Ali Asghari - Academia.edu (original) (raw)
Papers by Ali Asghari
Scandinavian Journal of Pain, Nov 30, 2019
Background and aims: The purpose of this study was to (a) develop and (b) conduct exploratory fac... more Background and aims: The purpose of this study was to (a) develop and (b) conduct exploratory factor analysis on a novel self-report instrument for symptoms associated with altered central pain processing. Methods: We first developed a 25-item questionnaire based on previous literature identifying symptoms and behaviours that may reflect altered spinal and supraspinal pain processing. We then administered this questionnaire to 183 people with chronic pain (n = 99) and healthy individuals (n = 84). Exploratory factor analysis was conducted to identify the factor structure of the questionnaire. Results: Our results support a two-factor solution for the 25-item questionnaire that accounted for 57.2% of the total variance of responses in people with and without chronic pain. Factor one (11 items) included items related to alterations in sensation of pain, while factor two (seven items) included items associated with emotional and fatigue symptoms. Seven items showed weak factor loadings and were eliminated. Reliability was excellent, while both factors showed strong correlations with previouslyvalidated self-report Instruments: (pain catastrophising, mood, vigilance, pain self-efficacy) and conditioned pain modulation, providing evidence for their validity. Conclusions: We have developed a questionnaire containing two factors that appear to be related to two different symptom clusters, one of which is specifically related to pain and one of which contains other health-related symptoms related to mood and fatigue. These factors show excellent internal consistency and validity. This questionnaire may be a quick, easy and reliable instrument to assess central pain processing in clinical settings.
Current Opinion in Psychiatry, Sep 1, 2014
To explores the potential role of psychological treatments for older people who are affected by c... more To explores the potential role of psychological treatments for older people who are affected by chronic pain. It is now widely recognized that chronic pain is a highly prevalent health problem among older people, and guidelines have evolved to assist with the assessment and management of chronic pain. However, despite the fact that psychological treatments have been shown to be effective for a range of other conditions such as depression and anxiety, there is a relative paucity of studies focused on pain management. Although more evidence is needed, the trend from existing studies indicates that older people find psychological treatments for chronic pain to be relevant, acceptable in content, and beneficial in reducing distress and disability. Particular challenges arise for the delivery of psychological interventions to people with pain and cognitive impairment associated with dementia. There is a growing interest in this population and a good deal of research has focused on the assessment of pain, but with a small number of exceptions, almost no research activity as yet in developing psychological treatments for people with pain and dementia. We conclude that there is sufficient evidence that psychological interventions are efficacious for older people with chronic pain. We propose a number of areas for research focus over the next 10 years that will help to consolidate our knowledge and to explore new avenues for the psychological management of chronic pain in older people.
iews on the association between chronic pain conditions and depression have a long history in bot... more iews on the association between chronic pain conditions and depression have a long history in both the pain and psychiatric literature. These ideas have included pain being an antecedent to depression, depression being a consequence of chronic pain,
Pain, 2019
Normative data for chronic pain questionnaires are essential to the interpretation of aggregate s... more Normative data for chronic pain questionnaires are essential to the interpretation of aggregate scores on these questionnaires, for both clinical trials and clinical practice. In this study, we summarised data from 13,343 heterogeneous patients on several commonly used pain questionnaires that were routinely collected from 36 pain clinics in Australia and New Zealand as part of the electronic Persistent Pain Outcomes Collaboration (ePPOC) including the Brief Pain Inventory (BPI); the Depression Anxiety and Stress Scales (DASS); the Pain Self-Efficacy Questionnaire (PSEQ); and the Pain Catastrophizing Scale (PCS). The data are presented as summarised normative data, broken down by demographic (age, sex, work status, etc) and pain site/medical variables. The mean BPI severity score was 6.4 (moderate-severe), and mean interference score was 7.0. The mean DASS depression score was 20.2 (moderate-severe), mean DASS anxiety was 14.0 (moderate), and mean DASS stress was 21.0 (moderate). Th...
