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Biomedical subjects

F J Keefe

Publications and source records attributed to F J Keefe.

At least 55 records · Page 3Linked to original sources
PubMed1990

A comparison of coping strategies in chronic pain patients in different age groups.

This study examined the effects of age on the frequency of use and perceived effectiveness of coping strategies in patients having chronic pain. Subjects were chronic pain patients in four age groups (young, middle, older, and geriatric). All subjects completed the Coping Strategies Questionnaire, which measures the use and perceived effectiveness of a variety of cognitive and behavioral coping strategies in controlling and decreasing pain. Subjects also completed measures of pain, depression, and psychological distress. Data analysis revealed that there were no significant age differences in either the use or perceived effectiveness of pain coping strategies. Correlational analyses based on data combined from the different age groups suggested that, while certain pain coping strategies appear to be adaptive (e.g., coping self-statements), other coping strategies appear to be maladaptive (e.g., catastrophizing, diverting attention, increasing behavioral activities). Patients who rated their ability to decrease pain as relatively high, reported lower levels of depression and pain. These findings are consistent with a contextual perspective on coping which postulates that few, if any, age differences in coping are to be expected when individuals are coping with a similar life event.

Adaptation, Psychological↗
PubMed1989

Sickle cell disease pain: relation of coping strategies to adjustment.

This study examines pain coping strategies in a relatively neglected pain population, sickle cell disease (SCD) patients. Seventy-nine patients diagnosed with SCD were given a structured interview to assess pain, activity level, and health care use during painful episodes. Patients also completed the SCL-90-R as an index of psychological distress and the Coping Strategies Questionnaire. Regression analyses controlled for age, sex, and disease severity measures. Results indicated that the coping strategies factors were important predictors of pain and adjustment. Individuals high on Negative Thinking and Passive Adherence had more severe pain, were less active and more distressed, and used more health care services. Individuals high on Coping Attempts were more active during painful episodes.

Adaptation, Psychological↗
PubMed1987

The assessment of pain in rheumatoid arthritis. Validity of a behavioral observation method.

It is difficult to objectively measure pain in rheumatoid arthritis (RA). A behavioral observation method for the assessment of RA pain has been developed. In this study, videotapes were made of 53 RA patients while they performed standardized maneuvers. Trained raters viewed the videotapes and recorded the frequencies of 7 pain behaviors. Clinical and laboratory measures of rheumatoid disease activity also were recorded for each patient. Rheumatology fellows viewed 20 randomly chosen video recordings of the patients and made global estimates of the intensity and unpleasantness of pain. Significant positive correlations were found between total pain behavior scores and measures of disease activity. The fellows' estimates of the intensity and unpleasantness of the patients' pain also were significantly and positively correlated with the total pain behavior scores. The behavioral observation method may be useful in the assessment of RA pain and may be included as an objective outcome measure in clinical trials with RA patients.

Adult↗
PubMed1987

The relation of stress and family environment to atopic dermatitis symptoms in children.

The relation of stress and family environment to symptom severity in children with atopic dermatitis (AD) was examined. Forty-four children with severe AD and their families completed questionnaires measuring life events, chronic everyday problems and family environment. Measures of symptom severity were collected during medical evaluation and included an estimate of body surface affected by AD, course of AD symptoms over time, medication usage, and scratching intensity during the day and night. Regression analyses indicated that the measures of stress and family environment were important predictors of symptom severity even after controlling for demographic and medical status variables such as age and serum IgE level. These results have important implications for health care professionals working with children who have AD. Future research directions in the area of stress and AD are discussed.

Adolescent↗
PubMed1987

Coping with cancer.

This study examined coping strategies in head and neck cancer patients. The relationships between the use of approach and avoidant coping strategies and the physical and emotional distress of 35 newly diagnosed head and neck cancer patients during the early stages of cancer treatment were evaluated. Patients were categorized on the basis of coping strategy at the time of diagnosis and then evaluated twice during the course of their treatment at four- to six-week intervals. Cancer patients who predominantly employed either approach or avoidant strategies had lower initial levels of emotional distress than patients who did not use either of these strategies. Although symptoms of distress decreased in patients using approach or avoidance, symptoms increased for those patients who did not use these strategies. The level of stress for this cancer population is highest at the point of confirmed diagnosis and recedes during the course of treatment. The theoretical and clinical implications of these findings are discussed.

