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Who benefits from m...
Who benefits from multimodal rehabilitation - an exploration of pain, psychological distress, and life impacts in over 35,000 chronic pain patients identified in the Swedish Quality Registry for Pain Rehabilitation
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- Gerdle, Björn (author)
- Linköpings universitet,Linköping University,Linkoping Univ, Pain & Rehabil Ctr, Dept Med & Hlth Sci, SE-58185 Linkoping, Sweden,Avdelningen för samhällsmedicin,Medicinska fakulteten,Region Östergötland, Smärt och rehabiliteringscentrum
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- Åkerblom, Sophia (author)
- Lund University,Lunds universitet,Institutionen för psykologi,Samhällsvetenskapliga institutioner och centrumbildningar,Samhällsvetenskapliga fakulteten,Department of Psychology,Departments of Administrative, Economic and Social Sciences,Faculty of Social Sciences,Skåne University Hospital,Skane Univ Hosp, Dept Pain Rehabil, Lund, Sweden;Lund Univ, Dept Psychol, Lund, Sweden
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- Brodda Jansen, Gunilla (author)
- Division of Rehabilitation Medicine, Department of Clinical Sciences, Danderyd Hospital, Stockholm, Sweden,Danderyd Hosp, Div Rehabil Med, Dept Clin Sci, Stockholm, Sweden
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- Enthoven, Paul (author)
- Linköpings universitet,Linköping University,Linkoping Univ, Pain & Rehabil Ctr, Dept Med & Hlth Sci, SE-58185 Linkoping, Sweden,Avdelningen för fysioterapi,Medicinska fakulteten
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- Ernberg, Malin (author)
- Karolinska Institutet,Karolinska Inst, Dept Dent Med, Huddinge, Sweden;SCON, Huddinge, Sweden
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- Dong, Huan-Ji, 1981- (author)
- Linköpings universitet,Linköping University,Linkoping Univ, Pain & Rehabil Ctr, Dept Med & Hlth Sci, SE-58185 Linkoping, Sweden,Avdelningen för samhällsmedicin,Medicinska fakulteten,Region Östergötland, Smärt och rehabiliteringscentrum
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- Stålnacke, Britt-Marie (author)
- Umeå University,Umeå universitet,Rehabiliteringsmedicin,Umea Univ, Dept Community Med & Rehabil, Rehabil Med, Umea, Sweden
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- Äng, Björn (author)
- Uppsala universitet,Uppsala University,Dalarna University College,Karolinska Institutet,Högskolan Dalarna,Medicinsk vetenskap,Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge, Sweden; Center for Clinical Research Dalarna – Uppsala University, Falun, Sweden; School of Education, Health and Social Studies, Dalarna University, Falun, Sweden,Centrum för klinisk forskning Dalarna,Karolinska Inst, Dept Neurobiol Care Sci & Soc, Div Physiotherapy, Huddinge, Sweden;Dalarna Univ, Sch Educ Hlth & Social Studies, Falun, Sweden,Karolinska Inst, Sweden; Uppsala Univ, Sweden; Dalarna Univ, Sweden
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- Boersma, Katja, professor, 1973- (author)
- Örebro University,Örebro universitet,Institutionen för juridik, psykologi och socialt arbete,Orebro Univ, Sch Law Psychol & Social Work, Orebro, Sweden
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(creator_code:org_t)
- DOVE Medical Press Ltd. 2019
- 2019
- English.
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In: Journal of Pain Research. - : DOVE Medical Press Ltd.. - 1178-7090. ; 12, s. 891-908
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Abstract
Subject headings
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- Background: Chronic pain patients frequently suffer from psychological symptoms. There is no consensus concerning the prevalence of severe anxiety and depressive symptoms and the strength of the associations between pain intensity and psychological distress. Although an important aspect of the clinical picture is understanding how the pain condition impacts life, little is known about the relative importance of pain and psychological symptoms for individual's life impact. The aims of this study were to identify subgroups of pain patients; to analyze if pain, psychological distress, and life impact variables influence subgrouping; and to investigate how patients in the subgroups benefit from treatments.Methods: Background variables, pain aspects (intensity/severity and spreading), psychological distress (depressive and anxiety symptoms), and two life impact variables (pain interference and perceived life control) were obtained from the Swedish Quality Registry for Pain Rehabilitation for chronic pain patients and analyzed mainly using advanced multivariate methods.Results: Based on >35,000 patients, 35%-40% had severe anxiety or depressive symptoms. Severe psychological distress was associated with being born outside Europe (21%-24% vs 6%-8% in the category without psychological distress) and low education level (20.7%-20.8% vs 26%-27% in the category without psychological distress). Dose relationships existed between the two psychological distress variables and pain aspects, but the explained variances were generally low. Pain intensity/severity and the two psychological distress variables were significantly associated (R2=0.40-0.48; P>0.001) with the two life impact variables (pain interference and life control). Two subgroups of patients were identified at baseline (subgroup 1: n=15,901-16,119; subgroup 2: n=20,690-20,981) and the subgroup with the worst situation regarding all variables participated less in an MMRP (51% vs 58%, P<0.001) but showed the largest improvements in outcomes.Conclusion: The results emphasize the need to assess both pain and psychological distress and not take for granted that pain involves high psychological stress in the individual case. Not all patients benefit from MMRP. A better matching between common clinical pictures and the content of MMRPs may help improve results. We only partly found support for treatment resistance in patients with psychological distress burden.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Neurologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Neurology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Omvårdnad (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Nursing (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Annan medicin och hälsovetenskap -- Övrig annan medicin och hälsovetenskap (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Other Medical and Health Sciences -- Other Medical and Health Sciences not elsewhere specified (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap -- Sjukgymnastik (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences -- Physiotherapy (hsv//eng)
Keyword
- anxiety
- chronic pain
- control
- depression
- life impact
- sociodemographic
- Hälsa och välfärd
- Health and Welfare
- Anxiety
- Chronic pain
- Control
- Depression
- Life impact
- Sociodemographic
Publication and Content Type
- ref (subject category)
- art (subject category)
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Gerdle, Björn
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Åkerblom, Sophia
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Brodda Jansen, G ...
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Enthoven, Paul
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Ernberg, Malin
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Dong, Huan-Ji, 1 ...
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Stålnacke, Britt ...
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Äng, Björn
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Boersma, Katja, ...
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- Articles in the publication
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Journal of Pain ...
- By the university
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Högskolan Dalarna
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Örebro University
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Umeå University
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Karolinska Institutet
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Lund University
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Uppsala University
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Linköping University
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