The effectiveness of Pictorial Representation of Illness and Self Measure (PRISM) for the assessment of the suffering and quality of interpersonal relationships of patients with chronic pain

Abstract Background Pictorial Representation of Illness and Self Measure (PRISM) is a tool that can be used to visualize and evaluate the burden of suffering caused by an illness. The aim of this study was to identify which aspects of the burden of chronic pain patients are associated with Self/illness separation (SIS), an indicator of the magnitude of suffering. We also examined the effectiveness of PRISM for evaluating changes in the relationships between patients and their medical care and significant others due to our inpatient treatment. Methods Seventy-two patients with chronic pain who were outpatients or admitted to the Department of Psychosomatic Medicine completed PRISM, depression and anxiety scales, and three types of pain-related self-assessment questionnaires (Brief Pain Inventory, Short-form McGill Pain Questionnaire, and Pain Catastrophizing Scale). Outpatients were queried at the time of outpatient visits and inpatients at the time of admission. In addition to PRISM disks related to illness, we asked each patient to place disks related to things important to them and their medical care. Of the inpatients, 31 did PRISM at the time of discharge. Among the reported important factors, which significant other was placed at the time of admission and discharge was evaluated. The distances of self/medical care separation (SMcS) and self/significant others separation (SSoS) were measured. Results Of the 21 scales measured, 10 showed a significant correlation with SIS. Factor analysis of these 10 scales extracted three factors, Life interferences, Negative affects, and Pain intensity. The SMcS and SSoS distances were shorter at discharge than at admission. Conclusions PRISM for patients with chronic pain is an integrated evaluation method that reflects three aspects of pain. By adding medical care and significant others to the usual method of placing only illness on the sheet it became possible to assess changes in the quality of interpersonal relationships.

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The nature and prevalence of chronic pain in homeless persons: an observational study

F1000Research ◽

10.12688/f1000research.2-164.v1 ◽

2013 ◽

Vol 2 ◽

pp. 164 ◽

Cited By ~ 10

Author(s):

Rebecca Fisher ◽

Judith Ewing ◽

Alice Garrett ◽

E Katherine Harrison ◽

Kimberly KT Lwin ◽

...

Keyword(s):

Chronic Pain ◽

Neuropathic Pain ◽

Short Form ◽

Homeless People ◽

Brief Pain Inventory ◽

Homeless Persons ◽

Lower Limbs ◽

Mcgill Pain Questionnaire ◽

Wide Range

Background: Homeless people are known to suffer disproportionately with health problems that reduce physical functioning and quality of life, and shorten life expectancy. They suffer from a wide range of diseases that are known to be painful, but little information is available about the nature and prevalence of chronic pain in this vulnerable group. This study aimed to estimate the prevalence of chronic pain among homeless people, and to examine its location, effect on activities of daily living, and relationship with alcohol and drugs.Methods: We conducted face-to-face interviews with users of homeless shelters in four major cities in the United Kingdom, in the winters of 2009-11. Participants completed the Brief Pain Inventory, Short Form McGill Pain questionnaire, Leeds Assessment of Neuropathic Symptoms and Signs, and detailed their intake of prescribed and unprescribed medications and alcohol. We also recorded each participant’s reasons for homelessness, and whether they slept rough or in shelters.Findings: Of 168 shelter users approached, 150 (89.3%) participated: 93 participants (63%) reported experiencing pain lasting longer than three months; the mean duration of pain experienced was 82.2 months. The lower limbs were most frequently affected. Opioids appeared to afford a degree of analgesia for some, but whilst many reported symptoms suggestive of neuropathic pain, very few were taking anti-neuropathic drugs.Interpretation: The prevalence of chronic pain in the homeless appears to be substantially higher than the general population, is poorly controlled, and adversely affects general activity, walking and sleeping. It is hard to discern whether chronic pain is a cause or effect of homelessness, or both. Pain is a symptom, but in this challenging group it might not always be possible to treat the underlying cause. Exploring the diagnosis and treatment of neuropathic pain may offer a means of improving the quality of these vulnerable people’s lives.

