title: Higher levels of pain readiness to change and more positive affect reduce pain reports--a weekly assessment study on arthritis patients.
abstract: The objective of the study was to analyze the relationships between Pain Readiness to Change, weekly measures of positive and negative affect and pain over eight subsequent weeks in patients with rheumatoid arthritis (RA). Factor analysis based on data from three different samples of patients with rheumatic diseases and other chronic pain conditions suggested a three factor solution for the Norwegian version of the Pain Stages of Change questionnaire (PSOCQ) representing Precontemplation, Contemplation, and Action/Maintenance (ACT) stages from the original Transtheoretical Model. Multilevel analyses on the weekly assessed data from a sub sample of 40 patients with RA revealed that higher levels of Pain Readiness to Change represented by high ACT scores were associated with more positive affect from week to week while no association was found between Readiness to Change and weekly pain. However, there was an interaction effect between Pain Readiness to Change and weekly positive affect on weekly pain, indicating that those persons having a higher level of Readiness to Change reported less pain in weeks when they also experienced increased positive affect. This may imply that a combination of cognitive factors and positive affect is most effective in relation to pain reduction. Results encourage continued investigation of apparent interactions between chronic pain, affect, and pain self-management.
authors.affiliation: Institute of Basic Medical Science, Department of Behavioural Sciences in Medicine, University of Oslo, Oslo, Norway Psychology Service, VA Connecticut Healthcare System, Departments of Psychiatry, Neurology, and Psychology, Yale University, New Haven, CO, USA Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway Vikersund Kurbad, Vikersund, Norway.
authors.forename: Elin B
authors.initials: EB
authors.lastname: Strand
authors.forename: Robert D
authors.initials: RD
authors.lastname: Kerns
authors.forename: Anne
authors.initials: A
authors.lastname: Christie
authors.forename: Kjell
authors.initials: K
authors.lastname: Haavik-Nilsen
authors.forename: Mari
authors.initials: M
authors.lastname: Klokkerud
authors.forename: Arnstein
authors.initials: A
authors.lastname: Finset
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000339:Affect; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy; D001294:Attitude to Health; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010146:Pain / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control* / Q000523:psychology*; D010147:Pain Measurement / Q000379:methods*; D011795:Surveys and Questionnaires