Mindfulness-based stress reduction training yields improvements in well-being and rates of perceived nursing errors among hospital nurses.

INTRODUCTION: This pilot study aims to further document mindfulness-based stress reduction (MBSR)'s effect on well-being while exploring its impact on errors among hospital nurses. BACKGROUND: The concept of mindfulness has been found to be highly relevant to holistic nursing practices but remains understudied and underused. Preliminary evidence suggests that MBSR can reduce stress among nurses. As stress and mental processes such as inattention are potential sources of error, MBSR may also help to improve patient safety. Reducing errors is of significant relevance in healthcare settings. DESIGN: A randomized controlled trial with a matched pair design was conducted. METHODS: Seventy Registered Nurses and licensed practical nurses were randomized to MBSR (N = 37) or a waitlist control condition (N = 33). RESULTS: Intention-to-treat ANCOVAs revealed that MBSR produced significant improvements in distress. High levels of treatment satisfaction were reported by a majority of participants. Of the nurses who reported that errors had been a problem for them (28.6%), a perceived improvement was noticed by over a third (37.5%) at 3 months post-treatment. CONCLUSION: These initial findings suggest that the benefits of MBSR may extend to nursing errors.

Self-Compassion: Evaluation of a Psychoeducational Website.

BACKGROUND: Low levels of self-compassion are associated with a number of mental health problems. Recent findings suggest that self-compassion can be significantly increased through traditional therapist led interventions such as Mindful Self-Compassion (MSC). AIMS: The goal of this study was to assess the impact of a psychoeducational website modeled on MSC on measured levels of self-compassion and two related constructs: shame and rumination. METHOD: Participants (N = 9) were recruited from a pool of university students and employees. Single case AB protocols were used. RESULTS: Analyses using the Critical Difference statistic revealed significant improvement in self-compassion and shame for the majority of participants, but limited changes in rumination. CONCLUSIONS: These preliminary findings suggest that self-compassion may be enhanced through the use of a psychoeducational website. It may be worthwhile to develop a structured internet-based treatment course for individuals who would not otherwise access traditional psychological services.

Self-Compassion: Evaluation of a Psychoeducational Website - CORRIGENDUM.

Please note that the self-compassion Website (www.self-compassion.org) and the Mindfulness Self-Compassion program (MSC) offer some similar self-compassion and guided meditation exercises, but differ in structure and content. As currently described on www.CenterforMSC.org, MSC is an 8-week empirically-supported program targeting non-clinical populations. It is offered in a group format and is not led by therapists necessarily. MSC is not considered by the authors as a form of group therapy. As such, 'resource-building course' should have been used in the original paper in lieu of 'group therapy'.

German Language Adaptation of the Headache Management Self-Efficacy Scale (HMSE-G) and Development of a New Short Form (HMSE-G-SF).

OBJECTIVE: This study aims to develop and validate a German version of French and colleagues' Headache Management Self-efficacy Scale and to construct an abbreviated form for use in behavioral headache research. Furthermore, the contribution of headache-specific self-efficacy to pain-related disability in German chronic headache sufferers was examined. BACKGROUND: Headache-specific self-efficacy refers to an individuals' confidence that they can engage in behaviors to either prevent headache episodes or to manage headache-related pain and disability. Self-efficacy beliefs have been shown repeatedly to be positively associated with psychological well-being, effective coping, and enhanced treatment outcomes. METHODS: A cross-sectional sample of 304 individuals diagnosed with either migraine, chronic tension-type headache, or a combination of 2 or more headache disorders completed the German Headache Management Self-efficacy Scale and questionnaires assessing headache activity, pain-related coping, general self-efficacy, depression, and anxiety. Responsiveness of the scale was analyzed in a longitudinal subsample of 32 inpatients undergoing headache treatment. Finally, a short form was constructed and evaluated regarding psychometric properties. RESULTS: The German Headache Management Self-efficacy Scale showed good reliability (Cronbach's α = 0.87) as did the 6-item short form (Cronbach's α = 0.72). In the longitudinal sample, both versions showed a good ability to change over time (SRM= 0.52-1.16). Chronic headache patients with higher levels of self-efficacy reported lower levels of disability (r = -0.26 to -0.31). Multiple regression analyses revealed headache intensity and headache-specific self-efficacy as strongest predictors of headache-related disability (ßself-efficacy = -0.21, ßintensity = 0.26). CONCLUSIONS: Both the 25-item version and the 6-item version appear to be valid, reliable measures of self-efficacy beliefs. These scales will allow clinicians to identify headache sufferers with low levels of headache-specific self-efficacy with the goal of enhancing this expectancy for improvement. The new short form can help accomplish this goal without adding significantly to the burden of the self-report assessment batteries used in clinical settings.

