title: The complexity of the relationship between chronic pain and quality of life: a study of the general Norwegian population.
abstract: OBJECTIVE
  The aims of this paper were to evaluate the relationship between chronic pain and global quality of life (GQOL) and to explore the effect of possible confounders, mediators, and moderators such as selected demographic variables, chronic illnesses, stress-related symptoms, fatigue, and subjective health of the relationship between chronic pain and GQOL.
  
  
  METHODS
  We used a cross-sectional design, including 1,893 respondents from a population of 4,000 of Norwegian citizens, aged 19-81 years, who were randomly drawn from the National Register by Statistics Norway in November 2000 (48.5%). Pain duration of more than 3 months was categorized as having chronic pain. The Quality of Life Scale, the Fatigue Severity Scale, and the Posttraumatic Stress Scale were used as our main dependent and independent variables, respectively. A series of multiple regression analyses (GLM in SPSS) were applied using GQOL as the dependent variable, entering subsets of independent variables in a theoretically predefined sequence.
  
  
  RESULTS
  In the total model, there was no significant relationship between chronic pain and GQOL. The model explained 39% of the variance in GQOL. For direct effect sizes, stress-related symptoms were related most strongly to GQOL, followed by subjective health, fatigue, chronic illnesses, and selected demographic variables.
  
