Developing a Short Multidimensional Measure of Pain Self-efficacy: The Chronic Pain Self-efficacy Scale-Short Form

Abstract Background and Objectives The 22-item Chronic Pain Self-efficacy Scale (CPSS) measures three domains of pain self-efficacy: pain management, physical functioning, and coping with symptoms. This study aims to develop a short form (CPSS-SF) that retains the multidimensional structure of the instrument. Research Design and Methods Six hundred sixty-four community-dwelling Chinese older adults aged 60–95 years with chronic pain completed a survey. Confirmatory factor analysis (CFA) was conducted on the 22-item CPSS. Regression analyses were performed to examine the items’ correlations with criterion variables. After CPSS-SF items were selected, the performance of CPSS-SF subscales in terms of accounting for pain-related outcomes was compared with the full version. Results CFA supported a modified 3-factor model of the CPSS. On the basis of factor loadings on the 3 dimensions and the items’ correlations with pain intensity and pain disability, 11 items were selected for the CPSS-SF, which correlated at .97 with the full version. Regression analyses showed that the associations of the CPSS-SF subscales with pain intensity, pain disability, depressive symptoms, instrumental activities of daily living, and physical and mental health-related quality of life, were indistinguishable from their full-version counterparts. Discussion and Implications The CPSS-SF is a valid instrument that can be used in lieu of the full scale. Its availability will facilitate the assessment of pain self-efficacy in research and clinical settings due to its brevity but strong psychometric properties. However, the current evidence is limited to Chinese older adults; more research is needed to ascertain its validity in other age and cultural groups.

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Early maladaptive schemas in Finnish adult chronic male and female pain patients

Scandinavian Journal of Pain ◽

10.1016/j.sjpain.2010.09.003 ◽

2010 ◽

Vol 1 (4) ◽

pp. 196-202 ◽

Cited By ~ 8

Author(s):

Tom H.J. Saariaho ◽

Anita S.I. Saariaho ◽

Irma A. Karila ◽

Matti I. Joukamaa

Keyword(s):

Chronic Pain ◽

Pain Intensity ◽

Short Form ◽

Early Maladaptive Schemas ◽

Maladaptive Schemas ◽

Emotional Maltreatment ◽

Male And Female ◽

Pain Disability ◽

Chronic Pain Patients ◽

Pain Patients

AbstractBackground and aims of the studyThe connection between chronic pain and traumatic experiences in childhood has been established in several studies. The association of emotional maltreatment with chronic pain has been studied, but to a lesser degree. Schema therapy [24] is an extension of cognitive therapy and presents the early maladaptive schema (EMS) concept. EMSs reflect early, mainly emotional maltreatment. The aim of the present study was to examine the existence of EMSs, the association between EMSs and pain variables and EMS driven patterns.Patients and measuresThe study consisted of 271 first visit pain patients. Their socio-demographic data, pain variables and pain disability were assessed. The presence of EMSs was measured using the Young Schema Questionnaire Short Form Extended. One hundred and three successive participants were also interviewed according to the cognitive case conceptualization.ResultsMore than half (58.3%) of the chronic pain patients scored EMSs as meaningful. The patients with meaningful EMSs had significantly higher pain intensity, duration of pain and pain disability. The two most frequently occurring EMSs in male pain patients were Unrelenting Standards/Hypercriticalness (US) (36.2%) and Self-Sacrifice (SS) (23.6%) and in female pain patients SS (40.3%) and US (27.1%). The speech contents of five of the highest scoring US and SS male and female patients (n = 20) were analyzed. The analyses showed schema driven behavior which exacerbated the pain situation. US and SS schemas had a stronger motivational effect on their behavior than the pain itself. Regression analyses showed that Self-Sacrifice schema in women and Emotional Deprivation schema in the total sample predicted pain disability as did pain intensity and the number of pain locations.ConclusionsThis study suggested that a remarkable amount of chronic pain patients may suffer from early maladaptive schemas which have an effect on their current pain situation and may reflect underlying early emotional maltreatment.

