The validity of 4 common pain intensity measures is supported, although the 0–10 Numerical Rating Scale and Visual Analogue Scale evidenced the most responsivity.
The Visual Analogue Scale (VAS), ...Numerical Rating Scale (NRS), Verbal Rating Scale (VRS), and the Faces Pain Scale-Revised (FPS-R) are among the most commonly used measures of pain intensity in clinical and research settings. Although evidence supports their validity as measures of pain intensity, few studies have compared them with respect to the critical validity criteria of responsivity, and no experiment has directly compared all 4 measures in the same study. The current study compared the relative validity of VAS, NRS, VRS, and FPS-R for detecting differences in painful stimulus intensity and differences between men and women in response to experimentally induced pain. One hundred twenty-seven subjects underwent four 20-second cold pressor trials with temperature order counterbalanced across 1°C, 3°C, 5°C, and 7°C and rated pain intensity using all 4 scales. Results showed statistically significant differences in pain intensity between temperatures for each scale, with lower temperatures resulting in higher pain intensity. The order of responsivity was as follows: NRS, VAS, VRS, and FPS-R. However, there were relatively small differences in the responsivity between scales. A statistically significant sex main effect was also found for the NRS, VRS, and FPS-R. The findings are consistent with previous studies supporting the validity of each scale. The most support emerged for the NRS as being both (1) most responsive and (2) able to detect sex differences in pain intensity. The results also provide support for the validity of the scales for use in Portuguese samples.
OBJECTIVE:Current models of chronic pain recognize that psychosocial factors influence pain and the effects of pain on daily life. The role of such factors has been widely studied on English-speaking ...individuals with chronic pain. It is possible that the associations between such factors and adjustment may be influenced by culture. This study sought to evaluate the importance of coping responses, self-efficacy beliefs, and social support to adjust to chronic pain in a sample of Portuguese patients, and discuss the findings with respect to their similarities and differences from findings of studies on English-speaking individuals.
MATERIALS AND METHODS:Measures of pain intensity and interference, physical and psychological functioning, coping responses, self-efficacy, and satisfaction with social support were administered to a sample of 324 Portuguese patients with chronic musculoskeletal pain. Univariate and multivariate analyses were computed. Findings were interpreted with respect to those from similar studies using English-speaking individuals.
RESULTS:Coping responses and perceived social support were significantly associated with pain interference and both physical and psychological functioning; self-efficacy beliefs were significantly associated with all criterion variables. All coping responses, except for task persistence, were positively associated with pain interference and negatively associated with physical and psychological functioning, with the strongest associations found for catastrophizing, praying/hoping, guarding, resting, asking for assistance, and relaxation.
DISCUSSION:The findings provide support for the importance of the psychosocial factors studied in terms of adjustment to chronic pain in Portuguese patients, and also suggest the possibility of some differences in the role of these factors due to culture.
Abstract
Objective
Chronic pain is a multidimensional experience associated with psychosocial (e.g., pain-related beliefs and pain coping responses) and spiritual factors. Spirituality is a universal ...aspect of the human experience that has been hypothesized to impact pain experience via its effects on pain, physical/psychological function, resilience and pain-related beliefs, and pain coping responses. However, research evaluating the associations between measures of spirituality and measures of pain and function in individuals with chronic pain is limited. This study seeks to address this limitation.
Methods
Participants were 62 Portuguese adults with chronic musculoskeletal pain. Participants completed measures of spirituality, pain intensity, physical and psychological function, and pain coping responses.
Results
Spirituality as hope and a positive perspective toward life was positively and moderately associated with better psychological function and coping responses of ignoring pain sensations and coping self-statements. Spirituality as a search for meaning and sense of purpose was positively and moderately associated with the coping response of task persistence.
Conclusions
These findings suggest the possibility that spirituality may be a useful resource for facilitating psychological adjustment, potentially promoting the use of some adaptive pain coping responses.
