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      Impact of Chronic Pain on Patients’ Quality of Life: A Comparative Mixed-Methods Study

      research-article
      , BPharm, MClinPharm, PhD 1 , , MSc, PhD 2 , , BSc, PhD 2
      Journal of Patient Experience
      SAGE Publications
      chronic pain, quality of life, mixed-methods, SF-36, qualitative

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          Abstract

          Background:

          Chronic pain has become a common problem within primary care and can negatively impact patients’ lives.

          Objective:

          To assess and explore the impact of chronic pain on patients’ quality of life (QoL) using quantitative and qualitative data, respectively.

          Methods:

          A convergent parallel mixed-methods design was used. Chronic pain patients were recruited from a community-based pain clinic located in the North of England. Quality of life was assessed using Short-Form 36 version 2. Quality of life data were also extracted from the Third Oxford and Lifestyles Survey and Welsh Health Survey to allow comparison of QoL of chronic pain patients with that of the general population and patients with long-term conditions. Qualitative interviews were conducted face-to-face using a semistructured topic guide. Quantitative data were analyzed using SPSS version 24 and qualitative data were analyzed thematically.

          Results:

          Seventy-nine patients participated in the quantitative phase. The mean (standard deviation) age was 46.5 (14.5). Lower back (54; 68.3%) followed by lower limb were the most common pain sites. Compared with the general population and patients with long-term conditions, chronic pain patients had significantly lower mean QoL scores across all domains of SF-36 (All P < .05). Six themes emerged from qualitative data: interference with physical functioning, interference with professional life, interference with relationships and family life, interference with social life, interference with sleep, and interference with mood.

          Conclusion:

          The multidimensional negative impact of chronic pain leads to poorer QoL among patients with chronic pain compared to the general population and patients with other long-term conditions.

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          Most cited references29

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          Grading the severity of chronic pain.

          This research develops and evaluates a simple method of grading the severity of chronic pain for use in general population surveys and studies of primary care pain patients. Measures of pain intensity, disability, persistence and recency of onset were tested for their ability to grade chronic pain severity in a longitudinal study of primary care back pain (n = 1213), headache (n = 779) and temporomandibular disorder pain (n = 397) patients. A Guttman scale analysis showed that pain intensity and disability measures formed a reliable hierarchical scale. Pain intensity measures appeared to scale the lower range of global severity while disability measures appeared to scale the upper range of global severity. Recency of onset and days in pain in the prior 6 months did not scale with pain intensity or disability. Using simple scoring rules, pain severity was graded into 4 hierarchical classes: Grade I, low disability--low intensity; Grade II, low disability--high intensity; Grade III, high disability--moderately limiting; and Grade IV, high disability--severely limiting. For each pain site, Chronic Pain Grade measured at baseline showed a highly statistically significant and monotonically increasing relationship with unemployment rate, pain-related functional limitations, depression, fair to poor self-rated health, frequent use of opioid analgesics, and frequent pain-related doctor visits both at baseline and at 1-year follow-up. Days in Pain was related to these variables, but not as strongly as Chronic Pain Grade. Recent onset cases (first onset within the prior 3 months) did not show differences in psychological and behavioral dysfunction when compared to persons with less recent onset. Using longitudinal data from a population-based study (n = 803), Chronic Pain Grade at baseline predicted the presence of pain in the prior 2 weeks. Chronic Pain Grade and pain-related functional limitations at 3-year follow-up. Grading chronic pain as a function of pain intensity and pain-related disability may be useful when a brief ordinal measure of global pain severity is required. Pain persistence, measured by days in pain in a fixed time period, provides useful additional information.
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            • Record: found
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            Are quality of life measures patient centred?

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              • Abstract: found
              • Article: not found

              Noncancer pain conditions and risk of suicide.

              There are limited data on the extent to which suicide mortality is associated with specific pain conditions.
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                Author and article information

                Journal
                J Patient Exp
                JPX
                spjpx
                Journal of Patient Experience
                SAGE Publications (Sage CA: Los Angeles, CA )
                2374-3735
                2374-3743
                05 July 2018
                June 2019
                : 6
                : 2
                : 133-141
                Affiliations
                [1 ]Leicester School of Pharmacy, De Montfort University, Leicester, United Kingdom
                [2 ]School of Healthcare, University of Leeds, Leeds, United Kingdom
                Author notes
                [*]Muhammad Abdul Hadi, Leicester School of Pharmacy, De Montfort University, Room 00.11 Hawthorne Building, The Gateway, Leicester LE1 9BH, United Kingdom. Email: muhammad.hadi@ 123456dmu.ac.uk
                Author information
                https://orcid.org/0000-0003-0108-7833
                Article
                10.1177_2374373518786013
                10.1177/2374373518786013
                6558939
                31218259
                42ae56b6-5c0d-4852-aeef-9403de0f3ccb
                © The Author(s) 2018

                This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License ( http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

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                Research Articles

                chronic pain,quality of life,mixed-methods,sf-36,qualitative

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