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- Börsbo, Björn, 1952-
(author)
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Relationships between Psychological Factors, Disability, Quality of Life and Health in Chronic Pain Disorders
- 2008
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Doctoral thesis (other academic/artistic)abstract
- Chronic pain is a very common condition with a prevalence of 40-65% in the community. The high prevalence of chronic pain causes a lot of human suffering but also high societal costs. The development and maintenance of chronic pain constitutes a complex interplay between neurobiological, psychosocial and genetic factors. A biopsychosocial model of chronic pain has been suggested to make a comprehensive context of the understanding of this issue.The main aims of this thesis were to analyze the relationships of the different components of the biopsychosocial model of pain and to study the relative importance of pain, stress and different psychological factors on disability and health related quality of life.The thesis is based on two groups of patients. One group consists of 275 patients with chronic Whiplash Associated Disorder (WAD) and one group comprise 433 patients with WAD, fibromyalgia (FM) and patients with chronic pain related to Spinal Cord Injury (SCI). The patients were investigated by questionnaires assessing different aspects of pain, depression, anxiety, catastrophizing, self-efficacy, disability and Health Related Quality of Life (HRQL).The main results were that psychological factors (especially depression) correlated relatively strongly with perceived HRQL and disability. The degree of depression appeared to have the most important relationship to perceived HRQL. Despite the fact that the patients rated depression just mild or moderate, depression had a great importance for the outcome of HQRL and disability. Pain intensity and duration played, in the cross-sectional perspective, a minor role for perceived HRQL, whereas pain intensity related more to the outcome of perceived disability.From a clinical point of view it is important to assess the complex and unique situation of each individual with respect to depression, anxiety, self-efficacy and pain when planning treatment and rehabilitation in order to optimise the outcome of such programmes.
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| 2. |
- Raak, Ragnhild, 1948-
(author)
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Identification of subgroups in experimental and chronic pain : Sensory, emotional and evaluative aspects
- 2002
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Doctoral thesis (other academic/artistic)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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