جستجوی مقالات مرتبط با کلیدواژه « ترس از درد » در نشریات گروه « پزشکی »

Spinal anesthesia is a type of neuraxial anesthesia that brings ample benefits. However, due to the fear of this type of anesthesia, many pregnant people refuse to experience it. In this study, we aimed to investigate the levels and causes of fear of spinal anesthesia in candidates for cesarean section.

The current study is a cross-sctional study performed on 67 patients undergoing cesarean section who were referred to the operation room of Shariati Hospital, in Tehran from September 2018 to September 2019. Matthey questionnaire, which consisted of three sections (demographic information, history of spinal anesthesia and fear of anesthesia), was filled out by candidates and after collecting information, the data were analyzed by SPSS software.

Pain over the surgery showed a significant relationship with the history of spinal anesthesia in 4 pregnant women (12.9%) and in 25 women (65.8%) without a history of anesthesia (P<0.0001). In addition, the fear of being awake and looking at the cesarean section during surgery was significant in 7 patients (22.6%) with a history of spinal anesthesia and 18 patients (47.4%) without a history of disease (P<0.0001). Fear of anesthesia needle was also significantly observed in 7 patients (23.3%) with a history of spinal anesthesia and 23 patients (60.5%) with no history of spinal anesthesia (P<0.0001). Fear of back injury was seen in 9 candidates (29%) of patients with a history of spinal anesthesia and in 23 patients (60.5%) of patients without a history of anesthesia (P<0.033). The results of our study also showed a significant relationship between the history of general anesthesia and fear of nausea and vomiting (P<0.046) as well as fear of anesthesia needles (P<0.001).

Patients with a history of spinal anesthesia were significantly less afraid of feeling pain during surgery, seeing surgery, spinal anesthesia needles, and spinal impairments. Moreover, patients with a history of general anesthesia were significantly more afraid of spinal anesthesia, nausea and vomiting than others.

Patellofemoral Pain Syndrome is accompanied by Pelvic Drop and Valgus Dynamic Knee. Pain And fear of pain have been reported as some mechanisms of its occurrence. The present study is to investigate the effect of twelve-week neurofeedback training on perceptual pain intensity, fear of pain, pelvic drop, and dynamic knee valgus index in men with Patellofemoral Pain Syndrome.

32 patients with PFPS participated in this study. They were randomly divided into experimental (n = 16) and control (n = 16) groups. The instruments used in this study consist of the VAS scale for pain, McNeil questionnaire for fear of pain, camera and Kinova Software for pelvis drop and dynamic valgus index when going down the stairs. The experimental group performed neurofeedback training for twelve weeks, 3 times per week, and 30 Min per Session; however, the control group did not receive any treatment during this time.  The covariance statistical method was used through SPSS software, version 21, for data analysis.

The results showed that the experimental group after twelve weeks of neurofeedback training had significant improvement in pain reduction(0/001), fear of pain (P = 0.004) and Valgus Knee Dynamics Index (P = 0.005); however, there was no significant improvement in drop pelvis (P = 0.45).

It seems that the pelvic drop and Knee Dynamic Valgus Index are influenced by perceptual pain intensity and fear of pain. Dynamic Knee Valgus Index has been significantly influenced by perceptual pain intensity and fear of pain since it decreased after twelve weeks of neurofeedback training.

Vaginal delivery is one of the most stressful experiences of a mother's life. Therefore, a significant number of pregnant mothers select cesarean delivery as a method of termination of pregnancy to get rid of these conditions. Since one of the important factors in choosing cesarean in pregnant women is fear of labor pain. The aim of this study was to evaluate the effectiveness of reducing the fear of labor pain in the way of the reality therapy on the choice of vaginal delivery in pregnant women. The research method was semi-experimental with pre-test, post-test design, with control group. The statistical sample of study included 39 pregnant women with gestational age ≥4 weeks in Nowshahr city, in Iran. These women had chosen cesarean section method for the termination of pregnancy and were visited for Midwifery Care in the Urban and Rural Health Centers from December of 2017 to March 2018. The sample was selected targeted non-random method and randomly divided into two experimental (20) and control groups (19). The reality therapy was performed in 8 sessions of 90 minute, twice a week for the experimental group. The. Childbirth Attitudes Questionnaire (CAQ) was used for data collection. The data was analyzed using Analysis of covariance (ANCOVA). After the intervention, the fear of labor pain in the experimental group was significantly different from that of the control group (p<.05). The scores of fear of labor pain in women who decided to undergo vaginal delivery after the reality therapy showed no significant difference with those who continued to perform cesarean section delivery for termination of pregnancy. The result showed that reality therapy can be used to reduce the fear of childbirth.