  
  CONCLUSIONS
  These findings support the assumption of a complex and indirect relationship between chronic pain and GQOL.
authors.affiliation: Institute of Nursing and Health Sciences, Medical Faculty, University of Oslo, Pb.1153 Blindern, 0316, Oslo, Norway. a.k.wahl@medisin.uio.no
authors.forename: Astrid K
authors.initials: AK
authors.lastname: Wahl
authors.forename: Tone
authors.initials: T
authors.lastname: Rustøen
authors.forename: Berit
authors.initials: B
authors.lastname: Rokne
authors.forename: Anners
authors.initials: A
authors.lastname: Lerdal
authors.forename: Øistein
authors.initials: Ø
authors.lastname: Knudsen
authors.forename: Christine
authors.initials: C
authors.lastname: Miaskowski
authors.forename: Torbjørn
authors.initials: T
authors.lastname: Moum
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005221:Fatigue; D005260:Female; D006304:Health Status; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D009664:Norway; D010146:Pain; D010147:Pain Measurement; D011594:Psychometrics; D011788:Quality of Life; D013315:Stress, Psychological; D011795:Surveys and Questionnaires; D013997:Time Factors
references.citation: Eur J Pain. 2006 May;10(4):287-333
references.pmid: 16095934
references.citation: Psychol Bull. 2007 Jul;133(4):581-624
references.pmid: 17592957
references.citation: Pain. 2004 Oct;111(3):245-252
references.pmid: 15363867
references.citation: J Pain Symptom Manage. 2005 Sep;30(3):234-42
references.pmid: 16183007
references.citation: J Consult Clin Psychol. 2001 Aug;69(4):655-62
references.pmid: 11550731
references.citation: Pain. 2000 Apr;85(3):317-332
references.pmid: 10781906
references.citation: Pain. 2008 Jul 15;137(2):276-285
references.pmid: 17937976
references.citation: Clin J Pain. 2003 Jan-Feb;19(1):48-54
references.pmid: 12514456
references.citation: Pain Pract. 2001 Jun;1(2):150-61
references.pmid: 17129291
references.citation: Pain. 2000 Feb;84(2-3):347-52
references.pmid: 10666540
references.citation: J Nurs Meas. 2004 Fall;12(2):147-59
references.pmid: 16092712
references.citation: JAMA. 1995 Jan 4;273(1):59-65
references.pmid: 7996652
references.citation: Eur J Pain. 2005 Feb;9(1):15-24
references.pmid: 15629870
references.citation: Headache. 1992 Mar;32(3):147-51
references.pmid: 1563947
references.citation: Qual Life Res. 2004 Jun;13(5):1001-9
references.pmid: 15233513
references.citation: Clin Psychol Rev. 2001 Aug;21(6):857-77
references.pmid: 11497210
references.citation: Arch Gen Psychiatry. 1998 Jul;55(7):626-32
references.pmid: 9672053
references.citation: Arch Neurol. 1989 Oct;46(10):1121-3
references.pmid: 2803071
references.citation: Spine J. 2003 Jul-Aug;3(4):270-6
references.pmid: 14589185
references.citation: Spine (Phila Pa 1976). 2006 May 1;31(10):1156-62
references.pmid: 16648753
references.citation: Health Qual Life Outcomes. 2003 Oct 23;1:60
references.pmid: 14613562
references.citation: Qual Life Res. 2004 Mar;13(2):299-310
references.pmid: 15085902
references.citation: Pain. 2001 Jan;89(2-3):127-34
references.pmid: 11166468
references.citation: Scand J Psychol. 1999 Jun;40(2):101-8
references.pmid: 10399493
references.citation: Med Care. 2008 Sep;46(9):954-62
references.pmid: 18725850
references.citation: Pain. 1997 Dec;73(3):393-400
references.pmid: 9469530
references.citation: Intern Med J. 2004 Jul;34(7):403-9
references.pmid: 15271174
references.citation: Clin J Pain. 2006 Feb;22(2):160-6
references.pmid: 16428950
references.citation: J Pain. 2009 Apr;10(4):408-15
references.pmid: 19327643
references.citation: J Psychosom Res. 2009 Feb;66(2):119-26
references.pmid: 19154854
references.citation: Health Psychol. 2008 Mar;27(2S):S136-43
references.pmid: 18377155
references.citation: Health Qual Life Outcomes. 2008 Nov 11;6:98
references.pmid: 19014459
references.citation: Eur J Pain. 2002;6(2):133-40
references.pmid: 11900473
references.citation: Lancet. 1999 Oct 9;354(9186):1248-52
references.pmid: 10520633
references.citation: Am J Ind Med. 2000 Dec;38(6):707-22
references.pmid: 11071692
references.citation: Eur J Pain. 2004 Dec;8(6):517-23
references.pmid: 15531219
references.citation: Pain. 2004 May;109(1-2):4-7
references.pmid: 15082120
references.citation: J Rheumatol. 2000 Jun;27(6):1521-5
references.pmid: 10852282
references.citation: Soc Psychiatry Psychiatr Epidemiol. 1999 Nov;34(11):570-9
references.pmid: 10651175
references.citation: Eur J Pain. 2006 Jul;10(5):423-33
references.pmid: 16054407
references.citation: Eur J Pain. 2008 Apr;12(3):339-50
references.pmid: 17855135
references.citation: Acta Anaesthesiol Scand. 2008 Jan;52(1):143-8
references.pmid: 18005378
references.citation: J Pain. 2004 Nov;5(9):483-90
references.pmid: 15556826
references.citation: Dis Colon Rectum. 2006 Sep;49(9):1362-70
references.pmid: 16741597
references.citation: Eur J Pain. 2004 Dec;8(6):555-65
references.pmid: 15531224
references.citation: J Consult Clin Psychol. 2008 Jun;76(3):397-407
references.pmid: 18540733
references.citation: Acta Psychiatr Scand Suppl. 1989;355:38-49
references.pmid: 2624133
references.citation: Acta Psychiatr Scand Suppl. 1989;355:25-37
references.pmid: 2624132
references.citation: Pain. 2008 Mar;135(1-2):142-50
references.pmid: 17611036
references.citation: J Affect Disord. 2000 Jan-Mar;57(1-3):235-9
references.pmid: 10708837
references.citation: J Pain. 2008 Jul;9(7):588-96
references.pmid: 18343728
references.citation: Pain. 2008 May;136(1-2):97-116
references.pmid: 17707589
references.citation: Pain Med. 2003 Dec;4(4):331-9
references.pmid: 14750909
references.citation: Health Qual Life Outcomes. 2005 Apr 28;3:30
references.pmid: 15860132
references.citation: Health Psychol. 2008 Mar;27(2):215-20
references.pmid: 18377140
references.citation: Am J Epidemiol. 2003 Jan 15;157(2):141-8
references.pmid: 12522021
references.citation: Scand J Caring Sci. 1998;12(4):215-22
references.pmid: 10067647
references.citation: J Pain. 2007 Aug;8(8):614-23
references.pmid: 17543586
references.citation: Scand J Public Health. 2005;33(2):123-30
references.pmid: 15823973