Spinal Cord, 2007
Cross-sectional study with repeated measurements. Objectives: To examine the patient's perspectiv... more Cross-sectional study with repeated measurements. Objectives: To examine the patient's perspective of the impact of spinal cord injury (SCI) on physical, cognitive, emotional function, and quality of life (QOL). Setting: Australia. Methods: A sample of 63 patients with SCI, 32 of whom had recent injuries, and 31 with established injuries were administered the Ruff Neurobehavioral Inventory to examine patients' subjective evaluation of pre-and post-injury functioning. Current happiness levels were also evaluated using the Subjective Happiness Scale. A follow up assessment was performed 6 months later to examine changes over time. Results: A significant difference was found between perception of pre-and postmorbid function on composite Cognitive (t ¼ 5.99, df ¼ 62, Po0.001), Physical (t ¼ 11.56, df ¼ 62, Po0.001), and QOL (t ¼ 7.16, df ¼ 62, Po0.001) scales and on several of the Emotional subscales including anxiety, paranoia and suspicion, and substance abuse (Po0.001). A series of hierarchical regression analyses indicate that post-SCI pain was a significant predictor of: cognitive (R 2 ¼ 0.20, Po0.001); emotional (R 2 ¼ 0.13, Po0.004); and of QOL (R 2 ¼ 0.22, Po0.001) functioning. With the exception of a decrease in happiness (Po0.01), there were no significant changes in any measures over the 6 month time period. Conclusions: There are significant changes in patients' perceptions of physical and cognitive functioning, and of QOL before and after SCI and some aspects of emotional functioning. Pain has a significant adverse effect on functioning. Happiness decreased slightly in the 6 months between surveys.
European Journal of Pain, 2013
BackgroundBehavioural exposure methods can reduce pain‐avoidance behaviours, but outcomes vary. O... more BackgroundBehavioural exposure methods can reduce pain‐avoidance behaviours, but outcomes vary. One possible explanation is that patients employ cognitive (experiential) avoidance during behavioural exposure. If so, reducing cognitive avoidance during behavioural exposure should help. One option is interoceptive exposure (IE), which involves sustained exposure (via attention) to pain sensations. In order to test if IE could improve outcomes from behavioural exposure, this study with mixed chronic pain patients compared outcomes from a cognitive behavioural therapy (CBT) pain management programme incorporating either IE or distraction from pain.MethodsOne hundred forty chronic pain patients were randomly assigned to CBT + IE or CBT + distraction. Outcome measures included pain, disability, depression and medication. Measures reflecting degree of threat of pain were also employed (catastrophizing, fear‐avoidance, pain self‐efficacy and pain acceptance). An intention‐to‐treat approach,...
The Journal of Pain, Feb 1, 2013
Health-related research suggests the belief in a just world can act as a personal resource that p... more Health-related research suggests the belief in a just world can act as a personal resource that protects against the adverse effects of pain and illness. However, currently, little is known about how this belief, particularly in relation to one's own life, might influence pain. Consistent with the suggestions of previous research, the present study undertook a secondary data analysis to investigate pain catastrophizing as a mediator of the relationship between the personal just world belief and chronic pain outcomes in a sample of chronic pain support group attendees. Partially supporting the hypotheses, catastrophizing was negatively correlated with the personal just world belief and mediated the relationship between this belief and pain and disability, but not distress. Suggestions for future research and intervention development are made.
Research on the role of acceptance in adjustment to persisting pain has been facilitated by the d... more Research on the role of acceptance in adjustment to persisting pain has been facilitated by the development of the Chronic Pain Acceptance Questionnaire (CPAQ). However, to date the CPAQ has been used to explore acceptance of pain without taking into account the likely contribution of other cognitive variables that have been shown to influence adjustment to persisting pain. This study examined the role of pain acceptance, as measured by the CPAQ, in accounting for adjustment to pain when controlling for the effects of other cognitive variables. The results indicated that while the Activity engagement subscale of the CPAQ was predictive of depression severity, neither of the CPAQ’s two subscales was predictive of pain severity or physical disability. These findings differ from some reported previously and they suggest that the CPAQ, by itself, may not be sufficient to explain the processes of acceptance of pain and, hence, adjustment to pain. The findings also indicate that the Pain ...
