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Purpose: Small fiber neuropathy (SFN) is characterized by neuropathic pain, associated with decreased quality of life (QOL). It remains unclear which psychosocial factors play a role in SFN. The experience sampling method (ESM) allows a profound understanding of the real-time fluctuations in reaction to events. The main goal of this study was to increase knowledge of the interrelationships between pain intensity, physical activity, and psychosocial factors in patients with SFN in daily practice over time. Patients and Methods: A prospective observational ESM study with the PsyMate© application (smart-eHealth GmbH, Luxembourg) was conducted at the Adelante location of Maastricht University Medical Center+ in the Netherlands. Participants with idiopathic SFN, older than 18 years, with an indication for rehabilitation, were included. Pain intensity, fatigue, positive and negative affect, physical activity, avoidance behavior, and pain catastrophic thoughts were incorporated into the ESM questions. Participants received 10 beep signals per day followed by the above-mentioned questions, for consecutive 7 days. The results were analyzed with linear mixed-effect models. Results: Twenty-one participants were included with a mean age of 48.24 (SD ± 13.89) years, of whom 76.2% were female. More pain (now) resulted in more physical activity (later) (a) and more physical activity (now) resulted in more pain (later) (b). The first association (a) is influenced by pain catastrophic thoughts and fatigue, and the second (b) by an increase in affective states and a lower level of avoidance behavior. Conclusion: In idiopathic SFN, pain intensity, and physical activity showed a 2-sided association, influenced by catastrophic thoughts, fatigue, affective states, and avoidance behavior. [ABSTRACT FROM AUTHOR]

Background: In chronic pain syndromes, symptoms can fluctuate and change over time. Standard questionnaires cannot register these fluctuations. Nonetheless, the experience sampling method (ESM) is developed to collect momentary measurements of everyday complaints, tracing fluctuations in symptoms and disabling factors over time. Although valuable information can be collected in this way, assessment may also be a burden. This study aimed to investigate the acceptability, usability, and feasibility of ESM in chronic secondary pain syndromes, in a single-center study in the Netherlands. Methods: A prospective observational study with repeated measurements was conducted in patients with chronic secondary neuropathic and musculoskeletal pain syndromes, including small fiber neuropathy, spinal cord injury, and rheumatoid disorder. Results: Thirty-four participants were included and filled in the ESM, of whom 19 were diagnosed with small fiber neuropathy, 11 with spinal cord injury, and 4 with a rheumatoid disorder. The mean age was 54.7 ± 13.9 years (range: 23-77) of whom 52.9% were female. In total, 19 participants filled in the general and user-friendliness evaluation about the acceptability and usability of the ESM. The general evaluation showed no influence of ESM on participants' social contacts (mean 1.47, SD 1.12), activities (mean 1.74, SD 1.44), and mood (mean 1.89, SD 1.59). The answers options of ESM were a good representation of the experiences of participants (mean 4.58, SD 1.77). Regarding feasibility, the overall response rate for answering the beep signals of ESM was 44.5% in total. The missing rate per person varied from 13% to 97% with a median of 54.1%. Conclusion: The general evaluation and the user-friendliness revealed sufficient outcomes in favor of the ESM application. ESM seems a promising measurement tool to use in secondary chronic pain syndromes. [ABSTRACT FROM AUTHOR]

Purpose: Literature shows promising effects for interdisciplinary biopsychosocial rehabilitation programs in patients with chronic low back pain (CLBP). Not every patient needs an interdisciplinary rehabilitation trajectory provided in a secondary care setting. Patients with moderate complex psychosocial complaints might benefit from biopsychosocial interventions offered in primary care under supervision of a physician in rehabilitation medicine (i.e. biopsychosocial integrated care intervention). This study investigated the feasibility and effectiveness of such intervention in patients with CLBP with moderate complex psychosocial complaints. Methods: mixed-method. Patients (aged 18-65 years, low back pain ≥12 weeks, moderate complex psychosocial complaints) received the intervention (4 individual sessions, 8 group sessions) provided by trained primary care physiotherapists. Physicians in rehabilitation medicine provided one consultation afterwards. Data from patients (n¼18), physicians (n¼4) and physiotherapists (n¼12) were used. Results: Physiotherapists were satisfied with the training. Patient attendance was good for individual sessions, less for groups. Physiotherapists sufficiently delivered the intervention, although recruitment and contextual factors influenced delivery. Patients reported significantly reduced functional disability (Quebec Back Pain Disability Scale) post-treatment (-8.3, 95% CI -13.3 to -2.7) and at 3months follow-up (-7.6, 95% CI -12.9 to -2.2). Conclusions: A biopsychosocial integrated intervention is feasible and potentially effective in patients with CLBP. [ABSTRACT FROM AUTHOR]

Before patients with chronic pain enter pain rehabilitation treatment, they are examined by an interdisciplinary team (i.e. a rehabilitation physician, physiotherapist and psychologist). To start treatment aimed at improving functioning, the patient and his practitioners need to have a shared understanding of the psychosocial factors contributing to the patient's disabilities. Since patients with chronic pain are often dismissive of the role of psychosocial factors, the Findings: of the team's examination are thoroughly discussed with the patient to reach consensus. This study explores how patients with chronic pain and their practitioners talk through the team's hypotheses regarding the psychosocial factors involved in the patient's pain problem. Nine consultations were recorded at various Dutch rehabilitation units, resulting in approximately 4,5 hours of audio material. All nine patients participating had chronic primary musculoskeletal pain. Seven practitioners participated. The recordings were transcribed and analysed on a micro-level combining an applied conversation analytic research approach with discursive psychology. When talking through the rehabilitation team's hypotheses regarding the psychosocial factors involved in the patient's health situation, both patients and practitioners orient to the institutional goal of reaching consensus. Patients display an orientation to agreement as the relevant response to practitioners' deliveries of the team's findings. And, when it remains unclear whether the patient is in agreement, practitioners tend to pursue an unequivocal response. They design their turns in ways that pre-empt resistance and encourage patients to confirm the team's findings, rather than to voice their own concerns and perspectives. Patients and practitioners' orientations to the institutional need for consensus, may hinder an open dialogue about patients' potentially different perspectives. Findings: can be used by practitioners to reflect on how they can develop communication practices that are more likely to bring patients' potential concerns regarding the rehabilitation team's Findings: out into the open. [ABSTRACT FROM AUTHOR]