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Higher levels of pain readiness to change and more positive affect reduce pain reports – A weekly assessment study on arthritis patients

Strand, Elin B.a,*; Kerns, Robert D.b; Christie, Annec; Haavik-Nilsen, Kjelld; Klokkerud, Maric; Finset, Arnsteina

doi: 10.1016/j.pain.2006.08.015
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The objective of the study was to analyze the relationships between Pain Readiness to Change, weekly measures of positive and negative affect and pain over eight subsequent weeks in patients with rheumatoid arthritis (RA). Factor analysis based on data from three different samples of patients with rheumatic diseases and other chronic pain conditions suggested a three factor solution for the Norwegian version of the Pain Stages of Change questionnaire (PSOCQ) representing Precontemplation, Contemplation, and Action/Maintenance (ACT) stages from the original Transtheoretical Model. Multilevel analyses on the weekly assessed data from a sub sample of 40 patients with RA revealed that higher levels of Pain Readiness to Change represented by high ACT scores were associated with more positive affect from week to week while no association was found between Readiness to Change and weekly pain. However, there was an interaction effect between Pain Readiness to Change and weekly positive affect on weekly pain, indicating that those persons having a higher level of Readiness to Change reported less pain in weeks when they also experienced increased positive affect. This may imply that a combination of cognitive factors and positive affect is most effective in relation to pain reduction. Results encourage continued investigation of apparent interactions between chronic pain, affect, and pain self-management.

aInstitute of Basic Medical Science, Department of Behavioural Sciences in Medicine, University of Oslo, Oslo, Norway

bPsychology Service, VA Connecticut Healthcare System, Departments of Psychiatry, Neurology, and Psychology, Yale University, New Haven, CO, USA

cDepartment of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway

dVikersund Kurbad, Vikersund, Norway

*Corresponding author. Tel.: +47 22 85 10 21; fax: +47 22 85 13 00.

E-mail: e.b.strand@medisin.uio.no

Submitted February 1, 2006; revised August 3, 2006; accepted August 14, 2006.

© 2007 Lippincott Williams & Wilkins, Inc.
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