Thesis (Ph.D.)--University of Nebraska-Lincoln, 2007. / Title from title screen (site viewed Oct. 10, 2007). PDF text: x, 223 p. : ill. ; 10 Mb. UMI publication number: AAT 3262188. Includes bibliographical references. Also available in microfilm and microfiche formats.

Pain catastrophizing emerges in the literature as one of the most important psychological determinants of both pain itself and the negative outcomes commonly associated with it. However, despite decades of research confirming the impact of catastrophizing, there are still areas that remain unexplored or in which the surface has only been scratched. The overall aim of this dissertation was to expand existing knowledge about catastrophizing and to advance the theoretical framework around the concept. The role of catastrophizing was explored in three distinct areas: during pain in childbirth, in exposure treatment for back pain patients, and in a problem solving context. The findings from the three studies confirmed the vital role of catastrophizing in these areas. Firstly, catastrophizing played a critical role in pain in childbirth; women who catastrophized reported labor pain as more intense and the subsequent recovery period as longer than women who did not catastrophize. Secondly, catastrophizing was identified as a moderator of treatment effect in exposure in vivo for back pain patients with pain-related fear; patients who catastrophized were not helped by the exposure. Thirdly, catastrophizing played a role in a problem solving context; although this is in line with contemporary models such as the misdirected problem solving model, the results suggested a somewhat different pathway to this previous model. Taken together, these findings underscore the instrumental role of catastrophizing in diverse areas and imply a need for catastrophzing to be assessed and addressed in clinical contexts. In addition, the findings highlight a need for further development of the theoretical framework around catastrophizing as well as treatment interventions that directly target catastrophizing. Based on these needs, a new model of catastrophizing was proposed – a model of catastrophizing from a process perspective. In this model, the proposed function of catastrophizing is to down-regulate negative affect, as a form of internal avoidance. The model is a complement to existing theoretical models and provides a framework for developing treatment interventions that directly target catastrophizing, for example by problem solving skills training. Successful interventions for people who catastrophize would lead to several gains – for the individual in less suffering and increased ability to handle pain problems, and for society as a whole in reduced costs for health care for these individuals.

Syftet med denna enkätstudie var att jämföra två olika förklaringsmodeller för tinnitusbesvär; fear avoidance och acceptans. Förutom att undersöka sambanden till tinnitusbesvär, testades även modellerna mot utfallsmåtten tinnitusvigilans och livskvalitet. Då nivå av depression och ångest är kända prediktorer för tinnitusbesvär, användes de som kontrollvariabler. Även processerna mindfulness och värderad riktning testades. Deltagare i studien var 362 patienter med tinnitus som någon gång mellan åren 2004-2011 varit i kontakt med Öronkliniken Hörselvården vid universitetssjukhuset i Linköping. Hierarkiska regressionsanalyser visade att både acceptans och fear avoidance förklarade unika bidrag till utfallsmåtten tinnitusbesvär och tinnitusvigilans. Värderad riktning förklarade unik varians i utfallsmåttet livskvalitet. Utifrån multipla mediationsanalyser visade det sig att både acceptans och fear avoidance medierade sambandet mellan ljudnivån av tinnitus och tinnitusbesvär samt sambandet mellan ljudnivån av tinnitus och tinnitusvigilans. Ingen av mediatorerna bidrog med signifikant mer förklaringsvärde än den andra. Slutsatsen är att acceptans och fear avoidance är två viktiga och kompletterande modeller för att förklara graden av tinnitusbesvär och tinnitusvigilans. Resultatet från denna studie kan ha implikationer för utvecklingen av mer effektiva behandlingar för tinnitus.