Purpose: Chronic pain is a multidimensional experience that is influenced by biological, psychological, social, and spiritual factors. The Meaning Making Model is a recent cognitive behavioral model ...that has been developed to understand how psychosocial factors influence adjustment to stressful events, such as having a chronic illness. This qualitative study aims to understand the potential utility of this model for understanding the role of meaning making in adjustment to chronic pain. Materials and Methods: Eighteen community-dwelling adults with chronic low back pain or chronic pain due to osteoarthritis participated in four focus groups. Participants were asked open-ended questions about their pain experience, pain-related beliefs, meaning of pain, and the perceived association between pain and their meaning in life and sense of purpose. Data were submitted to thematic analysis and the identified themes were considered in light of the Meaning Making Model. Results: Three overarching themes emerged, each of which included two themes. The first overarching theme--"appraised meaning of pain"--included the themes "causal attributions" and "primary appraisals." The second--"meaning making processes"--included the themes "assimilation" and "accommodation." The third--"meanings made"--included the themes "pain as an opportunity" and "acceptance." Conclusion: The key themes that emerged as individuals with chronic pain discussed pain and its impact are consistent with those that would be hypothesized as important from the Meaning Making Model, providing preliminary support for the utility of this model in the context of chronic pain. People with chronic pain appear to appraise pain in terms of its cause, controllability, threat, loss, or challenge. When a discrepancy between the appraised meaning of pain and one's global meaning emerged, participants engaged in meaning making processes (accommodation and assimilation), resulting in meanings made, such as a reappraised meaning of pain, perceptions of growth, and acceptance. Keywords: chronic pain, meaning in life, meaning of pain, thematic analysis
The prevalence of obesity and non-alcoholic fatty liver disease (NAFLD) associated hepatocellular carcinoma (HCC) is rising, even in the absence of cirrhosis. We aimed to develop a murine model that ...would facilitate further understanding of NAFLD-HCC pathogenesis. A total of 144 C3H/He mice were fed either control or American lifestyle (ALIOS) diet, with or without interventions, for up to 48 weeks of age. Gross, liver histology, immunohistochemistry (IHC) and RNA-sequencing data were interpreted alongside human datasets. The ALIOS diet promoted obesity, elevated liver weight, impaired glucose tolerance, non-alcoholic fatty liver disease (NAFLD) and spontaneous HCC. Liver weight, fasting blood glucose, steatosis, lobular inflammation and lipogranulomas were associated with development of HCC, as were markers of hepatocyte proliferation and DNA damage. An antioxidant diminished cellular injury, fibrosis and DNA damage, but not lobular inflammation, lipogranulomas, proliferation and HCC development. An acquired CD44 phenotype in macrophages was associated with type 2 diabetes and NAFLD-HCC. In this diet induced NASH and HCC (DINAH) model, key features of obesity associated NAFLD-HCC have been reproduced, highlighting roles for hepatic steatosis and proliferation, with the acquisition of lobular inflammation and CD44 positive macrophages in the development of HCC-even in the absence of progressive injury and fibrosis.
Both plants and animals rely on nucleotide-binding domain and leucine-rich repeat-containing (NB-LRR or NLR) proteins to respond to invading pathogens and activate immune responses. How plant NB-LRR ...proteins respond to pathogens is poorly understood. We undertook a gain-of-function random mutagenesis screen of the potato NB-LRR immune receptor R3a to study how this protein responds to the effector protein AVR3a from the oomycete pathogen Phytophthora infestans. R3a response can be extended to the stealthy AVR3aEM isoform of the effector while retaining recognition of AVR3aKI. Each one of eight single amino acid mutations is sufficient to expand the R3a response to AVR3aEM and other AVR3a variants. These mutations occur across the R3a protein, from the N terminus to different regions of the LRR domain. Further characterization of these R3a mutants revealed that at least one of them was sensitized, exhibiting a stronger response than the wild-type R3a protein to AVR3aKI. Remarkably, the N336Y mutation, near the R3a nucleotide-binding pocket, conferred response to the effector protein PcAVR3a4 from the vegetable pathogen P. capsici. This work contributes to understanding how NB-LRR receptor specificity can be modulated. Together with knowledge of pathogen effector diversity, this strategy can be exploited to develop synthetic immune receptors.
