| 1. |
- Raak, Ragnhild, 1948-, et al.
(författare)
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Catastrophizing and health related quality of life : A 6-year follow-up of patients with chronic low back pain
- 2002
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Ingår i: Rehabilitation Nursing. - : Ovid Technologies (Wolters Kluwer Health). - 0278-4807. ; 27:3, s. 110-117
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Tidskriftsartikel (refereegranskat)abstract
- A pain rehabilitation model that focused on emotions was implemented to influence catastrophizing by, and health-related quality of life (HRQL) for, persons with chronic low back pain. Twelve individuals, 7 men and 5 women (aged 33 to 57 years), all with long-term pain despite treatment, were included in the study and a single case research experimental design (SCRED) was used to follow the patterns of coping with pain for 6 years. The HRQL was measured before and 6 years after the intervention. Coping strategies and HRQL were evaluated with the Coping Strategy Questionnaire (CSQ) and the SF-36, respectively. The evaluation of pain coping strategies after 3 years found decreased catastrophizing, a decrease that had continued 3 years later. HRQL showed significantly improved mental health and impaired physical capacity at the 6-year follow-up. Changes in catastrophizing or in HRQL did not appear to influence self-scored bodily pain. Altered catastrophizing appeared to be a long-term process. This research indicates the need for rehabilitation programs to assess and evaluate patients' pain and their need for improved quality of life, rather than focusing only on the elimination of pain.
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| 2. |
- Aspegren Kendall, Sally, 1950-, et al.
(författare)
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Differences in sensory thresholds in the skin of women with fibromyalgia syndrome : A comparison between ketamine responders and ketamine non-responders
- 2003
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Ingår i: Journal of Musculoskeletal Pain. - 1058-2452 .- 1540-7012. ; 11:2, s. 3-9
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To compare detection and pain thresholds in the skin of female fibromyalgia patients who were either ketamine responders or ketamine nonresponders.Methods: Detection thresholds to innocuous warmth, of cold, heat or cold pain, and touch and dynamic touch sensation were determined in the skin. Pressure pain thresholds, local and widespread pain intensity, and pain duration were also registered.Results: Ketamine nonresponse was associated with more pronounced hypersensitivity for thermal pain [especially cold pain] than ketamine response.Conclusions: Blockade of N-metyl-D-aspartic acid receptors by ketamine and the recording of pain thresholds in the skin, especially for cold pain, might reveal different mechanisms of allodynia.
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| 3. |
- Hurtig, Ingrid, 1947-, et al.
(författare)
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Quantitative sensory testing in fibromyalgia patients and in healthy subjects : identification of subgroups
- 2001
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Ingår i: The Clinical Journal of Pain. - : Ovid Technologies (Wolters Kluwer Health). - 0749-8047 .- 1536-5409. ; 17:4, s. 316-322
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To determine perception and pain thresholds in patients with fibromyalgia syndrome and in healthy controls, and to investigate whether patients with fibromyalgia syndrome can be grouped with respect to thermal hyperalgesia and whether these subgroups differ from healthy controls and in clinical appearance. Design: The authors conducted a quasi-experimental clinical study. Subjects: Twenty-nine women patients with fibromyalgia syndrome and 21 healthy pain-free age-matched women participated in the study. Methods: Quantitative sensory testing using a Thermotest instrument was performed on the dorsum of the left hand. Sleep and pain intensity were rated using visual analog scales. Results: Cold and heat pain but not perception thresholds differed significantly between patients with fibromyalgia syndrome and healthy subjects. Based on thermal pain thresholds, two subgroups could be identified in fibromyalgia syndrome using cluster analysis. Conclusion: Patients with fibromyalgia syndrome were subgrouped by quantitative sensory testing (i.e., thermal pain thresholds). Subgroups show clinical differences in pain intensities, number of tender points, and sleep quality. Cold pain threshold was especially linked to these clinical aspects.
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| 4. |
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| 5. |
- Raak, Ragnhild, 1948-, et al.
(författare)
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Background pain in fibromyalgia patients affecting clinical examination of the skin
- 2002
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 11:1, s. 58-64
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Tidskriftsartikel (refereegranskat)abstract
- • The purpose of this study was to investigate the relationship between on-going pain and acute thermal pain in patients suffering from chronic pain.• This experimental study in cold and heat sensitivity was performed in order to test the following hypothesis: that fibromyalgia patients scoring high in current background pain tolerate less experimental thermal pain in the skin than patients with low scores.• Ethical aspects of the study are discussed.• The level of tolerable experimental thermal stimuli was tested and compared between the `low-score' and the `high-score' patients.• Background pain seemed to affect the intensity of experimental cold pain.• Clinical routine examinations and bodily care of the skin that might interfere with background pain in the fibromyalgia patients are discussed.• Clinical practice should be carefully planned in order to assist fibromyalgia patients in understanding and coping with thermal conditions that might influence background pain.
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| 6. |
- Raak, Ragnhild, 1948-, et al.
(författare)
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Coping strategies and life satisfaction in subgrouped fibromyalgia patients
- 2003
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Ingår i: Biological Research for Nursing. - : SAGE Publications. - 1099-8004 .- 1552-4175. ; 4:3, s. 193-202
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Tidskriftsartikel (refereegranskat)abstract
- The present study describes pain- and stress-coping strategies and life satisfaction in subgroups of fibromyalgia patients. Thirty-two females with fibromyalgia syndrome (FMS) and 21 healthy pain-free women were studied. Those with FMS were classified as thermal (both heat and cold) pain sensitive or slightly cold pain sensitive based on pain thresholds determined using a Thermotest device. Global stress-coping styles, life satisfaction, and specific pain-coping strategies were measured. Patients classified as thermal pain sensitive were affected by physical symptoms to a greater extent than were those classified as slightly cold pain sensitive. The thermal pain sensitive group used more diverting attention coping strategies than the slightly cold pain sensitive group did. Separating fibromyalgia patients into subgroups might increase the potential for improving nursing care of these patients. Through the use of effective coping strategies in dealing with stress and pain, life satisfaction may also be enhanced.
