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ObjectiveThis study sets out to identify potential daily antecedents and consequences of pain-related activity avoidance and engagement behavior in adolescents with chronic pain.MethodsAdolescents (N = 65, Mage = 14.41) completed baseline self-reports and a diary for 14 days. Afternoon and evening reports were used to infer a network structure of within-day associations between pain intensity, pain-related fear, pain catastrophizing, affect, and pain-related activity avoidance and engagement behavior. Baseline psychological flexibility was examined as a potential resilience factor.ResultsActivity avoidance in the evening was predicted by pain-related fear and avoidance earlier that afternoon. Activity engagement was predicted by positive affect and activity engagement in the afternoon. Pain-related behavior in the afternoon was not related to subsequent changes in pain intensity, pain-related fear, pain catastrophizing, or affect. Pain-related fear in the afternoon was predictive of increased levels of pain and pain catastrophizing in the evening. Both pain-related fear and pain catastrophizing in the evening were predicted by negative affect in the afternoon. Psychological flexibility was associated with lower levels of daily activity avoidance and buffered the negative association between pain intensity and subsequent activity engagement.ConclusionsThis study provides insight into unique factors that trigger and maintain activity avoidance and engagement and into the role of psychological flexibility in pediatric pain. Future work should focus on both risk and resilience factors and examine the role of psychological flexibility in chronic pediatric pain in greater detail.

Objective Self-determination theory (SDT) may be a useful framework to understand why chronic pain affects partners. SDT postulates that individuals can engage in helping behaviors for different motives varying from more autonomous or volitional motives to more controlled or pressured motives. This article examines the relationship between partners' type of motivation to help (i.e., autonomous vs controlled) and their personal and relational functioning. Furthermore, mechanisms underlying this relationship (i.e., helping exhaustion and relationship-based need satisfaction) were examined. Methods In a sample of 48 couples, of which one partner had chronic pain (36 female patients), questionnaires measuring life satisfaction, positive and negative affect, anxiety and depressive feelings, relationship quality and relationship-based need satisfaction were filled out. Individuals with chronic pain (ICPs) also reported on pain intensity and disability whereas partners were requested to report on motives for helping and helping exhaustion. Results Data analysis with Structural Equation Modeling revealed that autonomous, relative to controlled, motives for helping among partners related positively to partners' well-being and relationship quality, and negatively to distress. The experience of helping exhaustion and relationship-based need satisfaction mediated these associations. Moreover, partners' autonomous helping motivation related positively to patient-reported relationship quality among ICPs high in pain intensity. Conclusions Applying SDT in a context of pain provides new insights into why chronic pain affects partners and how partners impact patient outcome. Directions for future research are outlined.

Background Farming is an occupation that predisposes individuals to health problems including musculoskeletal disorders (MSDs). There is limited research regarding MSDs among farmers especially in Ireland. Aims To establish the prevalence of MSDs, identify the most commonly affected body regions and to explore what factors may influence the development of the most common MSDs among farmers in Ireland. Methods A questionnaire survey of Irish farmers was conducted. The study sample comprised 600 farmers (100 farmers from each of the six main farm enterprise systems in Ireland). Results Of the 600 farmers, 56% had experienced a MSD in the previous year. The most commonly experienced MSDs were back pain (37%) and neck/shoulder pain (25%). Other MSDs experienced in the previous year included knee pain (9%), hand-wrist-elbow pain (9%), ankle/foot pain (9%) and hip pain (8%). Overall, MSDs were more common in farmers working longer hours (P < 0.05). Back pain was more prevalent in full-time farmers (P < 0.05), while prevalence of hip pain was greater in farmers who were older (P < 0.01), full time (P < 0.05), farming for longer (P < 0.01) and working for longer hours (P < 0.01). Farm enterprise was not a factor in influencing the development of MSDs. Conclusions These findings suggest that the number of hours worked by farmers, rather than enterprise specific tasks render farmers more susceptible to MSDs. Further investigation is needed to explore risk factors in the development of MSDs.