Aims and This study aimed to evaluate the structural model of the relationship between pain disposition, catastrophizing, fear of pain and pain adjustment in patients with Chronic musculoskeletal pain.
314 Patients with chronic musculoskeletal pain wete selected using convenience sampling method among clients of pain clinics in Isfahan, based on pain specialist diagnosis. They participated in the research by filling out six questionnaires: Chronic Pain Self-Efficacy Questionnaire(CPSEQ), Life-0rientation Questionnaire(LOQ), Conner-Davidson Resilience Scale(CDRS), Pain Catastrophizing Scale (PCS), Tampa Scale Kinesiophobia (TSK) and VanKroff Graded Chronic Pain Scale (CPG). Data was analyzed using structural equation modeling method.
Findings: Pain disposition had a significant reverse effect on catastrophizing; besides catastrophizing had significant direct effects on fear of pain and the latter had the same effect on pain adjustment (P The results of this research show that pain disposition plays a role of Protection against catastrophizing, fear of pain, pain intensity and inability.

Nowadays, fear-avoidance model is the best model for the assessment and treatment of chronic musculoskeletal pain in which, the role of the pain vulnerability (neuroticism, experiential avoidance and negative affect) is not well defined. The purpose of present study was to evaluate the structural pattern of the relationships between the pain vulnerability, catastrophizing, fear of pain and pain adjustment (pain intensity and inability) in the framework fear-avoidance model.
Patients with chronic musculoskeletal pain were selected from hospitals and private clinics in Isfahan city, Iran, during 2015 using convenience sampling method. They participated in the research by filling out six questionnaires: NEO Five-Factor Inventory (NEO-FFI), Positive and Negative Affect Schedule (PANAS), Acceptance and Action Questionnaire (AAQ), Pain Catastrophizing Scale (PCS), Tampa Scale Kinesiophobia (TSK) and Graded Chronic Pain Scale (GCP). Data were analyzed using structural equation modeling method.
Findings: Pain vulnerability had significant direct effects on catastrophizing and catastrophizing on fear of pain and fear of pain on pain adjustment (P The results of this research showed that pain vulnerability could predict pain adjustment in the framework fear-avoidance model. Therefore, reducing pain vulnerability can reduce pain intensity and inability in patients with chronic musculoskeletal pain.

Over the past decades, the rate of caesarean section has increased in industrialized and developing countries. There are many reasons for the global rise in caesarean section rates, but an important and influential factor is the fear of childbirth. Fear of childbirth itself is created for reasons such as fear of pain and low self-efficacy of childbirth. Therefore, this study was performed with aim to determine the effectiveness of cognitive-behavioral therapy on fear of childbirth, fear of pain, self-efficacy of childbirth and tendency toward caesarean section in nulliparous women.
This clinical randomized study was performed on 25 nulliparous women in Mashhad. The subjects were assigned to two groups of case and control. 9 sessions of cognitive-behavioral therapy was performed on intervention group by the researcher (clinical psychologist). Wijma fear of childbirth questionnaire, self-efficacy of childbirth questionnaire and fear of pain Scale were used as tools in post and pretest. Women's tendency to mode of delivery was assessed by a question at the beginning of sampling and at the end of treatment. In addition, the final mode of delivery was asked by phone call at the end of pregnancy. Data were analyzed by SPSS software (16 version) and covariance analysis and Fisher exact test. P Fear of childbirth, fear of pain, tendency to cesarean and cesarean rate ere reduced in the intervention group compared with the control group (P Cognitive-behavioral therapy decreases unnecessary cesarean sections by reducing the fear of childbirth, fear of pain and increasing self-efficacy of childbirth.

Rapid increase in the rate of cesarean section (CS) according to severe complications of CS compared to vaginal delivery caused CS as one of the major concerns in women's health. Regarding to the high prevalence of CS in Birjand and the importance of reducing primary CS, this study was performed with aim to investigate the relationship between fear of pain, fear of delivery and attitude toward CS with preferred mode of delivery among pregnant women referring to health and treatment centers in Birjand. This cross-sectional study was performed on 196 primiparous women referring to health and treatment centers of Birjand in 2013. Participants completed the questionnaires including demographic data and preferred mode of delivery, fear of pain, fear of delivery and attitude toward CS. Data were analyzed using SPSS software (version 16), and Fisher exact test, Chi-square, t-test, ANOVA, Mann-Whitney and Pearson correlation coefficient tests. P 154 women (81.1%) had tendency to vaginal delivery and 104 (54.7%) had high fear of pain. 69 (37.3%) had very fear of delivery. 160 (85.5%) had negative and very negative attitude to CS. There was significant differences between the preferred mode of delivery and fear of pain (P=0.047), fear of delivery (P=0.012), and attitude toward CS (P=0.008). Also, significant difference was observed between the preferred mode of delivery and educational level of husband (P=0.017), family income (P=0.022), and interval between marriage and pregnancy (P=0.001). Regarding to the importance of attitude toward CS and fear of delivery and their impact on selecting mode of delivery and subsequently on maternal and neonatal health, interventions appears to be needed for modifying the attitudes and reducing fear of delivery in primiparous women in Birjand.

