scholarly journals The Pain and Sleep Questionnaire Three-Item Index (PSQ-3): A Reliable and Valid Measure of The Impact of Pain on Sleep in Chronic Nonmalignant Pain of Various Etiologies

2012 ◽  
Vol 17 (4) ◽  
pp. 281-290 ◽  
Author(s):  
Lindsay E Ayearst ◽  
Zoltan Harsanyi ◽  
Kenneth J Michalko
Keyword(s):  
Chronic Pain ◽  
Outcome Measures ◽  
Internal Consistency ◽  
Regression Analyses ◽  
Controlled Clinical Trials ◽  
Single Item ◽  
Nonmalignant Pain ◽  
Health Related ◽  
Chronic Nonmalignant Pain ◽  
The Impact

BACKGROUND: Sleep disturbance is among the more common complaints reported by chronic pain patients. Because pain-related sleep disturbance may serve as a marker for the assessment of responses to treatment for chronic pain, inclusion of a measure designed to assess the impact of pain on sleep in clinical trial protocols is important, if not necessary. Measures typically used for this purpose lack scales specifically designed for the assessment of the impact of pain on sleep or are based on a single item. Single-item scales lack reliability and, therefore, validity.OBJECTIVES: To investigate the psychometric properties of the five-item Pain and Sleep Questionnaire (PSQ) Index, which is embedded in the eight-item inventory, by applying an accepted methodology using retrospective analyses in controlled clinical trials in which the measure had been administered among patients with chronic nonmalignant pain.METHODS: Data were pooled from nine independent, single-site, double-blind, randomized placebo-controlled clinical trials conducted over a period of approximately 10 years, the majority of which were cross-over designs. A cross-validation approach was adopted with exploratory and confirmatory factor analyses conducted to evaluate the underlying structure and dimensionality of the measure. Internal consistency reliability was evaluated using Cronbach’s alpha coefficient. Mean score differences were used to assess the ability of the index to detect important treatment changes. Correlation coefficients were calculated between index scores and scores from other health-related outcome measures to evaluate the criterion validity of the index. Finally, predictive validity was assessed using multiple regression analyses.RESULTS: Pooling the data resulted in a sample of 605 patients (65.5% female; mean age 55.7 years). Findings suggested a revised three-item PSQ Index (PSQ-3). The PSQ-3 demonstrated high internal consistency across samples (ranging from 0.82 to 0.93) and was sensitive to detecting meaningful treatment effects within different chronic pain categories. Moderate to strong correlations (r>0.40) between the PSQ-3 and other health-related outcome measures provided preliminary evidence for criterion-related validity. Results of multiple regression analyses demonstrated that the PSQ-3 accounted for between 29% and 40% of the variance in scores from other health-related outcome measures.CONCLUSIONS: Results support the scoring of a revised three-item index for the assessment of the impact of pain on sleep. The revised index demonstrated acceptable levels of internal consistency and preliminary support for the structural, criterion-related and predictive validity of the index was achieved.

Is Chronic Pain a Disease in Its Own Right? Discussions from a Pre-OMERACT 2014 Workshop on Chronic Pain

2015 ◽  
Vol 42 (10) ◽  
pp. 1947-1953 ◽  
Author(s):  
Ann M. Taylor ◽  
Kristine Phillips ◽  
Justin O. Taylor ◽  
Jasvinder A. Singh ◽  
Philip G. Conaghan ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Outcome Measures ◽  
Outcome Measure ◽  
Disease State ◽  
Nonmalignant Pain ◽  
Chronic Nonmalignant Pain

At the pain workshop held prior to the Outcome Measures in Rheumatology (OMERACT) 12 conference, chronic nonmalignant pain (CP) as a “disease” was discussed, in response to growing interest in this concept and in terms of the effect on the OMERACT Filter 2.0 framework. CP is often assessed as a unidimensional outcome measure; however, if CP is a disease, then outcome measures need to define the disease state and identify all its manifestations as well as its effects, as specified by Filter 2.0. The aim was to write a discussion piece, reflecting the workshop contributions and debate, as an important step in opening a dialogue around future OMERACT Filter 2.0 Framework developments.

