Pain medication beliefs mediate the relationship between pain catastrophizing and opioid prescription use in patients with chronic non-cancer pain

2021 ◽  
Author(s):  
Rachel. A. Elphinston ◽  
Michael. J.L. Sullivan ◽  
Michele. Sterling ◽  
Jason. P. Connor ◽  
John. A. Baranoff ◽  
...  
Keyword(s):  
Cancer Pain ◽  
Pain Catastrophizing ◽  
Pain Medication ◽  
Opioid Prescription ◽  
Medication Beliefs ◽  
The Relationship

scholarly journals Pain Catastrophizing Moderates Relationships between Pain Intensity and Opioid Prescription

2017 ◽  
Vol 127 (1) ◽  
pp. 136-146 ◽  
Author(s):  
Yasamin Sharifzadeh ◽  
Ming-Chih Kao ◽  
John A. Sturgeon ◽  
Thomas J. Rico ◽  
Sean Mackey ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Pain Intensity ◽  
Pain Treatment ◽  
Pain Catastrophizing ◽  
Tertiary Care ◽  
Treatment Center ◽  
Women Patients ◽  
Opioid Prescription ◽  
Men And Women ◽  
The Relationship

Abstract Background Pain catastrophizing is a maladaptive response to pain that amplifies chronic pain intensity and distress. Few studies have examined how pain catastrophizing relates to opioid prescription in outpatients with chronic pain. Methods The authors conducted a retrospective observational study of the relationships between opioid prescription, pain intensity, and pain catastrophizing in 1,794 adults (1,129 women; 63%) presenting for new evaluation at a large tertiary care pain treatment center. Data were sourced primarily from an open-source, learning health system and pain registry and secondarily from manual review of electronic medical records. A binary opioid prescription variable (yes/no) constituted the dependent variable; independent variables were age, sex, pain intensity, pain catastrophizing, depression, and anxiety. Results Most patients were prescribed at least one opioid medication (57%; n = 1,020). A significant interaction and main effects of pain intensity and pain catastrophizing on opioid prescription were noted (P < 0.04). Additive modeling revealed sex differences in the relationship between pain catastrophizing, pain intensity, and opioid prescription, such that opioid prescription became more common at lower levels of pain catastrophizing for women than for men. Conclusions Results supported the conclusion that pain catastrophizing and sex moderate the relationship between pain intensity and opioid prescription. Although men and women patients had similar Pain Catastrophizing Scale scores, historically “subthreshold” levels of pain catastrophizing were significantly associated with opioid prescription only for women patients. These findings suggest that pain intensity and catastrophizing contribute to different patterns of opioid prescription for men and women patients, highlighting a potential need for examination and intervention in future studies.

scholarly journals The Influence of Communicative Relations on Facial Responses to Pain: Does It Matter Who Is Watching?

2014 ◽  
Vol 19 (1) ◽  
pp. 15-22 ◽  
Author(s):  
Anna J Karmann ◽  
Stefan Lautenbacher ◽  
Florian Bauer ◽  
Miriam Kunz
Keyword(s):  
Facial Pain ◽  
Pain Catastrophizing ◽  
Video Recording ◽  
Heat Pain ◽  
Social Situations ◽  
Situational Demands ◽  
Facial Expressiveness ◽  
The Impact ◽  
The Relationship ◽  
Healthy Participants

BACKGROUND: Facial responses to pain are believed to be an act of communication and, as such, are likely to be affected by the relationship between sender and receiver.OBJECTIVES: To investigate this effect by examining the impact that variations in communicative relations (from being alone to being with an intimate other) have on the elements of the facial language used to communicate pain (types of facial responses), and on the degree of facial expressiveness.METHODS: Facial responses of 126 healthy participants to phasic heat pain were assessed in three different social situations: alone, but aware of video recording; in the presence of an experimenter; and in the presence of an intimate other. Furthermore, pain catastrophizing and sex (of participant and experimenter) were considered as additional influences.RESULTS: Whereas similar types of facial responses were elicited independent of the relationship between sender and observer, the degree of facial expressiveness varied significantly, with increased expressiveness occurring in the presence of the partner. Interestingly, being with an experimenter decreased facial expressiveness only in women. Pain catastrophizing and the sex of the experimenter exhibited no substantial influence on facial responses.CONCLUSION: Variations in communicative relations had no effect on the elements of the facial pain language. The degree of facial expressiveness, however, was adapted to the relationship between sender and observer. Individuals suppressed their facial communication of pain toward unfamiliar persons, whereas they overtly displayed it in the presence of an intimate other. Furthermore, when confronted with an unfamiliar person, different situational demands appeared to apply for both sexes.

