Using the items listed above, the study was able to predict a patient's risk of developing chronic LBP with a probability of 78%. These items were assembled in a brief questionnaire and were paired with a corresponding evaluative tool. This enables practitioners to assess an individual patient's risk for chronicity by means of a simple calculator in just a few minutes. A validation study for the questionnaire is currently being prepared. MINI ABSTRACT: The objective of this study was the development of a brief questionnaire to assess the risk for chronicity for LBP.
Subjective disability is considered as the variable that reflects the impact of chronic pain on a patient's life. This study examines the questions of which syndrome or patient characteristics determine subjective disability and whether there are differences between samples of patients with chronic headaches and low back pain. Direct pain variables and depression, pain coping strategies, and pain-related self-statements (including catastrophizing) are introduced into multivariate regression analyses as potential predictors of disability using a sample of 151 pain patients. Disability is not predicted by pain severity in patients with headaches or back pain. Psychological variables, especially coping strategies, are far more influential. Coping explains more variance in disability in the headache sample than in the chronic law hack pain group, whereas depression is more relevant for the degree of disability in the back pain sample. In this study, we present a critical analysis of possible interpretations of our results. We point to an overlap of concepts underlying some of the variables used: this overlap also considerably invalidates conclusions drawn from a multitude of studies done in this field, including the one presented. We strongly argue for a conceptual clarification, and consequently for the revision of assessment instruments, before further empirical work in this area is done.
The present study, a qualitative case series report with a quantitative component, explores the relation between changes in family interaction patterns and therapy outcome at 9-month follow-up in a child-and familyoriented psychosocial treatment program developed to treat pediatric primary headache. Changes in the family interaction patterns of 38 children and adolescents diagnosed according to International Headache Society criteria were examined via qualitative methods. Therapy outcome was assessed on an 11-point numeric rating scale measuring the reduction of subjectively experienced global headache burden. At follow-up, 1 subgroup of families showed positive change, and a 2nd subgroup displayed either unchanged or worsened headache-associated interaction patterns. Participants from families with a positive change in headache-associated interaction patterns showed a 64% reduction (p ϭ .00) of global headache burden; participants with unchanged or worsened family interaction patterns showed only a 17% reduction. The findings are illustrated by case histories and discussed in the context of dynamic systems theory.
This article reviews the methods currently in use for the measurement of chronic pain. The most important items for inclusion in questionnaires about the history and in pain diaries to elicit data on the time-course of pain are presented, and both the aims and the advantages and disadvantages of various strategies are discussed. The documentation of chronic pain in outpatients would allow answers to some questions concerned with medical epidemiology if practiced in a large number of therapeutic institutions, especially if the data were processed and evaluated by microcomputer.
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