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Impact of emotional distress and pain-related fear on patients with chronic pain: Subgroup analysis of patients referred to multimodal rehabilitation
Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine. Danderyd Hosp, Dept Clin Sci, Div Rehabil Med, Stockholm, Sweden.
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2017 (English)In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 49, no 4, 354-361 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: Multimodal rehabilitation programmes (MMRP) for chronic pain could be improved by determining which patients do not benefit fully. General distress and pain-related fear may explain variations in the treatment effects of MMRP.

DESIGN: Cohort study with a cross-sectional, prospective part.

PATIENTS: Chronic musculoskeletal pain patients referred to 2 hospital-based pain rehabilitation clinics.

METHODS: The cross-sectional part of this study cluster analyses patients (n = 1,218) with regard to distress and pain-related fear at first consultation in clinical pain rehabilitation and describes differences in external variables between clusters. The prospective part follows the subsample of patients (n = 260) participating in MMRP and describes outcome post-treatment.

RESULTS: Four distinct subgroups were found: (i) those with low levels of distress and pain-related fear; (ii) those with high levels of pain-related fear; (iii) those with high levels of distress; and (iv) those with high levels of distress and pain-related fear. These subgroups showed differences in demogra-phics, pain characteristics, quality of life, and acceptance, as well as the degree of MMRP participation and MMRP outcome.

CONCLUSION: Among patients with chronic pain referred to MMRP there are subgroups with different profiles of distress and pain-related fear, which are relevant to understanding the adaptation to pain and MMRP outcome. This knowledge may help us to select patients and tailor treatment for better results.

Place, publisher, year, edition, pages
2017. Vol. 49, no 4, 354-361 p.
Keyword [en]
chronic pain, rehabilitation, multidisciplinary pain clinic, fear avoidance beliefs, distress, profiles, Swedish Quality Registry for Pain Rehabilitation
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Other Medical Sciences Other Medical Sciences not elsewhere specified
Research subject
Rehabilitation Medicine
Identifiers
URN: urn:nbn:se:umu:diva-134103DOI: 10.2340/16501977-2212ISI: 000398570000009PubMedID: 28352937OAI: oai:DiVA.org:umu-134103DiVA: diva2:1091396
Available from: 2017-04-26 Created: 2017-04-26 Last updated: 2017-05-29

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Stålnacke, Britt-Marie
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CiteExportLink to record
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