scholarly journals The relationship between psychosocial factors and reported disability: The role of pain self-efficacy

2021 ◽  
Author(s):  
Antonio Varela
Keyword(s):  
Physical Activity ◽  
Chronic Pain ◽  
Low Back Pain ◽  
Psychosocial Factors ◽  
Self Efficacy ◽  
Pain Catastrophizing ◽  
Low Back ◽  
Mediating Role ◽  
The Relationship

Abstract Background Chronic pain in all its forms and the accompanying level of disability is a healthcare crisis that reaches epidemic proportions and is considered a world level crisis. Chronic non-specific low back pain contributes a significant proportion of chronic pain. Specific psychosocial factors and their influence on reported disability in a chronic non-specific low back pain (CNLBP) population was researched. Methods Psychosocial factors examined include fear, catastrophizing, depression, and pain self-efficacy. This cross-sectional correlational study examined the mediating role between pain self-efficacy and the specific psychosocial factors with reported disability. The study included 90 participants with CNLBP between 20 and 60 years of age. Participants completed the Fear Avoidance Belief Questionnaire, The Pain Catastrophizing Scale, The Patient Health Questionnaire-9, The Pain Self-Efficacy Questionnaire, and The Lumbar Oswestry Disability Index to measure fear of physical activity, pain catastrophizing, depression, pain self-efficacy, and reported disability, respectively. The study used multivariate regression and mediation analyses. Results The principal finding of the study was a strong inverse relationship between pain self-efficacy and reported disability. Further, pain self-efficacy was considered a statistic mediator for all psychosocial factors investigated within this data set. Pain self-efficacy was strongly considered to have a mediating role between reported fear of physical activity and disability, reported pain catastrophizing and disability, and reported depression and disability. Additionally, adjusting for age and reported pain levels proved to be statistically significant, and it did not alter the role of pain self-efficacy. Conclusion The results identified that pain self-efficacy had a mediating role in the relationship between the specific psychosocial factors of fear, catastrophizing, and depression and reported disability. Pain self-efficacy plays a more significant role in the relationships between specific psychosocial factors and reported disability with CNLBP than previously considered.

scholarly journals The association between psychological characteristics and physical activity levels in people with knee osteoarthritis: a cross-sectional analysis

2020 ◽  
Author(s):  
Daisuke Uritani ◽  
Jessica Kasza ◽  
Penny K. Campbell ◽  
Ben Metcalf ◽  
Thorlene Egerton
Keyword(s):  
Physical Activity ◽  
Self Efficacy ◽  
Pain Catastrophizing ◽  
Psychological Characteristics ◽  
Activity Levels ◽  
Cross Sectional ◽  
Fear Of Movement ◽  
Physical Activity Levels ◽  
Steps Per Day ◽  
The Relationship

Abstract Background:The aim of this study was to examine the relationship between psychological characteristics and physical activity levels, measured as the average number of steps per day, in people with knee osteoarthritis (OA).Methods: This study analysed baseline data from a randomized controlled trial (Australian New Zealand Clinical Trials Registry reference: ACTRN12612000308897). A total of 167 adults aged over 50 years, with knee pain rated as four or more on an 11-point numeric rating scale, and knee OA diagnosed using American College of Rheumatology clinical criteria, were recruited from the community (62 men and 105 women; mean age, 62.2 ± 7.5 years). The average number of steps per day over seven consecutive days was measured using an accelerometer-based device. Psychological characteristics evaluated were: depressive symptoms (Depression Anxiety Stress Scale), self-efficacy (Arthritis Self-Efficacy Scale for pain and other symptoms), fear of movement (Brief Fear of Movement Scale for Osteoarthritis), and pain catastrophizing (Pain Catastrophizing Scale). The association between the average number of steps per day and psychological characteristics was analyzed using a multiple linear regression analysis, with the average number of steps per day as the dependent variable, adjusting for each psychological characteristic separately, and age, sex, body mass index, and pain entered as covariates.Results: There was evidence that the amount of physical activity was associated with fear of movement (coefficient [B]: -117, 95% confidence interval [95%CI]: -227 to -8) and with pain catastrophizing (B: -44, 95%CI: -86 to -1). The association with self-efficacy was similar (B:117, 95%CI: -12 to 246). However, the direction of the association with depressive symptoms was less clear (B: -59, 95%CI: -138 to 19).Conclusions: The results of this study revealed that the relationship was such that lower fear of movement and lower pain catastrophizing may be associated with more steps per day. It may be hypothesized that fear of moving and pain catastrophizing lead to activity avoidance and that strategies to improve these disease-related psychological aspects may be useful in enhancing physical activity participation, although this hypothesis is highly speculative and needs further testing given the cross-sectional design of this study.