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Sleep disturbance in patients attending specialized chronic pain clinics in Denmark: a longitudinal study examining the relationship between sleep and pain outcomes

Scandinavian Journal of Pain ◽

10.1515/sjpain-2020-0155 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Henrik Bjarke Vaegter ◽

Mette Terp Høybye ◽

Frederik Hjorth Bergen ◽

Christine E. Parsons

Keyword(s):

Quality Of Life ◽

Chronic Pain ◽

Sleep Quality ◽

Pain Intensity ◽

Sleep Disturbances ◽

Pain Disability ◽

Pain Clinics ◽

Pain Outcomes

Abstract Objectives Sleep disturbances are highly prevalent in patients with chronic pain. However, the majority of studies to date examining sleep disturbances in patients with chronic pain have been population-based cross-sectional studies. The aims of this study were to 1) examine the frequency of sleep disturbances in patients referred to two interdisciplinary chronic pain clinics in Denmark, 2) explore associations between sleep disturbances and pain intensity, disability and quality of life at baseline and follow-up, and 3) explore whether changes in sleep quality mediated the relationships between pain outcomes at baseline and pain outcomes at follow-up. Methods We carried out a longitudinal observational study, examining patients enrolled in two chronic pain clinics assessed at baseline (n=2,531) and post-treatment follow-up (n=657). Patients reported on their sleep disturbances using the sleep quality subscale of the Karolinska Sleep Questionnaire (KSQ), their pain intensity using 0–10 numerical rating scales, their pain-related disability using the Pain Disability Index (PDI), and quality of life using the EuroQol-VAS scale. The average time between baseline and follow-up was 207 days (SD=154). Results At baseline, the majority of patients reported frequent sleep disturbances. We found a significant association at baseline between self-reported sleep disturbances and pain intensity, pain-related disability, and quality of life, where greater sleep disturbance was associated with poorer outcomes. At follow-up, patients reported significant improvements across all pain and sleep outcomes. In two mediation models, we showed that changes in sleep disturbances from baseline to follow-up were significantly associated with (i) pain intensity at follow-up, and (ii) pain disability at follow-up. However, baseline pain intensity and disability scores were not associated with changes in sleep disturbances and, we did not find evidence for significant mediation of either pain outcome by changes in sleep disturbances. Conclusions Self-reported sleep disturbances were associated with pain outcomes at baseline and follow-up, with greater sleep disturbances associated with poorer pain outcomes. Changes in sleep quality did not mediate the relationships between baseline and follow-up scores for pain intensity and disability. These findings contribute to a growing body of evidence confirming an association between sleep and chronic pain experience, particularly suggestive of a sleep to pain link. Our data following patients after interdisciplinary treatment suggests that improved sleep is a marker for a better outcome after treatment.

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Pain Intensity and Pain Interference in Older Adults: Role of Gender, Obesity and High-Sensitivity C-Reactive Protein

Gerontology ◽

10.1159/000446651 ◽

2016 ◽

Vol 63 (1) ◽

pp. 3-12 ◽

Cited By ~ 16

Author(s):

Vahid Eslami ◽

Mindy J. Katz ◽

Robert S. White ◽

Erin Sundermann ◽

Julie M. Jiang ◽

...

Keyword(s):

Older Adults ◽

Pain Intensity ◽

Short Form ◽

High Sensitivity ◽

Pain Interference ◽

C Reactive Protein ◽

Medical Outcomes ◽

Cross Sectional ◽

Reactive Protein ◽

Aging Study

Background: Among older adults, pain intensity and pain interference are more common in women than men and associated with obesity and inflammatory markers. Objective: We examined whether the obesity and pain relationship is mediated by the high-sensitivity C-reactive protein (hsCRP), a nonspecific marker of systemic inflammation, and whether this relationship differs by sex. Methods: Items from Medical Outcomes Study Short Form-36 were used to measure pain intensity and pain interference in daily life. Ordinal logistic regression was used to assess the cross-sectional association among body mass index (BMI), hsCRP levels, pain intensity and pain interference using gender-stratified models adjusted for demographic variables. Results: Participants included 667 community-residing adults over the age of 70 years, free of dementia, enrolled in the Einstein Aging Study (EAS). In women (n = 410), pain intensity was associated with obesity [BMI ≥30 vs. normal, odds ratio (OR) = 2.29, 95% confidence interval (CI) 1.43-3.68] and higher hsCRP (OR = 1.28, 95% CI 1.08-1.51). In a model with obesity and hsCRP, both remained significant, but the association between hsCRP and pain intensity was somewhat attenuated. Obesity (OR = 3.04, 95% CI 1.81-5.11) and higher hsCRP levels (OR = 1.30, 95% CI 1.08-1.56) were also independently associated with greater pain interference in women. After adjustment for pain intensity and BMI, hsCRP was no longer associated with pain interference in women. Greater pain intensity and being overweight or obese continued to be significantly associated with pain interference in women. In men (n = 257), obesity and hsCRP were not associated with pain intensity or pain interference. Conclusions: In women, the relationship between obesity and higher levels of pain intensity or interference may be accounted for by factors related to hsCRP.

