Psychological aspects of chronic pain: a literature review

The influence of psychological variables on the experience of chronic pain continues to be underestimated by many healthcare practitioners. This literature review attempts to highlight the applicability of the conceptualization of chronic pain within the biopsychosocial model and diathesis-stress framework. Within these paradigms the emotional disorders more frequently associated with the experience of chronic pain are explored. Attention is also paid to mechanisms underlying the development and maintenance of chronic pain-related emotional disorders. Finally, the implications of a more holistic conceptualization of chronic pain for clinical practice are investigated.South African Psychiatry Review Vol. 11(4) 2005: 139-14

Pain severity, coping and satisfaction with life in patients with chronic pain

Objectives: The primary study aim was to determine whether or not a statistically significant relationship exists between pain severity and satisfaction with life in patients with chronic pain. The second aim was to explore the extent to which coping responses might influence this relationship.Design: A cross-sectional non-experimental research design was employed.Setting and subjects: A sample of 172 adults suffering from chronic pain was recruited from the outpatient clinic at the Pain Control Unit at Universitas Hospital in Bloemfontein.Outcome measures: Participants completed measures of pain severity (Pain Severity Scale of the West-Haven-Yale Multidimensional Pain Inventory), satisfaction with life (Satisfaction with Life Scale) and coping responses (Coping Responses Inventory-Adult version).Analysis: Pearson correlation coefficients were calculated between the measures of pain severity and satisfaction with life. Regression analyses were employed to explore the effect of coping responses on the relationship between pain severity and satisfaction with life.Results: A statistically significant negative correlation was apparent between pain severity and satisfaction with life. Approach coping was found to moderate the relationship between pain severity and satisfaction with life, while avoidance coping appeared to have no significant effect on this relationship. The relationship between pain severity and satisfaction with life appears to change as a function of the level of approach coping exhibited by individuals suffering from chronic pain.Conclusion: Satisfaction with life significantly correlates with pain severity in patients with chronic pain. Approach coping moderates this relationship.South Afr J Anaesth Analg 2013;19(5):252-25

An examination of factors influencing the choice of therapy for patients with coronary artery disease

Background A diverse range of factors influence clinicians' decisions regarding the allocation of patients to different treatments for coronary artery disease in routine cardiology clinics. These include demographic measures, risk factors, co-morbidities, measures of objective cardiac disease, symptom reports and functional limitations. This study examined which of these factors differentiated patients receiving angioplasty from medication; bypass surgery from medication; and bypass surgery from angioplasty. Methods Univariate and multivariate logistic regression analyses were conducted on patient data from 214 coronary artery disease patients who at the time of recruitment had been received a clinical assessment and were reviewed by their cardiologist in order to determine the form of treatment they were to undergo: 70 would receive/continue medication, 71 were to undergo angioplasty and 73 were to undergo bypass surgery. Results Analyses differentiating patients receiving angioplasty from medication produced 9 significant univariate predictors, of which 5 were also multivariately significant (left anterior descending artery disease, previous coronary interventions, age, hypertension and frequency of angina). The analyses differentiating patients receiving surgery from angioplasty produced 12 significant univariate predictors, of which 4 were multivariately significant (limitations in mobility range, circumflex artery disease, previous coronary interventions and educational level). The analyses differentiating patients receiving surgery from medication produced 14 significant univariate predictors, of which 4 were multivariately significant (left anterior descending artery disease, previous cerebral events, limitations in mobility range and circumflex artery disease). Conclusion Variables emphasised in clinical guidelines are clearly involved in coronary artery disease treatment decisions. However, variables beyond these may also be important factors when therapy decisions are undertaken thus their roles require further investigation

Modelling of bubble departure in flow boiling using equilibrium thermodynamics

To improve the closure relations employed for component-scale Computational Fluid Dynamics simulation of boiling flows, a first-principles method for predicting bubble departure diameters in flow boiling has been developed. The proposed method uses minimisation of the free energy of a system in thermodynamic equilibrium to predict the contact angle and the resistance to sliding of a vapour bubble attached to a surface in the presence of a forced liquid flow. Predictions of the new method are compared with measurements from existing experimental databases, and agreement with data is shown to be comparable or superior to that obtained with previous bubble departure models that have generally used a force-balance approach. The main advantages of the energy-based method over the previous force-based methods are that its formulation is simpler, and that the new model does not require the use of ad hoc tunable parameters to define force terms, or geometrical characteristics of the attached bubble such as its base area, which cannot be confirmed experimentally. This increases confidence in the validity of the new approach when applied outside the rather limited range of current test data on bubble departure in flow boiling

The role of coping responses in the relationship between perceived stress and satisfaction with life amongst chronic pain patients

Background: This study aimed to determine the effect of coping responses on the relationship between perceived stress and satisfaction with life in a sample of chronic pain patients. Methods: One hundred and seventy-two adult outpatients at the Pain Control Unit at Universitas Hospital in Bloemfontein completed measures of perceived stress (Perceived Stress Scale), satisfaction with life (Satisfaction with Life Scale) and coping responses (Coping Responses Inventory – Adult Version). Descriptive statistics were calculated for the sample. Correlation coef cients were calculated between perceived stress and satisfaction with life. Regression analyses were employed to determine the effect of coping responses on the relationship between perceived stress and satisfaction with life. Results: A statistically signi cant negative correlation was found between perceived stress and satisfaction with life. Approach coping moderates the relationship between perceived stress and satisfaction with life, while avoidance coping has no effect on the relationship. The relationship between perceived stress and life satisfaction therefore appears to change as a function of the level of approach coping that patients with chronic pain exhibit. Conclusion: Approach coping moderates the relationship between perceived stress and satisfaction with life amongst chronic pain patients.Keywords: coping; perceived stress; satisfaction with life; chronic pai

Mindfulness and burnout among competitive adolescent tennis players

Background. Burnout among adolescent athletes is a cause for concern. However, little is known about the intrapersonal factors that may be related to burnout in this population.Objectives. To explore the relationship between burnout and mindfulness among competitive adolescent tennis players.Methods. Competitive adolescent tennis players (N=104; mean age 16 years) completed measures of mindfulness and athlete burnout. Correlations were calculated with regard to mindfulness and burnout. A one-way multivariate analysis of variance (MANOVA) was conducted to determine whether athletes assigned to three levels of mindfulness (high, moderate and low) differed significantly with regard to burnout.Results. Mindfulness exhibited significant negative correlations with global burnout, emotional/physical exhaustion, reduced sense of accomplishment and sport devaluation. The results of the MANOVA indicated that individuals in the three mindfulness groups (high, moderate and low) reported significantly different levels of burnout. Post hoc analyses revealed that participants in the high mindfulness group reported a significantly lower sense of reduced accomplishment and global burnout than participants in the low mindfulness group. In addition, participants in the low mindfulness group reported significantly higher levels of global burnout than individuals in the high and moderate mindfulness groups.Conclusion. Mindfulness appears to be negatively related to athlete burnout among competitive adolescent tennis players. Furthermore, athletes reporting different levels of mindfulness exhibit differing levels of burnout. The potential protective effect of mindfulness with regard to burnout among adolescent athletes warrants further investigation