Long Term Conditions

Psychological Well-being - Addressing psychological aspects of long term conditions and healthcare

This group focuses on the brain-body connection and examines the impact of physical health on our psychological wellbeing and how our psychological health affects long term conditions. By exploring the mechanisms of these connections, we seek to develop and evaluate the effectiveness of various psychological therapies. The group’s current research is in two areas: pain in osteoarthritis and psychological aspects of medical and dental treatment which includes psychological interventions to improve health.

  1. Pain in osteoarthritis and psychological aspects of medical and dental treatment
  2. Psychological aspects of medical and dental treatment


1. Understanding pain in people with arthritis

The focus of our research is understanding, measuring, and treating people with pain associated with osteoarthritis of the knee. The programme of research includes:

(i) qualitative studies to understand the experience of pain from patients’ perspective;

(ii) conducting feasibility randomised controlled trials to examine the role of psychological interventions for people with arthritis pain, including cognitive behaviour therapy and acceptance and commitment therapy (NIHR-funded Home-Administered Pre-surgical Psychological Interventions for Knee Osteoarthritis [HAPPiKNEES] trial); and

(iii) examining the psychometric properties of scales to assess process and outcome of rehabilitation using Rasch analysis (funded by Arthritis Research UK).

We are also members of the Arthritis Research UK Pain Centre.  


2. Psychological aspects of medical and dental healthcare

This research focuses on the patient experience in medical and dental healthcare. This programme of research includes studies exploring (i) the role of motives, expectations and information in dental and medical treatment (HLS QR grant) (ii) anxiety in medical and dental settings and (iii) psychological interventions in improving patient outcomes in dental and medical treatment (British Academy funded Cochrane review on psychological interventions for reducing postoperative morbidity in dental surgery in adults; The effect of emotional disclosure on dental anxiety funded by Friends of St Guy’s Hospital Research Grant).

Members: Prof Nadina Lincoln, Prof Penny Standen, Dr Heather Buchanan, Dr Roshan das Nair, Dr Bryan Moreton, Dr Simon Clarke, Nektaria Pouli (PhD student); Hannah Jones (PhD student)
Methodological expertise: The team has expertise in using several qualitative methods (including thematic analysis, text analysis, discourse analysis) and quantitative methods (including Rasch Analysis) for scale development and evaluation. We also undertake systematic reviews, meta-analyses, and qualitative meta-syntheses.


FAPERJ-NOTTINGHAM-BIRMINGHAM Brazil fund. Psychology and Dentistry: A multidisciplinary Nottingham-Birmingham-Rio de Janeiro collaboration (Buchanan, De Oliveira, Hill) for two years of exchange visits on key areas for cross-cultural study development and funding based on the joint research including oral health-related quality of life in paediatric patients with oral health-related conditions and stress and burnout in dental health professionals. £7,500.

Body-mind physiotherapy for people with intellectual disabilities in acute mental health services Psychomotor therapy is a form of specialist physiotherapy that uses body awareness exercises and physical activity as a therapeutic tool for stimulating reflection. It has been used successfully with other client groups and this project jointly with the division of psychiatry aims to evaluate its effectiveness in people with intellectual disabilities and mental health problems.

Developing and testing new approaches to use of family history in risk assessment for cancer and cardiovascular disease in primary care. http://www.nottingham.ac.uk/research/groups/geneticsandethnicity/index.aspx  

Increasing physical activity in people with intellectual disabilities
Even if they have minimal physical limitations, people with intellectual disabilities are less likely than the general population to meet the recognised minimum levels of physical activity. Using pedometers and enhanced personalised feedback is being evaluated as a mean to increase daily activity.

HAPPiKNEES (Home-Administered Pre-surgical Psychological Intervention for Knee Osteoarthritis): An NIHR-RfPB funded feasibility randomised controlled trial examining the effectiveness of a one-to-one psychological intervention (based on Cognitive Behaviour Therapy and Acceptance and Commitment Therapy) to improve patients’ mood in effecting post-surgical outcomes. This multi-centre trial is in its set-up phase and will be recruiting patients from the East Midlands. The trial is run in collaboration with the Arthritis Research UK Pain Centre.

Understanding how group-based interventions work: A social identity approach to adjustment groups for people with multiple sclerosis: This project consists of three interlinked projects: A pilot randomised controlled trial comparing the delivery of an adjustment group intervention delivered in group vs. individual format (funded by Nottingham University Hospitals Charity) and two studies examining social and family identity change in people with multiple sclerosis. These are funded by MS Society and ESRC PhD studentships.

A Cochrane systematic review funded by the British Academy of Psychological interventions for reducing postoperative morbidity in dental surgery in adults. 
Psychological interventions on post-surgical outcomes following joint replacement surgery with people with osteoarthritis: A systematic review. Psychological interventions are common treatment approaches for pain and mood and there is good evidence for their effectiveness in a number of health conditions. However, the value of psychological interventions in improving outcomes for patients with OA who have had Total Knee Replacement or Total Hip Replacement is unclear. This review seeks to summarise and evaluate the available evidence in order to determine the clinical effectiveness of these interventions with this population. The review is being conducted under the Cochrane Collaboration with the Cochrane Musculoskeletal Group.
Measures of pain relevant to knee osteoarthritis. This is a multi-centre cross-sectional questionnaire study funded by Arthritis Research UK to examine the measurement properties of a set of questionnaires covering different aspects of osteoarthritis knee pain (i.e., physical, social and psychological components). In addition, the relationship between pain thresholds, as established by quantitative sensory testing, and mood is being explored.
The association between pain, depression and anxiety in knee osteoarthritis: A systematic review. A systematic review is being conducted to explore the association between pain in knee osteoarthritis and depression and anxiety. This review will also document the methods and materials used to assess this relationship and the quality of the studies. 

A Pain Centre grant funded by the Arthritis Research Campaign. Mechanisms of Pain Research Centre. £2,499,951 from 1 October 2009 for 5 years.





Long Term Conditions Research Group

School of Medicine
Division of Rehabilitation and Ageing
telephone: +44 (0)115 823 0226