Article

A Prospective Investigation of Acceptance and Control-Oriented Coping with Chronic Pain

Pain Management Unit, Royal National Hospital for Rheumatic Diseases, University of Bath, Bath, BA1 1RL, UK.
Journal of Behavioral Medicine (Impact Factor: 3.1). 09/2007; 30(4):339-49. DOI: 10.1007/s10865-007-9104-9
Source: PubMed

ABSTRACT Historically, investigations of coping with chronic pain primarily have sought methods for gaining greater control over pain and pain-related distress. Recently, it has been suggested to expand the framework of coping so that control efforts are redirected from circumstances where they fail, and so that coping can more explicitly incorporate potentially more practical and flexible notions of acceptance. The purpose of the present study was to evaluate the role of control-oriented and acceptance-oriented coping responses for patient functioning using a prospective design. Participants included 120 adult patients with chronic pain who completed measures of coping, pain, disability, depression, and pain-related anxiety at two time points, separated by an average of 3.7 months (SD = 2.6 months). Factor analyses revealed four factors within the coping data: Pain Management, Pain Control, Help Seeking, and Activity Persistence. A series of correlation and linear regression analyses was performed to assess the relations of these factors at initial assessment to functioning later in time. In general, Activity Persistence was associated with better functioning over time while control-oriented responses were associated with greater difficulty. The factor representing more or less traditional pain management methods showed surprisingly limited relations with aspects of patient functioning. Analyses of concurrent change in coping and functioning highlighted a unique, apparently unhelpful, role of Pain Control. These results support the inclusion of contextual acceptance-related processes in current frameworks for understanding adjustment to chronic pain.

2 Followers
 · 
106 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: No standard definition exists for the concept "persistent pain self-management" or how it should be defined in relation to older adults. Poorly defined concepts can result in misunderstandings in the clinical setting and can hinder research through difficulties identifying or measuring the concept. To ascertain attributes, referents, antecedents, and consequences of the concept older adults' persistent pain self-management and develop a theoretical definition. Rodgers evolutionary model of concept analysis was used to systematically analyze articles from the academic and grey literature (N = 45). Data were extracted using standardized extraction forms and analyzed using thematic analysis. This concept was discussed in three ways: as an intervention, in reference to everyday behaviors, and as an outcome. Five defining attributes were identified: multidimensional process, personal development, active individuals, symptom response, and symptom control. Patients' perceived need and ability to manage pain with support from others is necessary for pain self-management to occur. Numerous physical, psychological, and social health consequences were identified. A theoretical definition is discussed. Our findings have clarified existing use and understanding regarding the concept of older adults' persistent pain self-management. We have identified three areas for future development: refinement of the attributes of this concept within the context of older adults, an exploration of how providers can overcome difficulties supporting older adults' persistent pain self-management, and a clarification of the overall theoretical framework of older adults' persistent pain self-management.
    Pain Medicine 10/2013; 15(2). DOI:10.1111/pme.12251 · 2.24 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Current models of chronic pain recognize that psychosocial factors influence pain and the effects of pain on daily life. The role of such factors has been widely studied in English speaking individuals with chronic pain. It is possible that the associations of between such factors and adjustment may be influenced by culture. This study sought to evaluate the importance of coping responses, self-efficacy beliefs, and social support to adjustment to chronic pain in a sample of Portuguese patients, and discuss the findings with respect to their similarities and differences from findings of studies with English speaking samples. Measures of pain intensity and interference, physical and psychological functioning, coping responses, self-efficacy, and satisfaction with social support where administered to a sample of 324 Portuguese patients with chronic musculoskeletal pain. Univariate and Multivariate analysis were computed. Findings are interpreted with respect to those from similar studies using English speaking samples. Coping responses and perceived social support were significantly associated with pain interference and both physical and psychological functioning; self-efficacy beliefs were significantly associated with all criterion variables. All coping responses, except for task persistence, were associated positively with pain interference and negatively associated with physical and psychological functioning, with the strongest associations found for catastrophizing, praying/hoping, guarding, resting, asking for assistance and relaxation. The findings provide support for the importance of the psychosocial factors studied in adjustment to chronic pain in Portuguese patients, and also suggest the possibility of some differences in the role of these factors due to culture.
    The Clinical journal of pain 08/2014; DOI:10.1097/AJP.0000000000000027 · 2.70 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Tinnitus is the experience of sounds without an identified external source, and for some the experience is associated with significant severity (i.e., perceived negative affect, activity limitation, and participation restriction due to tinnitus). Acceptance of tinnitus has recently been proposed to play an important role in explaining heterogeneity in tinnitus severity. The purpose of the present study was to extend previous investigations of acceptance in relation to tinnitus by examining the unique contribution of acceptance in accounting for tinnitus severity, beyond anxiety and depression symptoms. In a cross-sectional study, 362 participants with tinnitus attending an ENT clinic in Sweden completed a standard set of psychometrically examined measures of acceptance of tinnitus, tinnitus severity, and anxiety and depression symptoms. Participants also completed a background form on which they provided information about the experience of tinnitus (loudness, localization, sound characteristics), other auditory-related problems (hearing problems and sound sensitivity), and personal characteristics. Correlational analyses showed that acceptance was strongly and inversely related to tinnitus severity and anxiety and depression symptoms. Multivariate regression analysis, in which relevant patient characteristics were controlled, revealed that acceptance accounted for unique variance beyond anxiety and depression symptoms. Acceptance accounted for more of the variance than anxiety and depression symptoms combined. In addition, mediation analysis revealed that acceptance of tinnitus mediated the direct association between self-rated loudness and tinnitus severity, even after anxiety and depression symptoms were taken into account. Findings add to the growing body of work, supporting the unique and important role of acceptance in tinnitus severity. The utility of the concept is discussed in relation to the development of new psychological models and interventions for tinnitus severity.
    Ear and Hearing 02/2015; DOI:10.1097/AUD.0000000000000148 · 2.83 Impact Factor

Full-text

Download
18 Downloads
Available from
Sep 11, 2014