Therapeutic exercises are regarded as one of most important therapeutic interventions for patients with chronic low back pain. Stabilization exercises are among the most practical ones for these patients. Effects of these exercises on psychological factors associated with pain and consequential functional disabilities are still remained unknown. The purpose of this study was to assess the effect of stabilization exercises on fear of pain, movement and disability in patients with low back pain. Twenty one patients with recurrent non-specific low back pain (14 in experimental, 7 in control group) were participated in this study. The scores for fear of pain, fear of movement and disability were recorded in the questionnaires. The experimental group performed isolated abdominal hollowing and bracing exercises in three sets of ten for each with two minutes rest between each repeat. Patients performed exercises with the use of pressure biofeedback and under the supervision of a physiotherapist in different positions including supine, sitting on a chair, standing still and standing with rapid arm raises with maximum acceleration once a day and for 20 sessions. The variables studied in this research were evaluated in both experimental and control groups after training sessions. Performing the stabilization exercises did not affect the fear-avoidance belief (P >0.05), while decreased the disability associated with back pain (P=0.01). This study showed that the psychological fears associated with pain in patients with recurrent non-specific low back pain, which also leads to continuity of back pain cannot be alleviated by performing stabilization exercises.

Fear-avoidance beliefs (FAB) are one of the important psychologic factors related to disability and work abcence. The aim of this study is to investigate the association of FAB with disability and postural stability in patients with non specific chronic low back pain (NCLBP)and impact of short specific training on FAB in patients with NCLBP. In this semi experimental study, 51 subjects with NCLBP were evaluated. Pain intensity, FAB and disability were measured using questionnaires and Postural stability was measured using force plate. Abdominal and back muscle endurance was measured respectively by sit up and surensen tests. The association of FAB and pain intensity with parameters of postural stability was analyzed using multivariate general linear modle with adjusting for age, body mass index, physical activity, back and abdominal muscle endurance and sex. pain intensity and FAB (physical activity) were related to postural stability in unilateral standing (p<0.01). FAB (work) was related to disability and backmuscle endurance (p<0.01). In quiet standing FAB was not related to any parameter of postural stability. The exictance of association of FAB (physical activity) with center of pressure excursion and velocity in unilateral standing may help in applying a simple sterategy for evaluating patients with NSCLBP focusing on their psychosocial condition such as fear avoidance believes.

Fear of pain is related to disability and chronicity of low back pain. The aim of this study was to investigate the relation between fear avoidance beliefs (FAB) and postural stability and the influence of specific training on postural stability and FAB in individuals with non specific chronic low back pain (NSCLBP). Twenty seven females with NCLBP were recruited in this quasi-experimental study. Pain intensity، FAB، and disability were recorded using the questionnaires. The force plate was used to measure the postural stability. Abdominal and back muscle endurance was measured respectively by sit up and Biering-Sorensen tests. All tests were repeated ne week and one month after a short term specific training for FAB. Repeated measure analysis was used to compare the variables. To evaluate the association between variables Pearson correlation coefficient and mixed model analysis were used. All data were analyzed by SPSS، version16. Pain intensity، FAB، and disability scores showed a significant reduction after intervention (P < 0. 01). The time of sit up، Sorensen and single leg stance tests prominently increased (P < 0. 01). Center of pressure (COP) excursion and velocity variables faced with a considerable decrease (P < 0. 01). Pain intensity was mainly related to cop excursion and velocity during unilateral standing (P < 0. 01) but there is no relation between FAB and the parameters of postural stability. However، trend of changes in FAB was related to trend of changes in cop excursion and velocity during unilateral standing in mediolateral plan (P = 0. 04). Changes in FAB was related to the changes in COP excursion and velocity during unilateral standing. Specific training for FAB resulted in pain intensity reduction، FAB، and disability scores. It also led to an improvement he postural stability as well as increasing the time of sit up، Biering-Sorensen and single leg stance tests in subjects with NSCLBP.

In recent decades there had been considerable progress in the research works on chronic pain، perhaps as a consequence of costs and challenges associated with this problem. The aim of this study was to compare rheumatoid arthritis patients and healthy individuals in regard to fear of pain، pain catastrophizing and catastrophic cognition. In this study we selected 100 patients with rheumatoid arthritis and 100 healthy individuals from a public hospital using census sampling method. After informed consent، demographic variables such as age، sex، level of education، duration of illness were recorded for every subject. We used three questionnaires of fear of pain (FPQ)، catastrophic cognition (CCQ) and scale of pain catastrophizing (PCS) in this study. Multivariate analyses of variance (MANOVA) showed significant differences between the two groups in regard to the three cognitive variables of «fear of pain»، «catastrophic cognition» and «pain catastrophizing» (P<0. 05). These results suggested that fear of pain; catastrophic cognition and pain catastrophizing were important cognitive factors contributing to aggravation of pain in the patients with rheumatoid arthritis. The results of the current study are consistent with basic assumptions of cognitive–affective model which emphasizes the importance of the ‘pain experience’ as potential modulators of the pain–cognition relationship.

