Clinical Journal of Pain最新文献

{"title":"Initiatives Targeting Patients: A Systematic Review of Knowledge Translation Pain Assessment and Management Studies Focusing on Older Adults.","authors":"Laney Yarycky, Louise I R Castillo, Michelle M Gagnon, Thomas Hadjistavropoulos","doi":"10.1097/AJP.0000000000001192","DOIUrl":"10.1097/AJP.0000000000001192","url":null,"abstract":"<p><strong>Objectives: </strong>Older adults frequently experience persistent pain but are often unaware of self-management and other strategies that can help improve their condition. In a related article, we reported on pain assessment and management knowledge translation initiatives related to older adults that were targeting health professionals. In this paper, we report on initiatives targeting older adults.</p><p><strong>Materials and methods: </strong>Using systematic review methodology, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE, PsycInfo, and Web of Science databases were searched from inception to June 2023. Pain-related knowledge translation programs targeted towards older adults, their informal caregivers, and health care professionals were examined.</p><p><strong>Results: </strong>From an initial 21,669 search results, 172 studies met our inclusion criteria. Of these studies, 49 targeted older adults. These studies varied widely in focus and delivery format, but the majority were associated with a significant risk of bias. Older adults with musculoskeletal pain were the primary recipients of education. Most programs were classified as knowledge mobilization initiatives. The remainder were considered self-management programs. Knowledge users were satisfied with the suitability of the information presented, and patient outcomes were a primary concern across all studies. Behavioral changes and pain management outcomes, however, were underemphasized in the literature.</p><p><strong>Conclusion: </strong>Knowledge acquisition outcomes are overrepresented in the current literature compared with behavioral outcomes changes. Nonetheless, older adults report benefitting from the guidance provided in self-management programs when applying knowledge to practice. Future research is needed to better understand the facilitators and barriers to pain management changes in this population.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":"243-252"},"PeriodicalIF":2.6,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139418497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Remifentanil on Acute and Chronic Postsurgical Pain in Patients Undergoing Cardiac Surgery: A Systematic Review and Meta-analysis.","authors":"Bi Zhang, Chang Cai, Zhihao Pan, Liye Zhuang, Yong Qi","doi":"10.1097/AJP.0000000000001183","DOIUrl":"10.1097/AJP.0000000000001183","url":null,"abstract":"<p><strong>Objectives: </strong>Our purpose was to explore the effect of remifentanil on acute and chronic postsurgical pain after cardiac surgery.</p><p><strong>Materials and methods: </strong>Randomized controlled trials were retrieved from electronic databases, such as PubMed, Cochrane Library, China National Knowledge Internet databases, Scopus, and Web of Science. A systematic review, meta-analysis, and trial sequential analysis (TSA) were performed. Basic information and outcomes were extracted from the included studies. The primary outcome was chronic postsurgical pain. Secondary outcomes were scores of postsurgical pain and morphine consumption within 24 hours after cardiac surgery. Risk of bias (ROB) assessment was based on the Cochrane ROB tool version 2. The overall quality of the evidence was rated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system.</p><p><strong>Results: </strong>Seven studies consisting of 658 patients were enrolled in the meta-analysis. A single study had a high ROB and 2 studies had a moderate ROB. The incidence of chronic postsurgical pain (4 studies [415 patients]; risk ratio: 1.02 [95% CI: 0.53 to 1.95]; P = 0.95; I2 = 59%; TSA-adjusted CI: 0.78 to 1.20) and the postsurgical pain score (2 studies [196 patients]; mean difference: 0.09 [95% CI: -0.36 to 0.55]; P = 0.69; I2 = 0%; TSA-adjusted CI: -0.36 to 0.55) were not statistically different between the 2 groups. However, morphine consumption (6 studies [569 patients]; mean difference: 6.94 [95% CI: 3.65 to 10.22]; P < 0.01; I2 = 0%; TSA-adjusted CI: 0.00 to 0.49) was higher in the remifentanil group than in the control group.</p><p><strong>Conclusion: </strong>There was not enough evidence to prove that remifentanil can increase the incidence of chronic postsurgical pain after cardiac surgery, but interestingly, the results tended to support a trend toward increased complications in the intervention group. However, there was moderate certainty evidence that the use of remifentanil increases the consumption of morphine for analgesia, and more direct comparison trials are needed to inform clinical decision-making with greater confidence.