Psychometric Properties of the Arabic Version of the Pain Resilience Scale among Lebanese Adults with Chronic Musculoskeletal Pain.

Background: The Pain Resilience Scale (PRS), which measures behavioral perseverance and the ability to regulate emotions and cognition despite ongoing pain, lacks an Arabic version. Objectives: This study aimed to translate, culturally adapt, and validate an Arabic version of the Pain Resilience Scale (PRS-A) among Lebanese adults. Methods: Phase 1 involved translation and cross-cultural adaptation of the PRS into Arabic. Phase 2 examined the reliability and validity of the PRS-A. A convenience sample of 154 Lebanese adults with chronic musculoskeletal pain completed the PRS-A and self-report measures of pain catastrophizing, pain self-efficacy, pain intensity and interference, depression and anxiety, and quality of life. Results: The PRS-A yielded a two-factor structure with factor 1 representing "cognitive/affective positivity" and factor 2 representing "behavioral perseverance," accounting for 41.93% and 15.15% of the variance in pain resilience, respectively. Total PRS-A score (M = 33.20 and SD = 9.90) showed significant correlations with pain catastrophizing (M = 27.65, SD = 13.03, and r = -0.52), pain self-efficacy (median = 9.00, IQR = 4, and rho = 0.61), pain intensity (M = 4.50, SD = 2.25, and r = -0.28), pain interference (M = 4.30, SD = 2.89, and r = -0.56), physical (M = 34.95, SD = 9.52, and r = 0.34) and mental (M = 40.08, SD = 12.49, and r = 0.58) health functioning, anxiety (median = 7.00, IQR = 7, and rho = -0.57), and depression (median = 4.00, IQR = 6, and rho = -0.58). PRS-A subscale was also significantly related to all measures except pain intensity, which was correlated with cognitive/affective positivity (r = -0.33) but not behavioral perseverance (r = -0.09). Cronbach's alpha for the PRS-A was 0.87. Conclusion: The PRS-A demonstrated validity and acceptable reliability among Arab-speaking individuals with chronic musculoskeletal pain, suggesting its potential utility for assessing pain resilience within this population.

Pain resilience and catastrophizing combine to predict functional restoration program outcomes.

OBJECTIVE: Whereas decades of research have been devoted to psychological factors that confer vulnerability to disability and other negative outcomes in the face of chronic pain, recent studies have begun to emphasize psychological characteristics that contribute to enhanced adaptation and better clinical outcomes. Accordingly, the present study was conducted as a longitudinal assessment of the predictive utility of pain resilience and pain catastrophizing as indicators of clinical outcomes among patients receiving a standardized treatment for chronic pain. METHOD: Using an observational design, analyses were conducted on measures of pain resilience, pain catastrophizing, quality of life, and clinical pain administered to 149 patients upon admission and prior to discharge from an 8-week outpatient functional restoration program. Hierarchical linear regressions were conducted to predict improvement in physical and mental health quality of life and clinical pain intensity at discharge based on individual differences in admission levels of pain-related catastrophizing and resilience. RESULTS: Results of the primary analyses indicated that pain catastrophizing and pain resilience independently predicted physical and mental health quality-of-life outcomes at discharge but did not significantly predict clinical pain intensity. Specifically, higher baseline pain resilience was associated with better quality-of-life outcomes, whereas higher baseline catastrophizing was associated with poorer outcomes. CONCLUSION: This study provides additional support for the notion that pain resilience assessment may help identify those most likely to benefit from targeted efforts to bolster resilience resources during treatment. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Predicting treatment failure in the subacute injury phase using the Orebro Musculoskeletal Pain Questionnaire: an observational prospective study in a workers' compensation system.

