Impact of controllability on pain and suffering

Löffler, Martin; Kamping, Sandra; Brunner, Michael; Bustan, Smadar; Kleinböhl, Dieter; Anton, Fernand; Flor, Herta

doi:10.1097/pr9.0000000000000694

Cited by 21 publications

(26 citation statements)

References 60 publications

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“…Regarding acute pain, the concept of suffering has also been suggested to be an additional parameter that goes beyond unpleasentness or distress (Bustan et al., 2015), again showing the multidimensional nature of pain. Interestingly, there are also results indicating that controllability could positively affect suffering (Löffler et al., 2018), although this has not yet been proven in a clinical context. The present study confirms the multidimensional nature of pain, but also the experience of pain surprisingly included many different aspects for the participants.…”

Section: Discussionmentioning

confidence: 99%

Patients´ experiences of pain in the intensive care – The delicate balance of control

Hylén

Åkerman

Idvall

et al. 2020

Journal of Advanced Nursing

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Aim To explore the patients´ experiences of pain when being cared for in the intensive care. Design An exploratory, qualitative design was chosen. Method Interviews were performed with patients (October 2015–March 2017) within a week of post‐intensive care (N = 16). Thematic analysis was used as method for analysis. Results The findings generated two themes – a lack of control and to struggle for control. Pain was described as overwhelming, both in body and mind and generating the experience of a lack of control, with feelings of incapacitation, isolation, and having their needs unmet. Feeling in control of the pain and thus in control of the situation was experienced as a constant struggle. Well‐planned care, finding ways to handle the pain and good communication were all helpful in this struggle. Conclusion The participants recalled their experience of pain in the ICU and control seems to be crucial for how pain is experienced. They experienced a lack of control due to not only the pain but also the treatment, which can be avoided by the nurse continuously evaluating and individualising the care. Balanced care, meeting the patients’ needs and good communication helps the patient feel more in control when experiencing pain. Impact The experience of pain is dependent on control for the intensive care patient. The nurse may help them gain control and thereby handle the experience of pain through including the patient, striving for better communication and implementing individualised care that continuously assesses and treats pain.

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Section: Discussionmentioning

confidence: 99%

Patients´ experiences of pain in the intensive care – The delicate balance of control

Hylén

Åkerman

Idvall

et al. 2020

Journal of Advanced Nursing

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“…Given that uncertainty is accompanied by uncontrollability 52 , future research could investigate ways in which treatments can increase people's experience of control over their pain. In support of this, controllability over pain was recently shown to selectively reduce pain-related suffering, but not pain intensity or pain unpleasantness, in healthy participants 31 . This is especially relevant for chronic pain, in which targeting the management and psychosocial concomitants of pain, is often more effective than targeting the pain itself 14,15 .…”

Section: Discussionmentioning

confidence: 85%

“…Sixty-five pain-free volunteers participated in this study. One participant was excluded prior to data analysis due to technical difficulties during data collection, amounting to 64 participants being included in the analyses (52 female, M SD (range) age = 22 4 years, (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)). The sample size was based on the same a priori power calculation as that of Glogan et al 17 (using G*Power; α = .05, d = .80, power = .80) for an independent t-test (two-tailed), which yielded a sample size of 52.…”

Section: Participantsmentioning

confidence: 99%

When Do We Not Face Our Fears? Investigating the Boundary Conditions of Costly Pain-Related Avoidance Generalization

Glogan

Vandael

Gatzounis

et al. 2021

The Journal of Pain

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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“…In laboratory settings, threatening social contexts facilitate pain-related fear learning (21) or threat (22), pain intensity (23) and can influence salience of noxious stimuli and modulate pain experience (24). Sense of control: Experimental studies suggest that an enhanced sense of control over pain does not reduce pain intensity but rather lessens the affective dimension of pain (25)(26)(27)(28).…”

Section: Introductionmentioning

confidence: 99%

The Stressful Characteristics of Pain That Drive You NUTS: A Qualitative Exploration of a Stress Model to Understand the Chronic Pain Experience

et al. 2020

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Objective Despite decades of research on the identification of specific characteristics of situations that trigger a physiological stress response (novelty, unpredictability, threat to the ego, and sense of low control [NUTS]), no integrative research has examined the validity of this framework applied to pain experiences. This study aimed to 1) explore the stressful characteristics of pain among individuals living with chronic pain and 2) examine whether the NUTS framework comprehensively captures the stressful nature of pain. Subjects Participants were 41 adult participants living with chronic pain. Methods Interviews in six focus groups were conducted in French using a semistructured interview guide. Participants first discussed how pain is stressful. Then, they were introduced to the NUTS framework and commented on the extent to which it captured their experience. The verbatim transcriptions of interviews were reviewed using reflexive thematic analysis. Analyses were conducted in French; quotes and themes were translated into English by a professional translator. Results The pain-NUTS framework adequately captured participants’ experiences. Multiple aspects of pain (pain intensity fluctuations, pain flare-up duration, pain quality and location, functional limitations, diagnosis and treatment) were associated with one or more stress-inducing characteristics. In addition, a second layer of meaning emerged in the context of chronic pain that provided contextual information regarding when, how, and why pain became more or less stressful. Conclusions The NUTS characteristics seem to offer a comprehensive framework to understand how pain and its context of chronicity can be a source of stress. This study provides preliminary support for the pain-NUTS framework to allow the formal integration of pain and stress research.

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Impact of controllability on pain and suffering

Abstract: Supplemental Digital Content is Available in the Text.

Cited by 21 publications

References 60 publications

Patients´ experiences of pain in the intensive care – The delicate balance of control

Patients´ experiences of pain in the intensive care – The delicate balance of control

When Do We Not Face Our Fears? Investigating the Boundary Conditions of Costly Pain-Related Avoidance Generalization

The Stressful Characteristics of Pain That Drive You NUTS: A Qualitative Exploration of a Stress Model to Understand the Chronic Pain Experience

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