These things will not eliminate pain, but they will help you to better manage pain, and help you to become more active and more involved in life. With knowledge and experimentation, you are the best judge of which self-management tools and techniques are best for you. The responsibility for managing your chronic pain day-to-day rests with you, not anybody else.
Many people can be of help to you — your family and friends, your health care team. But, in the end, the responsibility for self-management is yours. Acknowledging that overcoming chronic pain is a daily challenge, this book provides you with the self-management tools to help you meet that challenge. Skip to Content Welcome to Bull Publishing!
Health books that help people take care of themselves and their families. The correlations in Table 4 are computed between ad hoc scores obtained by averaging the items of a factor. This explains the differences in relative sizes and values of the correlations. The support factor had low factorial correlation coefficients 0. Such a relation could not be identified with this type of analysis because the three sections were analyzed separately.
Item composition of the Inventaire multidimensionel de la douleur , section 1, with factor loading. Interfactor correlations from the American, German-, Dutch-and French-speaking samples. For the 19 items taken together unifactorial structure , the alpha was computed to be 0.
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Note that a high Cronbach alpha coefficient does not indicate that items are one-dimensional. It is an indication of the reliability of the factor in its entirety. In the five-factor solution for the pain interference factor, the alpha was 0. Although the last two factors had lower internal consistencies, the alpha coefficients were still acceptable. The oblique solution without crossloadings should be preferred for its simplicity. Table 2 presents the factor loadings from the confirmatory FA for the oblique model without crossloadings, the closest model to that reported in the literature 2 , 11 , The factorial correlation coefficients between the factors were moderate to high range of absolute values between 0.
Questioning the distinction between the solicitous responses and distractive responses factors in this version could have been statistically justified because the factorial correlation coefficients exceeded 0. Moreover, qualitative analysis of the items allows for the observation of an important theoretical and clinical distinction between these two factors that would be lost if they were grouped together. Item composition of the Inventaire multidimensionnel de la douleur , section 2, with factor loading.
The Cronbach alpha coefficients were moderate to high. For the unidimensional solution with 12 items, the alpha was computed to be 0. For the negative responses factor, the alpha was 0. The fit indexes suggested that the three-factor oblique models with or without crossloadings were acceptable. In this case, it is customary to choose the most parsimonious one — the model without crossloadings. The factorial correlation coefficients between the factors were relatively high range of absolute values between 0. Another series of confirmatory FAs was therefore conducted to check the fit of a three-factor oblique model.
Table 3 shows the confirmatory FA factor loadings for the oblique three-factor model. Item composition of the Inventaire multidimensionnel de la douleur , section 3, with factor loading. For the 18 items together, the alpha was computed to be 0. For the household chores factor, the alpha was 0. For the outdoor work factor, the alpha was 0. When grouping the last two factors to create the leisure activities factor, as described in the literature 2 , 12 , 18 , better results were obtained with the new factor, with alpha at 0.
The fit of the four oblique models four factors with or without crossloading, three factors with or without crossloadings compared in this section was satisfactory. The simplest model the one with three oblique factors and without crossloadings should be considered.
Moreover, the internal consistency of the three-factor solution was better than each of the two original factors with which it was composed. The standardized RMR was 0. Because it is common to use unifactorial scoring in this section for cluster purposes 19 , the unifactorial model was evaluated. In fact, the unifactorial model had reasonable fit and internal consistency. The communalities of all 18 items were above 0. The ease of use of a unifactorial solution could therefore be justified.
Un régime de vie sain pour surmonter la douleur chronique
For section 3 of the IMD, no items were removed and a three-factor solution was suggested. To compare the correlation matrix among the various versions of the MPI, the correlation coefficients for the American, German and Dutch versions given in the article by Lousberg et al 2 were compared with the correlation coefficients obtained with the IMD. Table 4 gives the Pearson correlation coefficients computed among the scores on each factor.
The score for each factor was obtained by averaging the item scores according to the original factor structure; ie, no items were omitted or used more than once. If there were missing values for one or more items in the factor, that item was omitted and the score was computed with the rest of the items.
There was no case in this dataset in which the number of missing item values exceeded the number of valid answers for each factor. Visual assessment of the coefficients in Table 4 reveals a definite similarity between the intercorrelations of the different instruments. Similar to Lousberg et al 2 , high intercorrelations for the factor pairs pain severity — pain interference, life control — affective distress, and support — solicitous responses were observed, as well as between the solicitous responses and distractive responses factors. In addition, intercorrelations higher than those observed with the other instruments for the following intercorrelations were noted: Generally speaking, the IMD has good psychometric properties.
However, the statistical analyses pinpointed items or factors requiring discussion. In the assessment of the experience of pain section 1 , the five-factor structure is maintained. It is hardly surprising to find a strong correlation between the pain interference and pain severity factors.