Management of Chronic Nonmalignant Pain

1998 ◽  
Vol 11 (5) ◽  
pp. 374-381 ◽  
Author(s):  
James T. O'Donnell ◽  
Moriah B. Richie ◽  
Lori A. Nesbitt
Keyword(s):  
Chronic Pain ◽  
Clinical Research ◽  
Interpersonal Relationships ◽  
State Level ◽  
Social Consequences ◽  
High Quality ◽  
Level Of Functioning ◽  
Nonmalignant Pain ◽  
Chronic Nonmalignant Pain

Although advances in knowledge about the pathophysiology of pain have been impressive in recent years, high-quality clinical research in patients with chronic pain has not been abundant. Because chronic pain often leads to profound changes in psychologic state, level of functioning, and interpersonal relationships, treatment requires attention not only to the pathophysiologic cause of the pain (if one can be found) but also to the psychologic and social consequences (and antecedents).

scholarly journals Evaluation of an anti-stigma intervention for Mexican psychiatric trainees

2022 ◽  
Vol 8 (1) ◽  
Author(s):  
Emmeline Lagunes-Cordoba ◽  
Ruth Alcala-Lozano ◽  
Roberto Lagunes-Cordoba ◽  
Ana Fresan-Orellana ◽  
Manuela Jarrett ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Negative Attitudes ◽  
Middle Income ◽  
Self Reflection ◽  
Middle Income Countries ◽  
People With Mental Illness ◽  
Related Stigma ◽  
Health Related ◽  
The Impact

Abstract Background There is research evidence regarding the presence of stigmatising attitudes in psychiatrists towards people with mental illness, but a lack of studies and interventions focused on this issue in low and middle-income countries. Aims To assess the feasibility of implementing an anti-stigma intervention for Mexican psychiatric trainees, and its potential effects. Methods This study comprised a pre-post design with outcome measures compared between baseline and 3-month follow-up. Quantitative outcome measures were used to evaluate the potential effects of the intervention, whilst the process evaluation required the collection and analysis of both quantitative and qualitative data. Results Twenty-nine trainees (25% of those invited) participated in the intervention, of whom 18 also participated in the follow-up assessment. Outcome measures showed the intervention had moderately large effects on reducing stereotypes and the influence of other co-workers on trainees’ own attitudes. The main mechanisms of impact identified were recognition of negative attitudes in oneself and colleagues, self-reflection about the impact of stigma, one’s own negative attitudes and recognition of one’s ability to make change. Participants accepted and were satisfied with the intervention, which many considered should be part of their routine training. However, trainees’ work overload and lack of support from the host organisation were identified as barriers to implement the intervention. Conclusions A brief anti-stigma intervention for Mexican psychiatric trainees is feasible, potentially effective, well accepted and was considered necessary by participants. This study also suggests mechanisms of impact and mediators should be considered for developing further interventions, contributing to reducing the damaging effects that mental health-related stigma has on people’s lives.

Clinical trial designs in anaesthesia

2017 ◽  
Author(s):  
Simon J. Howell
Keyword(s):  
Clinical Trial ◽  
Clinical Trials ◽  
Outcome Measures ◽  
Control Group ◽  
Or Groups ◽  
Related Quality ◽  
Health Related ◽  
Economic Analyses ◽  
Surrogate Measures ◽  
The Impact

A clinical trial is a research study that assigns people or groups to different interventions and compares the impact of these on health outcomes. This chapter examines the design and delivery of clinical trials in anaesthesia and perioperative medicine covering the issues outlined below. The features of a high-quality clinical trial include well-defined inclusion and exclusion criteria, a control group, randomization, and blinding. Outcome measures may be broadly divided into counting the number of people who experience an outcome and taking measurements on people. The outcome measures selected for a clinical trial reflect the purpose of the study and may include ‘true’ clinical measures such as major postoperative complications or surrogate measures such as the results of a biochemical test. Outcome measures may be combined in a composite outcome. Assessment of health-related quality of life using a tool such as the SF-36 questionnaire is an important aspect of many clinical trials in its own right and also informs the economic analyses that may be embedded in a trial. Determining the number for recruits needed for a clinical trial requires both clinical and statistical insight and judgement. The analysis of a clinical trial requires a similarly sophisticated approach that takes into account the objectives of the study and balances the need for appropriate subgroup analyses with the risk of false-positive results. The safe and effective management of a clinical trial requires rigorous organizational discipline and an understanding of the ethical and regulatory structures that govern clinical research.

