scholarly journals Participants and developers experiences with a chronic pain self-management intervention under development: A qualitative study

2018 ◽  
Vol 6 ◽  
pp. 205031211881742 ◽  
Author(s):  
Kjersti Grønning ◽  
Torunn Hatlen Nøst ◽  
Toril Rannestad ◽  
Ola Bratås

Background: Non-pharmacological interventions aim to promote health and self-management for people with chronic pain. Objective: The aim of this study was to explore if the participants’ experiences with a self-management intervention under development were aligned with the developers’ rationale and desired outcome of the intervention. Methods: This was a qualitative study interviewing both participants and developers of a chronic pain self-management intervention. Seven participants, six females and one male in the age from early thirties to mid-seventies attended the chronic pain self-management intervention developed by the staff at a Healthy Life Centre. The data were analysed by the systematic text condensation method. Results: The analyses showed that the participants evaluated the intervention as valuable. They described using coping techniques to manage their chronic pain better, and the developers stated that the aim with the intervention was to provide the participants with coping techniques. The intervention was built upon the developers’ professional knowledge and experience in cognitive techniques, health theories, models for behavioural change, and service user involvement. Conclusion: This study found that the chronic pain self-management intervention was in concordance with theory of health promotion and empowerment. The participants experienced the intervention as targeting their resources, capacities, and fulfilling social needs, which aligned with the developers aim with the intervention. The participants found the intervention evocative; they learned new ways to manage their pain through theory/education, movement exercises, homework, and sharing their experiences with each other.

Pain Medicine ◽  
2019 ◽  
Vol 20 (10) ◽  
pp. 2018-2032 ◽  
Author(s):  
M Bérubé ◽  
C Gélinas ◽  
N Feeley ◽  
G Martorella ◽  
J Côté ◽  
...  

Abstract Objective 1) To assess the feasibility of research methods to test a self-management intervention aimed at preventing acute to chronic pain transition in patients with major lower extremity trauma (iPACT-E-Trauma) and 2) to evaluate its potential effects at three and six months postinjury. Design A pilot randomized controlled trial (RCT) with two parallel groups. Setting A supraregional level 1 trauma center. Methods Fifty-six adult patients were randomized. Participants received the intervention or an educational pamphlet. Several parameters were evaluated to determine the feasibility of the research methods. The potential efficacy of iPACT-E-Trauma was evaluated with measures of pain intensity and pain interference with activities. Results More than 80% of eligible patients agreed to participate, and an attrition rate of ≤18% was found. Less than 40% of screened patients were eligible, and obtaining baseline data took 48 hours postadmission on average. Mean scores of mild pain intensity and pain interference with daily activities (<4/10) on average were obtained in both groups at three and six months postinjury. Between 20% and 30% of participants reported moderate to high mean scores (≥4/10) on these outcomes at the two follow-up time measures. The experimental group perceived greater considerable improvement in pain (60% in the experimental group vs 46% in the control group) at three months postinjury. Low mean scores of pain catastrophizing (Pain Catastrophizing Scale score < 30) and anxiety and depression (Hospital Anxiety and Depression Scale scores ≤ 10) were obtained through the end of the study. Conclusions Some challenges that need to be addressed in a future RCT include the small proportion of screened patients who were eligible and the selection of appropriate tools to measure the development of chronic pain. Studies will need to be conducted with patients presenting more serious injuries and psychological vulnerability or using a stepped screening approach.


2018 ◽  
Vol 98 (5) ◽  
pp. 381-397 ◽  
Author(s):  
Hemakumar Devan ◽  
Leigh Hale ◽  
Dagmar Hempel ◽  
Barbara Saipe ◽  
Meredith A Perry

2015 ◽  
Vol 16 (4) ◽  
pp. S99
Author(s):  
J. Merlin ◽  
M. Bair ◽  
R. Kerns ◽  
K. Burgio ◽  
J. Turan

2015 ◽  
Vol 17 (03) ◽  
pp. 252-264
Author(s):  
Shilpa Patel ◽  
Peter J Heine ◽  
David R Ellard ◽  
Martin Underwood

BackgroundOsteoarthritis (OA) is a common condition expected to be the fourth leading cause of disability by the year 2020. Treatment with non-steroidal anti-inflammatory drugs is problematic in older adults (&gt;75 years) where the presence of comorbidities is more prevalent. Exercise has been recommended irrespective of age and comorbidity. The purpose of this project was to develop a combined exercise and self-management intervention to help older adults with OA to manage their comorbidities.MethodsLiterature reviews were conducted to inform the development of an intervention followed by a pilot study to assess feasibility and test outcome measures. Participant interviews and session observation were used to evaluate the pilot study.ResultsEvidence from the literature reviews suggested that a combined intervention consisting of behavioural change/self-management education and exercise was the most appropriate. Each component was developed and then tested as a combined package in a pilot study which comprised 12 sessions delivered over six weeks. Four males and six females aged between 75 and 92 years took part. The average attendance was 89%. Most participants reported some benefit and satisfaction with the programme along with changes in physical ability. The majority of participants continued with some form of exercise at three months.ConclusionThe intervention was well received and has encouraged 80% of participants to continue exercising after the programme. The small but positive changes seen in comorbidities, benefit of the intervention, satisfaction and general health are promising. Randomised controlled trial evidence of effectiveness and cost effectiveness is needed before such interventions can be recommended.


