scholarly journals A feasibility trial of a cognitive-behavioural symptom management program for chronic pelvic pain for men with refractory chronic prostatitis/chronic pelvic pain syndrome

2013 ◽  
Vol 5 (5) ◽  
pp. 328 ◽  
Author(s):  
Dean A. Tripp ◽  
J. Curtis Nickel ◽  
Laura Katz

Background: Our objective was to determine the feasibility of acognitive behavioural symptom management program for the acuteimprovement of psychosocial risk factors of diminished quality oflife (QoL) in men suffering from chronic prostatitis/chronic pelvicpain syndrome (CP/CPPS).Materials and Methods: We assessed CP/CPPS symptoms andimpact (i.e., chronic prostatitis symptom index [CPSI] pain, urinary,QoL domains), psychosocial risk factors were assessed at baselineand weekly for 8 weeks. We included the following psychosocialrisk factors: catastrophizing (Pain Catastrophizing Scale, PCS),mood (Center for Epidemiological Studies in Depression Scale,CES-D), social support (Multidimensional Scale of Perceived SocialSupport, MSPSS) and general pain (McGill Pain Questionnaire).Patient sessions dispute and replace pessimistic thinking withhealth-focused thinking and behaviour.Results: Eleven men completed the psychosocial management program(mean age = 51.3, standard deviaton [SD] = 12.49). MeanCPSI baseline total score was 25.2 (SD = 10.21). Repeated measuresANOVAs showed the program was associated with significantlinear reductions for pain (p = 0.051), disability (p= 0.020)and catastrophizing (p = 0.005), but no changes in depressivesymptoms or social support. The CPSI baseline scores comparedto follow-up scores (n = 8) were significantly reduced (p = 0.007),with CPSI pain (p = 0.015) and QoL impact (p = 0.013) reduced,but not for urinary scores. Correlations between change scores atthe baseline and at 8 weeks for CPSI and psychosocial risk factorsindicated that reductions in catastrophizing were most stronglyassociated with score reductions for the CPSI; these reductions,however, were not significant.Conclusions: The psychosocial management program targets andsignificantly reduces several empirically supported psychosocialrisk factors associated with poorer CP/CPPS outcomes. Psychosocialmanagement for CP/CPPS is feasible, but requires a randomizedcontrolled trial with longitudinal follow-up.


2014 ◽  
Vol 8 (11-12) ◽  
pp. 403 ◽  
Author(s):  
Adrijana Krsmanovic ◽  
Dean A Tripp ◽  
J Curtis Nickel ◽  
Daniel A Shoskes ◽  
Michel Pontari ◽  
...  

Introduction: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a prevalent, chronic pelvic pain condition largely unresponsive to medical interventions. Psychosocial risk factors are associated with poor outcomes in CP/CPPS, but have not been examined for their intervening roles between pain and reduced quality of life (QoL). This study aimed to determine if psychosocial risk factors (i.e., patient coping and catastrophizing) mediate the association between pain and QoL.Methods: Using a cross sectional design, 175 men with CP/CPPS (mean age 46.83; SD 10.86) were recruited from tertiary care urology clinics and completed questionnaires on demographics, pain, QoL, pain coping, depression, and catastrophizing. An exploratory factor analysis was conducted and aggregate factor scores were examined to improve the amount of meaningful measurement to be used in multiple mediations. The models specified multiple risk factors as mechanisms between pain and both physical and mental QoL as the primary outcome measurements.Results: Four aggregate psychosocial factor scores were produced from the psychosocial measures (i.e., illness and wellness-focused behavioural coping, depression and catastrophizing). Illness focusedcoping partially mediated the relationship between pain and physical QoL. However, catastrophizing and illness-focused coping fully mediated the relation between pain and mental QoL, showing the association between pain and mental QoL was no longer significant when catastrophizing and illness-focused coping were in the model.Conclusion: Psychosocial factors function as mechanisms between higher pain and they are associated diminished mental QoL. These results introduce illness-focused coping as an important biopsychosocial target in CP/CPPS management.



Author(s):  
Aboubakari Nambiema ◽  
Julie Bodin ◽  
Susan Stock ◽  
Agnès Aublet-Cuvelier ◽  
Alexis Descatha ◽  
...  

The objective of this paper is to assess the combined effect of occupational biomechanical and psychosocial risk factors on the incidence of work-related upper-extremity musculoskeletal disorders (UEMSDs) and estimate the proportion and number of incident cases attributable to these risk factors in a working population. Using data from the French COSALI (COhorte des SAlariés LIgériens) cohort (enrolment phase: 2002–2005; follow-up phase: 2007–2010), a complete case analysis including 1246 workers (59% men, mean age: 38 years ± 8.6 at baseline) was performed. All participants underwent a standardized clinical examination at enrolment and 1611 workers were re-examined at follow-up. Population attributable fractions and the number of UEMSD cases attributable to occupational risk factors were calculated. During follow-up, 139 UEMSD cases were diagnosed, representing an estimated 129,320 projected incident UEMSD cases in the working population. After adjusting for personal factors, in model 1, 8664 cases (6.7%) were attributable to low social support, 19,010 (14.7%) to high physical exertion, and 20,443 (15.8%) to co-exposure to both factors. In model 2, 16,294 (12.6%) cases were attributable to low social support, 6983 (5.4%) to posture with arms above shoulder level, and 5043 (3.9%) to co-exposure to both factors. Our findings suggest that many cases of UEMSD could be potentially prevented by multidimensional interventions aimed at reducing exposure to high physical exertion and improving social support at work.



2007 ◽  
Vol 177 (4S) ◽  
pp. 33-34
Author(s):  
Daniel A. Shoskes ◽  
Chun-Te Lee ◽  
Donel Murphy ◽  
John C. Kefer ◽  
Hadley M. Wood


2007 ◽  
Vol 177 (4S) ◽  
pp. 31-31
Author(s):  
J. Curtis Nickel ◽  
Dean Tripp ◽  
Shannon Chuai ◽  
Mark S. Litwin ◽  
Mary McNaughton-Collins




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