For most people living with chronic pain, subjectively speaking, the severity of the pain explains their incapacity or the extent to which the pain interferes with certain activities. However, because certain individuals report a high degree of pain severity but a low degree of pain interference or vice versa, we have to distinguish between pain and disability Moreover, a number of studies 21 have reported clinical results using a five-factor factorial structure, with versions of the MPI in different languages.
Cluster profiling proposed by Rudy et al 22 is widely used 6 , 23 — 27 and implements the five factors in section 1 to categorize individuals based on a biopsychosocial perspective.
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Because replicating these findings would be of interest, retaining a five-factor structure seems meaningful because it conforms with what is reported in the literature on the MPI. It should be mentioned that this cluster profiling dysfunctional, interpersonally distressed, adaptive coper is widely used with the MPI and could be used with the IMD, using French-language sample results for the clustering. Specifically, the results for section 1 of the IMD indicated that an item did not fit well in any of the specific underlying factors for this population.
The statistical analyses show that this item was not strongly linked to the other two items in the factor.
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Both of these items, compared with the others in the pain interference factor, allude to relationship difficulties marriage, family and friendship relationships associated with the issue of pain. It may be that, for the respondents in this sample living with persistent pain, poor quality of interpersonal relations is more closely associated with affective distress. This is not surprising given that in a chronic pain condition, the poor quality of interpersonal relations is often an indicator of psychological difficulties It should be noted that structural differences can be associated with intercultural differences.
Some societies may be focused more on the individual well-being in a family unit, whereas others favour the well-being of the family unit over the well-being of each individual. Therefore, the perception of the feelings of others as well as the actual feelings of significant others will differ.
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In that matter, the pain interference factor has good statistical properties and changing the items would not be appropriate. Weak correlations were observed between the support factor and the other factors in section 1. Support clearly stands apart from the other factors in this section, which make no reference to other people. Moreover, in the results of the confirmatory FAs on the whole questionnaire of the original English version of the MPI, Deisinger et al 17 reported that the support factor related more to section 2 of the MPI than to section 1.
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However, the authors of the original tool appear to have deliberately incorporated an interpersonal component in section 1, which evaluates the experience of pain. Whether an individual feels supported by their significant other is an integral part of the experience of pain. Although the support scale has much to do with section 2, it is important that it remains in section 1 to do justice to the conjugal problems that sometimes stem from living with chronic pain.
This item does not seem to be representative of distractive responses elicited by people living with chronic pain because the vast majority of participants in our sample Moreover, whether this item is sufficiently relevant to contemporary life is open to discussion; other translations have also left it out 2 , As mentioned in the Results section, statistically speaking, it was justified to question the distinction between the distractive responses and the solicitous responses factors in section 2 because we obtained a factorial correlation coefficient of 0.
Although these factors were similar to each other in alluding to positive responses by the spouse compared with negative responses , they are clinically and theoretically very different Clinicians and researchers in the field of pain management need to distinguish between what encourages people to resume their normal activities and what encourages sedentariness in pain management. Creating a single positive responses factor would eliminate the distinction between encouraging the resumption of usual activities and encouraging passivity in managing pain.
For section 3, we suggest using a three-factor structure that combines the social activities and activities away from home scales into a single leisure activities scale.
This factorial grouping obtains better results, statistically speaking, and is theoretically very sound; grouping all leisure activities together is also reasonable. This grouping is found in other translations of the MPI 2 , On the other hand, from a clinical standpoint, such an item clearly alludes to the concept evaluated by the new scale leisure activities ; we therefore suggest retaining all items in section 3 of the IMD.
In addition, statistical findings show that using a factor that evaluates the general activity level, including all the items in section 3, is also acceptable. Many studies 30 , 31 use a general activity factor comprising all of the items rather than the subscales in this section. The profiling of persons living with chronic pain, therefore, takes into account only the general activity factor 19 , which provides some insight into the overall degree of activity.
Certain factors were found to correlate more closely than observed with the original tool and other translations 2. As expected, we noted a strong inverse correlation between the general activity and pain interference factors — a high degree of pain interference was associated with a low activity level. Analysis of pain interference items revealed a reference to various areas of activity family, social and work that can be adversely affected by pain.
The affective distress — general activity link is interesting; as expected, withdrawal from usual activities is directly associated with an increase in emotional problems. The solicitous responses — affective distress link is intriguing because receiving attentive responses from the spouse is associated with greater emotional distress in respondents. This may mean that the more an individual living with chronic pain perceives their significant other as being solicitous and attentive regarding their condition, the more they feel they are a burden to their spouse and immediate circle. Enabled Amazon Best Sellers Rank: Share your thoughts with other customers.
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