Psychologically-based chronic pain variables measure multiple domains of the pain experience such as anxiety, depression, catastrophizing, acceptance and stages of change. These variables measure ...specific areas such as emotional and cognitive states towards chronic pain and its management, acceptance towards the chronic pain condition, and an individual’s readiness to move towards self-management methods. Conceptually, these variables appear to be interrelated to each other, and also form groupings of similar underlying themes. Groupings that have been previously discussed for these variables include positive and negative affect, and improved and poor adjustment. Psychological experience of chronic pain as a whole is mostly understood through conceptually consolidating individual scores across different measures covering multiple domains. A map of these variables in relation to each other can offer an overview for further understanding and exploration. We hereby visualize highlights of relationships among 11 psychosocial chronic pain variables including measures examining physical and somatic aspects, using three-dimensional biplots. Variables roughly form two groupings, with one grouping consisting of items of negative affect, cognition, and physical state ratings, and the other grouping consisting of items of acceptance and the later three stages of change (contemplation, action, maintenance). Also, we follow up with canonical correlation as a complement to further identify key relationships between bimodal groupings. Key variables linking bimodal relationships consist of catastrophizing, depression and anxiety in one grouping and activity engagement in the other. Results are discussed in the context of existing literature.
BackgroundYoga integrates all aspects of self, with biological, mental, intellectual, and spiritual elements. The practice of yoga aligns with the biopsychosocial model of health and, as such, it can ...be instrumental in pain treatment.AimsThe purpose of this qualitative study was to explore perceptions regarding the yoga sessions for chronic pain through thematic content analysis with comparison of gender, veteran or civilian status, and delivery methods.MethodsPatients with chronic pain attended a 5-week intensive interdisciplinary chronic pain management program at the Michael G. DeGroote Pain Clinic. Participants were asked to complete six open-ended questions following four weekly 1-h yoga classes, through in-person or virtual delivery. Survey responses were thematically and separately analyzed by reviewers.ResultsForty-one (N = 41) participants (56% males, 71% veterans) with an average age of 50.87 (SD 10.10) years provided comments. Nine themes emerged: (1) mind and body are one through yoga practices; (2) meaningful practice of yoga basics is productive for range of motion/movement, tension in joints, and chronic pain; (3) yoga classes provide an enjoyable process of learning; (4) yoga reminds patients of their physical capabilities; (5) routine practices lead to improvements; (6) yoga improved on strategies for chronic pain; (7) yoga can be adapted for each patient; (8) mindset improves to include positive thinking, better focus, and willingness to try new things; and (9) improvements exist for the current yoga programming.ConclusionFindings of the current study were nine qualitative themes that present the experience of patients with chronic pain in the yoga sessions.
Background: In Canada, 41% of veterans experience chronic pain compared to the general population (20%). Many veterans with chronic pain also have comorbid disorders such as depression and ...posttraumatic stress disorder (PTSD), causing increased pain interference and disability.
Aim: This study aims to investigate the effectiveness of a 4-week interdisciplinary pain management program at the Michael G. DeGroote Pain Clinic in Hamilton, Ontario, Canada, and to explore differences in pain experience and treatment outcomes between veterans and nonveterans in the program.
Methods: Data were obtained from psychometric measures completed by 68 veterans and 68 nonveterans enrolled in the pain management program. By matching groups for age and gender, scores were compared between veterans and nonveterans. Outcomes investigated include catastrophizing, pain traumatization, stages of change, acceptance of pain, and program satisfaction. Multivariate analysis of variance (MANOVA) was conducted to examine session (admission-discharge) and group (veteran-nonveteran) differences, and independent t tests were used to examine differences in satisfaction measures.
Results: Results showed that the program was effective for all participants, with significant differences between admission and discharge on several measures. However, veterans experienced significantly greater improvements in pain catastrophizing, kinesiophobia, pain traumatization, pain acceptance, stages of change, and pain coping, compared to nonveterans (P < 0.05). Though no significant differences in program satisfaction were found between groups, case managers evaluated veterans as having achieved greater benefits from the program.
Conclusion: This study presents evidence supporting the effectiveness of an interdisciplinary pain management program in addressing pain-related variables in veterans and nonveterans and provides insight into how pain management is experienced differently by veterans.
Yoga as a holistic principle, not only practice of asanas or poses, integrates all aspects of the self, with biological, mental, intellectual, and spiritual elements. Yoga encompasses the ...biopsychosocial medical perspective, which regards pain as a dynamic interaction between physiological, psychological, and social factors. The purpose of this perspective article is to compare and contrast psychological practices such as mindfulness meditation, relaxation response (RR), and cognitive behavioral therapy (CBT) with Yoga in their management of chronic pain. The use of these practices is explored through history, literature, and research studies. Results from scientific studies on Yoga show changes in health-related pain outcomes for patients with chronic pain. The key aspects of Yoga, notably relaxation, positive thinking, and mindfulness, are discussed in relation to mindfulness meditation, RR, and CBT.
Numerous definitions of pain have been proposed over many years with different implications when applied to clinical practice. This paper reviews information regarding the evolution of definitions of ...pain terminology and pain syndromes as they relate to everyday practice for clinicians and those operating within the medicolegal judicial system, both trainees and seasoned professionals, with a focus on chronic pain. An historical overview of the evolution and chronology of chronic pain labels and definitions is provided with emphasis on those used currently in clinical practice. Subsequently, the paper mainly concentrates on the two more recent revisions of the Diagnostic and Statistical Manual of Mental Disorders (DSM) of the American Psychiatric Association (APA) and the basic principles of International Classification of Diseases (ICD) by the World Health Organization (WHO). It further provides a summary of the newly accepted WHO ICD-11 novel classification of pain disorders, a joint effort of WHO and the International Association for the Study of Pain (IASP). We conclude our review by providing our personal opinions and commentaries on controversies and dilemmas associated with the DSM, and ICD pain definitions and classifications, and offer useful tips for those who perform forensic examinations.
