Observational assessment of chronic pain patient-spouse behavioral interactions

Romano, Joan M.; Turner, Judith A.; Friedman, Larry S.; Bulcroft, Richard; Jensen, Mark P.; Hops, Hyman

doi:10.1016/s0005-7894(05)80345-4

Cited by 71 publications

(43 citation statements)

References 37 publications

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“…45 However, many other studies that assessed both variables did not report these correlations. 25,58,64,69,[71][72][73]77,85,86,96,100 Although it is unclear, it is likely that these researchers did not report the correlations because they were weak or not significant. Perceived spousal support is another marital variable that has been of particular interest to rheumatoid arthritis (RA) researchers.…”

Section: Pain Severitymentioning

confidence: 99%

“…In one case, depressive symptoms and marital satisfaction were not associated, 25 and in many instances, the relationship between marital satisfaction and depressive symptomatology was not reported. 39,60,69,73,85 The treatment literature also suggests a relationship between marital satisfaction and psychological distress. Saarijarvi et al 79,81 conducted couples therapy with ICPs and found that the treatment group reported significant decreases in psychological symptoms, whereas the control group reported increases in symptoms.…”

Section: Psychological Distressmentioning

confidence: 99%

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Chronic Pain in a Couples Context: A Review and Integration of Theoretical Models and Empirical Evidence

Leonard

Caño

Johansen

2006

The Journal of Pain

221

198

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Researchers have become increasingly interested in the social context of chronic pain conditions. The purpose of this article is to provide an integrated review of the evidence linking marital functioning with chronic pain outcomes including pain severity, physical disability, pain behaviors, and psychological distress. We first present an overview of existing models that identify an association between marital functioning and pain variables. We then review the empirical evidence for a relationship between pain variables and several marital functioning variables including marital satisfaction, spousal support, spouse responses to pain, and marital interaction. On the basis of the evidence, we present a working model of marital and pain variables, identify gaps in the literature, and offer recommendations for research and clinical work.Perspective-The authors provide a comprehensive review of the relationships between marital functioning and chronic pain variables to advance future research and help treatment providers understand marital processes in chronic pain.

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Section: Pain Severitymentioning

confidence: 99%

Section: Psychological Distressmentioning

confidence: 99%

Chronic Pain in a Couples Context: A Review and Integration of Theoretical Models and Empirical Evidence

Leonard

Caño

Johansen

2006

The Journal of Pain

221

198

View full text Add to dashboard Cite

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“…The observers coded both patient behaviors and spouse behaviors. Romano et al [21] found that patients show a much higher level of pain behavior than healthy control subjects during these tasks, and the spouses of patients having pain show a much higher level of solicitous behaviors than the spouses of healthy controls. Romano et al [22] also carefully examined sequences of patient and spouse behaviors to determine the relationship of spousal behaviors to the display of pain behavior.…”

Section: Research Applicationsmentioning

confidence: 99%

“…One of the most important and interesting directions for future research is an analysis of the social context of pain behavior. Romano et al [21,22] have studied pain behaviors that occur when chronic low-back pain patients and their spouses interact. In these studies, patients and their spouses were asked to complete a standard set of activities such as sweeping the floor, picking up and folding clothes, and making a bed.…”

Section: Research Applicationsmentioning

confidence: 99%

Current status and future direction of pain behavior observation

Keefe

1998

Current Review of Pain

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T om could tell that Mary's arthritis pain was bothering her more today. Although she didn't complain, Mary's movements were much more slow and stiff and she kept rubbing the fingers on her right hand. Because Mary's pain seemed so severe, Tom decided to cancel his plans to surprise Mary by taking her to the big college basketball game that night.Joe was eager to get back to work after his surgery and told Dr. Winter that his pain wasn't too bad and that he could handle it. Dr. Winter, however, noticed that Joe was still limping, braced himself when sitting, and grimaced when he got onto and off of the examining table. Dr. Winter increased Joe's pain medication and told him that he should not return to work for another 2 weeks.When people have pain they engage in nonverbal behaviors that communicate to others that pain is being experienced. These behaviors, called pain behaviors [1], not only serve to signal pain but can also influence the responses of significant others and health care professionals. Interestingly, as illustrated in the two cases described above, nonverbal pain behaviors are often seen as quite salient even if the person fails to report their pain or minimizes their own pain experience.Pain behaviors are overt and thus can be observed and recorded. Over the past 15 years, there has been growing interest in using pain behavior observation methods as a strategy for assessing patients with persistent pain [2,3]. The purpose of this paper is to provide an overview of the current status of pain observation methods. The paper is divided into two parts. In the first part, observation methods currently used to assess chronic pain patients are described and critically evaluated. In the second part, I highlight future directions for clinical and research applications of pain behavior observation methodologies. Pain Behavior Observation MethodsA hallmark of the behavioral approach to pain management is its emphasis on understanding and modifying pain behaviors [1]. Behaviorally oriented pain clinicians have developed and refined a number of strategies for observing pain behavior. These strategies can be grouped into two major categories: self-observation and direct observation. Self-observationIn the self-observation strategy patients can be asked to observe and record their own pain behavior. The earliest approaches to pain behavior assessment consisted of daily diaries. A good example of such diaries is a diary developed by Fordyce [1], in which patients are asked to indicate how much time each hour they spend engaging in three categories of behavior: 1) sitting, 2) standing or walking, and 3) reclining. The patient is also asked to make an Individuals who have pain engage in certain pain-related behaviors that tend to communicate their pain to others. There is growing recognition that the careful observation of such pain behaviors is an important component of a comprehensive pain assessment.This paper provides an overview of the current status of behavioral observation methods used to assess pain behavi...

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“…The observers code both patient behaviors and spouse behaviors. Romano et al [22] have found that patients show a much higher level of pain behavior than healthy control subjects during these tasks, and the spouses of patients having pain show a much higher level of solicitous behaviors than the spouses of healthy controls. Romano et al [23•] also carefully examined sequences of patient and spouse behaviors to determine the relationship of spousal behaviors to the display of pain behavior.…”

Section: Research Applicationsmentioning

confidence: 99%

Pain behavior observation: Current status and future directions

Keefe

2000

Current Review of Pain

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Individuals who have pain engage in certain pain-related behaviors that tend to communicate their pain to others. There is growing recognition that the careful observation of such pain behaviors is an important component of a comprehensive pain assessment. This article provides an overview of the current status of behavioral observation methods used to assess pain behavior. The first half of this article describes and evaluates the most commonly used pain behavior observation methods. These include self-observation methods such as activity diaries, and direct observation methods such as the use of standard behavior sampling methods and naturalistic observation methods. The second half of the article discusses several important future clinical and research applications of pain behavior observation methods. The need to develop practical, clinical methods for incorporating pain behavior observation methods into practice settings is emphasized. Important future research topics include studying the social context of pain behavior (eg, by examining how spouses respond to displays of pain behavior), examining the predictive validity of pain behavior (ie, how observed pain behaviors predict future disability and impairment), and identifying pain behavior subgroups within heterogeneous chronic pain populations. Further development and refinement of pain behavior observation methods is likely to increase our understanding of the varied ways that patients adapt to persistent pain.

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Observational assessment of chronic pain patient-spouse behavioral interactions

Cited by 71 publications

References 37 publications

Chronic Pain in a Couples Context: A Review and Integration of Theoretical Models and Empirical Evidence

Chronic Pain in a Couples Context: A Review and Integration of Theoretical Models and Empirical Evidence

Current status and future direction of pain behavior observation

Pain behavior observation: Current status and future directions

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