Daily pain coping among patients with chronic temporomandibular disorder pain: an electronic diary study.
OBJECTIVE
To describe patients' daily coping with the pain of chronic temporomandibular disorders (TMD), the conservative treatment received, and the self-care strategies used, and to examine the relationships between these strategies and daily pain intensity, activity interference, and jaw use limitations.


METHODS
TMD clinic patients (n = 137, 88% women) completed electronic diary measures of pain, interference, jaw use limitations, and use of 20 strategies 3 times daily for 2 weeks.


RESULTS
Reliability and validity were demonstrated for 4 scales of related coping items: cognitive coping, relaxation, activity reduction, and emotional support. Average scores were higher on the relaxation and activity reduction scales than on the cognitive coping and emotional support scales. Among the coping items not included in the scales, "did something to try to reduce pain" (direct action) was endorsed most frequently (reported in a median of 74% of interviews). Heat, cold, and seeking spiritual support were used least (< or = 5%). At times of increased pain, patients were more likely to use almost all types of strategies. Pain intensity was associated strongly with concurrent activity interference and jaw use limitations. When the design controlled for pain intensity, activity reduction and seeking emotional support were associated positively within-subjects with interference and jaw use limitations.


CONCLUSIONS
TMD clinic patients use a variety of treatment, self-care, and coping strategies to contend with daily pain. Inquiring about a broad range of strategies might help clinicians better understand how individual patients approach pain management. Research is needed to examine whether decreasing activity reduction and emotional support coping results in improved outcomes.
Aaron
Leslie A
LA
Department of Oral Medicine, School of Dentistry, University of Washington, Seattle 98195, USA.
Turner
Judith A
JA
Mancl
Lloyd A
LA
Sawchuk
Craig N
CN
Huggins
Kimberly H
KH
Truelove
Edmond L
EL
D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D034201:Computers, Handheld; D005157:Facial Pain / Q000209:etiology / Q000523:psychology*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008409:Mastication; D008875:Middle Aged; D018710:Pain Clinics; D010147:Pain Measurement / Q000379:methods*; D012064:Relaxation Therapy; D015203:Reproducibility of Results; D012648:Self Care; D012944:Social Support; D013705:Temporomandibular Joint Disorders / Q000150:complications / Q000523:psychology*