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Stiff upper lip: coping strategies of World War II veterans with phantom limb pain
1United Medical and Dental Schools, Guy's Hospital, London, United Kingdom.
Objective:
Study of coping with phantom pain in nonclinical war veteran amputees.
Design:
Semistructured interview with amputees in their home setting.
Setting:
Residential home for war veteran amputees or respondents' own homes.
Patients:
Amputee veterans of World War II with phantom pain.
Outcome Measures:
Pain (McGill Pain Questionnaire) and pain history, coping (daily coping; Stone and Neale, J Pers Soc Psychol 1984;46:892-906), size of social network, and quality of war memories.
Results:
No differences in pain or coping were associated with place of residence (and prevalence of cues) or social networks; war memories appeared not to be associated with availability of cues, whether media coverage or other amputees. There was some association between the emotional tone of war memories and pain intensity. Veteran amputees were in general accepting of high levels of pain and made little use of medical resources, relating that to past experience of their pain being dismissed.
Conclusion:
Coping with phantom pain in war veteran amputees is predominantly silent acceptance of the pain, with little use of social support however available, and rare recourse to medical help, based on past unhelpful experience. Pain and mood appeared to be unrelated to specific war cues, but higher pain scores were reported by those with unhappier war memories.