The relationship between spouse solicitousness and pain behavior: searching for more experimental evidence.

In this study 42 chronic back pain patients participated twice in a treadmill test. During 1 of these 2 sessions, the partner was present. Walking time, pain intensity ratings, and heart rate were measured before and after the tests. From the results of previous studies it was expected that, in the presence of a relatively solicitous spouse, patients would report more pain, would have a shorter walking time, and would exert themselves less physically. Spouse solicitousness was measured in 2 ways: from the patient's perspective as well as from that of the spouse. Results based on the patient's interpretation of his/her partner's responses are not in accordance with previous findings. Results based on the spouse's view demonstrate, however, that patients with solicitous spouses do, in fact, report more pain and walk for a shorter duration in the presence of the spouse than patients with relatively non-solicitous spouses. Theoretical and practical implications are discussed.

Assessment of the components of observed chronic pain behavior: the Checklist for Interpersonal Pain Behavior (CHIP).

This article describes the development of the Checklist for Interpersonal Pain Behavior (CHIP), an observation scale which assesses overt pain behavior. The study is an extension of an earlier study in which the dimensions and components of observed chronic pain behavior were examined. A broad definition of pain behavior is chosen (interpersonal pain behavior), namely the interaction between the pain patient and his/her direct environment. The list of pain behaviors, taken from the earlier study, has been transformed into a 78-item global rating scale to be used by nurses to quantify observed pain behavior in a clinical setting. Six studies examine the factor structure and the psychometric properties of this behavioral observation method. In the first study, 6 internally reliable factors are derived using factor analytic techniques from a sample of 152 chronic pain patients. They are labeled as: 'distorted mobility,' 'verbal complaints,' 'non-verbal complaints,' 'nervousness,' 'depression' and 'day sleeping.' Internal consistency of all factors, except 'day sleeping' was excellent. The following studies show that the CHIP is sufficiently reliable and valid. After a discussion on the advantages of this observation scale, the conclusion seems justified that the CHIP is a useful tool in pain assessment that can easily be used by nurses.

Dimensions and components of observed chronic pain behavior.

This study is a replication of a study done by Turk et al. but under different conditions. It is an attempt to empirically examine the dimensions and components of overt and observable chronic pain behavior. A broader definition of pain behavior is chosen, namely the interaction between the pain patient and his or her direct environment. The results suggest that pain behavior can be characterized by 3 dimensions: withdrawal-approach, high arousal-low arousal and visible-audible. Furthermore, chronic pain behavior seems to be composed of at least 9 components: anxiety, attention seeking, verbal pain complaints, medication use, general verbal complaints, distorted posture and mobility, fatigue, insomnia, and depressive mood. More dimensions and components were discovered than in the study by Turk and his colleagues. However, they correspond with the variety of psychosocial problems associated with the chronic pain syndrome. This information seems to provide a useful basis for the development of an observational measurement technique for chronic pain.