Behaviour Research and Therapy, 1997
The psychometric properties of the Depression Anxiety Stress Scales (DASS) were evaluated in two ... more The psychometric properties of the Depression Anxiety Stress Scales (DASS) were evaluated in two studies using large clinical samples (N = 437 and N = 241). In Study 1, the three scales comprising the DASS were shown to have excellent internal consistency and temporal stability. An exploratory factor analysis (principal components extraction with varimax rotation) yielded a solution that was highly consistent with the factor structure previously found in nonclinical samples. Between-groups comparisons indicated that the DASS distinguished various anxiety and mood disorder groups in the predicted direction. In Study 2, the conceptual and empirical latent structure of the DASS was upheld by findings from confirmatory factor analysis. Correlations between the DASS and other questionnaire and clinical rating measures of anxiety, depression, and negative affect demonstrated the convergent and discriminant validity of the scales. In addition to supporting the psychometric properties of the DASS in clinical anxiety and mood disorders samples, the results are discussed in the context of current conceptualizations of the distinctive and overlapping features of anxiety and depression.
Background: Regular physical activity contributes positively to physical and psychological health... more Background: Regular physical activity contributes positively to physical and psychological health. In the present study, the stages of change of physical activity and the total physical Aims: The aim of this study was to investigate the proportion of adolescent girls in each stages of change and the causative factors associated with physical activity such as the related social support and self efficacy in a sample of the high school students. Methods: In this study, Social Cognitive Theory (SCT) and the Transtheorical Model (TTM) guided instrument development. The data regarding the demographics, psychosocial determinants of physical activity, stage of change and physical activity was gathered by questionnaires. Several measures of psychosocial determinants of physical activity were translated from English into Persian using the back-translation technique. These translated measures were administered to 512 ninth and tenth-grade Iranian high school students for factor analysis. Resul...
Pain, 2019
Recommendations regarding the use of Opioid Analgesics in patients with chronic Non-Cancer Pain P... more Recommendations regarding the use of Opioid Analgesics in patients with chronic Non-Cancer Pain PURPOSE The Faculty of Pain Medicine (FPM) recognises the lack of definitive evidence supporting the long-term effectiveness of opioid analgesics in people experiencing chronic non-cancer pain (CNCP) and the substantial evidence of potential harm. This document outlines the current position of the FPM regarding opioid use in CNCP. It is anticipated that this position will evolve as the evidence base develops. CURRENT EVIDENCE The efficacy of opioid therapy is supported by strong evidence from randomised controlled trials in acute pain [1] and from systematic reviews in cancer pain [2,3], palliative care [4] and opioid dependency/addiction [5]. In CNCP systematic reviews report modest short term analgesic benefit [6,7]. However the duration of the RCTs reviewed (up to 4 months) was too short to adequately inform the long term role of opioid treatment in CNCP.
Pain, 2017
This study compares the outcomes, from pretreatment to 1-year follow-up, of an outpatient, CBT-ba... more This study compares the outcomes, from pretreatment to 1-year follow-up, of an outpatient, CBT-based pain self-management program (PSM) that included exercises, pain education, and pain coping strategies, with a control condition (exercise-attention control, EAC) that included exercises and a control for the attention of the treatment team. We previously reported short-term results (to 1-month follow-up) from the same study. This new paper considers the important issue of maintenance of treatment-related gains. The participants (n = 141) were a heterogeneous sample of ambulant, community-dwelling older adult patients with chronic pain (mean age: 73.90 [6.5] years [range: 65-87 years]). The long-term results indicate the pain self-management program group achieved and maintained significantly better results than the exercise-attention control group on the primary outcome, pain-related disability, as well as on usual pain, pain distress, depression, and fear-avoidance beliefs. The mea...
