title: Relationship between pain and post-traumatic stress symptoms in palliative care.
abstract: BACKGROUND
  Previous research suggests that patients receiving palliative care may simultaneously experience poorly managed pain and post-traumatic stress disorder (PTSD)-related symptoms as a result of their deteriorating health.
  
  
  OBJECTIVE
  To: 1) examine predictors of PTSD-related symptoms in patients requiring palliative care; 2) assess whether anxiety, depression, pain catastrophizing, and pain anxiety mediate the relationship between pain interference and PTSD-related symptoms; and 3) evaluate the impact of these variables on pain interference and PTSD-related symptoms.
  
  
  METHODS
  One hundred patients receiving palliative care at one of two palliative care sites in London, ON, Canada, completed the PTSD Checklist-Civilian version (PCL-C), the Hospital Anxiety and Depression Scale (HADS), the Pain Catastrophizing Scale (PCS), the Brief Pain Inventory-Short Form (BPI-SF), and the Pain Anxiety Symptoms Scale-20 (PASS-20). Hierarchical multiple regressions were used to examine HADS-Anxiety, HADS-Depression, PCS and PASS-20 scores as predictors of PCL-C scores; and mediation analyses were used to test the effect of HADS-Anxiety, HADS-Depression, PCS, and PASS-20 on the relationship between BPI-SF interference and PCL-C. Mediators that significantly affected this relationship in the individual mediator models were entered into a multiple mediator model.
  
  
  RESULTS
  Only pain anxiety and pain catastrophizing emerged as significant mediators of the relationship between pain interference and PTSD-related symptoms. After being entered in a multiple mediator model, pain anxiety emerged as the strongest mediator.
  
  
  CONCLUSIONS
  The findings of the present study reveal that pain and PTSD-related symptoms are important concerns in palliative care, and that pain must be addressed to best meet the needs of this population.
authors.affiliation: Parkwood Hospital Operational Stress Injury Clinic, London, Ontario, Canada. maya.roth@sjhc.london.on.ca
authors.forename: Maya L
authors.initials: ML
authors.lastname: Roth
authors.forename: Kate
authors.initials: K
authors.lastname: St Cyr
authors.forename: Ingrid
authors.initials: I
authors.lastname: Harle
authors.forename: Joel D
authors.initials: JD
authors.lastname: Katz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058443:Catastrophization / Q000175:diagnosis / Q000453:epidemiology*; D015984:Causality; D015897:Comorbidity; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology* / Q000451:nursing*; D009864:Ontario / Q000453:epidemiology; D010146:Pain / Q000175:diagnosis / Q000453:epidemiology*; D059408:Pain Management / Q000706:statistics & numerical data*; D010166:Palliative Care / Q000706:statistics & numerical data*; D011379:Prognosis; D012307:Risk Factors; D013223:Statistics as Topic; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology*; D055815:Young Adult