Low back pain (LBP) is one of the most prevalent musculoskeletal disorders in both developed and developing countries. LBP affects 70% to 80% of adults at some time in their lives. Recent evidence suggests that psychosocial factors especially fear avoidance beliefs (FAB) have a critical role to predict disease progression from an acute to a chronic stage as well as the failure of intervention. The aim of this study was to review the relationship between pain، fear avoidance beliefs and postural stability in subjects with non specific chronic low back pain (CLBP). In this narrative research، two databases (pub med and Medline) were searched using key words such as chronic low back pain، fear avoidance beliefs، posture، stability، balance، motor control، center of pressure، and force plate. The inclusion criteria was being related to FAB and postural stability and adults with non specific CLBP، in English language، up to 2011، by the format of cohort and cross sectional studies. The results showed that psychological factors like FAB influence the chronicity factor of LBP but the relationship between pain and postural stability was different in these studies. The only study on relationship between postural stability and FAB did not find any significant relationship. It seems that the different results of these studies are due to different methods of data collection. More exact studies are needed for evaluating the relationship between FAB and postural control.

To investigate and review psychological influences of pain such as kinesiophobia and pain-related fear on patients with musculoskeletal pain and on rehabilitation outcomes. Fear is a universal and powerful emotion and، as a result، it can have a profound impact on human behavior. the fear-motivated behavior has the potential to adversely impact rehabilitation outcomes for patients with musculoskeletal pain. cross-sectional studies consistently documented a positive association between elevated pain-related fear and increased pain intensity and disability. in addition، several longitudinal studies indicated that elevated pain-related fear is a precursor to poor clinical outcomes. existence of catastrophizing in patients effect on the fear of movement/ (re) injury. this fear contributes to avoidance behaviors and subsequent disuse، depression، and disability. it has been established that kinesiophobia plays a negative role in the outcome of the rehabilitation of acute and chronic low back pain، chronic fatigue syndrome and fibromyalgia syndrome. collectively، the recent studies suggest that physical therapists should consider the role of pain-related fear and avoidance behaviors in patients'' function and they should assess these cognitive and behavioral factors. or (physical therapists should assess pain-related fear when rehabilitating certain individuals with musculoskeletal pain.) currently، there is a lot of evidence for the assessment of pain-related fear in patients with musculoskeletal pain. self-report questionnaires are readily available for assessment and investigation of pain-related fear and several studies have found support for their validity and reliability. recent research indicated that besides fear-avoidance responses، endurance-related responses lead to chronic pain via physical overload. the existence of mental kinesiophobia has been established in patients with chronic stress complaints، and this concept is as relevant as the concept of kinesiophobia for back pain patients. For certain patients، fear of pain can be as disabling as pain itself. in conclusion، collaborative efforts are necessary to refine current screening techniques and develop interventions that effectively reduce pain-related fear.

The research purpose was to investigate the role of fear of pain in selective attention of patients with dental pain. Hence, a pictorial version of dot-probe was examined in a sample group of 120 subjects with dental complains. The results of this research revealed that subjects with high fear of pain as compared to subjects with low fear of pain in dot-probe attended away from painful stimuli, selectively (P<0.05). Overall it is concluded that, fear of pain plays an important role in attentive bias towards painful stimuli.

Fear of movement is a psychological construct with pivotal role in chronicity of pain. Chronic pain may lead to depression and anxiety in patients, which may change life quality and style. This study was aimed to evaluate the role of fear of movement in chronicity of pain in patients with musculoskeletal pain. Method and Materials: In a descriptive analytic study a sample of 170 patients with chronic musculoskeletal pain referred to an orthopedic clinic at Atieh hospital (Tehran, Iran) was selected. Based on scores of Tampa Scale of Kinesophobia, were divided into three groups of high, medium, and low fear of pain. Data was analyzed by SPSS 12 using ANOVA test.

Patients with higher fear of pain received higher scores on other pain related measures except estimation of pain severity during the current and the next week. In addition, regression analysis showed that scores on Pain Anxiety Symptoms Scale, and Pain vigilance and Awareness Questionnaire are the best predictors of Tampa Scale of Kinesophobia scores.

Fear of movement in patients with chronic pain is predictable by psychological variables which are correlated with pain specific anxiety rather than pain severity. Such variables can predict further movement and physical disability and have clinical implications for chronic pain management.