The Clinical journal of pain
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To search for generalizable, psychological predictors of chronic pain treatment outcome. ⋯ The "general predictors" of chronic pain treatment outcome may be difficult to find. Therefore, planning treatment for the individual patient may always have to be based on accurate multiaxial and multidimensional assessment of patient functioning.
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Some studies have found significant relations between both the factor scores and subscales of the Coping Strategies Questionnaire (CSQ) and various measures of adjustment to chronic pain. In their review of the literature on coping with chronic pain, Jensen et al. (Pain 1991;47:249-83) suggest that conceptual overlap between the subscales may inflate these observed correlations. In the present study, we examine the factor structure of the CSQ subscales which reflect coping, excluding the CSQ subscales which measure appraisal or activity. We then examine the relationship between the CSQ factors and subscales and pain adjustment, while controlling for selected variables. ⋯ The results suggest that praying/hoping and catastrophizing are related to poorer adjustment to chronic pain, that ability to control and decrease pain are related to better adjustment, and that catastrophizing appears to be a separate construct from depression. The results also suggest that the individual CSQ subscales may have greater utility in terms of examining coping, appraisals, and pain adjustment compared to the composite scores.
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To determine the clinical usefulness of skin temperature patterns for tracking reflex sympathetic dystrophy (RSD) by assessing (a) long-term relationships between changes in pain due to RSD and patterns of near surface blood flow and (b) relationships between site of pain and site of greatest asymmetries in near surface blood flow patterns. ⋯ Videothermography is not an appropriate tool to use alone for either single session diagnosis or multi-session tracking of RSD.
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We examined the extent to which preoperative state and trait anxiety, general need to control, need to control analgesia, expectations regarding postoperative pain, and demographic variables predict the severity of postoperative pain, discomfort, anxiety, duration of recovery, and patient-controlled analgesia (PCA) behaviors. ⋯ Psychological factors do influence postoperative recovery and pain control in women receiving PCA therapy after abdominal hysterectomy, and attention to individual patient differences may lead to improved postoperative outcomes.
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To examine patterns in both surgical and nonsurgical low back pain (LBP) hospitalizations through time and among geographic regions and to explore the practical implications of these patterns for health care reform. ⋯ Wide variations in LBP hospitalization practices raise the issue of which practices are most appropriate. Outcomes research addresses this issue, as does research on patient preferences for certain types of treatment. As indicated by the increasing rate of LBP surgery, more research also needs to be done on changing physician practice style. If such research were to result in a reduction in LBP hospitalization, savings in health care costs would be considerable.