The pain of a heart being broken: pain experience and use of analgesics by caregivers of patients with Alzheimer’s disease

BMC Psychiatry

Katarzyna Popiołek¹  Ewa Wojtyna² 

[1] Faculty in Katowice, University of Social Sciences and Humanities, ul. Techników 9, Katowice, 40-326, Poland;Institute of Psychology, University of Silesia, Katowice, ul. Grażyńskiego 53, Katowice, 40-126, Poland

关键词: Analgesic;    Social pain;    Alzheimer’s disease;    Caregiver;    Pain;   

Others  :  1225008
DOI  :  10.1186/s12888-015-0571-1

 received in 2014-10-30, accepted in 2015-07-22,  发布年份 2015

【 摘 要 】

Background

It has been observed that psychical suffering (e.g. the feeling of losing a significant person) tends to reduce the physical pain tolerance threshold, as well as to increase the subjective sense of painfulness. The purpose of this study was to assess pain sensation among a group of caregivers of patients with Alzheimer’s disease, and to determine the psychological factors (emotional and relational) that contribute to both pain perception and coping with pain via the use of analgesics.

Methods

The study comprised 127 caregivers of patients with Alzheimer’s disease. Questionnaires were used to elicit pain intensity, strength of emotional relationship between caregiver and patient, sense of painfulness of the loss experienced, depression level, and somatic ailments.

Results

A large majority (87.4 %) of participants reported pain complaints, while 93 % took analgesics without a doctor’s recommendation at least once a week; 8 % took painkillers daily. The strongest predictors of both perceived pain and tendency to use analgesics were sense of loss and painfulness of loss in relation to the patient’s deteriorating condition.

Conclusions

The pain experienced by caregivers may be connected to social pain resulting from the experience of losing someone they are close to. Caregivers may resort to excessive use of analgesics as a pain-coping strategy.

【 授权许可】

   
2015 Wojtyna and Popiołek.

【 图 表 】

Fig. 1.

