Relationship Between Pain and Post-Traumatic Stress Symptoms in Palliative Care
Abstract
http://www.journals.elsevier.com/journal-of-pain-and-symptom-management/
0885-3924
Context. Previous research suggests that patients receiving palliative care may
simultaneously experience poorly managed pain and post-traumatic stress
disorder (PTSD)-related symptoms as a result of their deteriorating health.
Objectives. To: 1) examine predictors of PTSD-related symptoms in patients
requiring palliative care; 2) assess whether anxiety, depression, pain
catastrophizing, and pain anxiety mediate the relationship between pain
interference and PTSD-related symptoms; and 3) evaluate the impact of these
variables on pain interference and PTSD-related symptoms.
Methods. One hundred patients receiving palliative care at one of two palliative
care sites in London, ON, Canada, completed the PTSD ChecklistdCivilian
version (PCL-C), the Hospital Anxiety and Depression Scale (HADS), the Pain
Catastrophizing Scale (PCS), the Brief Pain Inventory-Short Form (BPI-SF), and
the Pain Anxiety Symptoms Scale-20 (PASS-20). Hierarchical multiple regressions
were used to examine HADS-Anxiety, HADS-Depression, PCS and PASS-20 scores
as predictors of PCL-C scores; and mediation analyses were used to test the effect
of HADS-Anxiety, HADS-Depression, PCS, and PASS-20 on the relationship
between BPI-SF interference and PCL-C. Mediators that significantly affected this
relationship in the individual mediator models were entered into a multiple
mediator model.
Results. Only pain anxiety and pain catastrophizing emerged as significant
mediators of the relationship between pain interference and PTSD-related
symptoms. After being entered in a multiple mediator model, pain anxiety
emerged as the strongest mediator.
Conclusion. The findings of the present study reveal that pain and
PTSD-related symptoms are important concerns in palliative care, and that pain
must be addressed to best meet the needs of this population.
0885-3924
Context. Previous research suggests that patients receiving palliative care may
simultaneously experience poorly managed pain and post-traumatic stress
disorder (PTSD)-related symptoms as a result of their deteriorating health.
Objectives. To: 1) examine predictors of PTSD-related symptoms in patients
requiring palliative care; 2) assess whether anxiety, depression, pain
catastrophizing, and pain anxiety mediate the relationship between pain
interference and PTSD-related symptoms; and 3) evaluate the impact of these
variables on pain interference and PTSD-related symptoms.
Methods. One hundred patients receiving palliative care at one of two palliative
care sites in London, ON, Canada, completed the PTSD ChecklistdCivilian
version (PCL-C), the Hospital Anxiety and Depression Scale (HADS), the Pain
Catastrophizing Scale (PCS), the Brief Pain Inventory-Short Form (BPI-SF), and
the Pain Anxiety Symptoms Scale-20 (PASS-20). Hierarchical multiple regressions
were used to examine HADS-Anxiety, HADS-Depression, PCS and PASS-20 scores
as predictors of PCL-C scores; and mediation analyses were used to test the effect
of HADS-Anxiety, HADS-Depression, PCS, and PASS-20 on the relationship
between BPI-SF interference and PCL-C. Mediators that significantly affected this
relationship in the individual mediator models were entered into a multiple
mediator model.
Results. Only pain anxiety and pain catastrophizing emerged as significant
mediators of the relationship between pain interference and PTSD-related
symptoms. After being entered in a multiple mediator model, pain anxiety
emerged as the strongest mediator.
Conclusion. The findings of the present study reveal that pain and
PTSD-related symptoms are important concerns in palliative care, and that pain
must be addressed to best meet the needs of this population.