Ilse Viane

Acceptance of pain is an independent predictor of mental well-being in patients with chronic pain: empirical evidence and reappraisal

&NA; This paper reports upon: (1) the value of acceptance of pain in predicting well‐being in patients suffering from chronic pain and (2) the construct validity of acceptance by comparing two questionnaires designed to measure acceptance (the Chronic Pain Acceptance Questionnaire, CPAQ, unpublished doctoral dissertation, University of Nevada, Reno, NV, 1992 and the Illness Cognitions Questionnaire, ICQ, J Consult Clin Psychol 69 (2001) 1026). The results of two independent cross‐sectional studies are reported. Study 1 included 120 patients seeking help in tertiary care settings. In Study 2, 66 patients were recruited from a self‐support group for fibromyalgia patients and from a pain clinic. Both studies revealed that acceptance of pain predicted mental well‐being beyond pain severity and pain catastrophizing, but did not account for physical functioning. In both instruments, it was found that acceptance of pain was strongly related to engagement in normal life activities and the recognition that pain may not change. Acceptance in both instruments was strongly related to a cognitive control over pain. Study 2 further revealed that the correlation between the CPAQ and the ICQ is moderate, indicating that both instruments measured different aspects of acceptance. It is concluded that acceptance of chronic pain is best conceived of as the shift away from pain to non‐pain aspects of life, and the shift away from a search for a cure with an acknowledgement that pain may not change.

Acceptance of the unpleasant reality of chronic pain: Effects upon attention to pain and engagement with daily activities.

&NA; This paper investigates whether acceptance was related to less attention to pain, and to more engagement with daily activities. The results of two studies are reported. In a first cross‐sectional study, 501 chronic pain patients completed self‐report instruments on pain severity, attention to pain and acceptance. In a second diary study, 62 patients with chronic pain reported pain intensity, attention to pain and characteristics of goal‐directed behaviour 8 times a day using an experience sampling method. Acceptance was measured using a self‐report instrument. It was found that acceptance was related to less attention to pain (study 1 and study 2), more engagement with daily activities, a higher motivation to complete activities and a better efficacy to perform daily activities (study 2). Results are discussed in terms of how a positive life despite pain may be preserved by a flexible adjustment of personal goals to current limitations and adversities.

Meten van coping, ziekteopvattingen, en andere psychosociale factoren coping , ziekteopvattingen ziekteopvattingen , en andere psychosociale factoren psychosociale factoren

In een biopsychosociaal perspectief is een prominente plaats voorbehouden voor de rol van psychosociale factoren bij het instandhouden of verergeren van pijnproblemen en de aantasting van de kwaliteit van leven. In deze bijdrage geven we een overzicht van de psychosociale variabelen die vaak ingeroepen worden om de geringe samenhang tussen fysieke stoornissen, pijn, en functionele belemmeringen te verklaren. Achtereenvolgens komen aan bod: coping, ziekteopvattingen, vrees, hypochondrie, en aandacht. Ten slotte geven we een overzicht van de beschikbare Nederlandstalige instrumenten.