Partners' Experiences of Chronic Pain: A Qualitative Evidence Synthesis.

This systematic review of qualitative studies synthesised evidence on the experience chronic pain from the perspective of romantic partners. Medline via Ovid, Embase via Ovid, CINAHL via EBSCO, APA PsycInfo via Ovid, Scopus, and Web of Science databases were searched. Studies exploring the impact of chronic pain from partners' perspectives using qualitative data collection methods were eligible for inclusion. Thematic synthesis was conducted, and confidence in the review findings was assessed using GRADE CERQual criteria. A total of 198 participants were represented from 15 primary studies. Four interconnected analytical themes were developed: 'life is different', 'internal conflict between two worlds', 'togetherness vs separateness', and 'coping in the longer term'. Out of 27 review findings, 9 were assessed as high confidence, 12 as moderate confidence, 4 as low confidence, and 2 as very low confidence. Socially isolated partners, those in strained relationships, and partners who continually sacrificed their own needs were more likely to experience distressing emotions. Greater recognition of partners' needs is needed within pain management services.

Associations Between Adult Attachment, Pain Catastrophizing, Psychological Inflexibility and Disability in Adults with Chronic Pain.

We investigated whether attachment insecurity (anxiety and avoidance) moderated the association between satisfaction with social support and pain disability. We also tested whether the relationship between insecure attachment and pain disability was serially mediated by pain catastrophising and psychological inflexibility. A large-scale cross-sectional correlational design was employed. Data were collected using an online survey. Correlation, serial mediation and moderated regression analyses were used. Data from 894 people with self-reported chronic pain were analysed. Based on correlations, age, depression, and pain intensity were included as covariates. No direct effect of satisfaction with social support on pain disability was observed in the moderation. Attachment anxiety was positively associated with pain disability (b = 1.20, t = 2.03, p < .05), but attachment avoidance was not (b = -0.08, t = -0.13, p = .90). The association between attachment anxiety and pain disability was partially mediated by pain catastrophising and psychological inflexibility (c = 1.21, t = 4.37, p < .001; a1db2 = 0.33, t = 5.15, p < .001). The relationship between attachment avoidance and pain disability was fully mediated by pain catastrophising and psychological inflexibility (c = 0.15, t = 0.54, p = .59; a1db2 = 0.13, t = 2.24, p < .05). This study provided initial evidence that pain catastrophising and psychological inflexibility mediate the association between insecure attachment and pain disability. Follow-up research using a longitudinal design is recommended.

Psychological predictors of seasonal influenza vaccination uptake among adults with a high-risk physical health condition: a systematic review.

OBJECTIVE: This review tested the use of psychological theories for predicting seasonal influenza vaccination behaviour among adults with a health condition (for which the vaccine is clinically indicated). METHODS: Ovid (1946-August 2018), Embase (1974-August 2018), CINAHL (1958-August 2018) and PSYCInfo (1986-August 2018) databases were searched. Studies drawing upon a psychosocial or psychological theory to explain seasonal influenza vaccination behaviour among adults with a high-risk health condition were eligible for inclusion. Papers were systematically extracted by title, abstract and full text. Quantitative and qualitative studies were included, and all papers were quality assessed. RESULTS: A total of 4840 papers were identified after removal of duplicates. Twelve papers were retained in the narrative synthesis. Studies were conducted across a range of high-risk condition populations and most (83.3%) were cross-sectional. The Health Belief Model (HBM), the model of Psychological Flexibility, The Health Action Process Approach and House's Framework of Social Support were applied. Ten out of 12 papers (83.3%) drew on the HBM. CONCLUSION: There was evidence of an association between HBM perceived benefits, perceived barriers and vaccination behaviour, although there were inconsistencies across studies. This review highlighted the need for further research, particularly prospective studies of high methodological quality.

Health promotion in adults with Down's syndrome: Experiences of caregivers.

Individuals with Down's syndrome rely on caregivers to support lifestyle behaviour change. It is therefore important to understand how caregivers put health recommendations into practice. Through conducting semi-structured interviews, the present study sought to understand the facilitators and barriers that caregivers faced when implementing health promotion advice. Five interviews were conducted with paid support staff and four with family carers of individuals attending a specialist multidisciplinary Down's syndrome health promotion screening clinic. Three main themes emerged in their accounts, including active promotion of weight management by caregivers, benefits of working practices such as record keeping and communication channels and the importance of having access to social care services and recreational activities. These findings have important implications for professionals working in specialised healthcare settings who may be able to tailor communication and services to better meet the needs of individuals with Down's syndrome and their caregivers.

Predicting and understanding seasonal influenza vaccination behaviour among forensic mental health inpatients.

OBJECTIVES: This study aimed to identify demographic and psychological predictors of seasonal influenza vaccination intentions and behaviour among a sample of inpatients in a secure forensic mental health service. It also sought to explore patient experiences about being offered the vaccine. DESIGN: This study used a mixed-methods design. The quantitative element employed a prospective design using a questionnaire; both cross-sectional and prospective findings are reported. For the qualitative part of the study, semi-structured interviews were conducted and analysed using Interpretative Phenomenological Analysis (IPA). MAIN OUTCOME MEASURES: Seasonal influenza vaccination intentions and behaviour. RESULTS: Past behaviour, vaccine knowledge and cues to action were predictors of vaccination intention (N = 57). Cues to action remained as the only statistical predictor of vaccination behaviour (N = 55). Nine interviews were conducted with four vaccinated and five unvaccinated participants. Three main themes were formed in the IPA analysis; these were 'Managing Decisional Conflict', 'Interaction with Immune Function' and 'The Role of Others'. CONCLUSIONS: The results highlighted the integral role of health professionals in shaping patient's vaccination behaviour within a secure mental health setting. Recommendations for vaccination promotion strategies were offered.