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| 7. |
- Raak, Ragnhild, 1948-, et al.
(författare)
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Health experiences and employment status in subjects with chronic back pain : a long-term perspective
- 2006
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Ingår i: Pain Management Nursing. - : Elsevier BV. - 1524-9042 .- 1532-8635. ; 7:2, s. 64-70
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to describe health experiences, focused on gender and return to work, in subjects with chronic low back pain in a long-term perspective. The convenient sample consisted of 12 subjects who had attended a pain rehabilitation program 6 years earlier. Typed interviews were transcribed, and a content analysis approach was used. Five categories were found: coping, root causes, control/influence, pain, and sleep. The interviews showed that the subjects expressed well-being, although pain had become part of their daily life. However, both gender and well-being group differences were identified. The women and the group with reduced well-being used the root causes category in a higher degree than the men and the well-being group did. The conclusion is that there are differences according to both gender and return to work within the subjects with chronic pain and that these differences are related to both root causes and coping pattern.
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| 8. |
- Raak, Ragnhild, 1948-, et al.
(författare)
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Health related quality of life in subgroups of WAD (Whiplash associated disorder) individuals with respect to cold hyperalgesia in quantitative sensory testing (QST)
- 2006
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Ingår i: EFIC Pain in Europe V,2006.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background and aims The term Whiplash associated disorders (WAD) includes a wide range of complaints, with neck pain as predominating symptom. Living with long term pain influences quality of life. In previous studies of other chronic pain patients, subgrouping has been made according to cold pain thresholds measured in QST. The aims of the present study are threefold, (1) to evaluate thermal pain thresholds and health related quality of life in WAD patients compared to healthy pain-free individuals, (2) to explore whether subgrouping of the WAD patients was possible according to cold pain thresholds (CPT), and (3) to explore differences between the subgroups. Methods: Thermal pain thresholds were measured using QST. The SF-36 was used to assess health related quality of life. Results: WAD patients showed significantly decreased CPT (p=0.007) and lower scores on the SF-36 in all scales when compared with healthy pain-free individuals. After analyzing clusters (K-means algorithm) two subgroups of WAD emerged, slightly cold pain sensitive and highly pain sensitive. The slightly pain sensitive group differed significantly from the highly sensitive group on in the Role Emotional scale of SF-36 (p=0.025). Conclusions: Cold pain hyperalgesia seems to be a determinant for subgrouping of WAD patients, with respect to health related quality of life, and might be the result of central sensitization or peripheral mechanisms or as a result of personal characteristics. These group differences might be of importance when guiding patients to treatment interventions as well as when exposing subjects to cold in the clinical situation.
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| 9. |
- Raak, Ragnhild, 1948-
(författare)
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Icke nordiska och nordiska kvinnors förväntan på och upplevelse av akut smärta
- 2006
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Ingår i: Svenska läkaresällskapets Riksstämma,2006.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- ABSTRACT Cultural or ethnic background has been shown to be significant for how individuals experience pain. The aim of this study was to examine the expectation and experience of acute pain, the use of stress-coping styles, and the distribution of analgesics among non-Nordic and Nordic women in a dental treatment situation. Instruments used were the Visual Analogue Scale (VAS) and the Jalowiec Coping Scale (JCS). Non-Nordic women rated both expected and experienced pain significantly higher than Nordic women. No significant differences were found in stress-coping styles or in the distribution of analgesics between the two groups. Nurses must be sensitive to variations in pain communication styles across cultures.
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| 10. |
- Raak, Ragnhild, 1948-
(författare)
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Identification of subgroups in experimental and chronic pain : Sensory, emotional and evaluative aspects
- 2002
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- One hundred and two healthy subjects, 32 fibromyalgia patients and 12 chronic low back pain patients were included in the study. Quantitative sensory tests were performed to identify thermal hyperalgesia in the fibromyalgia group and to compare the results with those in healthy pain-free subjects. Different questionnaires were used to map pain and stress-coping strategies /styles. (Coping Strategy Questionnaire, Jalowiec Coping Scale) and quality of life (Life Satisfaction Questionnaire and the SF-36).Both healthy subjects and fibromyalgia patients suffering from chronic pain could be subgrouped according to experimental pain perception. On comparing the fibromyalgia subgroups, differences in both stress and pain-coping strategies were found. Thus, the confrontative stress-coping style was used more in the thermal painsensitive group than the others. Furthermore, attention-diverting and catastrophising pain-coping strategies were more frequent.The chronic back-pain patients who had decreased their catastrophising pain-coping strategy at the 3-year follow-up also perceived an improved quality of life at the 6-year follow-up.When. self-scoring life satisfaction, thermal pain-sensitive fibromyalgia patients experienced significantly more physical symptoms than slightly cold pain-sensitive patients and healthy subjects. They also had sleep disturbances, more tender points, more affective hand pain and increased hand pain intensity.The relation between sensation and emotion must be regarded as a product of a conscious mind while the emotional part of the pain sensation is not just a passive response to an external stimulus.
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