Disrupted sleep has long been associated with physical functioning and disability in chronic pain populations and recent research shows that patterns of sleep and rest can predict physical disability, independent of depression and pain levels in this group. However, it is unknown whether sleep quality may independently predict disability in this way. The aim of the present study was to examine the self-reported relationship between sleep and disability in 155 chronic pain patients attending a pain management service. The sample had an average age of 52.9 years and 69% were female with mean pain duration of 10.5 years. Disrupted sleep and rest patterns and poor sleep quality were positively correlated with depression and pain-related disability. Hierarchical regression analyses showed that sleep quality did not predict pain-related disability when depression and pain severity were taken into consideration. Separate mediation analyses of depression and pain severity revealed that both variables were important partial mediators of the relationship between sleep quality and disability. Depression was found to be a stronger mediator than pain severity. These findings highlight the important role of sleep in chronic pain suffering. However, due to the cross sectional nature of this study, the mediation pathways proposed require testing by further research adopting a prospective design. Ideally, future research should evaluate whether targeted interventions to improve sleep can reduce pain severity, depression and ultimately, pain-related disability.

Eight women with Chronic Pelvic Pain (CPP) were asked, by means of semi-structured interview, what had been helpful and unhelpful in terms of social support from their partners, families, friends, acquaintances, doctors, nurses and other women with CPP. Firstly, thematic analysis employing a pre-defined social support category system revealed that particular forms of tangible support were preferred from specific support providers but emotional and informational support was appreciated from the whole support network. Secondly, interpretative phenomenological analysis revealed three major additional themes: 'Pain and Suffering' described the trauma suffered by these patients and the anger and anxiety surrounding their experience; 'Ideal Social Support' revealed a picture of desired support consisting of enduring emotional and practical support which did not undermine individual autonomy; 'Shortfalls in Social Support' had subsidiary themes entitled 'Lack of empathy' and 'Lack of engagement'. These themes were described and discussed in relation to each other, extant research and their clinical implications.

There has been considerable interest in the application of the Stages of Change model developed by Prochaska and DiClemente. Much ha s b e e n written about the model's implications for lifestyle change interventions, and national training programmes are underway to train health care staff to provide brief stage-specific interventions. However, the r e i s , as yet, relatively little evidence comparing stage-based with non-stage-based interventions. It is argued from this review of the evidence that it is difficult to generalise from existing research t o s u p p o r t b r i e f s t a f f -t r a i n i n g a p p r o a c h e s .

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Training in cognitive therapy includes a grounding in relevant empirical research, and the development of a range of clinical skills. It is recognized that this training will need to be continually updated in line with new developments. Several postgraduate training courses in cognitive therapy or cognitive behaviour therapy exist in the United Kingdom. Such courses are expensive in terms of both direct and indirect costs. A postal survey was employed to investigate the effects of the one-year post-qualification course in cognitive therapy at the Newcastle Cognitive Therapy Centre on trainees who had attended the course. The questionnaire examined trainees’ views about the course, of their current clinical skills in cognitive therapy and their use of cognitive therapy since leaving the course. Finally, continuing professional development, on-going supervision and further training in cognitive therapy were examined.

People with chronic pain commonly complain of sleep disturbance. This study reports the characteristics of the pain and sleep of a large sample of patients with chronic pain (n=160). We compared subgroups of good sleepers with pain (n=48) and poor sleepers with pain (n=108).Poor sleepers with pain were younger, and reported more pain, pain-related disability, depression, pain-related anxiety and dysfunctional beliefs about sleep. Using simultaneous regression analysis we examined the roles of pain, dysfunctional beliefs about sleep, pain-related disability, depression, and pain-related anxiety in predicting concurrent sleep quality. The findings are relevant to the development of models of sleep disturbance co-morbid with chronic pain.3

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Teaching is an important part of the clinician's role, yet the dearth of suitable instruments creates an obstacle to its systematic evaluation. This is turn makes audit difficult and obstructs the feedback to the teacher, so diminishing learning and effectiveness. A new instrument, the Measure of Adult Styles of Teaching and Evaluation Record (MASTER) is offered as a partial solution to these associated problems. In a validity study, the ‘MASTER’ differentiated as predicted between didactic and experiential teaching methods employed to train care staff in an in‐service training programme. Inter‐rater reliability was also adequate. It is concluded that the MASTER is a sound instrument which can aid audit and the development of clinicians as teachers, but that a more substantive analysis is required before the MASTER can be considered suitable for a major evaluation.