scholarly journals The impact of factor infusion frequency on health-related quality of life in people with haemophilia

2020 ◽  
Vol 7 (1) ◽  
pp. 102-109 ◽  
Author(s):  
Gabriel Pedra ◽  
Pia Christoffersen ◽  
Kate Khair ◽  
Xin Ying Lee ◽  
Sonia O’Hara ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Infusion Rate ◽  
Clotting Factor ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
Severe Chronic Pain ◽  
The Impact

AbstractBackgroundSome studies suggest that people with haemophilia (PwH) who use prophylaxis value low frequency of clotting factor administration more than a lower risk of bleeding. However, more frequent infusions offer the potential of reducing joint disease and pain, which in turn may improve functioning and quality of life.AimsTo explore the impact on health-related quality of life (HRQoL) aspects of haemophilia associated with adherence and annual infusion rate in the context of factors influencing treatment that are important to patients, including prophylaxis, chronic pain, concomitant conditions and hospital admission.Materials and methodsHRQoL was assessed in participants with severe haemophilia in the ‘Cost of Haemophilia in Europe: a Socioeconomic Survey’ (CHESS) study who were using prophylaxis. Patients using on-demand treatment were excluded. This multivariate analysis examined the interaction between factors potentially influencing treatment and HRQoL, and minor and major bleeds.ResultsFrom the total CHESS population (n=1,285), 338 (26%) participants provided responses for major and minor bleeds and target joints, and 145 (11%) provided EQ-5D-3L responses. Major and minor bleeds were associated with pain. Patients with severe chronic pain reported a substantial negative impact on HRQoL; but this was significantly improved by increases in the annual infusion rate. This was not apparent in participants with mild or moderate pain.ConclusionIncreasing the frequency of prophylaxis infusions is associated with improved quality of life in PwH who have severe chronic pain. However, increasing the number of infusions per week in those with mild or moderate chronic pain with the intention of improving prophylactic effect may not have the same effect.

scholarly journals Chronic Pain and Etiology of Psychological Disturbances

2019 ◽  
Vol 4 ◽  
Author(s):  
Fatemeh Arbabi
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Pilot Study ◽  
Social Environments ◽  
Health Related Quality ◽  
Review Of Literature ◽  
Related Quality ◽  
Health Related ◽  
The Impact

Objective: The aim of this study was to review the impact of a possible association between self- efficacy, symptom severity, pain intensity, depression, anxiety and catastrophizing on health- related quality of life among chronic pain patients. Background: A large number of people experience and live with various types of physiological-oriented chronic pain (CP) diseases. Lives of individuals who suffer from CP may alter in various ways. Particularly, in terms of health-related quality of life after diagnosis. Even though, there has been significant increase in chronic pain research, this area of research continues to offer patients significant health repercussions. Findings: This research has discovered that, there still, is an urgent need for improvements in regard to treatment and quality of chronic pain management care. A range of literatures assessed several aspects in which CP alters the patients’ lives, as well as its potential repercussions in the workplace, on the dynamic of patients’ families, and their social environments. Methods: An exploratory review of literature alongside the implementation of a small exemplary pilot study that was solely undertaken to help further validate the results that were acquired via review of literature. The data presented in the pilot study were drawn from purposive sampling and structured survey questionnaires. Participants of the pilot study: Thirty adults (>18 years) diagnosed and currently living with various kinds of chronic physical non-cancer pain.

