Pain anxiety and rehabilitation outcomes after acquired brain injury

ABSTRACT

Purpose: The purpose of this study was to examine pain anxiety after acquired brain injury (ABI) and its relationship to rehabilitation outcomes.

Materials and Method: Participants consisted of 89 adults with an ABI participating in outpatient rehabilitation therapy. They completed a battery of neuropsychological tests at baseline along with surveys of mood, health-related self-efficacy, and pain anxiety. Separately, occupational therapists assessed basic and instrumental activities of daily living (ADLs) as well as therapy engagement across treatment after the sixth session.

Results: Individuals who reported high pain anxiety had fewer years of formal education, lower self-efficacy, and more emotional distress than those with low pain anxiety. Although Blacks were about half (56%) of the study sample, they comprised the majority (73.1%) of individuals in the high pain anxiety group. Pain anxiety was negatively related to therapy engagement. Moderation analysis using linear regression indicated that pain anxiety moderated the influence of self-efficacy on basic ADLs.

Conclusions: Pain anxiety, particularly when high, is negatively associated with rehabilitation outcomes for individuals with ABI. Among those with high pain anxiety, health-related self-efficacy is an important resilience characteristic to improve functional outcomes. In rehabilitation therapy, pain anxiety provides a novel intervention target to enhance ABI recovery.

KEYWORDS:

• Pain Anxiety
• self-Efficacy
• therapy Engagement
• functional Outcomes
• Acquired Brain Injury

Acknowledgments

It is important to acknowledge, first and foremost, all of the patients and occupational therapists that participated in this study. Without them, this work would not have been possible.

Declaration of Interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Additional information

Funding

This research was supported by grants from the Foundation for Rehabilitation Psychology (Williams) and Wayne State University (Williams and Parker). Dr. Sander’s time was partially supported by grant number [90DPTB0016] from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR). NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). The contents of this publication do not necessarily represent the policy or official views of NIDILRR, ACL, or HHS, and you should not assume endorsement by the Federal Government.