Understanding psychosocial impact of chronic pain

Abstract

Pain is one of the major health concerns among the people who seek medical support all over the world. When a patient comes with pain due to a treatable cause and it diminish after appropriate treatment within the estimated time of cure then it is called acute pain. But if still pain remains after suggested treatment and anticipated time of cure or it exceed the time frame of 3 months then it is called chronic pain. Chronic pain is a complex construct to understand. It is not just limited in physical suffering but also have psychological and social impact on a sufferer. Literature was reviewed to explore the commonly suggested psychological and social consequences of chronic pain. This study was aimed to see the impact of pain on these psychosocial aspects among the people with chronic pain in the context of Bangladesh. A questionnaire survey design was used to conduct the study. The research questionnaire contains demographic data sheet, Mc. Gill Pain Questionnaire Short Form, a composite questionnaire regarding various social and psychological impacts, The Pain Catastrophizing Scale, Self Reporting Questionnaire, Perceived Stress Scale, Beck Hopelessness Scale, WHO Quality of Life Brief, Copping questionnaire and General Health Questionnaire. A total of 400 adult pain patients comprised the sample. Purposive sampling technique was used to recruit participants from the Department of Orthopedic and Traumatology, outdoor and Physiotherapy Center of Department of Physical Medicine and Rehabilitation and Pain Clinic under the Department of Anesthesia, Analgesia and Intensive Care Medicine of Bangabandhu Sheikh Mujib Medical University (BSMMU). Descriptive statistics, correlational analysis and multivariate multiple regression analysis was used for data analysis.

Result revealed a very high prevalence of psychiatric morbidity (86%) and distress (92%) among the individual suffering from chronic pain. A large portion (90.3%) of respondents reported that they had experienced moderate level of stress. One third (35.5%) of the respondents reported that they had poor quality of life. This study also found pain has significant positive correlation with depression and anxiety, psychiatric morbidity, stress, hopelessness and pain catastrophizing. Level of activity showed poor but significant negative correlation with pain. Pain showed significant impact on depression, magnification of catastrophizing, rumination of catastrophizing, hopelessness of catastrophizing, problem focused copping, emotion focused copping and stress. But pain showed no significant impact on functional impairment. Age of chronic pain patient has significant impacts on functional difficulty, psychiatric morbidity, hopelessness and two domain of quality of life namely physical and environmental quality of life. Intensity of pain, duration of pain and age of the patient can explain significant proportion of variance (34.7%) in catastrophizing by hopeless thinking. By providing a vivid picture of psychological and social impact of pain, the findings reiterated the need for considering integration of biological, psychological and social aspect of intervention to reduce suffering of chronic pain patients.