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":"187-195"},"PeriodicalIF":2.6,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138488975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Neighborhood Characteristics and Chronic Pain in Children and Adolescents in the United States.","authors":"Daron M Vandeleur, Maia M Cunningham, Tonya M Palermo, Cornelius B Groenewald","doi":"10.1097/AJP.0000000000001179","DOIUrl":"10.1097/AJP.0000000000001179","url":null,"abstract":"<p><strong>Objective: </strong>To determine the associations between neighborhood characteristics and chronic pain during childhood and adolescence in the United States, 2020-2021.</p><p><strong>Methods: </strong>Cross-sectional analysis of the 2020 and 2021 National Survey of Children's Health. National Survey of Children's Health grouped parents' responses to questions about neighborhood characteristics into 5 categories: neighborhood support, neighborhood safety, school support, neighborhood amenities, and the presence of detracting neighborhood elements. Chronic pain was defined as parents reporting their children had \"frequent or chronic difficulty with repeated or chronic physical pain, including headache or other back or body pain during the past 12 months.\" Multivariable Poisson regression analyses estimated associations between neighborhood characteristics and chronic pain, adjusted for sociodemographic characteristics.</p><p><strong>Results: </strong>The sample contained 55,387 children (6 to 17 years), weighted to represent 44 million nationally. Children had significantly increased rates of chronic pain if they lived in neighborhoods that were unsupportive, unsafe, had unsafe schools, fewer amenities, and greater numbers of detracting elements ( P <0.0001). After adjusting for covariates, children had significantly increased chronic pain if they lived in neighborhoods that were not supportive (adjusted prevalence rate ratio=1.7 (95% CI: 1.5-1.9, P <0.0001), with similar patterns observed for living in neighborhoods characterized as not safe, that did not have safe schools, with fewer amenities, and/or more detracting elements.</p><p><strong>Discussion: </strong>Disadvantageous neighborhood characteristics are associated with pediatric chronic pain prevalence. Future research should investigate the underlying mechanisms of this association and guide neighborhood interventions aimed at preventing and decreasing childhood chronic pain and its associated burdens.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":"174-181"},"PeriodicalIF":2.6,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10922713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138446911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Associated With Interest in Engaging in Psychological Interventions for Pain Management.","authors":"Lisa R Miller-Matero, Marissa Yaldo, Sikander Chohan, Celeste Zabel, Shivali Patel, Timothy Chrusciel, Joanne Salas, Lauren Wilson, Mark D Sullivan, Brian K Ahmedani, Patrick J Lustman, Jeffrey F Scherrer","doi":"10.1097/AJP.0000000000001165","DOIUrl":"10.1097/AJP.0000000000001165","url":null,"abstract":"<p><strong>Objective: </strong>Engagement in evidence-based psychological interventions for pain management is low. Identifying characteristics associated with interest in interventions can inform approaches to increase uptake and engagement. The purpose of this study was to examine factors associated with interest in psychological interventions among persons with chronic noncancer pain receiving prescription opioids.</p><p><strong>Methods: </strong>Participants with chronic noncancer pain and a new 30 to 90 day opioid prescription were recruited from 2 health systems. Participants (N=845) completed measures regarding pain, opioid use, psychiatric symptoms, emotional support, and interest in psychological interventions for pain management.</p><p><strong>Results: </strong>There were 245 (29.0%) participants who reported a high interest in psychological interventions for pain management. In bivariate analyses, variables associated with interest included younger age, female sex, greater pain severity, greater pain interference, greater number of pain sites, lower emotional support, depression, anxiety, and post-traumatic stress disorder ( P <0.05). In a multivariate model, greater pain severity (odds ratio [OR]=1.17; CI: 1.04-1.32), depression (OR=2.10; CI: 1.39-3.16), post-traumatic stress disorder (OR=1.85; CI: 1.19-2.95), and lower emotional support (OR=0.69; CI: 0.5-0.97) remained statistically significant.</p><p><strong>Discussion: </strong>The rate of interest in psychological interventions for pain management was low, which may indicate that patients initiating opioid treatment of chronic noncancer pain have low interest in psychological interventions. Greater pain severity and psychiatric distress were related to interest, and patients with these characteristics may especially benefit from psychological interventions. Providers may want to refer to psychological interventions before or when opioids are initiated. Additional work is needed to determine whether this would reduce long-term opioid use.