The journal of pain : official journal of the American Pain Society
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We investigated associations between the number of pain sites (NPS) and role conflict with medically certified, pain-related sickness absence (SA) in employees of Norwegian enterprises (N = 5,654). Latent profile analyses identified exposure profiles based on 3 types of role conflict (work-role conflict, work-life conflict, and emotional dissonance). Multinomial logistic regressions estimated effects on absence (short-term absence of less than 56 days, long-term absence of more than 56 days) during 1 year after survey. ⋯ Our findings suggest that addressing role conflicts may prevent pain-related absence, possibly also for individuals already experiencing pain. PERSPECTIVE: This article elucidates the connections between role conflicts associated with work roles, the NPS, and SA due to pain. This should help organizations prevent pain-related absences from work and improve working conditions for workers who remain occupationally active in spite of pain problems.
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Pain-related avoidance is adaptive when there is a bodily threat, but when it generalizes to safe movements/situations, it may become disabling. Both subclinical anxiety-a vulnerability marker for chronic pain-and chronic pain are associated with excessive fear generalization to safe stimuli/situations. Previous research focused mainly on passive fear correlates (psychophysiological arousal and self-reports) leaving avoidance behavior poorly understood. ⋯ Because excessive pain-related avoidance specifically may cause withdrawal from daily life activities, these findings suggest that high-anxious individuals may be vulnerable to developing chronic pain disability. PERSPECTIVE: This paper shows that high-anxious people do not overgeneralize pain-related fear and pain expectancy learned in a threat context more to novel, safe contexts than low-anxious individuals, but that they do avoid more in those contexts. These findings suggest that high-anxious individuals may be vulnerable to developing chronic pain disability.
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A growing body of literature describes the use of buprenorphine for the treatment of chronic pain in people with sickle cell disease. The experiences of people with sickle cell disease who have tried buprenorphine have not yet reported. This qualitative descriptive study was conducted to explore perspectives on buprenorphine for chronic pain in sickle cell disease. ⋯ The experience of adulthood living with sickle cell disease before and after starting buprenorphine is qualitatively different with significant improvements in social functioning. PERSPECTIVE: This study examined the experience of adults with sickle cell disease and chronic pain transitioning from full agonist opioids to buprenorphine. It is the first qualitative study of buprenorphine in people with sickle cell disease, contributing to a small but growing literature about buprenorphine and sickle cell disease.
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Review Meta Analysis
ACCEPTANCE AND COMMITMENT THERAPY FOR CHRONIC PAIN: AN OVERVIEW OF SYSTEMATIC REVIEWS WITH META-ANALYSIS OF RANDOMIZED CLINICAL TRIALS.
This overview of reviews aimed to summarize the evidence from systematic reviews and meta-analyses of randomized clinical trials of the efficacy of acceptance and commitment therapy (ACT) for adults with chronic pain in relation to pain intensity, pain-related functioning, quality of life, and psychological factors. The Cumulative Index of Nursing and Allied Health Literature (CINAHL), Embase, PsycINFO, PubMed, and the Cochrane Library databases were searched from inception to July 2, 2023. AMSTAR 2 was used to assess the methodological quality of systematic reviews. ⋯ Overall, however, randomized clinical trials and systematic reviews show that ACT can improve outcomes related to chronic pain (eg, pain-related functioning). Future systematic reviews should address the methodological and clinical concerns identified here to produce higher-quality findings. PERSPECTIVE: Despite certain methodological and clinical issues, randomized clinical trials and systematic reviews of ACT appear to show that it can improve outcomes related to chronic pain (eg, psychological factors).