【 参考文献 】

• [1]Mura T, Dartigues J-F, Berr C: How many dementia cases in France and Europe? Alternative projections and scenarios 2010–2050. Eur J Neurol 2010, 17:252-259.
• [2]Cummings J, Zhong K: Treatments for behavioural disorders in neurodegenerative diseases: drug development strategies. Nat Rev Drug Discov 2006, 5(1):64-74.
• [3]Lanctôt K, Herrmann N, Rothenburg L, Eryavec G: Behavioral correlates of GABAergic disruption in AD. Int Psychogeriatr 2007, 19(1):151-158.
• [4]Croog S, Burleson J, Sudilovsky A, Baume R: Spouse caregivers of Alzheimer patients: problem responses to caregiver burden. Aging Ment Health 2006, 10(2):87-100.
• [5]Mausbach BT, Roepke SK, Chattillion EA, Harmell AL, Moore R, Romero-Moreno R, et al.: Multiple mediators of the relations between caregiving stress and depressive symptoms. Aging Ment Health 2012, 16(1):27-38.
• [6]Wojtyna E, Popiołek K: Character of the relationship with Alzheimer patient and the psychological costs of care. Polish Psychological Bulletin 2012, 43(4):244-252.
• [7]Wojtyna E, Banout M, Popiołek K. Objawy depresyjne a więź emocjonalna z chorym u opiekunów pacjentów z otępieniem alzheimerowskim [Depression and emotional bond with patient among caregivers of Alzheimer patients]. Czasopismo Psychologiczne [Journal of Psychology], 2014; 20(2): 259–265
• [8]Eisenberger N: The neural bases of social pain: Evidence for shared representations with physical pain. Psychosom Med 2012, 74(2):126-135.
• [9]Eisenberger NI, Jarcho JM, Lieberman MD, Naliboff BD: An experimental study of shared sensitivity to physical pain and social rejection. Pain 2006, 126:132-138.
• [10]Witte W, Stein C. History, definitions, and contemporary viewpoints. In: Kopf A, Patel NB, editors. Guide to pain management in low-resource settings. Seattle: International Association for the Study of Pain; 2010: p. 3–7
• [11]Monin J, Schulz R: Interpersonal effects of suffering in older adult caregiving relationships. Psychol Aging 2009, 24(3):681-695.
• [12]Zigmond AS, Snaith RP: The hospital anxiety and depression scale. Acta Psychiatr Scand 1983, 67(6):361-370.
• [13]Majkowicz M: Praktyczna ocena efektywności opieki paliatywnej – wybrane techniki badawcze [Practical assessment of efficiency of palliative care – selected study techniques]. In Ocena jakości opieki paliatywnej w teorii i praktyce [Assessment of palliative care in theory and practice]. Edited by Walden-Gałuszko K, Majkowicz M. Akademia Medyczna w Gdańsku, Gdańsk; 2000:21-42.
• [14]Pearlin LI, Mullan JT, Semple SJ, Skaff MM: Care giving and the stress process: an overview of concepts and their measures. Gerontol 1990, 30:583-594.
• [15]Bernstein MJ, Claypool HM: Social exclusion and pain sensitivity: why exclusion sometimes hurts and sometimes numbs. Per Soc Psychol Bull 2012, 38:185-196.
• [16]Chester DS, Pond RS Jr, Richman SB, DeWall N: The optimal calibration hypothesis: how life history modulates the brain’s social pain network. Front Evol Neurosci 2012, 4:ArtID 10.
• [17]DeWall CN, Baumeister RF: Alone but feeling no pain: effects of social rejection on physical pain tolerance and pain threshold, affective forecasting, and interpersonal empathetic concern. J Pers Soc Psychol 2006, 91:1-15.
• [18]Kross E, Berman MG, Mischel W, Smith EE, Wager TD: Social rejection shares somatosensory representations with physical pain. PNAS 2011, 108:6270-6275.
• [19]Nordgren LF, Banas K, MacDonald G: Empathy gap for social pain: Why people underestimate the pain of social suffering. J Pers Soc Psychol 2011, 100:120-128.
• [20]Wirga M, Wojtyna E: Udręki zdrowego umysłu. Neuropsychologia cierpienia [Torments of a healthy mind. Neuropsychology of suffering]. In Wielowymiarowość cierpienia [Multidimensionality of suffering]. Edited by Binnebesel J, Błeszyński J, Domżał Z. Wydawnictwo Naukowe WSEZ, Łódź; 2010:31-51.
• [21]MacDonald G, Leary MR: Why does social exclusion hurt? The relationship between social and physical pain. Psychol Rev 2005, 131:202-223.
• [22]Fauth E, Hess K, Piercy K, Norton M, Corcoran C, Rabins P, et al.: Caregivers’ relationship closeness with the person with dementia predicts both positive and negative outcomes for caregivers’ physical health and psychological well-being. Aging Ment Health 2012, 16(6):699-711.
• [23]Sullivan MJL: The Communal Coping Model of pain catastrophizing: Clinical and research implications. Can Psychol 2012, 53:32-41.
• [24]Wojtyna E: Irrational Suffering – An impact of cognitive behavioural therapy on the depression level and the perception of pain in cancer patients. In Mental illnesses - evaluation, treatments and implications. Edited by L'Abate L. InTech, Rijeka; 2012:227-244.
• [25]Monin JK, Schulz R: The effects of suffering in chronically ill older adults on the health and well-being of family members involved in their care. GeroPsych 2010, 23(4):207-213.
• [26]Schulz R, Monin JK, Czaja SJ, Lingler JH, Beach SR, Martire LM, et al.: Measuring the experience and perception of suffering. Gerontologist 2010, 50(6):774-784.
• [27]Frías MT, Shaver PR: The moderating role of attachment insecurities in the association between social and physical pain. J Res Pers 2014, 53:193-200.
• [28]Cooper C, Katona C, Orrell M, Livingston G: Coping strategies, anxiety and depression in caregivers of people with AD. Int J Geriatr Psychiatry 2008, 23(9):929-936.
• [29]Zhu CW, Scarmeas N, Ornstein K, Albert M, Brandt J, Blacker D, et al. Health-care use and cost in dementia caregivers: Longitudinal results from the Predictors Caregiver Study. Alzheimers Dement. 2015;11(4):444–454.
• [30]Sussman S, Rohrbach LA, Spruijt-Metz D, Barnett E, Lisha N, Sun P: One-year prediction of pain killer use among at-risk older teens and emerging adults. J Drug Educ 2012, 42:195-210.
• [31]Wojtyna E: O bólu i radzeniu sobie z nim w kontekście współczesnej mentalności [About pain and coping with it in the context of contemporary mentality]. In Kultura współczesna a zdrowie [Contemporary culture and health]. Edited by Górnik-Durose M. Gdańskie Wydawnictwo Psychologiczne, Sopot; 2013:137-153.
• [32]DeWall CN, MacDonald G, Webster GD, Masten CL, Baumeister RF, Powell C, et al.: Acetaminophen reduces social pain: Behavioral and neural evidence. Psychol Sci 2010, 21:931-937.