Coping Style Influences Compliance with Multidisciplinary Pain Management - Research Paper Example

Research Critique - Pain Management - Terry C. Scott William Carey Hattiesburg , Mississippi Summer Term 2007 Summary of the Report The report on the study article ‘Coping Style Influences Compliance with Multidiciplinary Pain Management’ examined several variables such as negative emotions and aggression affecting the treatment compliance on chronic pain. Based on the results of the test, there is a strong significant link among the individual patient’s coping and/or personality styles, the treatment for his physical condition, and the end result of the treatment. Emotional distress among the patients is a factor that makes them participate less with the treatment. The choice of the patients not to participation in the treatment results to a lesser degree of treatments’ success. It is the strong patients’ strong control over their emotions that contributes to the success of the treatment outcome. Researcher, Title, and Abstract Researcher(s) The researchers of this article are qualified to do the research. Daisha J. Cipher being the Assistant Professor of Biostatistics at the University of North Texas Health Science Center did an extensive research on the assessment and treatment of pain in elderly patients. Some of the recent publications she wrote includes: ‘Dementia, Pain, Depression, Behavioral Disturbances, and ADLs: Toward a Comprehensive Conceptualization of Quality of Life in Long-term Care’1 and ‘The Heterogeneous Pain Personality: Diverse Coping Styles Among Sufferers of Chronic Pain.’2 She has B.A., M.S., and Ph.D degree on Psychology aside from being an active member of the International Association for the Study of Pain among others.3 Ephrem Fernandez is a professor of Psychology at the Southern Methodist University and a special faculty in clinical psychology at the University of Texas Southwestern Medical Center. His research focuses primarily on chronic pain and suffering including psychological approaches to anger management. Among the past publications he wrote includes: ‘A Framework for Conceptualization and Assessment of Affective Disturbance in Pain’4; ‘Cognitive-Behavioral Therapy in Treatment Anger: A Meta-Analysis’5; ‘The Scope and Significance of Anger in the Experience of Chronic Pain’6; and ‘Sensory and Affective Components of Pain: Separation and Synthesis.’7 P. Andrew Clifford, the Director of Clinical Development for Senior Connections of Dallas did a wide research focusing on clinical psychology within the medical settings.8 (All the past journals written by the Authors including their educational attainments and profession adds up to the qualifications of the Authors to write this article.) Title The title ‘Coping Style Influences Compliance with Multidisciplinary Pain Management’ does not clearly indicate what the study is all about. The title alone does not give a direct idea on what can expected in the study. For instance, reading the phase ‘coping style’ does not necessarily pertain to the negative behavior of the patients such as depression or anger. It could also mean something a positive behavior such as a positive attitude towards the pain management treatment. Abstract The abstract is too brief. It does not give the reader a complete idea on what is to be expected from the entire article. Another problem with the written abstract is the fact that it is written only in one paragraph. It would be better if the abstract has been written in various sections. Introduction / Problem / Purpose The introduction gives adequate information with regards to the significance of the problem. It mentions the three main factors that contribute to a good multidisciplinary pain management (MPM): pharmacotherapy, physical therapy, and psychosocial interventions; as well as the goal of the multidisciplinary pain centers (MPCs). It clearly explains that some patients may either benefited from MPC approach and/or an alternative treatment. The introduction clearly defines the statement of the purpose; to determine whether attitude, affect and interpersonal pattern (coping styles) could affect the patients’ capability to handle chronic pain is mentioned but it is not explicitly stated. (Yes, I did paraphrase it.) The problem statement, to assess the personal traits of the patients with chronic pain using the MBHI scales based on negative emotion and aggression, is direct and to the point. Readers could easily understand the problem statement of the study. The researchers clearly indicate the significance of the study by noting that “patient’s compliance with the treatment is important factor on the outcome of the treatment.” Researchers also mentioned several past studies pertaining to this