P. Andrew Clifford

Coping Style Influences Compliance with Multidisciplinary Pain Management

The treatment of chronic pain disorders has become multifaceted in recognition of the complexities of chronic pain. However, few models have emerged to predict patients’ response to treatment. This study examined a path model of pain treatment outcome, incorporating the variables of coping style and treatment compliance. Results indicated that the suppression of negative emotion was associated with greater treatment compliance, whereas amplification of negative emotion was found to be associated with poorer treatment compliance. An aggressive coping style was found to be associated with poor treatment compliance. In turn, poor compliance predicted poor pre-/post-treatment functional capacity. Moreover, a path model incorporating compliance as a mediator between coping styles and functional impairment revealed an excellent model fit when compared to a path model with no mediators.

The Geriatric Multidimensional Pain and Illness Inventory: A new instrument assessing Pain and Illness in long-term care

Abstract The Geriatric Multidimensional Pain and Illness Inventory (GMPI) was developed in order to assess the perceptual, functional, and emotional concomitants of pain and illness in long-term care. The GMPI was administered to 401 adults aged 60 and older residing in one of 16 long-term care facilities. The GMPI items were analyzed for reliability, content validity, and convergent and discriminant validity. Factor analysis of the GMPI items revealed three subscales, level of pain severity, level of functional limitations associated with pain, and level of emotional distress associated with pain. The GMPI items were significantly correlated with items from the Geriatric Depression scale, the Neurobehavioral Cognitive Status Exam, and the Activities of Daily Living. The GMPI is evidenced to be a reliable and valid assessment tool for assessing pain of residents in long term care facilities. Its brevity and clearly defined assessment criteria are assets to the administering clinician. Research on the utility of the GMPI as a treatment outcome instrument in long-term care is warranted. The potential for social workers and registered nurses to administer the GMPI in long-term care settings is discussed.

Treatment outcome varies with coping style in chronic pain management

Coping styles are generally recognized as impacting health-related outcomes among persons with chronic illnesses. The current study examined the differential treatment outcomes of three coping style groups undergoing pain management treatment in a multidisciplinary pain center. A total of 66 patients suffering from chronic pain disorders were assessed with the Multidimensional Pain Inventory and the Beck Depression Inventory before, during, and after multidisciplinary pain management treatment. Coping style groups derived from the Millon Behavioral Health Inventory consisting of Amplie ers, Repressors, and Social Copers were compared with regard to reductions in pain, functional impairment, and depression levels. Repeated measures ANOVA revealed that all three of the coping style groups reported signie cantreductions in pain and functional impairment. However, only Amplie ers and Social Copers reported signie cant reductions in depression levels. Hierarchical linear modeling analyses revealed the coping style groups to have signie cantly different depression change curves from pre- to post-treatment. These preliminary results support the value of tailoring treatments in pain management programs toward patients’ coping styles. Patients who are high on Repression qualities do not appear to respond to therapies focused on alleviating depression. Thus, treatment methods that utilize modalities specie cally suited to help Repressors, Amplie ers, and Social Copers manage their chronic pain are likely to maximize their response to treatment. summary