Assessing Persistent Pain and Its Relation to Affective Distress, Depressive Symptoms, and Pain Catastrophizing in Patients with Chronic Wounds

OBJECTIVE: The purpose of this study was to examine pain experience among patients with chronic wounds, assess the utility of pain assessment scales for chronic wound-related pain, and determine the relation of wound-related pain to wound stage, affective distress, depressive symptoms, and pain catastrophizing. DESIGN: In this cross-sectional study of patients with a mix of chronic wounds (n = 69) recruited for a study evaluating a telemedicine system for assessing chronic wounds, 19 men (12 with spinal cord injury) with wound-related pain were identified. Questionnaires included the Numerical Pain Rating Scale, McGill Pain Questionnaire, Brief Symptom Inventory, Center for Epidemiologic Studies Depression Scale, and the catastrophizing scale of the Coping Strategies Questionnaire. RESULTS: The McGill Pain Questionnaire was more sensitive to pain experience than a single rating of pain intensity. Wound stage was positively related to severity of pain. Pain catastrophizing was positively related to pain intensity and higher levels of affective distress and depressive symptoms. CONCLUSIONS: Pain associated with chronic wounds is a significant clinical challenge for both patients and health practitioners.