The incidence of chronic post-surgical pain (CPSP) after various common operations is 10% to 50%. Identification of patients at risk of developing chronic pain, and the management and prevention of CPSP remains inadequate. The aim of this study was to develop an easily applicable risk index for the detection of high-risk patients that takes into account the multifactorial aetiology of CPSP. A comprehensive item pool was derived from a systematic literature search. Items that turned out significant in bivariate analyses were then analysed multivariately, using logistic regression analyses. The items that yielded significant predictors in the multivariate analyses were compiled into an index. The cut-off score for a high risk of developing CPSP with an optimal trade-off between sensitivity and specificity was identified. The data of 150 patients who underwent different types of surgery were included in the analyses. Six months after surgery, 43.3% of the patients reported CPSP. Five predictors multivariately contributed to the prediction of CPSP: capacity overload, preoperative pain in the operating field, other chronic preoperative pain, post-surgical acute pain and co-morbid stress symptoms. These results suggest that several easily assessable preoperative and perioperative patient characteristics can predict a patient's risk of developing CPSP. The risk index may help caregivers to tailor individual pain management and to assist high-risk patients with pain coping.
In this study, we demonstrated that going beyond conventional one-time measurements of acute pain by modelling pain trajectories may substantially enhance research on pain chronification in two ways: First, pain trajectories bear great potential to improve the prediction of CPSP. Second, they represent a meaningful link between psychosocial vulnerability and CPSP because they can be used to uncover mechanisms by which psychosocial vulnerability unfolds. The reported findings suggest that the incidence of CPSP may be reduced by optimizing post-operative pain monitoring.
Using data from the German Family Panel (pairfam) based on 11,746 intergenerational family relationships, the present study examined differences in parental closeness across relations with multiple, coresidential, and non‐coresidential adolescent and adult children. Replicating previous research in a multilevel analysis across families, the authors found a strong positive effect of biological descent on closeness in comparison to adoptive and steprelations; this parental favoritism toward biological offspring was partly explained by selection via parental resources and attitudes. Supplemental within‐parent fixed effect analyses suggested that the relative disadvantage of stepchildren was offset by longer duration of the stepparent–stepchild relationship, lower household income, fewer children in the household, and high parental affirmation of familism.
In this study, we demonstrated that there is substantial variation in postsurgical pain trajectories, not only with regard to postsurgical initial pain intensity, but also with regard to individual rates of pain resolution. Successful pain resolution appeared to be a better predictor of absence of increased pain intensities six months after surgery than initial pain immediately after surgery. Hence, attention should be given to appropriate pain treatment in order to minimize the risk of CPSP.
Using data from the German Family Panel (pairfam; n = 3,674 heterosexual couples), this study examines the impact of partners' individual levels and dyadic similarity concerning life goals, values, and personality traits on relationship satisfaction and union dissolution. Controlling for partners' individual characteristics and for relationship duration, it was found that similarity on specific dimensions and stereotype-adjusted profile correlations exerted significant yet small positive effects on both partners' relationship satisfaction. These effects largely translated into beneficial indirect effects on union dissolution 1 year later (Wave 2, n = 2,820). Moderator analyses indicated the existence of some effect heterogeneity across relationship duration and types. Generally, partners' respective individual characteristics appeared to predict relationship outcomes better than dyadic similarity measures.
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