistent relationship between rotator cuff tear characteristics observed on MRI and patient-reported pain and physical function.
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- 2022
245. Chronic pain disrupts ability to work by interfering with social function: A cross-sectional study.
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Hengstebeck, Elizabeth, Roskos, Steven, Breejen, Karen, Arnetz, Bengt, and Arnetz, Judy
- Abstract
Background and aims Some 100 million adults in the United States suffer from chronic pain. While research to date has focused primarily on pain interference with physical and psychological function and its effects on employment, few studies have examined the impact of pain interference on social functioning and its effects on employment. The aims of our study were to (1) evaluate the association between pain interference with ability to work and actual employment status among working age adults with chronic pain; and (2) evaluate pain interference with four types of functioning – cognitive, physical, psychological, and social – as possible mediators of pain interference with the ability to work. Methods Data were collected via a self-selected sample of individuals visiting the American Chronic Pain Association (ACPA) website. The final dataset included 966 respondents. We examined the association between pain interference with the ability to work and employment in a population with chronic pain. We then analyzed pain interference with four types of functioning, physical, psychological, cognitive, and social, for their impact on the ability to work. Results Pain interference with ability to work was significantly inversely associated with employment status, i.e., the less that pain interfered with one's ability to work, the greater the likelihood of being employed. Moreover, pain interference with ability to work was a stronger predictor of employment status than an individual's rating of their pain intensity. Pain interference with social functioning partially mediated the effects of pain interference with cognitive and physical functioning and fully mediated the effects of pain intensity and pain interference with psychological functioning on pain interference with the ability to work. Results suggest that pain interference with social function may be a significant contributor to pain interference with ability to work in working age adults with chronic pain. Conclusions In the development of effective solutions to address the economic and societal burden of chronic pain, this paper highlights the role of social function as an important, yet frequently overlooked, contributor to chronic pain's effect on the ability to work. Our findings underscore the importance of an integrated biopsychosocial approach to managing chronic pain, especially when addressing ability to work. From a clinical standpoint, assessing and managing pain intensity is necessary but not sufficient in addressing the far-reaching negative consequences of chronic pain. Implications The development of interventions that improve social function may improve the ability to work in adults with chronic pain. Likewise, sick leave should be prescribed restrictively in the management of chronic pain since it may further interfere with social functioning. Perspective This study highlights the importance of the assessment of pain interference with social function as a part of a comprehensive biopsychosocial approach to the evaluation and management of patients with chronic pain. Interventions that improve social function may improve the ability to work in this population. In addition, sick leave should be prescribed restrictively in the management of chronic pain since it by itself interferes with social functioning. [ABSTRACT FROM AUTHOR]
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- 2017
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246. Pain catastrophizing, perceived injustice, and pain intensity impair life satisfaction through differential patterns of physical and psychological disruption.
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Sturgeon, John A., Ziadni, Maisa S., Trost, Zina, Darnall, Beth D., and Mackey, Sean C.
- Abstract
Background and purpose Previous research has highlighted the importance of cognitive appraisal processes in determining the nature and effectiveness of coping with chronic pain. Two of the key variables implicated in appraisal of pain are catastrophizing and perceived injustice, which exacerbate the severity of pain-related distress and increase the risk of long-term disability through maladaptive behavioural responses. However, to date, the influences of these phenomena have not been examined concurrently, nor have they been related specifically to quality of life measures, such as life satisfaction. Methods Using data from an online survey of 330 individuals with chronic pain, structural path modelling techniques were used to examine the independent effects of pain catastrophizing, perceived injustice, and average pain intensity on life satisfaction. Two potential mediators of these relationships were examined: depressive symptoms and pain-related interference. Results Results indicated that depressive symptoms fully mediated the relationship between pain catastrophizing and life satisfaction, and pain interference fully mediated the relationship between pain intensity and life satisfaction. Both depressive symptoms and pain interference were found to significantly mediate the relationship between perceived injustice and life satisfaction, but perceived injustice continued to demonstrate a significant and negative relationship with life satisfaction, above and beyond the other study variables. Conclusions The current findings highlight the distinct affective and behavioural mediators of pain and maladaptive cognitive appraisal processes in chronic pain, and highlight their importance in both perceptions of pain-related interference and longer-term quality of life. [ABSTRACT FROM AUTHOR]
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- 2017
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247. Association of Physical Function, Anxiety, and Pain Interference in Nonshoulder Upper Extremity Patients Using the PROMIS Platform.
