{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,16]],"date-time":"2026-08-16T20:12:13Z","timestamp":1786911133536,"version":"build-2736575974"},"reference-count":41,"publisher":"Wiley","issue":"23-24","license":[{"start":{"date-parts":[[2023,9,6]],"date-time":"2023-09-06T00:00:00Z","timestamp":1693958400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Clinical Nursing"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Mental distress, non\u2010specific symptoms of depression and anxiety, is common in chronic pelvic pain (CPP). It contributes to poor recovery. Women's health nurses operate in multidisciplinary teams to facilitate the assessment and treatment of CPP. However, valid cut\u2010off points for identifying highly distressed patients are lacking, entailing a gap in CPP management.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>This instrumental cross\u2010sectional study identified a statistically derived cut\u2010off score for the Depression Anxiety Stress Scale\u20108 (DASS\u20108) among 214 Australian women with CPP (mean age\u2009=\u200933.3, SD\u2009=\u200912.4, range\u2009=\u200913\u201371\u2009years).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Receiver operator characteristic curve, decision trees and K\u2010means clustering techniques were used to examine the predictive capacity of the DASS\u20108 for psychiatric comorbidity, pain severity, any medication intake, analgesic intake and sexual abuse. The study is prepared according to the STROBE checklist.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Cut\u2010off points resulting from the analysis were ordered ascendingly. The median (13.0) was chosen as an optimal cut\u2010off score for predicting key outcomes. Women with DASS\u20108 scores below 15.5 had higher analgesic intake.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>CPP women with a DASS\u20108 score above 13.0 express greater pain severity, psychiatric comorbidity and polypharmacy. Thus, they may be a specific target for nursing interventions dedicated to alleviating pain through the management of associated co\u2010morbidities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Implications for patient care<\/jats:title><jats:p>At a cut\u2010off point of 13.0, the DASS\u20108 may be a practical instrument for recommending a thorough clinician\u2010based examination for psychiatric comorbidity to facilitate adequate CPP management. It may be useful for evaluating patients' response to nursing pain management efforts. Replications of the study in different populations\/countries are warranted.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jocn.16878","type":"journal-article","created":{"date-parts":[[2023,9,7]],"date-time":"2023-09-07T04:21:15Z","timestamp":1694060475000},"page":"8054-8062","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Cut\u2010off scores of the Depression Anxiety Stress Scale\u20108: Implications for improving the management of chronic pain"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6448-8282","authenticated-orcid":false,"given":"Amira Mohammed","family":"Ali","sequence":"first","affiliation":[{"name":"Department of Psychiatric Nursing and Mental Health, Faculty of Nursing Alexandria University  Alexandria Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rana Ali","family":"Alameri","sequence":"additional","affiliation":[{"name":"Fundamentals of Nursing Department, College of Nursing Imam Abdulrahman Bin Faisal University  Dammam Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiffany","family":"Brooks","sequence":"additional","affiliation":[{"name":"University of Adelaide and Aware Women's Health  North Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8896-8766","authenticated-orcid":false,"given":"Tazeen Saeed","family":"Ali","sequence":"additional","affiliation":[{"name":"School of Nursing and Midwifery Aga Khan University  Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nashwa","family":"Ibrahim","sequence":"additional","affiliation":[{"name":"Psychiatric and Mental Health Nursing Department, Faculty of Nursing Mansoura University  Mansoura 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