10.2196/23893 ◽  
2020 ◽  
Vol 4 (10) ◽  
pp. e23893
Author(s):  
Katrine Bostrøm ◽  
Elin Børøsund ◽  
Cecilie Varsi ◽  
Hilde Eide ◽  
Elise Flakk Nordang ◽  
...  

Background Chronic pain can be complex and taxing to live with, and treatment and support require a multicomponent approach, which may not always be offered or available. Smartphones, tablets, and personal computers are already incorporated into patients’ daily lives, and therefore, they can be used to communicate, educate, and support self-management. Although some web-based self-management interventions exist, research examining the evidence and effect of digital solutions supporting self-management for patients living with chronic pain is limited, findings are inconclusive, and new innovative ideas and solutions are needed. Objective This feasibility pilot study aimed to explore the system use, perceived usefulness, ease of use, and preliminary effects of EPIO, an app-based cognitive-behavioral pain self-management intervention program for patients living with chronic pain. Methods The EPIO intervention was delivered in a blended-care model containing (1) one face-to-face introduction session, (2) nine cognitive behavior–based pain self-management modules, delivered in an app-based format for smartphones or tablets, and (3) one follow-up phone call at 2 to 3 weeks after the introduction session. Patients living with chronic pain (N=50) completed pre-post outcome measures at baseline and 3 months after the introduction session, with registration of system use (ie, log data) until 6 months. The use, perceived usefulness, and ease of use of the EPIO program were examined through system use data, as well as a study-specific use/usability questionnaire and the System Usability Scale (SUS). Outcome measures to test feasibility of use and estimate preliminary effects included the Brief Pain Inventory, health-related quality of life (HRQoL) scale, Hospital Anxiety and Depression Scale, Self-Regulatory Fatigue scale, Pain Catastrophizing Scale, and Chronic Pain Acceptance Questionnaire. Results Participants (N=50) had a median age of 52 years (range 29-74 years) at inclusion and were mainly female (40/50, 80%). Thirty-one participants completed at least six of the nine modules within the 3-month study period (62% completion rate). Forty-five participants completed outcome measures at 3 months, and the EPIO program was rated as useful (ie, “totally agree” or “agree”; 39/45, 87%) and easy to use (42/45, 93%), and as having easily understandable exercises (44/45, 98%). The average overall system usability (SUS) score was 85.7, indicating grade A and excellent system usability. Preliminary psychosocial outcome measure estimates showed primarily nonsignificant pre-post intervention improvements at 3 months, but with significant positive effects related to some aspects of HRQoL (bodily pain, P=.02 and change, P=.049). Conclusions  Digital self-management intervention programs may be of use and support for patients living with chronic pain. In this feasibility study, EPIO showed an acceptable program completion rate and was rated as useful and easy to use, with excellent user satisfaction. Program optimization and efficacy testing in a large-scale randomized controlled trial are warranted and in progress. Trial Registration ClinicalTrials.gov NCT03705104; https://clinicaltrials.gov/ct2/show/NCT03705104


2018 ◽  
Author(s):  
Mélanie Bérubé ◽  
Céline Gélinas ◽  
Nancy Feeley ◽  
Géraldine Martorella ◽  
José Côté ◽  
...  

BACKGROUND A transition from acute to chronic pain frequently occurs after major lower extremity trauma. While the risk factors for developing chronic pain in this population have been extensively studied, research findings on interventions aiming to prevent chronic pain in the trauma context are scarce. Therefore, we developed a hybrid, Web-based and in-person, self-management intervention to prevent acute to chronic pain transition after major lower extremity trauma (iPACT-E-Trauma). OBJECTIVE This study aimed to assess the feasibility and acceptability of iPACT-E-Trauma. METHODS Using a descriptive design, the intervention was initiated at a supra-regional level-1 trauma center. Twenty-eight patients ≥18 years old with major lower extremity trauma, presenting with moderate to high pain intensity 24 hours post-injury were recruited. Feasibility assessment was two-fold: 1) whether the intervention components could be provided as planned to ≥80% of participants and 2) whether ≥80% of participants could complete the intervention. The rates for both these variables were calculated. The E-Health Acceptability Questionnaire and the Treatment Acceptability and Preference Questionnaire were used to assess acceptability. Mean scores were computed to determine the intervention’s acceptability. RESULTS More than 80% of participants received the session components relevant to their condition. However, the Web pages for session 2, on the analgesics prescribed, were accessed by 71% of participants. Most sessions were delivered according to the established timeline for ≥80% of participants. Session 3 and in-person coaching meetings had to be provider earlier for ≥35% of participants. Session duration was 30 minutes or less on average, as initially planned. More than 80% of participants attended sessions and <20% did not apply self-management behaviors relevant to their condition, with the exception of deep breathing relaxation exercises which was not applied by 40% of them. Web and in-person sessions were assessed as very acceptable (mean scores ≥3 on a 0 to 4 descriptive scale) across nearly all acceptability attributes. CONCLUSIONS Findings showed that the iPACT-E-Trauma intervention is feasible and was perceived as highly acceptable by participants. Further tailoring iPACT-E-Trauma to patient needs, providing more training time for relaxation techniques, and modifying the Web platform to improve its convenience could enhance the feasibility and acceptability of the intervention. CLINICALTRIAL International Standard Randomized Controlled Trial Number (ISRCTN): 91987302; http://www.controlled-trials.com/ISRCTN91987302 (Archived by WebCite at http://www.webcitation.org/6ynibjPHa)


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