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Comparative Study
Self-report and pain behavior among patients with chronic pain.
- Stephanie McCahon, Jenny Strong, Renee Sharry, and Tess Cramond.
- Department of Occupational Therapy, University of Queensland, Brisbane, Queensland, Australia.
- Clin J Pain. 2005 May 1; 21 (3): 223-31.
ObjectivesTo determine the relationship between pain behaviors and self-report of pain and disability in patients with chronic pain.MethodsThirty-nine patients (59% women), aged 19 to 79 years, admitted to a Multidisciplinary Pain Center with chronic noncancer pain, were assessed on the following: 1) pain intensity using a 0 to 10 Numerical Graphic Rating Scale; 2) the Pain Disability Index; 3) the Pain Self-Efficacy Questionnaire; 4) a 10-minute videotaped session involving sitting, standing, walking, and reclining, after which pain behaviors were coded using a standardized observational protocol.ResultsInterrelationships among pain intensity, pain disability, self-efficacy, and pain behavior were tested using the Pearson product-moment correlations. Significant relationships were found between pain behavior frequencies and self-reported pain intensity (r = 0.29, P < 0.05), self-reported pain disability (r = 0.54, P < 0.0005), and reported self-efficacy (r = -0.42, P < 0.005). Multiple regression analyses were performed to further investigate these interrelationships. Only the Pain Disability Index score was found to make a significant unique contribution (semipartial correlation of 15%, P < 0.008) to the prediction of total pain behavior score.DiscussionFindings suggest that pain behavior observation is a valid and reliable assessment tool for use with a heterogeneous chronic pain population. Significant associations were found between pain behaviors and self-report measures of pain intensity, pain disability, and self-efficacy; pain intensity scores displayed a weak relationship; and pain disability scores the strongest relationship with pain behavior. Viewed with previous research, the results of this study indicate the value of a multimodal, cognitive-behavioral approach to assessing patients with chronic pain.
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