Abstract
Background. Pain is common after stroke and Spinal Cord Injury (SCI) and it affects the sufferer’s ability to engage in important activities. Little is known about the associations between psychosocial factors and pain outcomes in this clinical group or their associations with future pain outcomes.
Objectives. To explore associations between demographics, psychosocial factors and pain intensity and pain interference on admission to rehabilitation, and after six months.
Methods. A longitudinal, prospective cohort study with participants with stroke and SCI completing questionnaires for pain intensity and interference (Brief Pain Inventory), mental health (Five Item Mental Health Index of the 36-Item Short Form Health Survey), pain coping strategies (Coping Strategies Questionnaire 1-Item version) and pain attitudes and beliefs (14 item version of the Survey of Pain Attitudes) within two weeks of admission to inpatient rehabilitation. After six months, participants completed measures of pain intensity and pain interference only.
Results. In all 32 participants completed the questionnaires at baseline and 18 after six months. A number of associations between psychosocial factors and pain outcomes were identified at baseline; (a) greater belief that harm would result from activity was associated with higher pain intensity and pain interference; (b) greater belief that there was a medical cure for their pain was associated with less pain interference; (c) greater belief that others should be solicitous to pain behaviours was associated with more pain interference and (d) poorer mental health was associated with greater pain interference. Additionally, poorer baseline mental health score was associated with greater pain intensity and pain interference after six months, and a stronger belief in a medical cure for pain at baseline was associated with less pain intensity and pain interference after six months.
Conclusions. In the current study a participants’ mental health and certain beliefs were associated with pain early after both stroke and SCI. At follow up participants’ mental health and beliefs were associated with six month pain outcomes. These findings highlight the importance of psychosocial factors in both of these clinical conditions. Adopting a biopsychosocial approach may improve these patients’ outcomes.