Pain
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We present a systematic review of prospective cohort studies. Our aim was to assess prognostic factors associated with functional recovery of patients with whiplash injuries. The failure of some patients to recover following whiplash injury has been linked to a number of prognostic factors. ⋯ High initial pain intensity is an important predictor for delayed functional recovery for patients with whiplash injury. Often mentioned factors like age, gender and compensation do not seem to be of prognostic value. Scientific information about prognostic factors can guide physicians or other care providers to direct treatment and to probably prevent chronicity.
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Comparative Study
Long term effects of oral sustained release morphine on neuropsychological performance in patients with chronic non-cancer pain.
Morphine is increasingly used in patients with chronic non-cancer pain, but a major concern associated with chronic use relates to possible cognitive side-effects. The aim of this long-term prospective study was to evaluate the cognitive impact of oral sustained release morphine in patients with non-cancer pain. A battery of neuropsychological tests to explore attention, psychomotor speed and memory was administered. ⋯ Morphine induced persisting effects on pain, and to a lesser extent on quality of life and mood. The visual analog scale score for side-effects increased at 12 months and essentially consisted of gastrointestinal disorders. This study demonstrates that 12 months treatment with oral morphine does not disrupt cognitive functioning in patients with chronic non-cancer pain and instead results in moderate improvement of some aspects of cognitive functioning, as a consequence of the pain relief and concomitant improvement of well-being and mood.
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Coping responses have been shown to be associated with physical and psychological functioning in patients with chronic pain. Assessment of coping strategies has received increasing attention, with several measures of cognitive and behavioral coping showing promise. One such instrument is the Chronic Pain Coping Inventory (Pain 60 (1995) 203), a 65-item measure of behavioral and cognitive pain coping strategies often targeted as part of multidisciplinary pain treatment. ⋯ This article describes the development of an abbreviated (42-item) CPCI. The results demonstrate very high correlations between the original and abbreviated CPCI scales, as well as comparable internal consistency, test-retest stability, and validity coefficients. The findings support the reliability and validity of the abbreviated CPCI, and suggest that it could be substituted for the CPCI without sacrificing reliability and validity in situations where a briefer measure of coping with chronic pain is preferable.
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Comparative Study
Functional self-efficacy and pain-related disability among older veterans with chronic pain in a primary care setting.
We examined the relationship between functional self-efficacy and pain-related disability in a sample of older veterans with chronic pain. A total of 1045 veterans aged 65 years or older who received primary care at the VA Connecticut Healthcare System in West Haven, CT, were assessed for the presence of chronic pain (i.e. pain due to a non-cancer cause for >/=3 consecutive months in the past 12 months); 303 (26%) screened positive; and 245 (81%) participated. Using a ten-item functional self-efficacy questionnaire (scale: 0-40), participants were categorized into three functional self-efficacy groups: low, score