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- Hellström, Christina, et al.
(författare)
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Perceived future in chronic pain: the relationship between outlook on future and empirically derived psychological patient profiles.
- 2000
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Ingår i: European journal of pain (London, England). - : Wiley. - 1090-3801. ; 4:3, s. 283-90
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Tidskriftsartikel (refereegranskat)abstract
- Perceived (subjective) future has been found to be a significant factor in explaining the relationship between pain and pain-related distress. The present study is based on the assumption that chronic pain patients with the three psychological profiles introduced by Turk and Rudy in 1988 could also be found in a sample of chronic pain patients and if so, these profiles have different perspectives on the future. The Multidimensional Pain Inventory (MPI) and The Future Scale were used to collect data from 569 patients with heterogeneous non-malignant chronic pain. A cluster analysis was conducted, where the resulting clusters closely resembled the profiles labelled by Turk and Rudy as 'dysfunctional', 'interpersonally distressed' and 'adaptive coper'. The results indicated that patients with adaptive coper profile have a more positive perception, while those with an interpersonally distressed profile have a more negative perception of the future. With an increased duration of pain, the proportion of the adaptive coper category decreased linearly, while an opposite trend was noted for the interpersonally distressed category. These results may better enable profiled psychological interventions in clinical pain treatment, e.g. by providing patients with therapies focused on positive future orientation, resulting in increased motivation for health-seeking behaviour and better abilities to cope with pain.
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- Hellström, Christina, et al.
(författare)
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Subjective future as a mediating factor in the relation between pain, pain-related distress and depression.
- 1999
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Ingår i: European journal of pain (London, England). - 1532-2149. ; 3:3, s. 221-233
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Tidskriftsartikel (refereegranskat)abstract
- The coincidence of chronic pain, psychological distress and depression has been well documented in several studies. However, there is still debate about the type of causality linking these factors and whether psychological distress and depression precede or are a consequence of pain. This study contributes to this debate through an analysis of the latent structure behind these complex concepts. To test the hypothesis that subjective future (i.e. how the pain patient perceives the future) has an impact on pain, data were analysed from 660 chronic pain patients who were tested with The Multidimensional Pain Inventory (MPI), The Symptom Distress Checklist (SCL-90) and a Future Scale, which was constructed from items of the Sense of coherence-scale. By use of path analysis and structural equation modeling (S.E.M.) four latent constructs were tested: Pain, Interference, Distress and Subjective future. The results indicated that Subjective future has a strong impact on Distress, is a mediating variable, which contributes to conceptually explaining and practically nullifying the relationship between Pain and Distress, and finally that Pain is a concept, that changes with increasing duration. Copyright 1999 European Federation of Chapters of the International Association for the Study of Pain.
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- Peterson, Leif, 1943, et al.
(författare)
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A multi-facet pain survey of psychosocial complaints among patients with long-standing non-malignant pain
- 2017
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Ingår i: Scandinavian Journal of Pain. - : Walter de Gruyter GmbH. - 1877-8860 .- 1877-8879. ; 17, s. 68-76
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Tidskriftsartikel (refereegranskat)abstract
- © 2017 Scandinavian Association for the Study of Pain Background and aims Psychometric inventories and scales intended to measure cognitive, emotional and behavioural concomitants of pain are typically constructed by deducting items from theoretically derived concepts related to pain states, e.g. social support, perceived control, depressiveness, and catastrophizing. The aim of this study was to design a clinically useful, generic pain distress inventory – The Multi-Facet Pain Survey (MFPS) – inductively derived from psychological and social complaints reported by a study group of individuals with severe chronic nonmalignant pain. Methods Extensive clinical interviews with hospitalized chronic pain patients were made by clinical psychologists. The purpose was to highlight the patients’ pain histories and their beliefs and feelings about the pain, and to determine factors possibly influencing their rehabilitation potential. The types of distress reported were sorted into categories with a procedure similar to content analysis. Distress reports were converted to statements, forming items in a questionnaire, the Multi-Facet Pain Survey. Results Our analyses supported a distress structure including 15 categories, or “facets”, comprising in all 190 types of psychosocial distress. Ten of the facets denote beliefs about the present condition and aspects of distress experienced in daily life (e.g. cognitive problems); three facets reflect the illness history, and two the patient's views on future prospects. To improve the clinical utility, we shortened the scale into a 53 items inventory. A factor analysis of these 53 items revealed four clinically meaningful factors: (1) stress-related exhaustion; (2) impact of pain on daily life; (3) self-inefficacy in regard to future prospects; and (4) negative experiences of health care. While the second factor represents distress directly related to the pain, the first factor reflects long-term exhaustion effects of the pain condition similar to those seen in individuals exposed to long periods of stress. Items loading in the third factor reflect a pessimistic outlook on the future. The content validity of the scale was explored by predicting and testing correlations between the 15 MFPS facets, and the Symptom Checklist (SCL-90) and the West Haven Yale Multidimensional Pain Inventory (MPI). Some of the MFPS facets showed little or no agreement with any of the subscales of the comparison measures. The homogeneity was satisfactory both for facets and factors. Conclusions The Multi-Facet Pain Survey (MFPS) facets cover a broad array of experienced psychosocial distress in patients with severe, longstanding pain. Some facets of psychosocial impact of longstanding pain states shown in the qualitatively derived distress facets, or by the latent factors found in the factor analysis, may complement our understanding of the long-term impact of pain. Consequently, MFPS may improve the assessment of psychological and social complaints and complications in patients with chronic pain. Implications The MFPS will hopefully be an assessment tool supporting the psychological contribution to a biopsychosocial evaluation of patients with severe, longstanding pain. By exposing a broad range of suffering, MFPS may contribute to alternative treatment options and a better prognosis of future rehabilitation.
