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Journal of Oral & Facial Pain and Headache



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J Orofac Pain 30 (2016), No. 1     27. Jan. 2016
J Orofac Pain 30 (2016), No. 1  (27.01.2016)

Page 14-20

Explanatory Models of Illness and Treatment Goals in Temporomandibular Disorder Pain Patients Reporting Different Levels of Pain-Related Disability
Forssell, Heli / Kotiranta, Ulla / Kauko, Tommi / Suvinen, Tuija
Aims: To explore whether temporomandibular disorder (TMD) pain patients reporting different levels of pain-related disability differ in terms of illness explanations and treatment expectations.
Methods: Consecutive TMD pain patients (n = 399; mean ± SD age, 40.5 ± 12.7 years; 83% women) seeking treatment in primary care completed the Explanatory Model Scale (EMS). Patients were asked to indicate their expectations regarding the treatment. Each patient's pain-related disability level was determined using the Graded Chronic Pain Scale, with scores indicating no (0 disability points), low (1-2 disability points), or high (3-6 disability points) disability. Differences between EMS factor scores were evaluated using the Mann-Whitney U test. Differences between study groups were analyzed using logistic regression.
Results: High-disability patients considered physical and stress factors as more important in causing and in aggravating pain and as targets of treatment compared with patients with no disability (P = .0196 and P = .0251, respectively). The great majority of patients indicated they would like to receive information, decrease pain, and increase jaw function, with no significant subtype differences noted. Compared with no-disability patients, low-disability and high-disability patients were more likely to expect increased ability to perform daily functions (P < .0001 in both comparisons), increased work ability (P < .0001 in both comparisons), and better stress management skills (P = .0014 and P = .0001, respectively).
Conclusion: Illness explanations and goals for treatment differ in patients reporting different levels of TMD pain-related disability.

Keywords: explanatory models of illness, GCPS, primary health care, RDC/TMD Axis II, TMD pain