• Changes in problem-solving sty...

*Result*: Changes in problem-solving style when pain does not resolve. A longitudinal analysis of adults with chronic pain after total knee replacement.

Title:
Changes in problem-solving style when pain does not resolve. A longitudinal analysis of adults with chronic pain after total knee replacement.
Authors:
Gibby A; Centre for Pain Research, University of Bath, Bath, United Kingdom., Braun M; Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium.; Institue for Implementation Science in Healthcare, University of Zurich, Zurich, Switzerland., Bertram W; Bristol Medical School, University of Bristol, Bristol, United Kingdom.; National Institute for Health Research, Bristol Biomedical Research Centre, Bristol, United Kingdom., Crombez G; Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium., Gooberman-Hill R; Bristol Medical School, University of Bristol, Bristol, United Kingdom.; National Institute for Health Research, Bristol Biomedical Research Centre, Bristol, United Kingdom., Peters TJ; Bristol Dental School, University of Bristol, Bristol, United Kingdom., Wylde V; Bristol Medical School, University of Bristol, Bristol, United Kingdom.; National Institute for Health Research, Bristol Biomedical Research Centre, Bristol, United Kingdom., Eccleston C; Centre for Pain Research, University of Bath, Bath, United Kingdom.; Department of Experimental-Clinical and Health Psychology, Ghent University, Ghent, Belgium.; Department of Psychology, The University of Helsinki, Helsinki, Finland.
Source:
Pain [Pain] 2026 Feb 01; Vol. 167 (2), pp. 338-343. Date of Electronic Publication: 2025 Sep 09.
Publication Type:
Journal Article
Language:
English
Journal Info:
Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 7508686 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1872-6623 (Electronic) Linking ISSN: 03043959 NLM ISO Abbreviation: Pain Subsets: MEDLINE
Imprint Name(s):
Publication: 2015- : Hagerstown, MD : Lippincott Williams & Wilkins
Original Publication: Amsterdam, Elsevier/North-Holland.
MeSH Terms:
Arthroplasty, Replacement, Knee*/adverse effects , Arthroplasty, Replacement, Knee*/psychology , Problem Solving*/physiology , Chronic Pain*/psychology , Chronic Pain*/etiology , Postoperative Pain*/psychology, Humans ; Male ; Female ; Middle Aged ; Aged ; Longitudinal Studies ; Pain Measurement ; Adult
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Grant Information:
RP-PG-0613-20001 Programme Grants for Applied Research
Contributed Indexing:
Keywords: Acceptance; Chronic pain; Problem solving; Total knee replacement
Entry Date(s):
Date Created: 20250909 Date Completed: 20260109 Latest Revision: 20260127
Update Code:
20260130
PubMed Central ID:
PMC12794342
DOI:
10.1097/j.pain.0000000000003799
PMID:
40923911
Database:
MEDLINE

*Further Information*

*Abstract: One-fifth of adults who receive a total knee replacement (TKR) go on to develop chronic pain. The behavioural approach taken to find a solution to pain may vary from assimilative (pursuit of analgesia) to accommodative (acceptance of pain insolubility and adoption of alternative goals). A total of 313 patients participated in a trial of an enhanced care pathway for TKR reported pain at 3 months after surgery. Participants undertook treatment as usual or treatment as usual with a new optimised support and treatment after replacement care pathway. Several pain and psychosocial outcomes (including problem-solving) were assessed. Two of the 3 problem-solving subscales moved from assimilative to accommodative over time (solving pain, acceptance of insolubility) and the overall belief in a solution decreased. Despite this shift to a more accommodative (accepting) problem-solving approach, participants reported lower meaningfulness of life over time. This reduced meaningfulness of life was associated with an increase in pain severity, interference, and reduced knee function. These interactions were not moderated by the treatment pathway to which participants were allocated. Overall, these results suggest that while patients who have pain after TKR become less determined to pursue analgesic solutions, this accommodation is not a naturally occurring positive acceptance. We discuss the possible reasons for this lack of functional and adaptive accommodation to chronic pain over the 12 months postoperative period.
(Copyright © 2025 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the International Association for the Study of Pain.)*