Adaptation, Psychological↗
PubMed1987

The assessment of pain in rheumatoid arthritis: disease differentiation and temporal stability of a behavioral observation method.

An observation method for the assessment of pain behaviors in patients with rheumatoid arthritis (RA) has been developed. We investigated the extent to which the frequencies of pain behaviors differentiated patients with RA and patients with chronic low back pain from depressed and nondepressed, pain free, control subjects. The reliability of the pain behavior frequencies of patients with RA across 2 observation sessions also was determined. Total pain behavior scores clearly differentiated patients with RA and low back pain from depressed and nondepressed, pain free, control subjects. Pain behavior observed in patients with RA showed a high degree of stability over time. The results of our study suggest that the behavioral observation method will prove useful in the assessment of RA pain in clinical and research settings.

Adult↗
PubMed1986

Self-report of depressive symptoms in low back pain patients.

Two studies designed to examine the self-report of depressive symptoms in low back pain patients are presented. Symptoms of depression were assessed with the Beck Depression Inventory. In the first study, a sample (N = 134) of patients who presented for neurosurgical evaluation were evaluated. In the second study, a subgroup of patients found to have lumbar disc protrusion were compared to a subgroup with few or no positive physical findings at the time of physical examination. If the cut-off scores recommended by Beck were used, patients in both studies would be classified as mildly depressed. Both studies found that patients were significantly more likely to report somatic than cognitive symptoms of depression. Patients with multiple physical findings or a disc abnormality at the time of operation were not found to be more likely to report somatic symptoms than patients with few physical findings.

Adult↗
PubMed1986

Illness behavior as a predictor of pain and overt behavior patterns in chronic low back pain patients.

This study examined the relationship of self-reports of illness behavior to pain ratings and overt pain behaviors in a group of chronic low back pain patients referred for pain management. Illness behavior was measured using the Pilowsky and Spence Illness Behavior Questionnaire (IBQ) and pain behavior was recorded using a standard behavioral observation method. Multivariate regression analyses revealed that scores on the IBQ were highly predictive of a variety of indices of pain and pain behavior. These results were obtained even after controlling for significant demographic and medical status variables. The findings of this study support the utility of the IBQ in the behavioral assessment of chronic pain patients.

Back Pain↗
PubMed1984

Behavioral and psychological approaches to the assessment and treatment of chronic pain.

This article briefly reviews behavioral and psychologic methods currently used to assess chronic pain patients. Assessment techniques designed to measure pain report, overt behavior patterns, and psychologic functioning are described. A variety of behavioral treatment procedures for chronic pain are also discussed. Treatment techniques can be grouped into two major categories: operant conditioning methods, and self-management strategies. Critical needs for future research are briefly identified.

Adaptation, Psychological↗
PubMed1984

The Clinical Specialty Unit: the use of the psychiatry inpatient unit to treat chronic pain syndromes.

The authors describe a 15-bed psychiatry inpatient unit, the Clinical Specialty Unit (CSU), designed to treat patients with chronic pain syndromes. They argue that the use of psychiatry beds for this purpose is appropriate, given the nature of the chronic pain disorder, but is not without its liabilities. The administrative structure and roles of the multidisciplinary team are described.

Chronic Disease↗
PubMed1984

Long-term use of narcotic analgesics in chronic pain.

The use of narcotic analgesics have been avoided by clinicians in patients with chronic pain syndromes. Uncertainty as to the etiological cause of chronic pain, development of addiction and habituation and associated psychological and behavioral symptoms found in chronic pain states which are not amenable to narcotic medications are the major reasons narcotics are not prescribed. This communication describes the long-term use of low dose narcotic analgesics as a treatment component of a comprehensive pain management program and addresses the questions of whether or not narcotic efficacy is maintained in long-term use, improvement of patients' function is continued and side effects develop as a result of this treatment.

Adolescent↗