Pain Practice, 2006
Research suggests that a combination of a somatic and a psychosocial intervention for chronic non... more Research suggests that a combination of a somatic and a psychosocial intervention for chronic noncancer pain should be associated with a better outcome than either alone. This study presents data on a series of 31 patients who underwent sequential treatment with an implantable device targeting pain relief and a cognitivebehavioral pain management program that targeted improved function. A combination of treatments was used as there was a suboptimal response to the initial treatment. There were improvements in a range of outcomes at a longterm follow-up. Significant improvements were found in disability, affective distress, self-efficacy, and catastrophizing, but not in average pain severity. Further analyses failed to demonstrate an order effect. These results support the view that combined somatic and psychosocial interventions can achieve better outcomes than either alone in selected chronic pain patients. This approach requires that psychological assessment is essential before the use of an implantable device. This may not only improve patient selection, but also identify psychosocial factors that may be modified to enhance the effectiveness of invasive interventions. In addition, consideration for an implantable device following a suboptimal response to treatment in a cognitive-behavioral pain management program should include a re-evaluation of the patients' beliefs and use of self-management (coping) strategies before deciding on further treatment options.
PAIN, 2007
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European Journal of Pain, 2013
Background: The non-motor symptoms of Parkinson's disease (PD), pain, depression, anxiety and sle... more Background: The non-motor symptoms of Parkinson's disease (PD), pain, depression, anxiety and sleep disturbances are highly prevalent in persons with PD and have a profound impact on their quality of life (QOL). Catastrophizing is a negative coping style known to influence individuals' ability to cope with their medical symptoms and contributes to negative health-related outcomes, yet, it has not been studied in persons with PD. Objective: The objectives of this study were to measure catastrophizing in PD and explore its role as a mediator of the relationship between non-motor symptoms and QOL. Methods: One-hundred and three individuals diagnosed with PD completed questionnaires regarding pain catastrophizing, QOL and non-motor symptoms: pain, depression, anxiety and sleep disturbances. Results: More than half of the sample exhibited high levels of pain, anxiety and sleep disturbances. Catastrophizing was significantly correlated with QOL and with all of the non-motor symptoms. Catastrophizing mediated the relationship between all of non-motor symptoms and QOL as well as the relationship between age and QOL. Conclusions: Negative psychologic coping, specifically catastrophizing, has an important role in determining how destructive non-motor symptoms can be on the QOL of persons with PD. This is the first study to measure catastrophizing in this population and demonstrate its negative impact on QOL. Our findings emphasize the need to identify persons at risk for poor QOL and referrer them to appropriate psychological care. Evidence based interventions that target catastrophizing should be tested for their efficacy in persons with PD.
BMC Public Health, 2008
Background The present study aimed at assessing the psychometric properties of psychosocial deter... more Background The present study aimed at assessing the psychometric properties of psychosocial determinants of physical activity-related measures in Iranian adolescent girls. Methods Several measures of psychosocial determinants of physical activity were translated from English into Persian using the back-translation technique. These translated measures were administered to 512 ninth and tenth-grade Iranian high school students. Results The results of a series of factor analysis showed that the self-efficacy scale contained a single factor, the social support scale contained two factors: family support and friend support, the physical activity 'pros & cons' scale contained two factors: physical activity pros scale and physical activity cons scale, the change strategies scale contained a single factor, the environment scale also contained a single factor. Chronbach's alphas, mean inter-item correlations and test-retest coefficients showed that these solutions were reliable. ...