Chronic pain is a multidimensional experience and pain treatments targeting psychosocial factors reduce pain and improve function. These treatments often overlook the sociocultural factors that ...influence pain and the psychological factors associated with function in people with chronic pain. Although preliminary findings suggest that cultural background may influence pain and function via their effects on beliefs and coping, no previous study has directly tested if the country of origin moderates the associations between these psychological factors and pain and function. This study sought to address this knowledge gap. Five hundred sixty-one adults with chronic pain, born and living in the USA (n = 273) or Portugal (n = 288), completed measures of pain, function, pain-related beliefs, and coping. Between-country similarities were found in the endorsement of beliefs related to disability, pain control, and emotion, and in asking for assistance, task persistence, and coping self-statement responses. Portuguese participants reported greater endorsement of harm, medication, solicitude, and medical cure beliefs, more frequent use of relaxation and support seeking, and less frequent use of guarding, resting, and exercising/stretching. In both countries, disability and harm beliefs and guarding responses were associated with worse outcomes; pain control and task persistence were associated with better outcomes. Six country-related small effect-size moderation effects emerged, such that task persistence and guarding are stronger predictors of pain and function in adults from the USA, but pain control, disability, emotion, and medication beliefs are more important in adults from Portugal. Some modifications may be needed when adapting multidisciplinary treatments from one country to another.
This article examines the similarities and differences in beliefs and coping endorsed by adults with chronic pain from 2 countries, and the potential moderation effects of country on the associations between these variables and pain and function. The findings suggest that some modifications may be needed when culturally customizing psychological pain treatments.
•Country moderates the link between only a few beliefs and coping responses and pain and function.•Task persistence and guarding are stronger predictors of pain and function in adults from the USA.•Pain control, disability, emotion, and medication beliefs are more important in Portuguese adults.•Only few adjustments are needed for adapting psychosocial treatments from one country to another.•Culturally customizing psychosocial pain treatments might contribute to improve their efficacy.
Abstract
Objective
To evaluate the extent to which pain-related beliefs, appraisals, coping, and catastrophizing differ between countries, language groups, and country economy.
Design
Systematic ...review.
Methods
Two independent reviewers searched 15 databases without restriction for date or language of publication. Studies comparing pain beliefs/appraisals, coping, or catastrophizing across two or more countries or language groups in adults with chronic pain (pain for longer than three months) were included. Two independent reviewers extracted data and performed the quality appraisal. Study quality was rated as low, moderate, or high using a 10-item modified STROBE checklist. Effect sizes were reported as small (0.20–0.49), medium (0.50–0.79), or large (≥0.80).
Results
We retrieved 1,365 articles, read 42 potential full texts, and included 10 (four moderate-quality, six low-quality) studies. A total of 6,797 adults with chronic pain (33% with chronic low back pain) were included from 16 countries. Meta-analysis was not performed because of heterogeneity in the studies. A total of 103 effect sizes were computed for individual studies, some of which indicated between-country differences in pain beliefs, coping, and catastrophizing. Of these, the majority of effect sizes for pain beliefs/appraisal (60%; eight large, eight medium, and eight small), for coping (60%; seven large, 11 medium, and 16 small), and for catastrophizing (50%; two medium, one small) evidenced statistically significant between-country differences, although study quality was low to moderate.
Conclusions
In 50% or more of the studies, mean scores in the measures of pain beliefs and appraisals, coping responses, and catastrophizing were significantly different between people from different countries.
This systematic review examined the extent to which measures of religiosity/spirituality (R/S): (1) are associated with pain, function, pain-related beliefs (beliefs), coping responses, and ...catastrophizing in people with chronic pain; and (2) moderate the association between beliefs, coping and catastrophizing, and pain and function. Experimental and observational studies examining at least one of these research questions in adults with chronic pain were eligible. Two reviewers independently performed eligibility screening, data extraction, and quality assessment. Twenty studies were included. Most studies focused on the association between R/S and pain or function. When significant associations emerged, those between R/S and psychological function were weak to strong and positive; those between religious/spiritual well-being and pain and physical dysfunction were negative, but weak. Few studies examined the associations between R/S and beliefs/coping/catastrophizing; none examined the moderation role of R/S. The findings suggest that R/S is associated with pain and psychological function in people with chronic pain, and that viewing oneself as being “spiritual,” regardless of religion, may contribute to positive psychological adjustment. More research is needed to determine the reliability of this finding. PROSPERO registry CRD42018088803.
PDF