matter but such compliance related to coping/personality styles and outcome of the treatment has not been empirically studied. As an introduction to the study, researchers indicate a clear theoretical framework with regards to the difference between having an intervention and no intervention on patients’ negative emotions, aggression, and treatment outcome. With all the information they relate, couldn’t the authors have related more clearly why they factor analyses of the coping styles were done? I really bogged down there. (I agree with you. I believe that the Authors did use the past studies to support their arguments.) Literature Review There is no problem with the literature review. It is in accordance with the introduction, methodology, up to the conclusion. The reason why most of the citations in the study are dated between the mid- to late 1980s and early to mid-1990s is primarily because the researchers were aiming to create a new study based on the previous studies such as: the significant relationship between compliance and treatment outcome9; personality traits affecting the treatment compliance10; and compliance in relation to treatment outcome.11 Almost all of the references used in this study came from legitimate journals. Conceptual Model or Representation The report clearly shows conceptual representation of the study. The diagram describes the major features in the study showing how negative emotion and aggression affects the treatment compliance and the outcome of the treatment in relation to the difference between applying a direct intervention and having no intervention on the patient’s negative emotions and aggression. Research Design The Authors used the Millon Behavioral Health Inventory (MBHI). It is a valid and reliable method in measuring the patients’ response to the medical evaluation and treatment. The study also stated how the MBHI method functions. The Authors did not explicitly state the research design they used in the article. Assumptions and Limitations Researchers did not state the assumptions of the study explicitly. The findings of this study are limited to the two assumptions only. It does not include the effects of patients’ defensive coping traits or having a severe stressor that are normally found in patients diagnosed with the end state renal disease to the treatment compliance and outcome of the treatment. Population / Sample / Setting The study stated the number of participants (61) including their qualifications to participate in the study. It is important to identify the population since it will give the reader a better picture of the measurement used in the study. The size of the sample is adequate enough to justify the result of the study. The setting was also identified. Participants were taken from a clinic with tertiary setting gives the reader a rough idea that the participants taken are experiencing recurrent intractable pain for a long period of time. Definitions The Authors did not define some medical terms. Readers without medical background may find it difficult to understand the Authors’ purpose of writing the article. Data Collection / Analysis Data Collection Method The authors identified that participants that experienced recurrent pain for more than six months that cannot be treated with traditional medical approaches were referred to the pain management center to undergo through a multidisciplinary evaluation and treatment. This is appropriate since readers would have a rough idea where the authors gathered the data used in this study. However, the Authors did not describe how these data were collected. Instrument(s) The authors used the Millon Behavioral Health Inventory (MBHI), an instrument that has eight scales that assess the coping style in medical setting including 14 other scales to measure psychogenic attitudes, somatization, and prognosis or simply the response of the patients when it comes to medical evaluation and treatment; and Multidimensional Pain Inventory (MPI), an instrument with empirically derived scales to measure the patients’ functional impairment. Additionally, a set of rating scales were developed by the authors since there is no instrument available to measure the compliance with chronic pain treatment. Researchers mentioned about the reliability and validity of MBHI and MPI used in this study. The authors also describe how to use the rating scale they have developed to measure the compliance with chronic pain treatment. The Authors also mentioned that the MBHI has been adopted from MBHI: Millon, Green, and Meagher (1979) and MPI from Kerns et al. (1985). Data Analysis Methods Researchers mentioned that the factor score formulas were derived from the factor analyses by Cipher. They mentioned an appropriate step-by-step