Bakgrund:  En främre korsbandsskada med följd operativ-, eller konservativ behandling kan vara en utmanande process för en idrottare och kan leda till en lång, ofrivillig frånvaro från fotbollsspel. Flera studier behandlar olika typer av idrottsskador på ett biomedicinskt och psykologiskt plan. Det råder däremot brist på forskning rörande hur olika upplevelser under en rehabilitering kan påverka en spelares self-efficacy och rörelserädsla.   Syfte:  Syftet med studien är att undersöka hur fotbollsspelares upplevelser under rehabiliteringen av en främre korsbandsskada har påverkat deras nuvarande self-efficacy och rörelserädsla inom sin idrott.   Metod och design: En kvalitativt explorativ design har valts och semistrukturerade intervjuer med totalt fem studiedeltagare har tillämpats för insamling av data. Samtliga intervjuer genomfördes i mjukvaran Zoom och analyserades genom en kvalitativ innehållsanalys.  Resultat:  Informanterna uttryckte både homo- och heterogena upplevelser under rehabiliteringen. Fysioterapeutens vägledning och socialt stöd från omgivning visade sig variera mellan deltagarna, samtidigt som en stark motivation yttrade sig hos majoriteten. Efter återgång till fotboll visade det sig att trygghet och oro skiljde sig mellan deltagarna, samtidigt som undvikandebeteende kunde utläsas hos samtliga individer.    Konklusion:  Studiens resultat visar att det kan antas finnas ett samband mellan en idrottares upplevelser under rehabiliteringen och dess påverkan på self-efficacy och rörelserädsla efter återgång till fotboll. Studiedeltagarna som uttrycker sig har haft goda rehabiliteringsupplevelser beskriver tankar som kan tolkas som högre self-efficacy och mindre rörelserädsla jämfört med resterande deltagare. Samtidigt uppvisar de andra med sämre upplevelser mer otrygghet, rädsla och passivitet vid fotbollsspel. / Background:  An injury of the anterior cruciate ligament with operative or conservative treatment might be a challenging process for athletes and could lead to a long involuntary absence from football. Many studies research different types of sport injuries on a biomedical and psychological level. However, there is a lack of research regarding different experiences during a rehabilitation process and its effect on a player’s self-efficacy and fear of movement.   Purpose:  To investigate how football player’s experiences during the rehabilitation of an anterior cruciate ligament injury have affected their current self-efficacy and fear of movement.    Method and design:  A qualitative exploratory design has been chosen and semi-structured interviews with a total of five participants have been applied for the collection of data. All interviews were conducted in the Zoom software and were analyzed through a qualitative content analysis.     Result:  The informants expressed both homo- and heterogeneous experiences during the rehabilitation. The physiotherapist’s guidance as well as social support turned out to vary between the participants, while a strong motivation was expressed by the majority. After returning to football, the feeling of security and anxiety differed between the participants, while avoidant behaviour was shown in all individuals.    Conclusion:  The results of the study show that it can be assumed that there is a connection between an athlete’s experiences during rehabilitation and its impact on self-efficacy and fear of movement after returning to football. Participants who express positive rehabilitation experiences tend to show higher self-efficacy, while individuals with worse experiences show more insecurity, fear and passivity.

Bakgrund:  En främre korsbandsskada med följd operativ-, eller konservativ behandling kan vara en utmanande process för en idrottare och kan leda till en lång, ofrivillig frånvaro från fotbollsspel. Flera studier behandlar olika typer av idrottsskador på ett biomedicinskt och psykologiskt plan. Det råder däremot brist på forskning rörande hur olika upplevelser under en rehabilitering kan påverka en spelares self-efficacy och rörelserädsla.   Syfte:  Syftet med studien är att undersöka hur fotbollsspelares upplevelser under rehabiliteringen av en främre korsbandsskada har påverkat deras nuvarande self-efficacy och rörelserädsla inom sin idrott.   Metod och design: En kvalitativt explorativ design har valts och semistrukturerade intervjuer med totalt fem studiedeltagare har tillämpats för insamling av data. Samtliga intervjuer genomfördes i mjukvaran Zoom och analyserades genom en kvalitativ innehållsanalys.  Resultat:  Informanterna uttryckte både homo- och heterogena upplevelser under rehabiliteringen. Fysioterapeutens vägledning och socialt stöd från omgivning visade sig variera mellan deltagarna, samtidigt som en stark motivation yttrade sig hos majoriteten. Efter återgång till fotboll visade det sig att trygghet och oro skiljde sig mellan deltagarna, samtidigt som undvikandebeteende kunde utläsas hos samtliga individer.    Konklusion:  Studiens resultat visar att det kan antas finnas ett samband mellan en idrottares upplevelser under rehabiliteringen och dess påverkan på self-efficacy och rörelserädsla efter återgång till fotboll. Studiedeltagarna som uttrycker sig har haft goda rehabiliteringsupplevelser beskriver tankar som kan tolkas som högre self-efficacy och mindre rörelserädsla jämfört med resterande deltagare. Samtidigt uppvisar de andra med sämre upplevelser mer otrygghet, rädsla och passivitet vid fotbollsspel. / Background:  An injury of the anterior cruciate ligament with operative or conservative treatment might be a challenging process for athletes and could lead to a long involuntary absence from football. Many studies research different types of sport injuries on a biomedical and psychological level. However, there is a lack of research regarding different experiences during a rehabilitation process and its effect on a player’s self-efficacy and fear of movement.   Purpose:  To investigate how football player’s experiences during the rehabilitation of an anterior cruciate ligament injury have affected their current self-efficacy and fear of movement.    Method and design:  A qualitative exploratory design has been chosen and semi-structured interviews with a total of five participants have been applied for the collection of data. All interviews were conducted in the Zoom software and were analyzed through a qualitative content analysis.     Result:  The informants expressed both homo- and heterogeneous experiences during the rehabilitation. The physiotherapist’s guidance as well as social support turned out to vary between the participants, while a strong motivation was expressed by the majority. After returning to football, the feeling of security and anxiety differed between the participants, while avoidant behaviour was shown in all individuals.    Conclusion:  The results of the study show that it can be assumed that there is a connection between an athlete’s experiences during rehabilitation and its impact on self-efficacy and fear of movement after returning to football. Participants who express positive rehabilitation experiences tend to show higher self-efficacy, while individuals with worse experiences show more insecurity, fear and passivity.

