Research: KEEFE and colleagues, Man

Listed in Issue 24


KEEFE and colleagues, Management Programme, Duke University Medical Center, Durham, North Caroline 27710 USA analysed pain coping processes in patients with rheumatoid arthritis.



53 people recorded in daily diaries the pain coping strategies they used each day for 30 consecutive days, rating the efficacy of their coping, joint pain and mood - positive and negative. Variables were examined across- persons and within-persons over time.


With regard to across-persons level of analysis 1) daily coping efficacy was not related to pain coping or pain intensity; and 2) more frequent daily use of a wide variety of pain coping strategies was correlated with greater pain. Within-person analyses provided information regarding the relationships among coping, pain and mood not apparent in the across-persons results. These analyses demonstrated that increases in daily coping efficacy were not only related to decreases in pain, but also to decreases in negative mood and increased positive mood. Time-lagged effects of coping and coping efficacy were also discovered. People who reported high levels of coping efficacy on one particular day experienced lower pain levels on the following day . Daily use of pain reduction and relaxation strategies also contributed to improvement in next-day pain and enhancement of positive mood.


The implications of these findings regarding pain assessment and coping in patients with rheumatoid arthritis are discussed.


Keefe FJ et al. Pain coping strategies and coping efficacy in rheumatoid arthritis: a daily process analysis. Pain 69(1-2): 35-42. Jan 1997.

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