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The Situated Influence of Chronic Pain Perception on Chinese Older Adults’ Self-Management in Home Care

Geriatrics ◽

10.3390/geriatrics3040064 ◽

2018 ◽

Vol 3 (4) ◽

pp. 64

Author(s):

Fang Liu ◽

Min Tong

Keyword(s):

Older Adults ◽

Chronic Pain ◽

Chronic Disease ◽

Pain Perception ◽

Community Dwelling ◽

Self Management ◽

Chinese Older Adults ◽

Care Experience ◽

Management Capacity ◽

Important Others

Background and objective: Worldwide, 26 million older adults die from chronic disease, and chronic pain is typically a part of the experience of chronic disease. This study explores the perception of chronic pain for home-dwelling Chinese older adults and its influence on (1) self-management ability and (2) management and reduction of chronic pain. Methods: Adopting a qualitative study design, we conducted in-depth interviews with 10 Chinese community-dwelling older adults who experience chronic pain. Half of our informants perceive chronic pain, whereas the other half, diagnosed with Alzheimer’s disease, do not report that they perceive chronic pain. Data were analyzed with inductive thematic analysis. Results: Chronic pain perception plays important roles in (1) defining the challenge of self-management, (2) connecting previous caretaking experience, (3) adjusting the identity of self-management, (4) acquiring support from important others and (5) re-planning self-management arrangements. Conclusion: Pain perception helps to motivate Chinese older adults to face health challenges and regain self-management capacity through adjustments in self-identity and care experience with the support of important others. Pain perception can consolidate the situation of independent living of older adults. It helps to motivate Chinese older adults to face health challenges and regain self-management capacity.

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A physical activity program versus usual care in the management of quality of life for pre-frail older adults with chronic pain in primary care: randomized controlled trial.

10.21203/rs.3.rs-33919/v1 ◽

2020 ◽

Author(s):

Pedro Otones ◽

Eva García ◽

Teresa Sanz ◽

Azucena Pedraz

Keyword(s):

Quality Of Life ◽

Physical Activity ◽

Older Adults ◽

Chronic Pain ◽

Usual Care ◽

Pain Intensity ◽

Physical Performance ◽

Frail Older Adults

Abstract Background Exercise have shown being effective for managing chronic pain and preventing frailty status in older adults but the effect of an exercise program in the quality of life of pre-frail older adults with chronic pain remains unclear. Our objective was to evaluate the effectiveness of multicomponent structured physical exercise program for pre-frail adults aged 65 years or more with chronic pain to improve their perceived health related quality of life, compared with usual care. Methods Open label randomized controlled trial. Participants were community-dwelling pre-frail older adults aged 65 years or older with chronic pain and non-dependent for basic activities of daily living attending a Primary Healthcare Centre. Forty-four participants were randomly allocated to a control group (n = 20) that received usual care or an intervention group (n = 24) that received an 8-week physical activity and education program. Frailty status (SHARE Frailty Index), quality of life (EuroQol-5D-5L), pain intensity (Visual Analogue Scale), physical performance (Short Physical Performance Battery) and depression (Yessavage) were assessed at baseline, after the intervention and after 3 months follow-up. The effect of the intervention was analysed by mean differences between the intervention and control groups. Results The follow-up period (3 months) was completed by 32 patients (73%), 17 in the control group and 15 in the intervention group. Most participants were women (78.1%) with a mean age (standard deviation) of 77.2 (5.9) years and a mean pain intensity of 48.1 (24.4) mm. No relevant differences were found between groups at baseline. After the intervention, mean differences in the EuroQol Index Value between control and intervention groups were significant (-0.19 95%CI(-0.33- -0.04)) and remained after three months follow-up (-0.21 95%CI(-0.37- -0.05)). Participants in the exercise group showed better results in pain intensity and frailty after the intervention, and an improvement in physical performance after the intervention and after three months. Conclusions An eight-week physical activity and education program for pre-frail older adults with chronic pain, compared with usual care, could be effective to improve quality of life after the intervention and after three-months follow-up. Study registration details: This study was retrospectively registered in ClinicalTrials.gov with the identifier NCT04045535.