OBJECTIVE: The goal of the present study was to examine if patient scores on a brief biopsychosocial screening questionnaire--the Orebro Musculoskeletal Pain Questionnaire (OMPQ)--could predict clinical discharge status ("fit" vs "not fit" for return to work) after a standardized 6-week physical therapy-based work conditioning program. METHODS: The OMPQ was administered to a derivation sample of 200 injured workers with soft tissue injuries before beginning treatment. A clinical cutoff score of 147 was subsequently tested in a second validation sample of 211 injured workers. RESULTS: The OMPQ was able to correctly predict the discharge status of 85% of claimants. CONCLUSIONS: These results suggest that the OMPQ can facilitate clinical decision-making through early identification of individuals likely to fail a unidisciplinary physical therapy program and who may benefit from more complete biopsychosocial treatment.

The Development and Psychometric Validation of an Arabic-Language Version of the Pain Catastrophizing Scale.

Context. The Pain Catastrophizing Scale (PCS) is the most widely used measure of pain-specific catastrophizing. Objectives. The purpose of the present study was to develop and psychometrically evaluate an Arabic-language version of the PCS. Methods. In Study 1, 150 adult chronic nonmalignant pain patients seeking treatment at a hospital setting completed the PCS-A and a number of self-report measures assessing clinical parameters of pain, symptoms of depression, and quality of life. Study 2 employed a cold pressor pain task to examine the PCS-A in a sample of 44 healthy university students. Results. Exploratory factor analyses suggested a two-factor structure. Confirmatory factor analysis comparing the 2-factor model, Sullivan's original 3-factor model, and a 1-factor model based on the total score all provided adequate fit to the data. Cronbach's alpha coefficients across all models met or exceeded accepted standards of reliability. Catastrophizing was associated with higher levels of depression and increased pain intensity and interference. Catastrophizing predicted decreased quality of life, even after controlling for the contribution of gender, employment, depression, and pain interference. PCS-A scores were positively correlated with heightened experimental pain severity and decreased pain tolerance. Conclusion. The present results provide strong support for the psychometric properties of the PCS-A.

The influence of acute anxiety on assessment of nociceptive flexion reflex thresholds in healthy young adults.

The nociceptive flexion reflex (NFR) is a polysynaptic withdrawal reflex that occurs in response to painful stimulation. In human studies, NFR responsiveness has been used as a direct measure of nociception as well as an indirect measure of supraspinal modulation of nociceptive transmission. Previous studies have suggested that anxiety may influence NFR responding, and therefore it has been recommended that anxiety be reduced by familiarizing participants with assessment methodology prior to formal NFR assessment. The present study was designed to assess the influence of anxiety on NFR threshold. Using a repeated measures design, 40 men and women completed an NFR threshold assessment twice within session one, and twice again during a second session conducted 24h later. Within each assessment session, state anxiety was measured at the beginning of the session and immediately following each NFR threshold assessment. Results indicated that although anxiety increased in response to NFR threshold assessment and was positively related to subjective pain reports, anxiety was not related to observed NFR threshold levels. These findings suggest that individual differences in anxiety do not significantly affect NFR threshold level determinations under standard testing conditions.

Treatment outcome in psychiatric inpatients: the discriminative value of self-esteem.

