illness perceptions and psychological distress in women with chronic pelvic pain

with the highest density of Vietnamese migrants was established atthe psychiatric department of Königin-Elisabeth-Hospital.

http://dx.doi.org/10.1016/j.jpsychores.2013.03.033

20 - Training program for physicians to facilitate shared decision-making (SDM) in oncologyW. Eich a, J. Nicolai a, A. Buchholz b, M. Härter b, C. Bieber c

a Department of Internal Medicine and Psychosomatics, University ofHeidelberg, Germany, b University Medical Center Hamburg-Eppendorf,University of Hamburg, Germany, c Department of Internal Medicine &Psychosomatics, University of Heidelberg, Germany

Objectives: An existing SDM training program was modified fortraining oncologists. Risk communication strategies and the use ofoncology specific Patient Decision Aids (PtDAs) were incorporated.The effects of the training on physician SDM-skills, patient outcome,and on physician–patient-interaction were assessed.Methods: Eighty-six oncologists were randomly assigned to an inter-vention and a control group in a cluster randomized design. Consulta-tions with eight patients per doctor were audiotaped and rated withregard to the achieved level of SDM (OPTION). Patients' preferred levelof participation (CPS), decisional conflict (DCS), satisfaction withdecision (SwD), perceived level of involvement in decision making(PEF-FB), the quality of the physician–patient interaction (DDPRQ,QQPI), and anxiety and depression (HADS) were assessed.Results: The training program was well received by oncologists. Theintervention group had significantly higher OPTION scores than thecontrol group (p ≤ 0.01). There were no significant differencesbetween intervention and control group with regard to the patients'preferred level of participation, decisional conflict, satisfaction withdecision, perceived level of involvement in decision making, thequality of the physician-patient interaction, anxiety and depression.Conclusions: Data showed that an SDM training program cansignificantly improve physicians' SDM skills. However, there wereneither significant group differences in patient outcome norphysician-patient-interaction. Both positive and negative lessonslearned are described.

http://dx.doi.org/10.1016/j.jpsychores.2013.03.034

21 - Illness perceptions and psychological distress in women withChronic Pelvic PainO. Fitzgibbon a, A. Chia b

a Albert Road Clinic, Melbourne, Australia, b Royal Women’s Hospital,Melbourne, Australia

Objective: Chronic Pelvic Pain (CPP) is a common and debilitatingbut under-researched condition. The Common Sense Model of IllnessPerceptions has been used to explore how chronic pain patientsconceptualise and understand their pain experience but it has notbeen explored in patients with CPP. The aim of the present study wasto examine the illness perceptions and levels of psychologicaldistress in a sample of women experiencing CPP. The study wasconducted within the context of multidisciplinary treatment at aspecialty chronic pelvic pain clinic.Methods: The participants were 31 women with CPP, who hadcompleted the assessment at amultidisciplinary pelvic painmanagementclinic. All participants completed a number of questionnaire measuresincluding the Illness Perceptions Questionnaire Revised–Chronic Pain(IPQ-R-CP) and the Hospital Anxiety and Depression Scale (HADS).Results: It was found that participants perceived their chronicpelvic pain to be a chronic and serious condition and had little

understanding of the nature of their pain, lacking a coherent viewand believing it to be a ‘mystery’. In addition, participants endorsedpsychosocial and ‘chance’ factors to be causative of their pain. It wasalso found that having perceptions of pain as being unresponsive topersonal control was associated with higher levels of anxiety.Conclusion: Illness perceptions represent a modifiable aspect of thepain experience and an important future direction for clinicians andresearchers wishing to gain a more comprehensive understanding ofthe experience of CPP and to use this knowledge to improve theefficacy of treatment.

http://dx.doi.org/10.1016/j.jpsychores.2013.03.035

22 - Psychological Distress and Social Determinants: Analysingtheir interaction on determining lower quality of life in primarycare patients in BrazilS. Fortes a, F.B. Portugal b, D.A. Gonçalves c, JDJ Mari d, C.S. Lopes e,M.R. Campos b

a Rio de Janeiro State University (UERJ), Brazil, b Sergio AroucaNational School of Public Health, Oswaldo Cruz Foundation (ENSP-FIOCRUZ), Brazil, c Universidade Federal de São Paulo, Brazil,d Universidade Federal de São Paulo, Public Centre for Mental Health,Health Services and Population Research Department, Institute ofPsychiatry, King’s College, London, United Kingdom, e Institute of SocialMedicine, Universidade do Estado do Rio de Janeiro (UERJ), Rio deJaneiro, RJ, Brazil

Background: Patients in psychological distress show lower quality oflife (QoL), which is also affected by socio-economic factors.Objective: Identify the associations among QoL, social determinantsand psychological distress, and how they interact, in primary care inthree municipalities in Brazil.Methodology:Multicenter cross-sectional study with 2,180 patients inSão Paulo and Rio de Janeiro (2009 to 2010), and in Petropolis (2002).Multiple linear regression with the following variables – gender, age,education, per capita family income, emotional distress (General HealthQuestionnaire –GHQ 3–4 points), common mental disorder (CMD –

GHQ N4), 'probable anxiety' and 'probable depression' – was used toanalyse their impact on the distinct domains of QoL.Results: Multivariate analysis demonstrated that part of thevariability (R2) of the domains is explained by the selected variables(35% of physical, 43% of psychological, 16% of social relationships,20% of environmental, 16% in quality of life evaluation andsatisfaction with health and 23% of the overall score). Emotionaldistress, CMD, anxiety and depression demonstrated a negativeassociation with all domains. Age associated negatively with mostdomains except social relationships and environment. Education waspositively associated with physical (β= 1.8) and psychological(β= 2.8) domains, but negatively with social relationships (β = -1,9). Income was associated positively with all domains exceptphysical and general satisfaction with health.Conclusion: This study has analysed the interaction between socialeconomical and mental health variables in determining quality oflife, which is affected by both of them, but for some of the domainsonly in a small proportion.

http://dx.doi.org/10.1016/j.jpsychores.2013.03.036

23 - Before and after acceding to A&E departments by migrants:Data from a 1-year observationE. Gazzoletti, C. Reggianini, S. FerrariSection of Psychiatry, Department of Diagnostic-Clinical Medicine andPublic Health, University of Modena & Reggio Emilia, Modena, Italy

Abstracts / Journal of Psychosomatic Research 74 (2013) 539–562 545