Pain Management for Pediatric Burns in the Outpatient Setting: A Changing Paradigm?

2020 ◽  
Vol 41 (4) ◽  
pp. 814-819
Author(s):  
Niti Shahi ◽  
Maxene Meier ◽  
Ryan Phillips ◽  
Gabrielle Shirek ◽  
Adam Goldsmith ◽  
...  
Keyword(s):  
Pain Control ◽  
Multimodal Therapy ◽  
Burn Injury ◽  
Total Body Surface Area ◽  
Medication Use ◽  
Pain Medication ◽  
Outpatient Setting ◽  
Burn Injuries ◽  
Opioid Prescription ◽  
Over The Counter

Abstract Childhood burns are common and distressing for children and their parents. Pain is the most common complaint and often thought to be undertreated, which can negatively influence the child’s care and increase the risk of posttraumatic stress disorder. There is limited literature on the role of opioids and multimodal therapy in the treatment of pediatric outpatient burns. We sought to evaluate the current use of opioids (including the use of multimodal therapies), storage, and disposal of opioids in this patient population. Parents of burn-injured children 8 months to 18 years old, who were seen in an outpatient setting within 2 weeks of their burn injury, were queried from April to December 2019 regarding their child’s pain control, opioid medication use, over-the-counter pain medication use, opioid storage, and disposal. A total of 142 parents of burn-injured children and their parents were surveyed. The median age of the burn-injured children was 2.7 years old and the majority (54.2%; 77/142) were male. The mean total body surface area (TBSA) was 1.8% and half sustained burn injuries to one or both hands. The most frequently used regimens for constant and/or breakthrough pain control were acetaminophen (62.7%) and nonsteroidal anti-inflammatory drugs (NSAIDs; 68.3%). Less than one fifth (26/142;18%) of patients were prescribed opioids and 88% filled their prescription. The median number of doses of opioids prescribed was eight doses, with a median of four doses of opioids unused. Only three patients used all of their prescribed opioids and no patient ≥12 years old used their entire prescription. Burns greater than 3% TBSA, irrespective of burn injury location, were associated with opioid prescription (P = .003). Approximately 40% (10/26) of parents who filled their child’s opioid prescription stored the opioid in a locked area. Fewer than one third (7/26) of patients were educated on how to dispose of excess opioid pain medication. Overall, most pediatric outpatient burn injuries can be successfully managed with over-the-counter medications. Providers, who care for burn-injured children ≤ 12 years old with burns that cover ≥3% TBSA in the outpatient setting, should consider no more than four opioid doses for initial pain control. This guideline, coupled with family and provider-centered education on multimodal therapy at the time of initial presentation and safe use of opioids, are important first steps to minimizing the use of opioids in the management of small area burns in children.

Disability, Quality of Life, and Pain Coping in Pediatric Migraine: An Observational Study

2017 ◽  
Vol 32 (8) ◽  
pp. 717-724 ◽  
Author(s):  
Serena L. Orr ◽  
Suzanne N. Christie ◽  
Salwa Akiki ◽  
Hugh J. McMillan
Keyword(s):  
Quality Of Life ◽  
Pediatric Patients ◽  
Pain Catastrophizing ◽  
Chronically Ill ◽  
Pain Coping ◽  
Pediatric Migraine ◽  
Related Quality ◽  
Lower Hrqol ◽  
The Relationship

Objectives: The objective was to examine the relationship between disability, health-related quality of life (HrQoL), and pain coping in pediatric migraineurs. Method: Eighty-five patients with migraine were recruited from Pediatric Neurology clinics. Participants completed the Pediatric Migraine Disability Assessment Scale, the Pediatric Quality of Life Inventory, the Pain Coping Questionnaire, and the Pain Catastrophizing Scale. Means were compared to published norms using t-tests. Spearman correlations and logistic regression were used to explore the relationships between the variables. Results: Mean HrQoL scores were lower than norms for controls and chronically ill pediatric patients ( P < .0001). Patients reported lower mean pain coping scores and higher mean pain catastrophizing scores than norms ( P < .0001). After controlling for age and sex, only the relationship between disability and HrQoL remained significant (OR = 0.91, 95% CI: 0.86-0.95). Conclusion: Pediatric patients with migraine report lower HrQoL, fewer pain coping strategies and more catastrophizing than controls, while disability is inversely associated with HrQoL.

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