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New Model for Couple Therapy for Patients with Chronic Pain and their Caregivers: An Attempt to Improve Quality of Life and Reduce Pain

Clinical Practice and Epidemiology in Mental Health ◽

10.2174/1745017902016010053 ◽

2020 ◽

Vol 16 (1) ◽

pp. 53-58

Author(s):

Shima Rouhi ◽

Payman Dadkhah ◽

Manijeh Firoozi ◽

Masoud Hashemi

Keyword(s):

Quality Of Life ◽

Chronic Pain ◽

Interpersonal Relationships ◽

Couple Therapy ◽

Short Form ◽

Control Group ◽

Improve Quality ◽

Innovative Therapy ◽

Quasi Experimental

Background: Several psychological interventions have been implemented to manage chronic pain. In this study, in addition to the patients, his/her spouses have participated in the program. Besides, this innovative therapy integrates several practical approaches into one comprehensive protocol. Objective: This study aimed to analyze the effectiveness of couple therapy (patient/caregiver-oriented) on improving the quality of life and reducing pain among patients with chronic pain. Methods: The present study is a quasi-experimental and clinical trial with a control group with pretest and posttest. The authors conducted this study at LABAFINEJAD Hospital in Tehran on 30 patients with chronic pain and their spouses by having a short form of a questionnaire for quality of life and chronic pain score questionnaire to measure the effectiveness of the treatment. Results: The results indicated that this treatment increased two aspects of quality of life remarkably, social function and strength for continuing the performance; that help boosts interpersonal relationships as well. Regarding the results, although the couple-based treatment could improve all aspects of pain, the two primary subscales, physical health and mental health, both enhanced. Besides, the treatment reduced the intensity of pain. Conclusion: Couple-based intervention through increasing social support, improving the quality of sex, decentralizing of pain, and paying attention to the neglected needs of caregivers and patients with chronic pain can improve quality of life and reduce pain in patients.

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Chronic Pain Assessment: A Seven-Factor Model

Pain Research and Management ◽

10.1155/2008/976341 ◽

2008 ◽

Vol 13 (4) ◽

pp. 299-308 ◽

Cited By ~ 21

Author(s):

Megan A Davidson ◽

Dean A Tripp ◽

Leandre R Fabrigar ◽

Paul R Davidson

Keyword(s):

Chronic Pain ◽

Coping Strategies ◽

Factor Model ◽

Pain Catastrophizing ◽

Short Form ◽

Activity Level ◽

Mcgill Pain Questionnaire ◽

Pain Coping ◽

Pain Experience ◽

The Core

BACKGROUND: There are many measures assessing related dimensions of the chronic pain experience (eg, pain severity, pain coping, depression, activity level), but the relationships among them have not been systematically established.OBJECTIVE: The present study set out to determine the core dimensions requiring assessment in individuals with chronic pain.METHODS: Individuals with chronic pain (n=126) completed the Beck Anxiety Inventory, Beck Depression Inventory, Beck Hopelessness Scale, Chronic Pain Coping Index, Multidimensional Pain Inventory, Pain Catastrophizing Scale, McGill Pain Questionnaire – Short Form, Pain Disability Index and the Tampa Scale of Kinesiophobia.RESULTS: Before an exploratory factor analysis (EFA) of the nine chronic pain measures, EFAs were conducted on each of the individual measures, and the derived factors (subscales) from each measure were submitted together for a single EFA. A seven-factor model best fit the data, representing the core factors of pain and disability, pain description, affective distress, support, positive coping strategies, negative coping strategies and activity.CONCLUSIONS: Seven meaningful dimensions of the pain experience were reliably and systematically extracted. Implications and future directions for this work are discussed.

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Severity of chronic pain and its relationship to quality of life in multiple sclerosis

Multiple Sclerosis Journal ◽

10.1191/1352458505ms1168oa ◽

2005 ◽

Vol 11 (3) ◽

pp. 322-327 ◽

Cited By ~ 118

Author(s):

Lorraine V Kalia ◽

Paul W OConnor

Keyword(s):

