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Title
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Towards a better understanding of pain after surgery for breast cancer : a biopsychosocial perspective
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Author
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Abstract
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| Pain is one of the most common and long-lasting side effects reported by women surgically treated for breast cancer. The neurophysiology of pain shows that a pain experience is determined not only by the stimulation from tissues such as muscles or nerves (biological level), but also by how a person feels and thinks about pain (psychological level), as well as one’s personal environment and how one feels supported in it (social level). In turn, pain will also have an impact on an individual’s physical and psychosocial functioning. Adequate evaluation and management of pain is necessary to prevent pain and improve biopsychosocial functioning, both in the short and long term after surgery for breast cancer. The aim of this doctoral thesis was twofold. The first aim of this doctoral thesis was to contribute to the understanding and biopsychosocial evaluation of the neurophysiological processes of pain and sensory disturbances in women after surgery for breast cancer. Therefore, three different studies were conducted. First, a systematic review of the existing literature regarding quantitative sensory testing (QST) methods and results in women after surgery for breast cancer, was conducted. QST is the umbrella term for non-invasive assessment techniques evaluating the functioning of the somatosensory nervous system. QST results were summarized using a narrative synthesis. Second, a reliability study evaluated both within- and between-rater reliability of a comprehensive QST protocol including static as well as dynamic QST methods in women treated for breast cancer. Third, a cross-sectional study examined whether questionnaires can be used for the evaluation of the neurophysiological processes of somatosensory functioning after surgery for breast cancer in clinical practice. The second aim of this doctoral thesis was to contribute to the prevention and treatment of pain and pain-related disability after surgery for breast cancer in the long term. Therefore, two studies were conducted. In a double-blinded randomized controlled trial the effectiveness and moderators of PNE after surgery for breast cancer were investigated on pain intensity, somatosensory and psychosocial functioning. By means of a prospective cohort study the perioperative biopsychosocial risk factors for pain and pain-related disability one year after surgery for breast cancer were investigated. The findings of this doctoral thesis are an important step forward in future research into the biopsychosocial evaluation and management of pain and sensory disturbances following breast cancer surgery. In addition to important research suggestions, deeper insights and recommendations for the biopsychosocial evaluation and management of pain in clinical practice were provided. |
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Language
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English
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Publication
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Antwerp
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University of Antwerp, Faculty of Medicine and Health Sciences, Department Rehabilitation Sciences and Physiotherapy, Research Group MOVANT
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2021
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Volume/pages
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353 p.
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Note
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Meeus, Mira [Supervisor]
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Devoogdt, Nele [Supervisor]
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Groef, De, An [Supervisor]
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Smeets, Ann [Supervisor]
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Full text (open access)
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The publisher created published version Available from 01.01.2203
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