Prediction of persistent post-operative pain: Pain-specific psychological variables compared with acute post-operative pain and general psychological variables
Horn-Hofmann C, Scheel J, Dimova V, Parthum A, Carbon R, Grießinger N, Sittl R, Lautenbacher S (2018)
Publication Type: Journal article
Publication year: 2018
Journal
Book Volume: 22
Pages Range: 191-202
Journal Issue: 1
DOI: 10.1002/ejp.1115
Abstract
BACKGROUND: Psychological variables and acute post-operative pain are of proven relevance for the prediction of persistent post-operative pain. We aimed at investigating whether pain-specific psychological variables like pain catastrophizing add to the predictive power of acute pain and more general psychological variables like depression. METHODS: In all, 104 young male patients undergoing thoracic surgery for pectus excavatum correction were studied on the pre-operative day (T0) and 1 week (T1) and 3 months (T2) after surgery. They provided self-report ratings (pain-related: Pain Catastrophizing Scale, Pain Anxiety Symptoms Scale = PASS, Pain Vigilance and Awareness Questionnaire = PVAQ; general psychological: Screening for Somatoform Symptoms, State-Anxiety Inventory-X1, Center for Epidemiologic Studies Depression Scale = CES-D). Additional predictors (T1) as well as criterion variables (T2) were pain intensity (Numerical Rating Scale) and pain disability (Pain Disability Index). RESULTS: Three months after surgery, 25% of the patients still reported clinically relevant pain (pain intensity ≥3) and over 50% still reported pain-related disability. Acute post-operative pain as well as general psychological variables did not allow for a significant prediction of persistent post-operative pain; in contrast, pain-related psychological variables did. The best single predictors were PASS for pain intensity and PVAQ for pain disability. CONCLUSIONS: Pain-related psychological variables derived from the fear-avoidance model contributed significantly to the prediction of persistent post-operative pain. The best possible compilation of these measures requires further research. More general psychological variables may become relevant predictors later in the medical history. SIGNIFICANCE: Our results suggest that pain-specific psychological variables such as pain anxiety and pain hypervigilance add significantly to the prediction of persistent post-operative pain and might even outperform established predictors such as acute pain and general psychological variables. Clinicians might benefit from the development of time-economic screening tools based on these variables.
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APA:
Horn-Hofmann, C., Scheel, J., Dimova, V., Parthum, A., Carbon, R., Grießinger, N.,... Lautenbacher, S. (2018). Prediction of persistent post-operative pain: Pain-specific psychological variables compared with acute post-operative pain and general psychological variables. European Journal of Pain, 22(1), 191-202. https://dx.doi.org/10.1002/ejp.1115
MLA:
Horn-Hofmann, C., et al. "Prediction of persistent post-operative pain: Pain-specific psychological variables compared with acute post-operative pain and general psychological variables." European Journal of Pain 22.1 (2018): 191-202.
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