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- The meaning making model applied to community-dwelling adults with chronic painPublication . Ferreira-Valente, Maria Alexandra; Fontes, Fernando; Pais-Ribeiro, José; Jensen, MarkPurpose: Chronic pain is a multidimensional experience that is influenced by biological, psychological, social, and spiritual factors. The Meaning Making Model is a recent cognitive behavioral model that has been developed to understand how psychosocial factors influence adjustment to stressful events, such as having a chronic illness. This qualitative study aims to understand the potential utility of this model for understanding the role of meaning making in adjustment to chronic pain. Materials and Methods: Eighteen community-dwelling adults with chronic low back pain or chronic pain due to osteoarthritis participated in four focus groups. Participants were asked open-ended questions about their pain experience, pain-related beliefs, meaning of pain, and the perceived association between pain and their meaning in life and sense of purpose. Data were submitted to thematic analysis and the identified themes were considered in light of the Meaning Making Model. Results: Three overarching themes emerged, each of which included two themes. The first overarching theme – “appraised meaning of pain” – included the themes “causal attributions” and “primary appraisals.” The second – “meaning making processes” – included the themes “assimilation” and “accommodation.” The third – “meanings made” – included the themes “pain as an opportunity” and “acceptance.” Conclusion: The key themes that emerged as individuals with chronic pain discussed pain and its impact are consistent with those that would be hypothesized as important from the Meaning Making Model, providing preliminary support for the utility of this model in the context of chronic pain. People with chronic pain appear to appraise pain in terms of its cause, controllability, threat, loss, or challenge. When a discrepancy between the appraised meaning of pain and one’s global meaning emerged, participants engaged in meaning making processes (accommodation and assimilation), resulting in meanings made, such as a reappraised meaning of pain, perceptions of growth, and acceptance.
- Effects of COVID-19 social distancing measures in individuals with chronic pain living in Spain in the late stages of the lockdownPublication . Miró, Jordi; Sánchez-Rodríguez, Elisabet; Ferreira-Valente, Maria Alexandra; Pais Brito, José Luis; Ciaramella, AntonellaSocial distancing measures during the lockdown have had a negative impact on chronic pain patients’ function. Research, however, has only focused on the early stages of the first lockdowns. The aim of this study was to improve the understanding of the effects of COVID-19 social distancing measures on individuals with chronic pain living in Spain during the late stages of the lockdown. A group of 361 adults with pain participated in this study. They responded to an online survey and provided information on sociodemographic issues, pain, fatigue, perceived health, and quality of life. The data showed that most participants suffered moderate to severe pain and interferences with pain treatment and an increase in pain intensity during the lockdown. Most participants also informed us that fatigue had worsened during the lockdown (62%). Importantly, females with lower monthly family income and lower education have been found to be associated with greater levels of pain and fatigue. Despite this, participants perceived themselves as having good health and good quality of life. The findings from this study can be used to inform policy and specific responses for future COVID-19 waves and future pandemics where social distancing measures must be implemented.
- Are prayer-based Interventions effective pain management options? A systematic review and meta-analysis of randomized controlled trialsPublication . Jarego, Margarida; Ferreira-Valente, Maria Alexandra; Queiroz-Garcia, Inês; Day, Melissa A.; Pais-Ribeiro, José; Costa, Rui M.; Pimenta, Filipa; Jensen, MarkThis review examined the efects of private and communal participatory prayer on pain. Nine databases were searched. Six randomized controlled trials were included. For private prayer, medium to large efects emerged for 67% to 69% of betweengroup comparisons; participants in the prayer condition reported lower pain intensity (0.59
- Immediate effects of hypnosis, mindfulness meditation, and prayer on cold pressor outcomes: A four-arm parallel experimental studyPublication . Ferreira-Valente, Maria Alexandra; Van Dyke, Benjamin; Day, Melissa A; Teotónio do Carmo, Catarina; P. Ribeiro, J.L.; Pimenta, Filipa; Costa, Rui M; Jensen, MarkPurpose: Previous research supports the usefulness of hypnosis (HYP), mindfulness meditation (MM), and prayer as pain self -management strategies in adults with chronic pain. However, their effects on acute pain have been less researched, and no previous head-to-head study compared the immediate effects of these three approaches on pain-related outcomes. This study compared the immediate effects of HYP, MM, and Christian prayer (CP) on pain intensity, pain tolerance, and stress as assessed by heart rate variability (HRV). Participants and Methods: A total of 232 healthy adults were randomly assigned to, and completed, a single 20-minute session of MM, SH, CP, or an attention control (CN), and underwent two cycles (one pre- and one post-intervention) of Cold Pressor Arm Wrap (CPAW). Sessions were audio-delivered. Participants responded to pre- and post-intervention pain intensity measurements. Pain tolerance (sec) was assessed during the CPAW cycles. HRV was assessed at baseline, and at pre- and post-intervention CPAW cycles. The study protocol was pre-registered at the ClinicalTrials.gov registry (NCT04491630). Results: Small within-group decreases in pain intensity and small increases in pain tolerance were found for HYP and MM from the pre- to the post-intervention. Small within-group improvements in the LH/HF ratio were also found for HYP. The exploratory between-group pairwise comparisons revealed a medium effect size effects of HYP on pain tolerance relative to the control condition. The effects of CP were positive, but small and not statistically significant. Only small to medium, though non-significant, Time × Group interaction effects were found. Conclusion: Study results suggest that single short-term HYP and MM sessions, but not biblical-based CP, may be useful for acute pain self-management, with HYP being the slightly superior option. Future research should compare the effects of different types of prayer and examine the predictors and moderators of these pain approaches’ effects on pain-related outcomes