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JUSTIFICATIVA E OBJETIVOS: Diversos estudos apontam que não existe uma relação direta entre fisio... more JUSTIFICATIVA E OBJETIVOS: Diversos estudos apontam que não existe uma relação direta entre fisiopatologia e intensidade da dor e níveis de incapacidade. Dado os aspectos multidimensionais da dor é necessário ampliar a compreensão desse processo para além da fisiopatologia da dor, o que contribuiu para o desenvolvimento de diversas medidas de incapacidade. O objetivo deste estudo foi acessar as propriedades psicométricas do Questionário de Incapacidade Roland Morris (QIRM), e testar sua validade e confiabilidade na população brasileira com dor crônica. MÉTODO: Estudo de corte transversal utilizando estatística descritiva e inferencial, análise de correlação, teste t e ANOVA. Os dados apresentados são de 311 participantes que compõem a amostra final. A análise da confiabilidade foi feita usando cálculos de fidedignidade segundo o método de split-half e consistência interna. A validade foi Validação do Questionário de Incapacidade Roland Morris para dor em geral *
Scandinavian Journal of Pain, Nov 30, 2019
Background and aims: The purpose of this study was to (a) develop and (b) conduct exploratory fac... more Background and aims: The purpose of this study was to (a) develop and (b) conduct exploratory factor analysis on a novel self-report instrument for symptoms associated with altered central pain processing. Methods: We first developed a 25-item questionnaire based on previous literature identifying symptoms and behaviours that may reflect altered spinal and supraspinal pain processing. We then administered this questionnaire to 183 people with chronic pain (n = 99) and healthy individuals (n = 84). Exploratory factor analysis was conducted to identify the factor structure of the questionnaire. Results: Our results support a two-factor solution for the 25-item questionnaire that accounted for 57.2% of the total variance of responses in people with and without chronic pain. Factor one (11 items) included items related to alterations in sensation of pain, while factor two (seven items) included items associated with emotional and fatigue symptoms. Seven items showed weak factor loadings and were eliminated. Reliability was excellent, while both factors showed strong correlations with previouslyvalidated self-report Instruments: (pain catastrophising, mood, vigilance, pain self-efficacy) and conditioned pain modulation, providing evidence for their validity. Conclusions: We have developed a questionnaire containing two factors that appear to be related to two different symptom clusters, one of which is specifically related to pain and one of which contains other health-related symptoms related to mood and fatigue. These factors show excellent internal consistency and validity. This questionnaire may be a quick, easy and reliable instrument to assess central pain processing in clinical settings.
Current Opinion in Psychiatry, Sep 1, 2014
To explores the potential role of psychological treatments for older people who are affected by c... more To explores the potential role of psychological treatments for older people who are affected by chronic pain. It is now widely recognized that chronic pain is a highly prevalent health problem among older people, and guidelines have evolved to assist with the assessment and management of chronic pain. However, despite the fact that psychological treatments have been shown to be effective for a range of other conditions such as depression and anxiety, there is a relative paucity of studies focused on pain management. Although more evidence is needed, the trend from existing studies indicates that older people find psychological treatments for chronic pain to be relevant, acceptable in content, and beneficial in reducing distress and disability. Particular challenges arise for the delivery of psychological interventions to people with pain and cognitive impairment associated with dementia. There is a growing interest in this population and a good deal of research has focused on the assessment of pain, but with a small number of exceptions, almost no research activity as yet in developing psychological treatments for people with pain and dementia. We conclude that there is sufficient evidence that psychological interventions are efficacious for older people with chronic pain. We propose a number of areas for research focus over the next 10 years that will help to consolidate our knowledge and to explore new avenues for the psychological management of chronic pain in older people.
iews on the association between chronic pain conditions and depression have a long history in bot... more iews on the association between chronic pain conditions and depression have a long history in both the pain and psychiatric literature. These ideas have included pain being an antecedent to depression, depression being a consequence of chronic pain,
Pain, 2019
Normative data for chronic pain questionnaires are essential to the interpretation of aggregate s... more Normative data for chronic pain questionnaires are essential to the interpretation of aggregate scores on these questionnaires, for both clinical trials and clinical practice. In this study, we summarised data from 13,343 heterogeneous patients on several commonly used pain questionnaires that were routinely collected from 36 pain clinics in Australia and New Zealand as part of the electronic Persistent Pain Outcomes Collaboration (ePPOC) including the Brief Pain Inventory (BPI); the Depression Anxiety and Stress Scales (DASS); the Pain Self-Efficacy Questionnaire (PSEQ); and the Pain Catastrophizing Scale (PCS). The data are presented as summarised normative data, broken down by demographic (age, sex, work status, etc) and pain site/medical variables. The mean BPI severity score was 6.4 (moderate-severe), and mean interference score was 7.0. The mean DASS depression score was 20.2 (moderate-severe), mean DASS anxiety was 14.0 (moderate), and mean DASS stress was 21.0 (moderate). Th...