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- Abrahamsson, Kajsa H., 1956, et al.
(författare)
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Ambivalence in Coping with Dental Fear and Avoidance: A Qualitative Study
- 2002
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Ingår i: Journal of Health Psychology. - : SAGE Publications. - 1359-1053 .- 1461-7277. ; 7:6, s. 653-664
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Tidskriftsartikel (refereegranskat)abstract
- Dental phobia is a widespread problem, which can have significant impact on the individual's health and daily life. This grounded theory study aims to explore the situation of dental phobic patients: how dental phobia interferes with their normal routines and functioning, social activities and relationships, what factors contribute to the maintenance of dental fear and how they cope with their fear. In the qualitative analysis of thematized in-depth interviews four main categories were developed: threat to self-respect and well-being, avoidance, readiness to act and ambivalence in coping. The results show that several psychological and social factors interact in determining how dental phobic individuals cope with their fear, and demonstrate in what way dental fear affects their daily lives.
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- Abrahamsson, Kajsa H., 1956, et al.
(författare)
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Dental phobic patients' view of dental anxiety and experiences in dental care: a qualitative study.
- 2002
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Ingår i: Scandinavian journal of caring sciences. - 0283-9318. ; 16:2, s. 188-96
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Tidskriftsartikel (refereegranskat)abstract
- Dental phobic patients' view of dental anxiety and experiences in dental care: a qualitative study The aim of this study was to explore and describe dental phobic patients' perceptions of their dental fear and experiences in dental care. The study sample consisted of 18 participants (12 women), with a mean age of 39.4 years, selected consecutively from patients applying for treatment at a specialized dental fear clinic in G?teborg, Sweden. Dental fear, assessed by the Dental Anxiety Scale, showed score levels well over established levels for severe dental fear. The method for sampling and analysis was inspired by the constant comparative method for Grounded Theory (GT). The thematized in-depth interviews took place outside the clinic and lasted for 1-1.5 h. All the interviews were conducted by the first author (KHA), audiotaped and transcribed verbatim. Three higher-order categories were developed and labelled existential threat, vulnerability and unsupportive dentist. Existential threat was identified as the core category, describing the central meaning of the subjects' experiences in dental care. The core category included two dimensions, labelled threat of violation and threat of loss of autonomy and independence. The core category and the descriptive categories are integrated in a model framing the process of dental fear, as described by the informants. In conclusion, the onset of dental fear was commonly related to individual vulnerability and to traumatic dental care experiences, where perceived negative dentist behaviour played a significant role. The patient was caught in a 'vicious circle' that was difficult to break, and where fear and anxiety were maintained by negative expectations about treatment and about patient's own ability to cope in dental care situations.
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- Abrahamsson, Kajsa H., 1956, et al.
(författare)
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Phobic avoidance and regular dental care in fearful dental patients: a comparative study.
- 2001
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Ingår i: Acta odontologica Scandinavica. - 0001-6357 .- 1502-3850. ; 16, s. 188-196
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Tidskriftsartikel (refereegranskat)abstract
- The present investigation was a comparative study of 169 highly fearful dental patients, some of whom received regular dental care (n = 28) and some who never, or only when absolutely necessary, utilized dental care (n = 141). It was hypothesized that phobic avoidance is related to anticipatory stress and anxiety reactions, negative oral health effects, psychological distress, and negative social consequences. Background factors (sex, age, education, and dental attendance pattern), dental anxiety, general fears, general state and trait anxiety, mood states, depression, and quality of life effects were studied. Data were analyzed with descriptive statistics and with exploratory factor and multiple logistic regression analysis. It was shown that dental anxiety is significantly higher among the avoiders and this is in particular evident for anticipatory dental anxiety. Oral health differed between the groups, and it was shown that avoiders had significantly more missing teeth, whereas regular attenders had significantly more filled teeth. The avoiders reported a stronger negative impact on their daily life, whereas there were no significant differences between the groups with regard to general emotions. The logistic regression analysis showed that phobic avoidance was predicted only by anticipated dental anxiety and missing teeth. It was concluded that differences between high dental fear patients with regular dental care and phobic avoidance were mainly related to anticipated fear and anxiety, oral health effects, and concomitant negative life consequences. These results are discussed in terms of subjective stress, negative cognitions, social support, and coping-strategies.
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