Adverse effects and cognitive function among primary care patients taking opioids for chronic nonmalignant pain

2006 ◽  
Vol 2 (3) ◽  
pp. 137 ◽  
Author(s):  
Randall T. Brown, MD ◽  
Megan Zuelsdorff, BS ◽  
Michael Fleming, MD, MPH
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Chronic Pain ◽  
Cognitive Function ◽  
Adverse Effects ◽  
Primary Care Physicians ◽  
Opioid Therapy ◽  
Chronic Opioid Therapy ◽  
Nonmalignant Pain ◽  
Chronic Nonmalignant Pain

Chronic opioid therapy is commonly prescribed for chronic nonmalignant pain. Few published data describe the adverse effects experienced by patients with chronic nonmalignant pain being treated by primary care physicians. A prevalence study was conducted on a sample of 1,009 patients (889 receiving chronic opioids) being treated by 235 primary care physicians. Standardized questionnaires and medical record reviews were used to assess rates of addiction, pain diagnosis and severity, opioid adverse effects, and mental health. The mean daily dose of opioids was 92 mg using a morphine-equivalent conversion. Side effects included constipation (40 percent), sleeping problems (25 percent), loss of appetite (23 percent), and sexual dysfunction (18 percent), with patients on daily opioids experiencing more side effects than subjects on intermittent medication. The Medical Outcomes Study Mental Health Inventory (MOS-MHI) cognitive functioning scale indicated poorer cognitive function in the overall sample of chronic pain patients as compared to a general clinical sample (Δ x 95 percent CI = 9.28, 13.76). However, there were limited differences in MOS scores between chronic pain subjects on daily opioids vs. intermittent opioids vs. no prescription opioids. A regression model suggests that psychological measures and pain severity are more predictive of decrements in cognitive function than specific opioid preparations or daily opioid dose. Physicians should closely monitor patients for adverse effects and adequacy of pain control when using chronic opioid therapy for chronic pain treatment. Psychological health, an important predictor of cognitive dysfunction, is a particularly important measure to actively monitor and manage.

Evaluation of the benefits from the introduction meeting for patients with chronic non-malignant pain and their relatives in interdisciplinary pain center

2017 ◽  
Vol 16 (1) ◽  
pp. 188
Author(s):  
H.L.A. Kristensen ◽  
M. Madsen ◽  
P.B.F. Jensen ◽  
W.Z. Pawlak
Keyword(s):  
Chronic Pain ◽  
Research Study ◽  
Pain Treatment ◽  
Multidisciplinary Therapy ◽  
Social Phobias ◽  
Nonmalignant Pain ◽  
Pain Center ◽  
Chronic Nonmalignant Pain ◽  
In The Beginning ◽  
Multidisciplinary Pain Center

AbstractBackgroundTreatment of patients with chronic nonmalignant pain (CNMP) is challenging and requires a multidisciplinary effort. In a multidisciplinary pain center, patients are treated by a team of doctor, nurse, physiotherapist, psychologist and social worker. Especially in the beginning of treatment patients receive much information. Many patients and their relatives have problems with comprehending it.ObjectiveThis is an action research study aimed to find the optimal mode for to introduce patients with CNMP and their relatives to the multidisciplinary pain treatment.MethodIn the fall of 2016, we began to invite patients and their relatives to the introduction meeting (IM), which takes place in groups of up to 20 people, has duration of 1 hour and is led by the physiotherapist and nurse, but the physician is also present. Invited patients are able to understand written and oral Danish and are not suffering from social phobias. During IM facts about the center, treatment course and pain physiology are presenter. Immediately after IM, participants are anonymously asked about their experiences.ResultsUp to date (February 2017) 254 patients were invited. Invitation was rejected by 63 patients (24,8%). Question about understanding of chronic pain was answered by 108 participants (both patients and their relatives), and 103 participants declared better understanding of chronic pain after IM end before. 69 participants answered question about understanding of treatment course in the center. All but 2 participants declared after IM at their understanding was better end before. In fact, 31 (44,9%) participants estimated changes in understanding of treatment course as much significant.ConclusionThe IM at the beginning of multidisciplinary therapy seems to be a promising activity for patients with CNMP referred to the multidisciplinary pain center, as well as for their relatives. Study is ongoing and updated results will be presented at the conference.

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