Coping with chronic pain

Many models of pain give coping an important role in understanding adaptation to chronic pain. Among these, Lazarus and Folkman's cognitive-phenomenological model of stress and coping provides a theoretical framework to conceptualise stress phenomena and coping strategies related to chronic pain. Chronic pain often necessitates new coping skills. An understanding of the concept of coping and how the patients cope is therefore crucial for the success of rehabilitation. The current study examined how coping, as measured by the Ways Of Coping Checklist, was related to medical variables, depression measured by the Short Zung depression rating scale, and Rosenberg's self-esteem scale. The study sample consisted of 88 people who were recruited for a multidisciplinary pain management programme. Data were collected as part of a routine pre-treatment evaluation. Results indicated that the most predominant stressors were related to family life and social activities. We also recognised on the one hand, appraising pain as a challenge was predictive of problem-focused coping, while on the other hand, appraising pain as a threat, experiencing depression, and reduced self-esteem were predictive of emotion-focused coping. Clinical implications of these results in nursing are discussed. (c) 2004 Elsevier Ltd. All rights reserved.