description on how the data was analyzed. Correlation between the two factors (Negative Expression and Aggression) and treatment compliance including the improvement in functional capacity; the Binomial Index of Model Fit (Fraas and Newman, 1994); and statistical comparison on mediational model were computed. Discussion of Findings Conclusion The authors made a brief conclusion based on the mediational model. The conclusion part of the study is based on findings and also in literature review. Relevance to Nursing Practice Since this is not nursing research, the Authors did not provide the relevance of the article to nursing. It only specified the effects of patients’ behavior to the success of the treatment. Recommendation for Future Studies The authors did not make any recommendations for future study. This part does not really affect the main purpose of the study. Readers who may consider doing a further study regarding the topic were not provided with a specific recommended topic or issue for future study. Interested future researchers will have to base their study on their own understanding and concerns. Reflection of the Research This article is useful on the part of nurses since it gives them the idea that negative emotions and aggression are factors that has to be considered when it comes to the success and/or failure of the treatments provided. Enabling the nurses to know about the relevance of these two factors would make the nurses more sensitive with regards to the patient’s emotions. References: Where did you get all these references? Usually the list consists of the article critiqued, the text used for critiquing ideas, and my guidelines if used. (The first 8 references were used to support the past journals written by the Authors. 1 reference is the article that was criticize for the purpose of the study. 9, 10, 11 were all part of the literature that were criticized.) 1 Cipher and Clifford, (2004) ‘Dementia, Pain, Depression, Behavioral Disturbances, and ADLs: Toward a Comprehensive Conceptualization of Quality of Life in Long-Term Care’ International Journal of Geriatric Psychiatry. 2004; 19: 741 – 748. Retrieved: June 11, 2007 < http://www.mindbodywellnesspc.com/ > 2 Cipher D.J., Clifford P.A., and Schumacker R.E. (2004) ‘The Heterogeneous Pain Personality: Diverse Coping Styles Among Sufferers of Chronic Pain’ Altern-Ther-Health-Med. November – December 2002; 8(6): 60 – 69. Retrieved: June 11, 2007 < http://grande.nal.usda.gov/ > 3 HSC (2007) ‘Daisha Cipher, Ph.D Biography’ University of North Texas Health Science Center. Retrieved: June 11, 2007 < http://www.hsc.unt.edu/ > 4 Fernandez E., Clark T.S., and Rudick-Davis (1998) ‘A Framework for Conceptualization and Assessment of Affective Disturbance in Pain’ in Block A.R., Kremer E.F., and Fernandez E. (Eds.) ‘Handbook of Pain Syndromes: Biopsychosocial Perspectives’ pp. 123 – 147. Mahwah, NJ: Erlbaum. 5 Beck, R. and Fernandez, E. (1998) ‘Cognitive-Behavioral Therapy in Treatment Anger: A Meta-Analysis’ Cognitive Therapy and Research; 1998(22); 63 – 74. 6 Fernandez, E. and Turk, D.C. (1995) ‘The Scope and Significance of Anger in the Experience of Chronic Pain’ Pain (61); 165 – 175. 7 Fernandez, E. and Turk, D.C. (1992) ‘Sensory and Affective Components of Pain: Separation and Synthesis’ Psychological Bulletin (112), 205 – 217. 8 Cipher D., Fernandez E., and Clifford P.A. (2002) ‘Coping Style Influences Compliance with Multidisciplinary Pain Management’ Journal of Health Psychology. Vol. 7(6); 665 – 673.9 Lutz R.W., Silbret M., and Olshan N. (1983) ‘Treatment Outcome and Compliance with Therapeutic Regimens: Long-term Follow Up of Multidisciplinary Pain Program’ Pain. 17; 301 – 308. in Cipher D., Fernandez E., and Clifford P.A. (2002) ‘Coping Style Influences Compliance with Multidisciplinary Pain Management’ Journal of Health Psychology. Vol. 7(6); 665 – 673. 10 Edelman, R.E. and Chambless, D.L. (1995) ‘Adherence During Sessions and Homework in Cognitive-Behavioral Group Treatment of Social Phobia’ Behavioral Research and Therapy, 33(5); 573 – 577 in Cipher D., Fernandez E., and Clifford P.A. (2002) ‘Coping Style Influences Compliance with Multidisciplinary Pain Management’ Journal of Health Psychology. Vol. 7(6); 665 – 673. 11 Funch, D.P. and Gale, E.N. (1986) ‘Predicting Treatment Completion in a Behavioral Therapy Program for Chronic Temporomandibular Pain’ Journal of Psychomatic Research, 30(1); 57 – 62. in Cipher D., Fernandez E., and Clifford P.A. (2002) ‘Coping Style Influences Compliance with Multidisciplinary Pain Management’ Journal of Health Psychology. Vol. 7(6); 665 – 673. Researcher… 4/5 Introduction… 7/10 Lit review…. 19/20 Research design 27/30 Data collection 8/10 Discussion 9/10 APA Format 12/15 Grade 86 Read More