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Kazmers, Nikolas H., Hung, Man, Rane, Ajinkya A., Bounsanga, Jerry, Weng, Cindy, and Tyser, Andrew R.
- Abstract
Purpose The relationship between psychosocial factors and self-reported physical function among hand and upper extremity patients is complex. The Patient-Reported Outcomes Measurement Information System (PROMIS) platform has attempted to create a variety of specifically targeted metrics that can be administered using computer adaptive testing (CAT). Three metrics measuring self-reported physical function (herein referred to in combination as “functional” metrics) include the PROMIS Physical Function (PF) CAT, PROMIS Upper Extremity (UE) CAT, and the Quick Disabilities of the Arm, Shoulder, and Hand ( Quick DASH). Two metrics assessing psychosocial factors include the PROMIS Anxiety and Pain Interference (PI) CATs (“nonfunctional” metrics). This study evaluates whether the functional metrics were correlated with nonfunctional metrics. Methods The 5 questionnaires were administered prospectively on a tablet computer to all consecutive adult patients presenting to an outpatient hand and upper extremity (nonshoulder) clinic at a tertiary academic medical center from January 1 to November 1, 2014. For patients with multiple visits during the study period, only the first was included. Data were evaluated retrospectively to assess the relationship between functional and nonfunctional measures, with Pearson correlation coefficients to understand the relationship between continuous variables, and 1-way analysis of variance to examine for differences in outcome measures across demographic groups. Multivariable linear regression analyses were performed to determine factors predicting functional disability. Results We included 1,299 patients: mean age was 46.8 years, 53% were female, and 23% were unemployed or on disability. The PROMIS PF CAT, PROMIS UE CAT, and Quick DASH scores were all significantly correlated with PROMIS Anxiety CAT (Pearson correlation coefficients, –0.46, –0.48, and 0.53, respectively) and PROMIS PI CAT (–0.60, –0.65, and 0.76, respectively) scores. Multivariable regression analyses demonstrated that increased PROMIS Anxiety and PI CAT scores each independently and adversely influenced PROMIS PF CAT, PROMIS UE CAT, and Quick DASH scores. Conclusions Increasing levels of patient anxiety and pain interference are independently associated with decreased patient-reported upper extremity function. Clinical relevance This study provides further support of the biopsychosocial model by highlighting that increased anxiety is associated with decreased self-reported function using the PROMIS platform. [ABSTRACT FROM AUTHOR]
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- 2017
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248. Efficacy of PROMIS Pain Interference and Likert Pain Scores to Assess Physical Function.
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St. John, Matthew J., Mitten, David, and Hammert, Warren C.
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Purpose The Patient Reported Outcome Measurement Information System (PROMIS), developed by the National Institutes of Health, utilizes a health domain related to Pain Interference (PI). We evaluated this domain and its association with physical function (as determined by PROMIS Physical Function [PF]), administered as a computer adaptive test (CAT), and secondarily its association to a numerical 0 to 10 pain score. Our null hypothesis was that PI, as measured by CAT, has no correlation to PF and thus, there is no difference between comparisons of numerical pain scores and PROMIS PF. Methods Adult patients presenting to an upper extremity clinic from February to December 2015 completed PROMIS PF, PI, and numerical 0 to 10 pain score questionnaires. The PROMIS modules were completed electronically in their computer adaptive form. Mean population scoring on each module is defined at 50. Patients were also asked to rate their pain on a 0 to 10 scale. These data were collected as routine clinical care and were extracted from the electronic health record for cross-sectional evaluation. Bivariate Pearson correlation analysis defined the association between the PROMIS modules and the numerical pain scores. Correlations between PF and PI were compared with correlations between PF and pain scores. Results We recorded data from patients' 10,574 first, 5,210 second, 2,633 third, 1,382 fourth, and 722 fifth visits. The PROMIS PI was negatively correlated to the PROMIS PF. Numerical pain scores were also negatively correlated to PROMIS PF. Numerical pain scores were less correlated than PROMIS PI through time relative to PF. Conclusions Both PROMIS PI and numerical pain scores had significant correlations with PF for each office visit. The PI had a larger correlation to PF than did numerical pain scores. The PI and numerical pain scale scores are also correlated. Clinical relevance Patient-reported pain using a 0 to 10 pain score can be a predictor of patients’ level of function, and although pain score does not replace other patient-reported outcomes, it can provide useful information, particularly when other patient-reported outcomes are not available. [ABSTRACT FROM AUTHOR]
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- 2017
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249. Cognitive intrusion of pain and catastrophic thinking independently explain interference of pain in the activities of daily living.