Quality Of Life ◽

Multiple Sclerosis ◽

Chronic Pain ◽

Short Form ◽

Depression Scale ◽

Pain Severity ◽

Anxiety And Depression ◽

Mcgill Pain Questionnaire ◽

Neurogenic Pain

Introduction: This study used reliable and validated instruments to compare pain severity in multiple sclerosis (MS) to that in other chronic painful conditions, and to examine relationships between chronic pain in MS and health-related quality of life (HRQOL). Methods: Ninety-nine MS patients completed a self-administered survey comprised of the Medical Outcomes 36-Item Short-Form Health Survey, the Short-Form McGill Pain Questionnaire, and the Hospital Anxiety and Depression Scale. Results: Pain severity was not different between MS patients with pain and rheumatoid arthritis (P=0.77) or osteoarthritis (P=0.98) patients. Chronic pain in MS was less often neurogenic than non-neurogenic, although severity of neurogenic pain was greater than that of non-neurogenic pain (P=0.048). Chronic pain in MS was found to have no significant relationship to age, disease duration or disease course. Instead, we found that pain was correlated with aspects of HRQOL, particularly mental health (r=0.44, P<0.0001) versus physical functioning (r=0.19, P>0.05). Chronic pain was significantly related to anxiety and depression for females but not for males with MS. Conclusions: Chronic pain in MS is as severe as pain in arthritic conditions and is associated with reduced HRQOL. Thus, pain can be a significant symptom for MS patients and the need for treatment may be underestimated.

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Duloxetine Added to Tramadol in Chronic Pain Syndrome

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.1844 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S500-S501

Author(s):

M. Domijan ◽

Z. Lončar ◽

S. Udovičić

Keyword(s):

Quality Of Life ◽

Chronic Pain ◽

Sleep Disturbances ◽

Short Form ◽

Pain Syndrome ◽

Mcgill Pain Questionnaire ◽

Chronic Pain Syndrome ◽

Reduction Of Pain ◽

Competing Interest

IntroductionAbout 15–20% of the population suffering from the chronic pain. Over time, chronic pain can result in different emotional problems, social isolation, sleep disturbances, which reduce the quality of life. Chronic pain syndrome (CPS) indicates persistent pain, subjective symptoms in excess of objective findings, associated dysfunctional pain behavious and self-limitation in activities of daily living. Duloxetine is a potent antidepressant approved by the Food and Drug Administration for the chronic musculoskeletal disorder, diabetic neuropathic pain, fibromyalgia, generallized anxiety disorder and major depressive disorder.ObjectiveTo determine the effect of duloxetine on the reduction of pain and psychosocial suffering.AimsThe goal of the treatment should be to effectively reduce pain while improving function and reducing psychosocial suffering.MethodsThirty-six adult, nondepressed patients, already on tramadol therapy were included. Patients with VAS (visual analogue scale) ≥ 4were treated with duloxetine for 13 weeks. We measured pain intensity with the McGill Pain Questionnaire-Short Form (MPQ-SF) and compared VAS before starting the treatment with duloxetine and weekly for 13 weeks.ResultsPain response was defined as a 30%decrease in the MPQ-SF. A total of 62.5% of the sample met these criteria for response. Among them, 13.8% of patients were discontinued because of adverse effects. Duloxetine significantly improved functioning and the quality of life in patients with CPS.ConclusionsBecause of it is analgesic properties, duloxetine in the lower antidepressant doses (60 mg taken ones daily) combined with tramadol (another analgesic agent) can be useful in CPS for patients who do not respond satisfactory to monotherapy.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Sensory profile and its impact on quality of life in patients with painful diabetic polyneuropathy

Journal of Neurosciences in Rural Practice ◽

10.4103/0976-3147.118766 ◽

2013 ◽

Vol 04 (03) ◽

pp. 267-270 ◽

Cited By ~ 3

Author(s):

Kongkiat Kulkantrakorn ◽

Chakraphong Lorsuwansiri

Keyword(s):

Quality Of Life ◽

Short Form ◽

Diabetic Polyneuropathy ◽

Sensory Profile ◽

Mcgill Pain Questionnaire ◽

Sharp Pain ◽

Sf 36 ◽

Sensory Score ◽

Almost All

ABSTRACT Context: Painful diabetic polyneuropathy (PDN) is common and causes significant disability. The sensory profile in each patient is different and affects quality of life. Aim: To describe the demographic, details of sensory profile and its impact on quality of life in patients with PDN. Settings and Design: A cross-sectional survey in patients with PDN who were treated in a University Hospital. Materials and Methods: They were interviewed with standard questionnaires, which included neuropathic pain scale (NPS), a short-form McGill Pain Questionnaire (SF-MPQ) and a short form-36 quality of life survey (SF-36). Statistical Analysis Used: Descriptive statistics were used in demographic data. Student′s t test was used to analyze continuous data. Multiple comparisons for proportions and correlations were made using Fisher Exact test and Pearson′s coefficient of correlation, respectively. Results: Thirty three patients were included in this study. In NPS, sharp pain was the most common symptom and itching was the least common. Almost all patients had more than one type of pain. The mean VAS was 53 mm. In SFMPQ, the sensory score, affective score and the present pain score fell in the moderate range. In SF-36, physical functioning was the most affected and social function was the least affected. Conclusions: PDN significantly affects patients′ quality of life, especially physical function and role limitation due to a physical problem. Almost all patients have many types of pain and sharp pain is the most common.