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":"67-71"},"PeriodicalIF":2.6,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10842945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41219296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Serratus Anterior Plane Block Versus Paravertebral and Intercostal Blocks for Pain Control After Surgery:: A Systematic Review and Meta-analysis.","authors":"Ping Qian, Xiaoyu Zheng, Huaying Wei, Kemin Ji","doi":"10.1097/AJP.0000000000001175","DOIUrl":"10.1097/AJP.0000000000001175","url":null,"abstract":"<p><strong>Objective: </strong>Our study aimed to compare the analgesic efficacy of serratus anterior plane block (SAB) with the paravertebral block (PVB) and intercostal block (ICB) for patients undergoing surgical procedures.</p><p><strong>Materials and methods: </strong>A literature search was performed on the databases of ScienceDirect, Google Scholar, PubMed, and Embase from inception to October 24, 2021. Only randomized controlled trials comparing SAB with either PVB or ICB and reporting pain outcomes were included.</p><p><strong>Results: </strong>A total of 16 randomized controlled trials were included. Thirteen compared SAB with PVB and 3 with ICB. Comparing SAB with PVB, we noted no difference in 24-hour morphine consumption between the groups (mean difference: 1.37; 95% CI: -0.33, 3.08; I2 = 96%; P = 0.11). However, the exclusion of 1 study indicated significantly increased analgesic consumption with the SAB. No difference was found in pain scores between SAB and PVB at 2, 4, 6, 8, 12, and 24 hours. Meta-analysis failed to demonstrate any statistically significant difference in time to the first analgesic request between the two groups (mean difference: -0.79; 95% CI: -0.17, 1.75; I2 = 94%; P = 0.11). We also noted no statistically significant difference in the incidence of nausea/vomiting with SAB or PVB (odds ratio: 0.79; 95% CI: 0.41, 1.51; I2 = 0%; P = 0.47).</p><p><strong>Conclusions: </strong>Evidence on the analgesic efficacy of the SAB versus the PVB is conflicting. Twenty-four-hour total analgesic consumption may be higher with the SAB as compared with PVB but with no difference in pain scores and time to the first analgesic request. Data on the comparison of the SAB with the ICB is insufficient to draw strong conclusions.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":"124-134"},"PeriodicalIF":2.9,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138048417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mindfulness-based Interventions for Chronic Low Back Pain: A Systematic Review and Meta-analysis.","authors":"Myrella Paschali, Asimina Lazaridou, Jason Sadora, Lauren Papianou, Eric L Garland, Aleksandra E Zgierska, Robert R Edwards","doi":"10.1097/AJP.0000000000001173","DOIUrl":"10.1097/AJP.0000000000001173","url":null,"abstract":"<p><strong>Objective: </strong>This systematic review aimed to compile existing evidence examining the effects of mindfulness-based interventions (MBIs) for chronic low back pain (CLBP). CLBP leads to millions of disabled individuals in the United States each year. Current pharmacologic treatments are only modestly effective and may present long-term safety issues. MBIs, which have an excellent safety profile, have been shown in prior studies to be effective in treating CLBP yet remained underutilized.</p><p><strong>Design: </strong>Ovid/Medline, PubMed, Embase, and the Cochrane Library were searched for randomized controlled trials (RCTs), pilot RCTs, and single-arm studies that explored the effectiveness of MBIs in CLBP.</p><p><strong>Methods: </strong>Separate searches were conducted to identify trials that evaluated MBIs in reducing pain intensity in individuals with CLBP. A meta-analysis was then performed using R v3.2.2, Metafor package v 1.9-7.</p><p><strong>Results: </strong>Eighteen studies used validated patient-reported pain outcome measures and were therefore included in the meta-analysis. The MBIs included mindfulness meditation, mindfulness-based stress reduction, mindfulness-based cognitive therapy, mindfulness-oriented recovery enhancement, acceptance and commitment therapy, dialectical behavioral therapy, meditation-cognitive behavioral therapy, mindfulness-based care for chronic pain, self-compassion course, and loving-kindness course. Pain intensity scores were reported using a numerical rating scale (0 to 10) or an equivalent scale. The meta-analysis revealed that MBIs have a beneficial effect on pain intensity with a large-sized effect in adults with CLBP.</p><p><strong>Conclusions: </strong>MBIs seem to be beneficial in reducing pain intensity. Although these results were informative, findings should be carefully interpreted due to the limited data the high variability in study methodologies, small sample sizes, inclusion of studies with high risk of bias, and reliance on pre-post treatment differences with no attention to maintenance of effects. More large-scale RCTs are needed to provide reliable effect size estimates for MBIs in persons with CLBP.