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Talaei-Khoei, Mojtaba, Ogink, Paul T., Jha, Ragini, Ring, David, Chen, Neal, and Vranceanu, Ana-Maria
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HYPERESTHESIA , *SENSORY disorders , *COGNITIVE ability , *PSYCHOLOGICAL distress , *ANALGESIA - Abstract
Patients with musculoskeletal illness often report that pain interferes with their ability to engage in activities of daily living. Catastrophic thinking is consistently depicted as an important cognitive factor that hinders adjustment to pain. Current research has also shown that pain negatively impacts an individual's ability to maintain attention on the task at hand. While a measure of the experience of cognitive intrusion of pain (ECIP) has been recently developed to quantify the extent of that impact, little research has explored this issue in everyday settings. This study tested the mediating roles of cognitive intrusion of pain and pain catastrophizing scale (PCS) on the association of pain intensity with pain interference in 142 patients with upper-extremity musculoskeletal illness. We found that both cognitive intrusion of pain ( b = 0.136, bootstrap SE = 0.048, 95% BCa CI [0.052, 0.245]) and pain catastrophizing ( b = 0.114, bootstrap SE = 0.044, 95% BCa CI [0.047, 0.221]) partly and independently mediated the relationship between pain intensity and pain interference. Although comparable, the mediation effect of cognitive intrusion of pain was slightly larger than that of pain catastrophizing (25.7%, bootstrap SE = 0.094 vs. 21.5%, bootstrap SE = 0.080). Results suggest that pain sensations can interfere with activities of daily living through two distinct mechanisms. A combination of traditional cognitive behavioral therapy and mindfulness skills training targeting both pain catastrophizing and cognitive intrusion has the potential to decrease pain interference and help patients return to normal healthy living in spite of acute or persistent pain. [ABSTRACT FROM AUTHOR]
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- 2017
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250. Pain Among Community-Dwelling Older Adults with Dementia: Factors Associated with Undertreatment.
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Wilson, Nancy, Thakur, Elyse R., Stanley, Melinda, Kunik, Mark E., Sansgiry, Shubhada, Amspoker, Amber B., Freshour, Jessica, and Snow, A. Lynn
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PAIN , *CONFIDENCE intervals , *UNDERTREATMENT , *MEDICAL care use , *RANDOMIZED controlled trials , *DEMENTIA , *MENTAL depression , *INDEPENDENT living , *QUESTIONNAIRES , *LOGISTIC regression analysis , *ODDS ratio , *PAIN management , *SECONDARY analysis - Abstract
Objective. To identify factors associated with no analgesic treatment in community-dwelling older adults with mild-to-moderate dementia and moderate-tosevere pain. Design. Secondary analysis of a randomized controlled trial. Setting. Michael E. DeBakey Veterans Affairs Medical Center. Subjects. Two hundred and two older adults (mean age =79.27 years). Methods. Guided by the Behavioral Model of Health Service Utilization, participants completed questionnaires regarding predisposing (age, gender, race, educational level, care partner relationship), enabling (income), and need (pain interference, depressive symptoms, cognitive functioning) characteristics. Results. Hierarchical logistic regression analyses revealed that participants with greater income (odds ratio [OR]50.79, 95% confidence interval [CI] = 0.63-0.99) and greater pain interference (OR=0.79, 95% CI=0.63-0.99) were less likely to have no analgesic treatment. We also examined whether other factors such as depressive symptoms influenced the relationship between pain interference and pain treatment. Those with less pain interference were more likely to have no analgesic treatment (OR=1.04, 95% CI=1.01-1.08), but only if they had lower levels of depressive symptoms (b=-0.52, P=0.005). Conclusion. The initiation of analgesic trials is complicated for individuals with dementia and comorbid pain and depressive symptomology. Future research should focus on identifying the most effective assessment and treatment procedures to best direct clinical care for this population. [ABSTRACT FROM AUTHOR]
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- 2017
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