Measuring control appraisals in chronic pain

Chronic Pain Center, VA Medical Center, Houston, TX 77030, USA.
Journal of Pain (Impact Factor: 4.01). 11/2002; 3(5):385-93. DOI: 10.1054/jpai.2002.126609
Source: PubMed


Research has established a positive association between appraisals of control over pain and indexes of adaptive psychologic and physical functioning among persons with chronic pain. A number of measures of control appraisals have been used in the research literature. The current study sought to determine the number of factors or dimensions embedded in these commonly used measures of pain control appraisal. The study also sought to determine the association between the control appraisal construct(s) and measures of patient functioning. Two hundred fifty-two persons with chronic pain completed a questionnaire packet that included multiple measures of control appraisals. A factor analysis resulted in 6 factors: 1 factor representing beliefs about control over life in general, 1 representing perceived control over the effects of pain on one's life, and remaining 4 factors that appear to be more closely tied to perceived control over pain itself. Consistent with previous research, control appraisals made a significant contribution to the prediction of functioning (depression, disability, and pain interference). Most importantly, perceived control over the effects of pain on one's life and perceived control over life in general were more strongly associated with functioning than perceptions of control over pain itself.

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    • "Role of multidisciplinary team (MDT): Evidence for adaptability of subjective responses to learning and experience, provides encouragement for evolving systems with MDT inputs for emotional and social support throughout the management plan.[37] An ideal system would integrate appropriate and timely inputs from the nurse, physiotherapist, psychotherapist, occupational therapist, yoga therapist, social worker, and family/community carer[3839] along with the pain physician. "
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    • "For example, relaxation may control both one's pain and the impact of pain on one's life. Regardless, though, as Tan et al. (2002) demonstrated, perceived control over the effects of pain was more strongly related to better adjustment and less disability than perceived control over pain itself. McCracken et al. (2004) proposed that the ineffective struggle to gain control over pain that is essentially uncontrollable should be abandoned, and that acceptance of pain may foster the sense of general life control. "
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    • "control pain may be especially unhelpful in the context of pain experiences that are particularly intense (Jensen and Karoly, 1991). Perceived control over effects of pain on life functioning is more strongly associated with functioning than perceived control over pain itself (Tan et al., 2003). Other data show that patients who report greater struggling to control pain also report greater pain, distress, and disability (McCracken et al., under review). "
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