ABSTRACT
PURPOSE: The aim of this study was to explore acute movement-evoked postoperative pain intensity trajectories over the first 5 days after total hip arthroplasty (THA) and to examine how these pain trajectories are associated with pain-related outcomes 6 weeks and 6 months later. METHODS: A total of 150 adult patients [72 women (48.0 %); mean age 60.0 ± 9.2 (standard deviation) years] completed pain questionnaires preoperatively, several times daily postoperatively until hospital discharge, and 6 weeks and 6 months after surgery. RESULTS: Results showed that the best model had four different acute postoperative pain trajectories and a significant quadratic term. The trajectories varied in terms of initial pain intensity levels and rates of decline/increase in pain over the first 4 postoperative days. Significant predictors of pain trajectory membership were preoperative pain disability and anxiety as well as cumulative morphine consumption 24 h following surgery. Pain trajectories were significantly associated with levels of pain intensity and anxiety at 6 weeks but not at 6 months postoperatively. CONCLUSION: This study showed that during the postoperative period patients differed in terms of pain intensity profiles and that these differences were associated with outcomes for up to 6 weeks following surgery. Pain trajectories were not predictive of persistent postoperative pain status at 6 months. Nonetheless, these results highlight the importance of patient heterogeneity in acute postoperative pain and pain-related outcomes months after THA.
Subject(s)
Acute Pain/epidemiology , Anxiety/epidemiology , Arthroplasty, Replacement, Hip , Pain, Postoperative/epidemiology , Adult , Aged , Female , Humans , Longitudinal Studies , Male , Middle Aged , Morphine/administration & dosage , Pain Measurement , Postoperative Period , Surveys and QuestionnairesABSTRACT
OBJECTIVE: To develop, and provide initial validation of, a 20-item Child Pain Anxiety Symptoms Scale (CPASS), a modified version of the adult 20-item Pain Anxiety Symptoms Scale. METHODS: A community sample of children and adolescents (N = 959) aged 8-18 years completed the CPASS and measures of pain catastrophizing, anxiety sensitivity, and general anxiety. Factor structure was assessed using exploratory and confirmatory factor analyses (EFA and CFA). RESULTS: EFA yielded a one- and a three-factor solution using 17 items of the CPASS. CFA supported a hierarchical model for both a 20-item four-factor solution (based on the adult literature) and a 20-item slightly modified four-factor solution. The CPASS showed excellent internal consistency (Cronbach's alpha = .903) and good construct, discriminant, and concurrent validity. CONCLUSIONS: This study provides support for the relevance of pain anxiety in a community sample of children and adolescents and offers preliminary validity and reliability for the CPASS.