- The role of perfectionistic self-presentation in pediatric painPublication . Sánchez-Rodríguez, Elisabet; Ferreira-Valente, Maria Alexandra; Pathak, Anupa; Solé, Ester; Sharma, Saurab; Jensen, Mark P.; Miró Canals, JordiThis study sought to better understand the associations between perfectionistic self-presentation and measures of pain intensity, pain catastrophizing, pain interference, and fatigue in children and adolescents with pain. In the study, 218 adolescents responded to measures of perfectionistic self-presentation (i.e., perfectionistic self-promotion, nondisplay of imperfection and nondisclosure of imperfection), pain intensity, pain catastrophizing, pain interference, and fatigue. Four hierarchical regression analyses and three mediation analyses were conducted. Our results showed that perfectionistic self-promotion was significantly and independently associated with pain intensity and that nondisplay of imperfection was significantly and independently associated with pain catastrophizing, pain interference, and fatigue. Nondisclosure of imperfection was not significantly associated with any criterion variable. Pain catastrophizing mediated the association between both perfectionistic self-presentation and nondisplay imperfection and pain interference but not between nondisclosure of imperfection and pain interference. The findings provide new information about the role of perfectionistic self-presentation in children and adolescents' experience of pain. These findings, if replicated, support perfectionism as a potential target of pain treatment in young people.
- The portuguese 35-item survey of pain attitudes applied to portuguese women with endometriosisPublication . Valente, Maria Alexandra Ferreira; Garcia, Inês Queiroz; Rosa, Ana Marques; Pereira, Anabela; Ribeiro, José Luis Pais; Jensen, Mark P.Background and aims endometriosis is a gynecologic recurring persistent condition affecting from 8% to 15% of premenopausal women worldwide. About 80% of women with endometriosis have at least one form of chronic pain - a multidimensional experience influenced by a number of psychosocial factors, including pain-related beliefs. The Survey of Pain Attitudes is the most commonly used measure of pain-related beliefs. This study aims to evaluate the psychometric properties of a Portuguese version of a brief version of the SOPA (the SOPA-35) in a sample of Portuguese women with Endometriosis. Methods A sample of 199 Portuguese women with Endometriosis provided demographic and pain history information, and completed a Portuguese version of the SOPA-35 and measures of pain intensity, disability, and psychological function. Analyses were performed to evaluate the factor structure of the Portuguese SOPA-35 items as well as the internal consistency, composite reliability, convergent validity, and concurrent validity of the scale scores. Results Confirmatory factor analysis supported a six-factor solution for a 19-item version of the Portuguese version of the Survey of Pain Attitudes (SOPA-19-P). The six scales evidenced marginal to good reliability (Cronbach's alphas: between 0.60 and 0.84; composite reliability: between 0.61 and 0.84). Four scales evidenced acceptable to good convergent validity (AVE: between 0.51 and 0.63). The findings also supported the concurrent validity of the SOPA-19-P. Conclusions The results support the use of the Portuguese SOPA-19-P for research and clinical purposes with Portuguese women in chronic pain due to endometriosis. Future research is warranted to further develop a European Portuguese version of SOPA. Implications The findings provide psychometric information about the SOPA-19-P. The results are helpful to researchers wishing to study the role of pain-related beliefs and their association with adjustment and treatment outcomes in women with chronic pain due to endometriosis.
- A biopsychosocial perspective of mental health risk in Italy during phase two of the COVID-19 lockdownPublication . Rossi, Martina; Jarego, Margarida; Ferreira-Valente, Maria Alexandra; Miró, Jordi; Sánchez-Rodríguez, Elisabet; Ciaramella, AntonellaAbstract: Introduction: Research into the first phase of the COVID-19 lockdown in Italy showed an association with an increased susceptibility to adverse mental health (MH) in the general population. We investigated in the same population the correlations between the various demographic, socioeconomic, biological/clinical history and psychological dimensions and MH in the second, “opening-up”, phase of the lockdown. Methods: An anonymous online survey collected data from 26 May to 4 July 2020 on demographic, socioeconomic, perceived risk, general health and quality of life appraisals, worry, interference in life, life satisfaction, perceived happiness and MH by using Mental Health Inventory-5 (MHI-5). Results: Of the 300 participants, only 195 responded to MH questions. Older age was positively associated with better MH (r=.15), as was education (r=.19). A negative correlation with MH, with medium-high effect size, was found with quality of life (r=.40) and health (r=.34) appraisals, and the factors “worry about sustenance” (r=.23) and “interference with life” (r=.32). A positive correlation, with strong effect size, was found between MH and life satisfaction (r=.53) and perception of happiness (r=.64). Discussion: During phase two of the lockdown, rather the real impact of COVID-19 restrictions on employment or economic resources, it was worry about finances that was associated with worse MH. Mental distress was associated with the loss of some positive psychological factors. From a homeostatic and biopsychosocial perspective of MH, life satisfaction and perceived happiness represent important mental resources for counteracting the effects of lockdown on MH.
