Canadian Journal of Pain-Revue Canadienne de la Douleur最新文献

Background: Over the past two decades, the prevalence of chronic pain has significantly increased globally, with approximately 20% of the world's population living with pain. Although quantitative measures are useful in identifying pain prevalence and severity, qualitative methods, and especially arts-based ones, are now receiving attention as a valuable means to understand lived experiences of pain. Photovoice is one such method that utilizes individuals' own photography to document their lived experiences.

Aims: The current study utilized an arts-based method to explore immigrant Indian women's chronic pain experiences in Canada and aimed to enhance the understanding of those experiences by creating a visual opportunity for them to share their stories.

Methods: Twelve immigrant Indian women captured photographs and participated in one-on-one interviews exploring daily experiences of chronic pain.

Results: Women's photographs, and description of these photographs, provided a visual entry into their lives and pain experiences. Three themes emerged from our analysis: (1) bodies in pain, (2) traversing spaces including immigration, and (3) pain management methods. Findings revealed that women's representations of pain were shaped by a clash between culturally shaped gender role expectations and changing gender norms due to immigration processes. The use of photovoice visually contextualized and represented pain experiences, proving to be a valuable tool for self-reflection.

Conclusions: This research uncovers the multifaceted nature of chronic pain and identifies the influence of immigration, gender, and social relations on the exacerbation of pain in immigrant Indian women.

Background: Until recently, treatments for chronic pain commonly relied on in-person interventions, and despite more hybrid care options today, capacity for delivery remains challenged. Digital programs focusing on the psychosocial aspects of pain may provide low-barrier alternatives.

Aims: Through a randomized controlled trial, we investigated the effectiveness of a multimodal mobile application.

Methods: Participants (n = 198; 82% women, mean age = 46.7 [13.1] years; mean pain duration 13.6 [11.2] years) with nonmalignant chronic pain were randomized to either a 6-week intervention (n = 98) or a wait-listed usual care group (n = 100). The intervention involved regular engagement with a user-guided mobile application (Curable Inc.) informed by the biopsychosocial model of pain that included pain education, meditation, cognitive behavioral therapy, and expressive writing. The co-primary outcomes were pain severity and interference at 6 weeks.

Results: We observed significant improvements in the intervention group compared to the control group with estimated changes of -0.67 (95% confidence interval [CI] -1.04 to -0.29, P < .001, d = 0.43) and -0.60 (95% CI -1.18 to -0.03, P = .04, d = 0.27) for pain severity and interference, respectively. There were significant improvements across secondary outcomes (Patient-Reported Outcome Measurement Information System pain interference; pain catastrophizing; anxiety, depression; stress). Frequency of app use was correlated with improved pain interference (P < .001) and pain catastrophizing (P = 0.018), and changes from baseline persisted in the intervention group at 12 weeks (P < .05).

Conclusions: A short-term mobile app intervention resulted in significant improvements across physical and mental health outcomes compared to wait-listed usual care.

Background: Living with chronic pain as a young adult (YA) can impact the physical, emotional, social, cognitive, and role function domains of life. Once YAs receive care for their specialist chronic pain care they are expected to self-navigate a complex health care system to transition to community-based care (i.e. primary care). Inadequate discharge planning may increase the unique difficulties YAs face in self-management, which may lead to adverse health outcomes, suboptimal discharge, and a need to reaccess care.

Aims: The purpose of this qualitative study is to explore how YAs with chronic pain define a successful discharge transition from a health service delivery model of specialized chronic pain services setting to self-management in a community setting (i.e. primary care) and contextual factors that promote discharge success.

Methods: This qualitative study included young adults with chronic pain. Data were obtained through semistructured interviews, which were transcribed verbatim and analyzed using inductive content analysis.

Results: Ten participants identified that successful discharge includes the following considerations: (1) acknowledging the tension between moving forward and looking back, (2) a collaborative discharge process, and (3) the need for ongoing, relevant resources and support.

Conclusion: This study provides a deeper understanding of how YAs with chronic pain characterize success in the discharge transition from specialized chronic pain services to community self-management. Our findings highlight the importance of provider-patient collaboration during the discharge planning process to develop a patient-centered self-management plan that incorporates community resources tailored to the needs of the individual to promote an optimal discharge.

[This retracts the article DOI: 10.1080/24740527.2022.2088027.].

Background: Chronic pain and higher body weight frequently co-occur. This common comorbidity is thought to be mediated by the use of comfort eating as a strategy for managing both the physical and psychological pain and discomfort associated with flare-ups of chronic pain. Valid and reliable assessment tools are needed to inform the development of effective treatments.

Aims: This study aimed to assess the psychometric properties of a new brief measure of pain-induced comfort eating in chronic pain, the Pain-Induced Comfort Eating Scale (PICES).

Methods: A sample of 166 patients with chronic pain completed an online test battery including the PICES along with measures of chronic pain and pain-related symptoms, disordered eating, and related psychological factors.

Results: Results of exploratory factor analysis revealed a single-factor model for the four-item PICES. Further, the PICES demonstrated evidence of good internal consistency as well as convergent validity with demonstrated correlations with related measures. The results of this study also revealed that comfort eating in chronic pain appears to be related to psychological distress; the PICES correlated more strongly with measures assessing mood and psychological distress compared to interference/intensity of physical pain itself. Scores on the PICES also correlated strongly with measures of uncontrolled and emotional eating.

Conclusions: Overall, our results indicate that the PICES provides a valid and useful brief measure of comfort eating in chronic pain that might be useful to inform treatments targeting the comorbid disordered eating practices that can lead to higher body weights in patients with chronic pain.

Introduction: Chronic pain is a costly and incapacitating condition, with a projected global prevalence of 20%. In South Africa, almost one in five adults experience chronic pain. The aim of this study was to assess the prevalence of chronic pain and the association between chronic pain intensity and the interference of pain with life domains in patients attending a primary health care center.

Methods: We conducted a cross-sectional quantitative study on a sample of 331 patients at Soshanguve Community Health Centre. The data were collected using the Wisconsin Brief Pain Questionnaire, a validated scale for measuring pain.

Results: The mean age of participants was 51.6 years (SD = ±15.15, range = 18-86). The median age was 48 years (interquartile range = 40-64). The prevalence of chronic pain was 21.5% (95% confidence interval [CI] 17.0-25.9). Approximately 58% of participants were female, and female patients were affected more frequently than male patients. Chronic pain was observed to be 11.1% more prevalent in females than in males. Chronic pain mildly impacted general activity in 33.8% of patients (95% CI 23.9-45.4), mood in 42.3% (95% CI 31.4-53.8), walking ability in 29.6% (95% CI 20.2-41.0), relationships in 47.9% (95% CI 36.7-59.3), sleep in 31.0% (95% CI 21.4-42.5), enjoyment of life in 39.4% (95% CI 28.9-51.1), and normal working ability in 25.3% (95% CI 16.7-36.6).

Conclusions: Findings from this study show that among patients who attended the primary health care clinic, chronic pain was highly prevalent and interfered with their life domains. The intensity of pain was high in a significant proportion of patients. These findings provide invaluable information needed for the improvement of resources at the primary care level to comprehensively evaluate pain in our communities.