Bio-Psychosocial Determinants of Persistent Pain 6 Months After Non-Life-Threatening Acute Orthopaedic Trauma

Clay, Fiona J.; Newstead, Stuart; Watson, Wendy L.; Ozanne‐Smith, Joan; Guy, Jonathon Hamilton; McClure, Roderick John

doi:10.1016/j.jpain.2009.12.002

Cited by 97 publications

(93 citation statements)

References 44 publications

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“…This study adds to a growing body of literature suggesting that early identification of psychosocial risk factors is needed to identify patients at high risk for poor outcomes after traumatic injury [3,11,12,60,66]. In particular, our findings contribute to research on the importance of pain catastrophizing and depressive symptoms to persistent postsurgical pain and physical disability.…”

Section: Methodsmentioning

confidence: 69%

“…Studies report levels of moderate to severe pain in 48% to 59% of trauma survivors at hospital discharge [3,65], 37% to 56% of patients within 6 months postinjury [10,11], and 63% at 1 year after major trauma [47]. The Lower Extremity Assessment Project found that 73% of patients reported pain 7 years after traumatic lower extremity injury [10].…”

Section: Introductionmentioning

confidence: 99%

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Psychosocial Factors Predict Pain and Physical Health After Lower Extremity Trauma

Archer

Abraham

Obremskey

2015

Clinical Orthopaedics &Amp; Related Research

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Background There has been increasing evidence to support the importance of psychosocial factors to poor outcomes after trauma. However, little is known about the contribution of pain catastrophizing and fear of movement to persistent pain and disability. Questions/purposes Therefore, we aimed to determine whether (1) high pain catastrophizing scores are independently associated with pain intensity or pain interference; (2) high fear of movement scores are independently associated with decreased physical health; and (3) depressive symptoms are independently associated with pain intensity, pain interference, or physical health at 1 year after accounting for patient characteristics of age and education. Methods Of 207 eligible patients, we prospectively enrolled 134 patients admitted to a Level I trauma center for surgical treatment of a fracture to the lower extremity. Sixty percent of patients (80 of 134) had an isolated lower extremity injury and the remainder sustained additional minor injury to the head/spine, abdomen/thorax, or upper extremity. Pain catastrophizing was measured with the Pain Catastrophizing Scale, fear of movement with the Tampa Scale for Kinesiophobia, and depressive symptoms with the Patient Health Questionnaire. Pain and physical health outcomes were assessed with the Brief Pain Inventory and the SF-12, respectively. Assessments were completed at 4 weeks and 1 year after hospitalization. Multiple variable hierarchical linear regression analyses were used to address study hypotheses. One hundred ten patients (82%)

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Section: Methodsmentioning

confidence: 69%

Section: Introductionmentioning

confidence: 99%

Psychosocial Factors Predict Pain and Physical Health After Lower Extremity Trauma

Archer

Abraham

Obremskey

2015

Clinical Orthopaedics &Amp; Related Research

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“…Psychological factors are critically important for understanding all dimensions of pain morbidity including pain severity, pain-related interference with daily activities, emotional adjustment to living with persistent pain, and healthcare utilization for pain complaints [84,85]. In addition, psychological factors can predict the onset of pain in previously healthy individuals [86,87], the development of chronic pain following acute injury [88], and the maintenance of chronic pain in patients with a history of persistent pain [89,90]. Psychological factors are not only important for understanding pain morbidity, they are crucial for identifying negative prognostic risk for patients seeking pain interventions [91].…”

Section: Psychological Screening and Pain Interventions: Lessons For Ipmmentioning

confidence: 99%

Interventional pain medicine: retreat from the biopsychosocial model of pain

Roth

Geisser

Williams

2011

Behav. Med. Pract. Policy Res.

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The field of pain medicine has shifted from multidisciplinary rehabilitation to procedure-focused interventional pain medicine (IPM). Considerable controversy exists regarding the efficacy of IPM and its more narrow focus on nociception as an exclusive target of pain treatment. This topical review aims to examine pain research and treatment outcome studies that support a biopsychosocial model of pain, and to critique the clinical practice of IPM given its departure from the premises of a biopsychosocial model. A modern definition of pain and findings from clinical and basic science studies indicate that pain-related psychological factors are integral to pain perception. The clinical viability of IPM is challenged based upon its biomedical view of peripheral nociception as a primary source of pain and the potential of this viewpoint to foster maladaptive pain attributions and discourage the use of pain coping strategies among chronic pain patients. IPM should adopt a biopsychosocial perspective on pain and operate within a framework of multidisciplinary pain rehabilitation to improve its effectiveness. KEYWORDS

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“…Despite this, the dimensions of recovery from the viewpoint of the injured person are not well understood. Recovery is often measured in terms of return to work (RTW), pain levels, and activities of daily living using standardized patient report instruments [2][3][4][5][6]. However, it is clear that these instruments only account for certain aspects of the recovery process as research indicates they do not align well with the injured person's experience of recovery.…”

Section: Introductionmentioning

confidence: 99%

Injured Workers Perspectives on Recovery following Non-Life-Threatening Acute Orthopaedic Trauma: A Descriptive Study

Clay

Shourie

Robinson

et al. 2014

ISRN Rehabilitation

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Background. Little is known about the recovery process following non-life-threatening acute orthopaedic trauma from the viewpoint of the injured person. A better understanding could facilitate optimal rehabilitative planning. Objective. To explore patients' views on factors important to them in recovery following non-life threatening acute orthopaedic trauma. Methods. Descriptive study utilizing content analysis and chi-square analysis. To better understand recovery expectations, 168 adults who had sustained non-life threatening acute orthopaedic trauma were surveyed at 2, 12, and 26 weeks after injury and invited to respond to the following question "what are the most important things necessary for you to best recover?" Results. According to participant's responses, major themes on recovery involved a return to health and a return to health but with an ongoing plan, and for a minority (12%) recovery involved a focus on their current status. The study found that some recovery expectations changed over time. Conclusion. The journey to recovery is complex, often prolonged, and highly individual. Responses suggest that some injured persons need more assistance for a successful recovery than others. Those who appeared "caught in the moment" of the injury may benefit from clinical and rehabilitative management focusing on long-term recovery and acceptance of the injury event.

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Bio-Psychosocial Determinants of Persistent Pain 6 Months After Non-Life-Threatening Acute Orthopaedic Trauma

Cited by 97 publications

References 44 publications

Psychosocial Factors Predict Pain and Physical Health After Lower Extremity Trauma

Psychosocial Factors Predict Pain and Physical Health After Lower Extremity Trauma

Interventional pain medicine: retreat from the biopsychosocial model of pain

Injured Workers Perspectives on Recovery following Non-Life-Threatening Acute Orthopaedic Trauma: A Descriptive Study

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