This qualitative phenomenological study examined the impact of the COVID-19 pandemic on the lives of patients living with chronic pain. Patients referred to an intensive interdisciplinary pain ...management program between June 2020 to June 2021 were asked, “How did the COVID-19 pandemic affect your life?” as part of their interdisciplinary assessment. Ninety patients (50 Veterans, 40 civilians) provided comments to this question, which were independently organized into themes using an inductive approach by 4 researchers. Nine main themes emerged: (1) changed psychological state, (2) minimal to no effect, (3) affected personal life activities, (4) changes in accessing care, (5) changes in work/education situation, (6) changes in family dynamics, (7) experiencing more annoyances, (8) COVID-19 pandemic is a barrier to making positive changes, and (9) got COVID-19. Themes are consistent with topics of interest in light of this ongoing, global stressor. Most commonly reported themes reflected changes in psychological well-being and changes in access to care, highlighting similarities between life with chronic pain and life under the pandemic for this group.
Integrating satisfaction measures with pain-related variables can highlight global change and improvement from the patients’ perspective. This study examined patient satisfaction in an ...interdisciplinary chronic pain management program. Nine hundred and twenty-seven (n = 927) participants completed pre- and post-treatment measures of pain, depression, catastrophizing, anxiety, stages of change, and pain acceptance. Multiple regression was used to examine these variables at admission and discharge as predictors of patient satisfaction. Pain-related variables explained 50.6% of the variance (R2 = .506, F
22,639 = 29.79, P < .001) for general satisfaction, and 38.9% of the variance (R2 = 0.389, F
22,639 = 18.49, P < .001) for goal accomplishment. Significant predictors of general satisfaction included depression (β = −0.188, P < .001) and the maintenance stage of change (β = 0.272, P < .001). The latter was also a significant predictor of goal accomplishment (β = 0.300, P < .001). Discharge pain-related measures are more influential than admission measures for predicting patient satisfaction. Patient satisfaction is significantly related to establishing a self-management approach to pain.
To determine the psychometric properties of the 11-item Tampa Scale for Kinesiophobia (TSK-11) in patients with heterogeneous chronic pain.
The study evaluated test-retest reliability (intra-class ...correlation coefficient), cross-sectional convergent construct validity (Pearson product-moment correlation between TSK-11 and the Pain Catastrophizing Scale PCS scores at admission), and sensitivity to change of the TSK-11 (area under the receiver operating characteristic ROC curve) in patients (n=74) with heterogeneous chronic pain. We used two data sets (retrospective, n=56; prospective, n=18). All patients attended the 4-week interdisciplinary chronic pain management programme at Chedoke Hospital, Hamilton Health Sciences, Hamilton, Ontario.
The test-retest reliability of the TSK-11 was 0.81 (95% CI, 0.58-0.93), the standard error of measurement was 2.41 (90% CI, 1.47-2.49), and the minimal detectible change score was 5.6. The correlation between TSK-11 and PCS at admission was 0.60 (95% CI, 0.43-0.73). The area under the ROC curve was 0.73 (95% CI, 0.57-0.88).
The study results provide evidence for the test-retest reliability, cross-sectional convergent construct validity, and sensitivity to change of the TSK-11 in a population with heterogeneous chronic pain.
LAY SUMMARY
Interdisciplinary pain rehabilitation programs are effective in treating chronic pain. Not many studies have explored how Veterans differ from civilians in responding to treatment. In ...this study, several measures were administered at different time points to examine and compare the long-term treatment outcomes of Veteran and civilian men and women. Results from 67 participants showed an overall long-term improvement in levels of pain-related disability, anxiety, and depression, as well as many other pain-related variables. While no differences in treatment outcomes between Veterans and civilians were found, men and women showed some differences. Women reported higher depressive symptoms overall and more pain-related disability than men at follow-up from the program. This study demonstrates the long-term effectiveness of interdisciplinary pain management programs regardless of Veteran status. It highlights some differences between genders. Previous studies have not compared the long-term outcomes of Veterans and civilians from an interdisciplinary program.
Introduction: The literature has established that interdisciplinary pain management programs are the most effective treatments for chronic pain. Patients see improvements in many pain-related variables such as pain intensity and disability upon discharge from these programs. Previous studies overlooked exploring different sub-groups in terms of their response to treatment. The present study explores how Veterans and civilians, and women and men, differ in long-term treatment outcomes from the four-week interdisciplinary pain management program at the Michael G. DeGroote Pain Clinic in Hamilton, Ontario, Canada. Methods: Data were obtained from psychometric measures administered at admission and discharge from the program and mailed to all completers at follow-up four months to four years after discharge. Results: Out of 197 participants, 67 (31 Veterans and 36 civilians; 34%) contacted completed all psychometric measures at follow-up. Factorial analyses of variance (ANOVAs), 3 × 2 × 2 with repeated measures, were conducted to examine time (admission, discharge, follow-up), Veteran status (Veteran, civilian), and gender (men, women). Post hoc tests were completed with the Bonferroni correction. Results showed the program was effective for all patients: they improved significantly at discharge and maintained most of their gains at follow-up. Women reported overall higher depression scores and higher pain-related disability at follow-up. Discussion: Results demonstrate the long-term effectiveness of interdisciplinary pain management programs regardless of Veteran status and highlight some differences between genders. This study adds new findings to current literature, as previous studies have not compared the long-term outcomes of Veterans and civilians from an interdisciplinary program.
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