Spinal Cord, 2007
Cross-sectional study with repeated measurements. Objectives: To examine the patient's perspectiv... more Cross-sectional study with repeated measurements. Objectives: To examine the patient's perspective of the impact of spinal cord injury (SCI) on physical, cognitive, emotional function, and quality of life (QOL). Setting: Australia. Methods: A sample of 63 patients with SCI, 32 of whom had recent injuries, and 31 with established injuries were administered the Ruff Neurobehavioral Inventory to examine patients' subjective evaluation of pre-and post-injury functioning. Current happiness levels were also evaluated using the Subjective Happiness Scale. A follow up assessment was performed 6 months later to examine changes over time. Results: A significant difference was found between perception of pre-and postmorbid function on composite Cognitive (t ¼ 5.99, df ¼ 62, Po0.001), Physical (t ¼ 11.56, df ¼ 62, Po0.001), and QOL (t ¼ 7.16, df ¼ 62, Po0.001) scales and on several of the Emotional subscales including anxiety, paranoia and suspicion, and substance abuse (Po0.001). A series of hierarchical regression analyses indicate that post-SCI pain was a significant predictor of: cognitive (R 2 ¼ 0.20, Po0.001); emotional (R 2 ¼ 0.13, Po0.004); and of QOL (R 2 ¼ 0.22, Po0.001) functioning. With the exception of a decrease in happiness (Po0.01), there were no significant changes in any measures over the 6 month time period. Conclusions: There are significant changes in patients' perceptions of physical and cognitive functioning, and of QOL before and after SCI and some aspects of emotional functioning. Pain has a significant adverse effect on functioning. Happiness decreased slightly in the 6 months between surveys.
European Journal of Pain, 2013
BackgroundBehavioural exposure methods can reduce pain‐avoidance behaviours, but outcomes vary. O... more BackgroundBehavioural exposure methods can reduce pain‐avoidance behaviours, but outcomes vary. One possible explanation is that patients employ cognitive (experiential) avoidance during behavioural exposure. If so, reducing cognitive avoidance during behavioural exposure should help. One option is interoceptive exposure (IE), which involves sustained exposure (via attention) to pain sensations. In order to test if IE could improve outcomes from behavioural exposure, this study with mixed chronic pain patients compared outcomes from a cognitive behavioural therapy (CBT) pain management programme incorporating either IE or distraction from pain.MethodsOne hundred forty chronic pain patients were randomly assigned to CBT + IE or CBT + distraction. Outcome measures included pain, disability, depression and medication. Measures reflecting degree of threat of pain were also employed (catastrophizing, fear‐avoidance, pain self‐efficacy and pain acceptance). An intention‐to‐treat approach,...
The Journal of Pain, Feb 1, 2013
Health-related research suggests the belief in a just world can act as a personal resource that p... more Health-related research suggests the belief in a just world can act as a personal resource that protects against the adverse effects of pain and illness. However, currently, little is known about how this belief, particularly in relation to one's own life, might influence pain. Consistent with the suggestions of previous research, the present study undertook a secondary data analysis to investigate pain catastrophizing as a mediator of the relationship between the personal just world belief and chronic pain outcomes in a sample of chronic pain support group attendees. Partially supporting the hypotheses, catastrophizing was negatively correlated with the personal just world belief and mediated the relationship between this belief and pain and disability, but not distress. Suggestions for future research and intervention development are made.
Research on the role of acceptance in adjustment to persisting pain has been facilitated by the d... more Research on the role of acceptance in adjustment to persisting pain has been facilitated by the development of the Chronic Pain Acceptance Questionnaire (CPAQ). However, to date the CPAQ has been used to explore acceptance of pain without taking into account the likely contribution of other cognitive variables that have been shown to influence adjustment to persisting pain. This study examined the role of pain acceptance, as measured by the CPAQ, in accounting for adjustment to pain when controlling for the effects of other cognitive variables. The results indicated that while the Activity engagement subscale of the CPAQ was predictive of depression severity, neither of the CPAQ’s two subscales was predictive of pain severity or physical disability. These findings differ from some reported previously and they suggest that the CPAQ, by itself, may not be sufficient to explain the processes of acceptance of pain and, hence, adjustment to pain. The findings also indicate that the Pain ...
