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Identification of subgroups in experimental and chronic pain: Sensory, emotional and evaluative aspects
Linköping University, Department of Medicine and Care, Pharmacology. Linköping University, Faculty of Health Sciences.
2002 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

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.

Place, publisher, year, edition, pages
Linköping: Linköpings universitet , 2002. , 51 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 714
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-27538Local ID: 12196ISBN: 91-7373-156-0 (print)OAI: oai:DiVA.org:liu-27538DiVA: diva2:248090
Public defence
2002-01-11, Berzeliussalen, Hälsouniversitetet, Linköping, 13:00 (Swedish)
Opponent
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2012-09-18Bibliographically approved
List of papers
1. Stress coping strategies in thermal pain sensitive and insensitive healthy subjects
Open this publication in new window or tab >>Stress coping strategies in thermal pain sensitive and insensitive healthy subjects
2001 (English)In: International Journal of Nursing Practice, ISSN 1322-7114, E-ISSN 1440-172X, Vol. 7, no 3, 162-168 p.Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to investigate stress coping strategies used in relation to heat and cold pain thresholds in healthy subjects. After using the Jalowiec Coping Scale, cold and heat pain thresholds were examined using the Quantitative Somatosensory Test in 47 healthy subjects. The participants were separated into thermal pain sensitive and insensitive groups, based on thermal pain perception. The results showed that subjects sensitive to thermal pain tended to adopt an emotive stress coping style significantly more commonly than the insensitive subjects. Furthermore, women displayed a marked preference for this style compared to men. The conclusion is that emotional stress coping did play a role in the perception of thermal pain in this group of healthy subjects and that clinical nursing interventions need to focus on the relationship between emotion and coping.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-27120 (URN)10.1046/j.1440-172X.2001.00258.x (DOI)11767 (Local ID)11767 (Archive number)11767 (OAI)
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
2. Background pain in fibromyalgia patients affecting clinical examination of the skin
Open this publication in new window or tab >>Background pain in fibromyalgia patients affecting clinical examination of the skin
2002 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 11, no 1, 58-64 p.Article in journal (Refereed) Published
Abstract [en]

• 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.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-27119 (URN)10.1046/j.1365-2702.2002.00542.x (DOI)11766 (Local ID)11766 (Archive number)11766 (OAI)
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
3. Quantitative sensory testing in fibromyalgia patients and in healthy subjects: identification of subgroups
Open this publication in new window or tab >>Quantitative sensory testing in fibromyalgia patients and in healthy subjects: identification of subgroups
Show others...
2001 (English)In: The Clinical Journal of Pain, ISSN 0749-8047, E-ISSN 1536-5409, Vol. 17, no 4, 316-322 p.Article in journal (Refereed) Published
Abstract [en]

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.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-26941 (URN)10.1097/00002508-200112000-00005 (DOI)11569 (Local ID)11569 (Archive number)11569 (OAI)
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
4. Coping strategies and life satisfaction in subgrouped fibromyalgia patients
Open this publication in new window or tab >>Coping strategies and life satisfaction in subgrouped fibromyalgia patients
2003 (English)In: Biological Research for Nursing, ISSN 1099-8004, E-ISSN 1552-4175, Vol. 4, no 3, 193-202 p.Article in journal (Refereed) Published
Abstract [en]

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.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-26942 (URN)10.1177/1099800402239622 (DOI)11570 (Local ID)11570 (Archive number)11570 (OAI)
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
5. Catastrophizing and health related quality of life: A 6-year follow-up of patients with chronic low back pain
Open this publication in new window or tab >>Catastrophizing and health related quality of life: A 6-year follow-up of patients with chronic low back pain
Show others...
2002 (English)In: Rehabilitation Nursing, ISSN 0278-4807, Vol. 27, no 3, 110-117 p.Article in journal (Refereed) Published
Abstract [en]

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.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-28114 (URN)10.1002/j.2048-7940.2002.tb01999.x (DOI)12923 (Local ID)12923 (Archive number)12923 (OAI)
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2012-09-18Bibliographically approved

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