Bibliographic record: RYŠAVÁ, Markéta. Health professionals' beliefs concerning the non-specific back pain and their influence on following the recommended therapy procedures. Prague: Charles University, 2nd Faculty of Medicine, Department of Rehabilitation and Sports Medicine, 2021. 138 p., Appendixes, Supervisor of the work: Mgr. Tomáš Kavka Abstract: Nonspecific back pain (nonspecific LBP) is the most common reason for visiting a doctor and it is the leading cause of activity limitation and inability to work by patients. The theoretical part of this thesis describes the issue of LBP and related clinical guidelines. In addition, it summarizes current research results of the influence of health professionals' fear-avoidance beliefs (FA beliefs) on their clinical decision making for LBP patients. The practical part relates to the research of FA beliefs and non-adherence to clinical guidelines regarding care of individuals experiencing LBP among health professionals in the Czech Republic. The degree of FA beliefs was evaluated using a translated and cross-culturally adapted questionnaire "Fear- Avoidance Beliefs Tool", while the degree of non-adherence was evaluated using a self- reported questionnaire in connection to fictitious clinical vignette. A generalized linear model was used for data processing. The...

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Chronic neck pain (CNP) is a common and disabling condition, accounting for substantial healthcare and societal costs. Previous studies have demonstrated that certain cognitive factors are related to levels of adjustment (levels of disability, pain and depression) in chronic pain conditions. However, this association has not been adequately explored in patients with CNP. The aim of study one was to determine the relationship between specific cognitive factors and levels of adjustment in participants with CNP. Furthermore, study two explored whether the relationship between the cognitive factors and levels of adjustment differed between those patients with idiopathic CNP and those with Chronic Whiplash Associated Disorder (CWAD). Finally, study three compared the efficacy of a physiotherapy led intervention, specifically designed to modify cognitive factors to a conventional physiotherapy intervention.Study one: Hierarchical multiple regression analyses were performed. Greater catastrophizing and lower functional self-efficacy beliefs were associated with greater levels of pain and disability. Additionally, lower functional self-efficacy beliefs were also associated with greater levels of depression. Study two: Data were dichotomised into two groups: those with CWAD and those with idiopathic CNP. T-tests were performed to compare differences in the cognitive scores and the same regression analyses as study one were performed for each sub-group. No significant differences existed between the two groups in terms of levels of pain, disability, depression or the cognitive factors. In both groups greater catastrophizing and lower functional self-efficacy beliefs were related to levels of disability. Likewise, lower self-efficacy beliefs were related to levels of depression in those participants with idiopathic CNP and those with CWAD. However, amongst those with idiopathic CNP, greater levels of catastrophizing and lower levels of pain vigilance and awareness were related to greater pain intensity. In contrast, amongst those with CWAD, none of the cognitive measures were significantly related to levels of pain intensity.Study three: Participants were randomly allocated to either a progressive neck exercise programme or an intervention which specifically targeted the modification of cognitive factors. T-tests revealed that treatment targeting cognitive factors resulted in greater improvements in pain and pain-related fear. Moreover, Χ2 tests revealed that a greater proportion of patients made clinically meaningful reductions in pain and disability in the group targeting cognitive factors. This thesis highlights that cognitive factors play an important role in determining levels of adjustment in patients with CNP. Furthermore, treatments designed to specifically target these factors result in superior clinical outcomes when compared to conventional physiotherapy interventions.