Behaviour Research and Therapy, 1997
The psychometric properties of the Depression Anxiety Stress Scales (DASS) were evaluated in two ... more The psychometric properties of the Depression Anxiety Stress Scales (DASS) were evaluated in two studies using large clinical samples (N = 437 and N = 241). In Study 1, the three scales comprising the DASS were shown to have excellent internal consistency and temporal stability. An exploratory factor analysis (principal components extraction with varimax rotation) yielded a solution that was highly consistent with the factor structure previously found in nonclinical samples. Between-groups comparisons indicated that the DASS distinguished various anxiety and mood disorder groups in the predicted direction. In Study 2, the conceptual and empirical latent structure of the DASS was upheld by findings from confirmatory factor analysis. Correlations between the DASS and other questionnaire and clinical rating measures of anxiety, depression, and negative affect demonstrated the convergent and discriminant validity of the scales. In addition to supporting the psychometric properties of the DASS in clinical anxiety and mood disorders samples, the results are discussed in the context of current conceptualizations of the distinctive and overlapping features of anxiety and depression.
Background: Regular physical activity contributes positively to physical and psychological health... more Background: Regular physical activity contributes positively to physical and psychological health. In the present study, the stages of change of physical activity and the total physical Aims: The aim of this study was to investigate the proportion of adolescent girls in each stages of change and the causative factors associated with physical activity such as the related social support and self efficacy in a sample of the high school students. Methods: In this study, Social Cognitive Theory (SCT) and the Transtheorical Model (TTM) guided instrument development. The data regarding the demographics, psychosocial determinants of physical activity, stage of change and physical activity was gathered by questionnaires. Several measures of psychosocial determinants of physical activity were translated from English into Persian using the back-translation technique. These translated measures were administered to 512 ninth and tenth-grade Iranian high school students for factor analysis. Resul...
Pain, 2019
Recommendations regarding the use of Opioid Analgesics in patients with chronic Non-Cancer Pain P... more Recommendations regarding the use of Opioid Analgesics in patients with chronic Non-Cancer Pain PURPOSE The Faculty of Pain Medicine (FPM) recognises the lack of definitive evidence supporting the long-term effectiveness of opioid analgesics in people experiencing chronic non-cancer pain (CNCP) and the substantial evidence of potential harm. This document outlines the current position of the FPM regarding opioid use in CNCP. It is anticipated that this position will evolve as the evidence base develops. CURRENT EVIDENCE The efficacy of opioid therapy is supported by strong evidence from randomised controlled trials in acute pain [1] and from systematic reviews in cancer pain [2,3], palliative care [4] and opioid dependency/addiction [5]. In CNCP systematic reviews report modest short term analgesic benefit [6,7]. However the duration of the RCTs reviewed (up to 4 months) was too short to adequately inform the long term role of opioid treatment in CNCP.
Pain, 2017
This study compares the outcomes, from pretreatment to 1-year follow-up, of an outpatient, CBT-ba... more This study compares the outcomes, from pretreatment to 1-year follow-up, of an outpatient, CBT-based pain self-management program (PSM) that included exercises, pain education, and pain coping strategies, with a control condition (exercise-attention control, EAC) that included exercises and a control for the attention of the treatment team. We previously reported short-term results (to 1-month follow-up) from the same study. This new paper considers the important issue of maintenance of treatment-related gains. The participants (n = 141) were a heterogeneous sample of ambulant, community-dwelling older adult patients with chronic pain (mean age: 73.90 [6.5] years [range: 65-87 years]). The long-term results indicate the pain self-management program group achieved and maintained significantly better results than the exercise-attention control group on the primary outcome, pain-related disability, as well as on usual pain, pain distress, depression, and fear-avoidance beliefs. The mea...