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":"105-113"},"PeriodicalIF":2.9,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71523268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal Pain Outcomes Following an Intensive Pediatric Pain Rehabilitation Program: Testing Potential Treatment Mechanisms.","authors":"Karen E Weiss, Rui Li, Xing Wang, Daron Vandeleur, Sabina Havkins, Tonya M Palermo","doi":"10.1097/AJP.0000000000001171","DOIUrl":"10.1097/AJP.0000000000001171","url":null,"abstract":"<p><strong>Objectives: </strong>This study tested performance measures of physical functioning and pain-related psychosocial measures as potential mechanisms of improvements in outcomes following intensive outpatient interdisciplinary pain rehabilitation for adolescents. We hypothesized that improvements in performance measures of physical functioning, fear of pain, pain catastrophizing, and self-efficacy during treatment would be related to improvements in pain, functional disability, and depressive symptoms.</p><p><strong>Methods: </strong>Seventy-seven adolescents, 10 to 18 years old, completed self-report measures before treatment, after the first week, at discharge, and at the 3-month follow-up. Participants completed physical performance measures of physical and exercise capacity and core strength on day 1, after the first week, and at discharge. Linear mixed models were used to examine the association between changes in potential mechanisms and changes in outcomes, adjusting for age, sex, pain duration, and baseline functional disability.</p><p><strong>Results: </strong>Statistically significant improvement in functional disability, pain, and depressive symptoms was demonstrated across the 4 time points. Improvements were also demonstrated in physical performance measures, fear of pain, pain catastrophizing, and self-efficacy. Improvements in pain catastrophizing predicted improvements in functional disability, pain, and depressive symptoms. Improvements in self-efficacy predicted improvements in all outcome variables except depression. Improvements in physical performance measures predicted improvements in some aspects of functional disability and pain, but not depressive symptoms.</p><p><strong>Discussion: </strong>This study contributes to the growing literature on the effectiveness of pediatric intensive interdisciplinary pain rehabilitation programs and mechanisms that influence improvements in outcomes, an area that is currently underexplored. Results are important to guide future research and inform clinical practice.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":"82-91"},"PeriodicalIF":2.6,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11654719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71428722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of Erector Spinae Plane Block Versus Thoracolumbar Interfascial Plane Block in Patients Undergoing Spine Surgery: A Systematic Review and Meta-analysis.","authors":"Qing Peng, Bo Meng, Sheng Yang, Zhenghu Ban, Yu Zhang, Man Hu, Wenjie Zhao, Haisheng Wu, Yuping Tao, Liang Zhang","doi":"10.1097/AJP.0000000000001177","DOIUrl":"10.1097/AJP.0000000000001177","url":null,"abstract":"<p><strong>Objectives: </strong>As 2 novel peripheral nerve blocks, the erector spinae plane block (ESPB) and thoracolumbar interfascial plane (TLIP) block can relieve postoperative pain in spinal surgery. This systematic review and meta-analysis aimed to determine the efficacy and safety of ESPB versus TLIP block in patients undergoing spine surgery.</p><p><strong>Methods: </strong>An extensive search of English online databases, including PubMed, Web of Sciences, Embase, Medline, and Cochrane Central Register of Controlled Trials, and Chinese online databases like Wanfang Data, CNKI, and CQVIP until March 31, 2023, with no language restrictions, was performed. This systematic review and meta-analysis are based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement and have been registered on PROSPERO (International Prospective Register of Systematic Reviews) with registered ID: CRD42023420987.</p><p><strong>Results: </strong>Five studies involving 457 patients were eligible for inclusion in this study. Compared with TLIP block, ESPB had lower postoperative opioid consumption at postoperative 48 hours (standard mean difference =-1.31, 95% CI:-2.54 to -0.08, P =0.04, I2 =80%) and postoperative pain score at postoperative 24 hours (standard mean difference =-0.72, 95% CI=-1.43 to -0.02, P =0.04, I2 =95%) in patients undergoing spine surgery. Complications associated with ESPB and TLIP block were not reported in the included studies.</p><p><strong>Discussion: </strong>ESPB and TLIP block are 2 novel and effective block methods. Patients receiving ESPB had lower postoperative opioid consumption and postoperative pain scores compared with patients receiving TLIP block; there was no statistically significant difference's between the 2 groups in intraoperative opioid consumption, adverse events, and rescue analgesia.