UNLABELLED: Self-esteem has been identified as an important clinical variable within various psychological and psychiatric conditions. Surprisingly, its prognostic and discriminative value in predicting treatment outcome has been understudied. OBJECTIVE: The current study aims to assess, in an acute psychiatric setting, the comparative role of self-esteem in predicting treatment outcome in depression, anxiety, and global symptom severity, while controlling for socio-demographic variables, pre-treatment symptom severity, and personality pathology. DESIGN: Treatment outcome was assessed with pre- and post-treatment measures. METHOD: A heterogeneous convenience sample of 63 psychiatric inpatients completed upon admission and discharge self-report measures of depression, anxiety, global symptom severity, and self-esteem. RESULTS: A significant one-way repeated-measures multivariate analysis of variance (MANOVA) followed up by analyses of variance (ANOVAs) revealed significant reductions in depression (eta2 = .72), anxiety (eta2 = .55), and overall psychological distress (eta2 = .60). Multiple regression analyses suggested that self-esteem was a significant predictor of short-term outcome in depression but not for anxiety or overall severity of psychiatric symptoms. The regression model predicting depression outcome explained 32% of the variance with only pre-treatment self-esteem contributing significantly to the prediction. CONCLUSIONS: The current study lends support to the importance of self-esteem as a pre-treatment patient variable predictive of psychiatric inpatient treatment outcome in relation with depressive symptomatology. Generalization to patient groups with specific diagnoses is limited due to the heterogeneous nature of the population sampled and the treatments provided. Implications for clinical practice and future research are discussed.

Fear of movement/(re)injury in chronic pain: a psychometric assessment of the original English version of the Tampa scale for kinesiophobia (TSK).

The Tampa scale for kinesiophobia (TSK) was developed to measure fear of movement/(re)injury in chronic pain patients. Although studies of the Dutch adaptation of the TSK have identified fear of movement/(re)injury as an important predictor of chronic pain, pain-related avoidance behaviour, and disability, surprisingly little data on the psychometric properties of the original English version of the TSK are available. The present study examined the reliability, construct validity and factor structure of the TSK in a sample of chronic pain patients (n=200) presenting for an interdisciplinary functional restoration program. Consistent with prior evaluations of the Dutch version of the TSK, the present findings indicate that the English TSK possesses a high degree of internal consistency and is positively associated with related measures of fear-avoidance beliefs, pain catastrophizing, pain-related disability and general negative affect. The TSK was not related to individual differences in physical performance testing as assessed using standardised treadmill and lifting tasks. Confirmatory factor analyses suggest that the TSK is best characterized by a three-factor trait method model that includes all 17 of the original scale items and takes into account the distinction between positively and negatively keyed items. The results of the present study provide important details regarding the psychometric properties of the original English version of the TSK and suggest that it may be unnecessary to remove the negatively keyed items in an attempt to improve scale validity.

Secondary prevention of work disability: community-based psychosocial intervention for musculoskeletal disorders.

INTRODUCTION: One objective of the present research was to examine the degree to which psychological risk factors could be reduced through participation in a community-based psychosocial intervention for work-related musculoskeletal disorders. A second objective was to examine whether psychosocial risk reduction had an effect on the probability of return to work. METHODS: Participants were 215 Workers Compensation Board claimants with work-related musculoskeletal disorders who had been absent from work for an average of approximately 7 months (M = 28.8 weeks, range = 4-100 weeks) and were referred to a community-based multidisciplinary secondary prevention program in Nova Scotia, Canada. RESULTS: In the current sample, 63.7% of participants returned to work within 4 weeks of treatment termination. The percentage reductions in targeted risk factors from pretreatment to posttreatment were as follows: catastrophizing (32%), depression (26%), fear of movement/re-injury (11%), and perceived disability (26%). Logistic regression indicated that elevated pretreatment scores on fear of movement and re-injury (OR = 0.58, 95% CI = 0.35-0.95) and pain severity (OR = 0.64, 95% CI = 0.43-0.96) were associated with a lower probability of return to work. A second logistic regression addressing the relation between risk factor reduction and return to work revealed that only reductions in pain catastrophizing (OR = 0.17, 95% CI = 0.07-0.46) were significant predictors of return to work. CONCLUSIONS: The results of the present study provide further evidence that risk factor reduction can impact positively on short term return to work outcomes. SIGNIFICANCE: Outcomes of rehabilitation programs for work disability might be improved by incorporating interventions that specifically target catastrophic thinking. Community-based models of psychosocial intervention might represent a viable approach to the management of work disability associated with musculoskeletal disorders.