- Prayer as a pain intervention: protocol of a systematic review of randomised controlled trialsPublication . Ferreira-Valente, Maria Alexandra; Jarego, Margarida; Queiroz-Garcia, Inês; Pimenta, Filipa; Costa, Rui Miguel; Day, Melissa A; Pais Brito, José Luis; Jensen, MarkBackground Pain is a universal experience and the most common reason for seeking healthcare. Inadequate pain management negatively impacts numerous aspects of patient health. Multidisciplinary treatment programmes, including psychosocial interventions, are more useful for pain management than purely biomedical treatment alone. Recently, researchers showed increasing interest in understanding the role of spirituality/religiosity and spiritual/religious practices on pain experience, with engagement in religious practices, such as prayer, showing to positively impact pain experience in religious individuals. This systematic review will seek to summarise and integrate the existing findings from randomised controlled trials assessing the effects of prayer and prayerbased interventions on pain experience. Methods The systematic review procedures and its report will follow the Preferred Reporting Items for Systematic reviews and Meta-Analyses statement. Electronic searches in nine databases (Web of Science Core Collection, MEDLINE, SCIELO Citation Index, PubMed, Cochrane Central Register of Controlled Clinical Trial, PsycINFO, Scopus, LILACS and Open-SIGLE) will be performed to identify randomised controlled trials of prayer-based interventions. Two independent researchers will assess studies for inclusion and extract data from each paper. Risk of bias assessment will be assessed independently by two reviewers based on the Consolidated Standards of Reporting Trials statement. Qualitative synthesis of the body of research will be conducted using a narrative summary synthesis method. Meta-analysis will be limited to studies reporting on the same primary outcome. Formal searches are planned to start in June 2021. The final report is anticipated to be completed by September 2021. Discussion Findings will be useful to (1) understand the condition of our knowledge in this field and (2) provide evidence for prayer effectiveness in reducing pain intensity and pain-related stress and increasing pain tolerance in adults experiencing acute or chronic pain.
- Correction to: Does religiosity/spirituality play a role in function, pain‑related beliefs, and coping in patients with chronic pain? A systematic reviewPublication . Valente, Maria Alexandra Ferreira; Sharma, Saurab; Torres, Sandra; Smothers, Zachary; Ribeiro, José Luis Pais; Abbott, J. Haxby; Jensen, MarkThis systematic review examined the extent to which measures of religiosity/spirituality (R/S): (1) are associated with pain, function, pain-related beliefs (beliefs), coping responses, and catastrophizing in people with chronic pain; and (2) moderate the association between beliefs, coping and catastrophizing, and pain and function. Experimental and observational studies examining at least one of these research questions in adults with chronic pain were eligible. Two reviewers independently performed eligibility screening, data extraction, and quality assessment. Twenty studies were included. Most studies focused on the association between R/S and pain or function. When significant associations emerged, those between R/S and psychological function were weak to strong and positive; those between religious/ spiritual well-being and pain and physical dysfunction were negative, but weak. Few studies examined the associations between R/S and beliefs/coping/catastrophizing; none examined the moderation role of R/S. The findings suggest that R/S is associated with pain and psychological function in people with chronic pain, and that viewing oneself as being “spiritual,” regardless of religion, may contribute to positive psychological adjustment. More research is needed to determine the reliability of this finding. PROSPERO registry CRD42018088803.
- Mental, physical and socio-economic status of adults living in spain during the late stages of the state of emergency caused by COVID-19Publication . Sánchez-Rodríguez, Elisabet; Ferreira-Valente, Maria Alexandra; Pimenta, Filipa; Ciaramella, Antonella; Miró, JordiResearch has shown that the confinement measures implemented to curb the spread of COVID-19 can have negative effects on people’s lives at multiple levels. The objective of this cross-sectional study was to better understand the mental, physical, and socio-economic status of adults living in Spain during the late stages of the state of emergency caused by COVID-19. Five hundred and forty-four individuals responded to an online survey between 3 June and 30 July 2020. They were asked to report data about their mental and physical health, financial situation, and satisfaction with the information received about the pandemic. Means, percentages, t-test, ANOVAs, and logistic regressions were computed. A third of the participants reported symptoms of anxiety, depression, and stress, and worries about their health and the future. Participants also described mild levels of fatigue and pain during lockdown (66%), and a reduction in household income (39%). Respondents that were female, younger, single, and with lower levels of education reported experiencing a greater impact of the COVID-19 pandemic. The data showed that the negative effects of lockdown were present in the late stages of the state of emergency. The findings can be used to contribute to the development of programs to prevent or mitigate the negative impact of confinement measures.