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Psychosocial factors, disability and quality of life in chronic shoulder pain patients with central sensitization

Health Psychology Research ◽

10.4081/hpr.2020.8874 ◽

2020 ◽

Vol 8 (2) ◽

Author(s):

Prachita P. Walankar ◽

Vrushali P. Panhale ◽

Manali M. Patil

Keyword(s):

Quality Of Life ◽

Shoulder Pain ◽

Central Sensitization ◽

Pain Catastrophizing ◽

Short Form ◽

Well Being ◽

Sf 36 ◽

Pain Patients ◽

Chronic Shoulder Pain

Chronic shoulder pain is a complex and multidimensional phenomenon with multiple causative factors involved in its perpetuation. Alteration of central nervous system processing along with the central sensitization is a predominant feature in chronic pain. Reduction in physical function has an impact on the psychological well-being of an individual. The aim of the study was to compare pain, kinesiophobia, catastrophizing, disability and quality of life in chronic shoulder pain patients with and without central sensitization. Eighty chronic unilateral shoulder pain patients in the age group of 40 to 60 years were recruited. Of them, 38 were chronic shoulder pain with central sensitization and 42 without central sensitization, classified on the basis of central sensitization inventory. Pain catastrophizing was measured using the pain catastrophizing scale, kinesiophobia using Tampa scale of kinesiophobia, disability using Shoulder pain and disability index and quality of life using 36-Item Short Form Health Survey questionnaire was evaluated in both the groups. Increased pain catastrophizing (p=0.000), kinesiophobia (p=0.000) and disability (p=0.000) was observed in centrally sensitized chronic shoulder pain patients. Also, physical component summary (p=0.000) and mental component summary (p=0.000) of SF-36 quality of life were reduced in chronic shoulder pain with central sensitization as compared to without central sensitization. Hence, these components should be included during assessment which will provide a holistic and multimodal approach towards the understanding, planning and management of chronic shoulder pain patients.

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Biopsychosocial baseline values of 15 000 patients suffering from chronic pain: Dutch DataPain study

Regional Anesthesia and Pain Medicine ◽

10.1136/rapm-2020-101476 ◽

2020 ◽

Vol 45 (10) ◽

pp. 774-782

Author(s):

Brigitte Brouwer ◽

Sophie Waardenburg ◽

Christian Jacobs ◽

Marjori Overdijk ◽

Carsten Leue ◽

...

Keyword(s):

Chronic Pain ◽

Pain Catastrophizing ◽

Daily Practice ◽

Integrated Treatment ◽

Pain Severity ◽

Numerical Rating ◽

Treatment Plans ◽

Pain Center ◽

Pain Patients

Background and objectivesChronic pain affects many adults. To improve our daily practice, we need to understand multidisciplinary approaches, integrated treatment plans and the biopsychosocial context of these patients. To date, almost 15 000 chronic pain patients have been referred to the Maastricht University Pain Center in the Netherlands.MethodsThis study describes 11 214 of these patients suffering from chronic pain. Chronic pain was analyzed using relevant Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials instruments.ResultsMost patients were female (59.3%). The prevalence of low education was 59%, and unemployment/disability was 35.9%. The mean age was 55.6 years. Severe pain (Numerical Rating Sale score 7–10) was reported by 71.9% of the patients; psychological and quality of life values deteriorated when pain severity increased. Approximately 36% of patients showed severe signs of depression or anxiety, and 39% displayed high pain catastrophizing. Of all patients, 17.8% reported high values for pain severity, catastrophizing and anxiety or depression.ConclusionsBased on baseline biopsychosocial values, this study shows the complexity of patients referred to pain centers. Pain management with a biopsychosocial approach in an integrated multidisciplinary setting is indispensable. Above all, adjusted education on chronic pain and attention to its biopsychosocial aspects are deemed necessary.

