Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) is a prevalent, refractory pelvic pain condition characterized by pain in the pelvic area and urinary frequency, largely unresponsive to medical interventions. This study used multiple mediations to test the associations of validated pain appraisal and behavioural coping strategies between pain and quality of life. Patients (N = 175) were recruited from tertiary care urology clinics and completed questionnaires. Exploratory factor analyses were conducted on four individual measures (Chronic Pain Coping Inventory, Survey of Pain Attitudes – Control subscale, Center for Epidemiologic Studies Depression Scale, and Pain Catastrophizing Scale), then on the empirically derived factors that produced four factors to be used in regression and multiple mediation models: illness-focused behavioural coping, catastrophizing, wellness-focused behavioural coping, and depression. In regressions, CP/CPPS patient symptoms (p < .01), illness-focused behavioural coping (p < .01) and wellness-focused behavioural coping (p < .05) predicted physical quality of life, while catastrophizing (p < .01) and illness-focused behavioural coping (p < .05) predicted mental quality of life. Mediation analyses showed that illness-focused behavioural coping strategies partially mediated the relationship between pain and physical quality of life, whereas catastrophizing and illness-focused behavioural coping strategies both fully mediated the relationship between pain and mental quality of life. These results identify catastrophizing and illness-focused coping as key psychosocial targets for interventions for patient quality of life in CP/CPPS. / Thesis (Master, Psychology) -- Queen's University, 2013-08-27 17:07:11.853

Abstract The principal aim of a population-based cross-sectional survey was to generate information on the lifetime occurrence of prostatitis in Finnish men and their exposure to the disease, and also on the influence of prostatitis-related fears and disturbances on their sexual life. A second aim was to develop and clinically validate a new diagnostic tool for differential diagnosis between the forms of chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), especially between patients belonging to categories IIIA and IIIB in the new NIH (National Institutes of Health) clinical classification. Altogether 1832 men out of 2500 aged 20–59 years chosen randomly from the two most northerly provinces of Finland (Oulu and Lapland) participated in the epidemiological study, a response rate of 75%. The overall lifetime prevalence of prostatitis was 14.2%. The risk of having had the disease increased with age, being 1.7 times greater in the men aged 40–49 years than in those aged 20–39 years, and 3.1 times greater in those aged 50–59 years. More than a quarter of the 261 men who had or had had prostatitis symptoms (27%) suffered from them at least once a year, while 16% suffered from chronic prostatitis symptoms throughout the year. 63% of the men with prostatitis had their worst symptoms during the wintertime (November–march). 17% of the men with chronic prostatitis reported a constant fear of undetected prostate cancer. Erectile dysfunction was reported by 43% of the symptomatic men and decreased libido by 24%. Self-assessment of personality showed that the men with prostatitis were more often busy and nervous and had a meticulous attitude to life and problems than were the non-symptomatic men. 197 patients with chronic prostatitis/chronic pelvic pain syndrome participated in three clinical case-control studies during the years 1995–2000, at Oulu University Hospital, the District Hospital of Oulainen and Seinäjoki Central Hospital. The first prostatic tissue pressure measurement (PTPM) study included 34 patients and 9 controls. A novel method was developed to measure intraprostatic tissue pressure with a Stryker® intracompartmental pressure monitor. The PTPM showed a clear increase (p &lt; 0.001) in the patients with symptoms of prostatitis and benign prostatic enlargement (BPE) relative to the controls and the patients with BPE but without pain symptoms. The second PTPM study included 42 patients with chronic prostatitis symptoms without significant BPE and 12 new controls. Significantly higher pressure readings (p &lt; 0.001) were recorded at all three measurement points in the patients than in the controls. 48 new patients and 12 new controls were enrolled for the third PTPM study, the purpose of which was to confirm the results of the previous ones and to compare the prostatic tissue pressures of two clinical groups (IIIA and IIIB). The prostatic tissue pressure was again significantly higher in the patients with chronic prostatitis symptoms than in the controls (p &lt; 0.001). An interesting finding was that prostatitis patients belonging to clinical category IIIA had significantly higher tissue pressures (p &lt; 0.01) than those in category IIIB, probably reflecting more severe inflammation in the prostatic tissue. This new PTPM method provides a more precise and/or exact tool for differential diagnosis between the forms of pelvic pain and CP/CPPS.

Bakgrund: Aktuell forskning om kroniskt bäckenbottensmärtsyndrom (CP/CPPS) visar brist på behandlingsalternativ som adekvat lindrar symtomen. Män och kvinnor med diagnosen CP/CPPS upplever vanligtvis ett långvarigt symtomförlopp som uppkommer både fysiskt och mentalt. CP/CPPS påverkar patientens livskvalitet och diagnosen i sig påverkas av sjuksköterskan och sjuksköterskans roll inom den personcentrerade vården. Metod: En litteraturöversikt av kvalitativ ansats genomfördes för att analysera kvalitativa intervjudata som avsåg patientupplevelser av CP/CPPS.Resultat: Analysen resulterade i fyra teman: Patienter med en CP/CPPS-diagnos upplever svårigheter i sina sexuella relationer; Patienter upplever ofta en känslomässig påverkan på grund av CP/CPPS-relaterade symtom såsom ångest eller katastroftänkande; CP/CPPS orsakar social isolering som påverkar patienternas dagliga liv; Vårdrelaterade känslor av hjälplöshet och hopplöshet upplevs av CP/CPPS-patienter där patienter känner att deras problem inte ses eller hörs av medicinska leverantörer, vilket får dem att känna en brist av kontroll över sina liv. Konklusion: Patientupplevelser av CP/CPPS manifesteras negativt, vilket resulterar i en minskning av livskvalitet. För att kunna förstå och försöka hjälpa patienten i sin kamp med CP/CPPS, krävs först en förförståelse för hur de negativa manifestationerna av CP/CPPS flätas samman och förvärras genom en ömsesidig påverkan. / Background: Current research about Chronic Pelvic Pain Syndrome (CP/CPPS) shows a lack of treatment options that give adequate results. Men and women diagnosed with CPPS usually experience a long course of symptoms which manifest in different ways, both physically and mentally. CP/CPPS has strong ties to patient quality of life and the diagnosis is impacted by the nurse and the nurse’s role within person-centred care. Method: A literature review was carried out to analyse qualitative interview data that pertained to patient experiences of CP/CPPS. Results: The analysis resulted in four themes: Patients with a CP/CPPS diagnosis experience difficulties in their sexual relationships; Patients often experience an emotional impact due to CP/CPPS related symptoms such as anxiety or catastrophic thinking; CP/CPPS causes social withdrawal which impacts patients’ daily life; Care-related helplessness and hopelessness are experienced by CP/CPPS patients whereby patients feel that their issues were not being seen or heard by medical providers which caused them to feel a loss of control over their lives. Conclusion: Patient experiences of CP/CPPS manifest themselves negatively and have an impact on a patient’s well-being, life world and even relationships both personal and within care. To understand and attempt to aid patients in their struggle with CP/CPPS, there first requires a pre-understanding of how the negative manifestations of CP/CPPS intertwine and exacerbate one another.