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":"114-123"},"PeriodicalIF":2.9,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138048416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient Motivation to Reduce or Discontinue Opioids for Chronic Pain: Self-efficacy, Barriers, and Readiness to Change.","authors":"Taylor B Crouch, Emily Donovan, Wally R Smith, Kelly Barth, William C Becker, Dace Svikis","doi":"10.1097/AJP.0000000000001167","DOIUrl":"10.1097/AJP.0000000000001167","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to assess levels and predictors of self-efficacy and motivation to change opioid use among a community sample of patients using opioids for chronic pain, as well as patient-reported barriers to pursuing opioid discontinuation.</p><p><strong>Methods: </strong>Participants with a variety of chronic pain conditions, recruited from ResearchMatch.org , completed a battery of electronic, self-report questionnaires assessing demographic and medical characteristics, pain treatment history, and levels of readiness, self-efficacy, and other attitudes toward reducing or discontinuing opioid use. Multiple regression analyses and analyses of variance were conducted to examine predictors of readiness and self-efficacy to change opioid use. A modified version of rapid qualitative analysis was utilized to analyze themes in participant responses to an open-ended item about \"what it would take\" to consider opioid discontinuation.</p><p><strong>Results: </strong>The final sample included N=119 participants, the majority of whom were female (78.2%), Caucasian (77.3%), and well-educated. Readiness and self-efficacy to decrease or stop opioid use were fairly low on a 0 to 10 Visual Analog Scale (2.6 to 3.8) and significantly higher to decrease than stop ( P <0.01). Higher readiness to change was predicted by lower pain severity and higher concern about opioids, whereas higher self-efficacy was predicted by shorter pain duration. Results from the qualitative analyses revealed that the availability of an alternative treatment option was the most commonly cited requirement to consider opioid discontinuation.</p><p><strong>Discussion: </strong>Patients with lower pain severity, shorter duration of pain, and higher concerns about opioids may be a prime target from a motivation standpoint for interventions addressing opioid tapering and discontinuation.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":"18-25"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10841444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49684579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preliminary Validation of the Pain Relief Motivation Scales.","authors":"Janelle E Letzen, Carly A Hunt, Caroline Webb, Maria Vetter, Patrick H Finan, Paul Karoly, Chung Jung Mun","doi":"10.1097/AJP.0000000000001170","DOIUrl":"10.1097/AJP.0000000000001170","url":null,"abstract":"<p><strong>Objectives: </strong>Pain typically prompts individuals to seek relief. This study aimed to develop and psychometrically validate the Pain Relief Motivation Scales, applying revised \"reinforcement sensitivity theory\" to measure the neuropsychological systems underlying motivation for pain relief. We hypothesized a 6-factor structure based on previous work, including one Behavioral Inhibition System (BIS) factor, one Fight-Flight-Freeze System factor, and 4 Behavioral Activation System (BAS) factors.</p><p><strong>Methods: </strong>Items were generated by adapting the reinforcement sensitivity theory of personality questionnaire for relevance to pain relief. Adults with chronic pain were recruited internationally to participate in online survey batteries at baseline and 1 week later in 2021. We randomly split the sample to conduct exploratory factor analysis (n = 253) and confirmatory factor analysis (n = 253). Psychometric properties were estimated using the full sample (N = 506).</p><p><strong>Results: </strong>Parallel analysis revealed that a 5-factor structure best fits the data (21 items): (1) hopelessness about pain relief (BIS), (2) hesitancy for engaging in pain treatments (BIS), (3) persistence in engaging in pain treatments (BAS), (4) relief reactivity (BAS), and (5) risky relief seeking (BAS). Acceptable internal consistency (Cronbach alpha = 0.68 to 0.80) and test-retest reliability (Intraclass correlation coefficients = 0.71 to 0.88) were observed. Construct validity varied from weak to moderate ( r = 0.02 to 0.45).</p><p><strong>Conclusion: </strong>As the first attempt to create an instrument measuring neuropsychological systems underlying motivation for pain relief, the findings show that additional work is needed to refine theory and psychometric rigor in this area. Cautiously, the results suggest that a BIS-BAS model, with minimal Fight-Flight-Freeze System contributions, might be useful for understanding the motivation for relief.</p>","PeriodicalId":50678,"journal":{"name":"Clinical Journal of Pain","volume":" ","pages":"46-56"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10841969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71428723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}