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Patients with chronic pain: evaluating depression and their quality of life in a single center study in Greece

BMC Psychology ◽

10.1186/s40359-019-0366-0 ◽

2019 ◽

Vol 7 (1) ◽

Cited By ~ 2

Author(s):

Ekaterini Rapti ◽

Dimitrios Damigos ◽

Paraskevi Apostolara ◽

Vasiliki Roka ◽

Chara Tzavara ◽

...

Keyword(s):

Quality Of Life ◽

Health Care ◽

Chronic Pain ◽

Regression Analysis ◽

Short Form ◽

Medical Center ◽

Demographic Data ◽

Greek Language ◽

Common Location

Abstract Background Chronic pain constitutes one of the most common reasons for seeking health care services and may even lead to disability. Chronic pain has been associated with depression and deterioration of the quality of life. The aim of our study is to outline the burden of chronic pain in the context of a primary health care (PHC) setting in Greece and to investigate its association with depression and quality of life. Methods A cross-sectional study was conducted from September 2016 to November 2016. The subjects of the study comprised 200 individuals who visited the regional medical center of Ag. Theodoroi, Greece. The collected data were from a representative sample of 200 adults and included demographic data, social and medical history, presence and characteristics of chronic pain and questions from three questionnaires for the assessment of pain (BPI- short form), the investigation of depression (PHQ-9) and the evaluation of the quality of life (EuroQ-5D) validated in Greek language. Multiple regression analysis was used in order to find associated factors with quality of life, depression and chronic pain. Results A percentage of 56.8% of the participants, the majority of whom (62%) were women, reported chronic pain. Among individuals with pain, lower back area was the most common location. Based on the given questionnaire, depression was detected in 22. 5% of the participants who claimed chronic pain. Regression analyses revealed that women and respondents with chronic mental disorders like depression and anxiety had significantly higher scores on the pain scale and suffered pain which had a greater impact on their daily activities. According to regression analysis decreased quality of life was expressed by women, as well as participants with a chronic mental disorder. A significant reverse correlation emerged between the quality of life, depression and pain scales. Conclusion Chronic pain, as it has been studied within this PHC setting, is a common health care problem. Individuals who had experienced chronic pain and depression had a lower health-related quality of life.

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Long-term Outcomes of Deep Brain Stimulation for Neuropathic Pain

Neurosurgery ◽

10.1227/neu.0b013e31827b97d6 ◽

2012 ◽

Vol 72 (2) ◽

pp. 221-231 ◽

Cited By ~ 93

Author(s):

Sandra G.J. Boccard ◽

Erlick A.C. Pereira ◽

Liz Moir ◽

Tipu Z. Aziz ◽

Alexander L. Green

Keyword(s):

Quality Of Life ◽

Neuropathic Pain ◽

Short Form ◽

Case Series ◽

Mcgill Pain Questionnaire ◽

Euroqol 5D ◽

Deep Brain

Abstract BACKGROUND: Deep brain stimulation (DBS) to treat neuropathic pain refractory to pharmacotherapy has reported variable outcomes and has gained United Kingdom but not USA regulatory approval. OBJECTIVE: To prospectively assess long-term efficacy of DBS for chronic neuropathic pain in a single-center case series. METHODS: Patient reported outcome measures were collated before and after surgery, using a visual analog score, short-form 36-question quality-of-life survey, McGill pain questionnaire, and EuroQol-5D questionnaires (EQ-5D and health state). RESULTS: One hundred ninety-seven patients were referred over 12 years, of whom 85 received DBS for various etiologies: 9 amputees, 7 brachial plexus injuries, 31 after stroke, 13 with spinal pathology, 15 with head and face pain, and 10 miscellaneous. Mean age at surgery was 52 years, and mean follow-up was 19.6 months. Contralateral DBS targeted the periventricular gray area (n = 33), the ventral posterior nuclei of the thalamus (n = 15), or both targets (n = 37). Almost 70% (69.4%) of patients retained implants 6 months after surgery. Thirty-nine of 59 (66%) of those implanted gained benefit and efficacy varied by etiology, improving outcomes in 89% after amputation and 70% after stroke. In this cohort, >30% improvements sustained in visual analog score, McGill pain questionnaire, short-form 36-question quality-of-life survey, and EuroQol-5D questionnaire were observed in 15 patients with >42 months of follow-up, with several outcome measures improving from those assessed at 1 year. CONCLUSION: DBS for pain has long-term efficacy for select etiologies. Clinical trials retaining patients in long-term follow-up are desirable to confirm findings from prospectively assessed case series.

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