Pain Practice, 2006
Research suggests that a combination of a somatic and a psychosocial intervention for chronic non... more Research suggests that a combination of a somatic and a psychosocial intervention for chronic noncancer pain should be associated with a better outcome than either alone. This study presents data on a series of 31 patients who underwent sequential treatment with an implantable device targeting pain relief and a cognitivebehavioral pain management program that targeted improved function. A combination of treatments was used as there was a suboptimal response to the initial treatment. There were improvements in a range of outcomes at a longterm follow-up. Significant improvements were found in disability, affective distress, self-efficacy, and catastrophizing, but not in average pain severity. Further analyses failed to demonstrate an order effect. These results support the view that combined somatic and psychosocial interventions can achieve better outcomes than either alone in selected chronic pain patients. This approach requires that psychological assessment is essential before the use of an implantable device. This may not only improve patient selection, but also identify psychosocial factors that may be modified to enhance the effectiveness of invasive interventions. In addition, consideration for an implantable device following a suboptimal response to treatment in a cognitive-behavioral pain management program should include a re-evaluation of the patients' beliefs and use of self-management (coping) strategies before deciding on further treatment options.
PAIN, 2007
RefDoc Refdoc est un service / is powered by. ...
European Journal of Pain, 2013
Background: The non-motor symptoms of Parkinson's disease (PD), pain, depression, anxiety and sle... more Background: The non-motor symptoms of Parkinson's disease (PD), pain, depression, anxiety and sleep disturbances are highly prevalent in persons with PD and have a profound impact on their quality of life (QOL). Catastrophizing is a negative coping style known to influence individuals' ability to cope with their medical symptoms and contributes to negative health-related outcomes, yet, it has not been studied in persons with PD. Objective: The objectives of this study were to measure catastrophizing in PD and explore its role as a mediator of the relationship between non-motor symptoms and QOL. Methods: One-hundred and three individuals diagnosed with PD completed questionnaires regarding pain catastrophizing, QOL and non-motor symptoms: pain, depression, anxiety and sleep disturbances. Results: More than half of the sample exhibited high levels of pain, anxiety and sleep disturbances. Catastrophizing was significantly correlated with QOL and with all of the non-motor symptoms. Catastrophizing mediated the relationship between all of non-motor symptoms and QOL as well as the relationship between age and QOL. Conclusions: Negative psychologic coping, specifically catastrophizing, has an important role in determining how destructive non-motor symptoms can be on the QOL of persons with PD. This is the first study to measure catastrophizing in this population and demonstrate its negative impact on QOL. Our findings emphasize the need to identify persons at risk for poor QOL and referrer them to appropriate psychological care. Evidence based interventions that target catastrophizing should be tested for their efficacy in persons with PD.
BMC Public Health, 2008
Background The present study aimed at assessing the psychometric properties of psychosocial deter... more Background The present study aimed at assessing the psychometric properties of psychosocial determinants of physical activity-related measures in Iranian adolescent girls. Methods Several measures of psychosocial determinants of physical activity were translated from English into Persian using the back-translation technique. These translated measures were administered to 512 ninth and tenth-grade Iranian high school students. Results The results of a series of factor analysis showed that the self-efficacy scale contained a single factor, the social support scale contained two factors: family support and friend support, the physical activity 'pros & cons' scale contained two factors: physical activity pros scale and physical activity cons scale, the change strategies scale contained a single factor, the environment scale also contained a single factor. Chronbach's alphas, mean inter-item correlations and test-retest coefficients showed that these solutions were reliable. ...
files.bvs.br
JUSTIFICATIVA E OBJETIVOS: Diversos estudos apontam que não existe uma relação direta entre fisio... more JUSTIFICATIVA E OBJETIVOS: Diversos estudos apontam que não existe uma relação direta entre fisiopatologia e intensidade da dor e níveis de incapacidade. Dado os aspectos multidimensionais da dor é necessário ampliar a compreensão desse processo para além da fisiopatologia da dor, o que contribuiu para o desenvolvimento de diversas medidas de incapacidade. O objetivo deste estudo foi acessar as propriedades psicométricas do Questionário de Incapacidade Roland Morris (QIRM), e testar sua validade e confiabilidade na população brasileira com dor crônica. MÉTODO: Estudo de corte transversal utilizando estatística descritiva e inferencial, análise de correlação, teste t e ANOVA. Os dados apresentados são de 311 participantes que compõem a amostra final. A análise da confiabilidade foi feita usando cálculos de fidedignidade segundo o método de split-half e consistência interna. A validade foi Validação do Questionário de Incapacidade Roland Morris para dor em geral *