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Loneliness, social isolation, and pain following the COVID-19 outbreak: data from a nationwide internet survey in Japan

10.21203/rs.3.rs-240504/v1 ◽

2021 ◽

Author(s):

Keiko Yamada ◽

Kenta Wakaizumi ◽

Yasuhiko Kubota ◽

Hiroshi Murayama ◽

Takahiro Tabuchi

Keyword(s):

Chronic Pain ◽

Pain Intensity ◽

Social Isolation ◽

Multinomial Logistic Regression ◽

Short Form ◽

Analysis Of Covariance ◽

Internet Survey ◽

Pain Prevalence ◽

Pain History ◽

Perceived Social Isolation

Abstract The aim of cross-sectional study was to investigate the association between pain and loneliness and increased social isolation during the COVID-19 pandemic. A total of 25,482 participants, aged 15–79 years, were assessed using an internet survey; the University of California, Los Angeles Loneliness Scale (Version 3), Short Form 3-item (UCLA-LS3-SF3) was used to assess loneliness, and a modified item of the UCLA-LS3-SF3 was used to measure the perception of increased social isolation during the pandemic. The outcome measures included the prevalence/incidence of pain (i.e., headache, neck or shoulder pain, upper limb pain, low back pain, and leg pain), pain intensity, and chronic pain history/prevalence. Pain intensity was measured by the pain/discomfort item of the 5-level version of the EuroQol 5 Dimension scale. Odds ratios of pain prevalence/incidence and chronic pain history/prevalence according to the UCLA-LS3-SF3 scoring groups (tertiles) and the frequency of the perceived increase in social isolation (categories 1–5) were calculated using multinomial logistic regression analysis. The mean pain intensity values among different loneliness and social isolation levels were tested using an analysis of covariance. Increased loneliness and the severity of the perceived social isolation were positively associated with pain prevalence/incidence, intensity, and the history/prevalence of chronic pain.

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Sex Differences in Coping Strategies Based on Chronic Pain Intensity Among Older Adults

Journal of Gerontological Nursing ◽

10.3928/00989134-20210908-05 ◽

2021 ◽

Vol 47 (10) ◽

pp. 30-36

Author(s):

Joyce Rutyelle da Serra ◽

Layz Alves Ferreira Souza ◽

Maressa Gonçalves da Paz ◽

Bruna da Silva Ferreira Tatagiba ◽

Lilian Varanda Pereira

Keyword(s):

Older Adults ◽

Chronic Pain ◽

Sex Differences ◽

Pain Intensity ◽

Coping Strategies

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Association of fear-avoidance and self-efficacy on pain disability in individuals with co-morbid post-traumatic stress and chronic pain

Journal of Health Psychology ◽

10.1177/1359105320947819 ◽

2020 ◽

pp. 135910532094781 ◽

Cited By ~ 1

Author(s):

Anna Devlin ◽

Sara Casey ◽

Scott Williams ◽

Melita J Giummarra

Keyword(s):

Chronic Pain ◽

Traumatic Stress ◽

Self Efficacy ◽

Fear Avoidance ◽

Post Traumatic Stress ◽

Pain Disability ◽

Stress Symptoms ◽

Lower Pain ◽

Post Traumatic ◽

Indirect Association

This study investigated relationships between post-traumatic stress symptoms (PTSS) and pain disability. Fifty people with chronic pain (probable PTSD, n = 22) completed measures assessing pain interference, PTSS, fear avoidance, and pain self-efficacy. We hypothesized that people with probable PTSD would have higher fear avoidance and lower pain self-efficacy; and that PTSS would be indirectly associated with pain disability via fear avoidance and self-efficacy. People with probable PTSD had higher fear avoidance, but there were no differences in self-efficacy, pain severity or disability. There was an indirect association between PTSS and pain disability via fear avoidance, but not via self-efficacy.

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