A(pp)ceptance: Increasing physicians’ acceptance for chronic pain apps (Preprint)

2021 ◽  
Author(s):  
Hauke Jeldrik Hein ◽  
Julia Anna Glombiewski ◽  
Winfried Rief ◽  
Jenny Riecke
Keyword(s):  
Chronic Pain ◽  
Medical Students ◽  
Repeated Measures ◽  
Repeated Measures Design ◽  
Health Apps ◽  
Video Intervention ◽  
Performance Expectancy ◽  
Chronic Pain Patients ◽  
Secondary Outcomes ◽  
Pain Patients

BACKGROUND Chronic pain is one of the most costly and widespread medical conditions in the world. Despite effective forms of treatment, there is an urgent need to optimize therapies. Studies on the effectiveness of health apps for chronic pain patients are increasing and show promising results as a treatment adjunct or stand-alone treatment. Nevertheless, physicians’ acceptance of electronic health interventions has been somewhat reluctant, resulting in low prescription rates of health apps. OBJECTIVE The aim of our study was to determine and enhance physicians’ acceptance, performance expectancy and credibility of health apps for chronic pain patients. We further investigated predictors of acceptance. METHODS In a repeated measures design, 248 physicians were randomly assigned to either an experimental group (short educational video about health apps) or a control group (short video about chronic pain). Primary outcome measure was acceptance. Performance expectancy and the credibility of health apps were secondary outcomes. In addition, we assessed 101 medical students to evaluate the effectiveness of the video intervention in young professionals. RESULTS In general, physicians' acceptance of health apps for chronic pain patients was moderate (M=9.51, SD=3.53, scale ranges from 3-15). All primary and secondary outcomes were enhanced by the video intervention: A repeated-measures ANOVA yielded a significant interaction effect for acceptance (F(1, 246)=15.28, P=.01), performance expectancy (F(1, 246)=6.10, P=.01) and credibility (F(1, 246)=25.61, P<.001). The same pattern of results was evident among medical students. Linear regression analysis revealed credibility (β=.34, P<.001) and performance expectancy (β .30, P<.001) as the two strongest factors influencing acceptance, followed by skepticism (β=-.18, P<.001) and intuitive appeal (β=.11, P=.03). CONCLUSIONS Physicians’ acceptance of health apps was moderate, and was strengthened by a three minutes video. Besides performance expectancy, credibility seems to be a promising factor associated with acceptance. Future research should focus on ways to implement acceptability-increasing interventions into routine care. CLINICALTRIAL Open Science Framework: https://osf.io/x693r Registration DOI: 10.17605/OSF.IO/X693R

scholarly journals Differences in Swedish and Australian medical student attitudes and beliefs about chronic pain, its management, and the way it is taught

2018 ◽  
Vol 18 (3) ◽  
pp. 533-544 ◽  
Author(s):  
Linda Rankin ◽  
Britt-Marie Stålnacke ◽  
Christopher J. Fowler ◽  
Gisselle Gallego
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Medical Students ◽  
Clinical Guidelines ◽  
Management Education ◽  
Attitudes And Beliefs ◽  
Chronic Pain Management ◽  
Chronic Pain Patients ◽  
Swedish Medical ◽  
Pain Patients

Abstract Background and aims Medical students receive training in the management of chronic pain, but the training is often suboptimal. Considering that the basis for physician’s knowledge is their medical education, it is important to explore the attitudes and beliefs of medical students with respect both to chronic pain management and to their views on current pain education. Therefore, the aim of this study was to compare Swedish and Australian medical student’s attitudes and beliefs about patients with chronic pain, and their perceptions regarding their chronic pain management education. Methods An online survey was conducted with final year Australian and Swedish medical students from two different universities between December 2016 and February 2017. Attitudes and beliefs towards chronic pain patients were measured using the Health Care Providers’ Pain and Impairment Scale (HC-PAIRS). A thematic analysis was conducted on open end questions regarding their views on their education and important skills for chronic pain management. Results A total of 57 Swedish and 26 Australian medical students completed the HC-PAIRS scale. The Swedish medical students showed statistically significantly lower total mean HC-PAIRS scores compared to Australian medical students (46 and 51, respectively). Australian students had statistically significantly higher scores than the Swedish students for two of four factors: functional expectations and need for cure, whereas no significant differences were seen for the factors social expectations or for projected cognition. From the open end questions it was evident that final year medical students are knowledgeable about key chronic pain items described in clinical guidelines. However, both cohorts described their chronic pain training as poor and in need of improvement in several areas such as more focus on the biopsychosocial model, working in multidisciplinary teams, seeing chronic pain patients and pharmacological training. Conclusions Attitudes and beliefs are formed during medical education, and our study exploring attitudes of medical students towards chronic pain and how it is taught have provided valuable information. Our survey provided detailed and cohesive suggestions for education improvement that also are in line with current clinical guidelines. This study indicates that the Swedish final year students have a more positive attitude towards chronic pain patients compared to their Australian counterparts. The majority of students in both cohorts perceived chronic pain management education in need of improvement. Implications This study highlights several areas of interest that warrant further investigation, for example, the impact of a changed medical curriculum in alignment with these clinical guidelines requested by students in this survey, and correspondingly if their attitudes towards chronic pain patients can be improved through education. Further, we conclude that it would be valuable to align the implementation of the HC-PAIRS instrument in order to achieve comparable results between future studies.

scholarly journals Pre-Exposure Cybersickness Assessment Within a Chronic Pain Population in Virtual Reality

2021 ◽  
Vol 2 ◽  
Author(s):  
Phillip Brown ◽  
Wendy Powell
Keyword(s):  
Chronic Pain ◽  
Virtual Reality ◽  
Repeated Measures ◽  
Self Report ◽  
Symptom Reporting ◽  
Simulator Sickness ◽  
Post Exposure ◽  
Chronic Pain Patients ◽  
Zero Baseline ◽  
Pain Patients

Virtual Reality (VR) is being increasingly explored as an adjunctive therapy for distraction from symptoms of chronic pain. However, using VR often causes cybersickness; a condition with symptoms similar to those of motion and simulator sickness. Cybersickness is commonly assessed using self-report questionnaires, such as the Simulator Sickness Questionnaire (SSQ), and is traditionally conducted post-exposure. It’s usually safe to assume a zero baseline of cybersickness as participants are not anticipated to be exhibiting any sickness symptoms pre-exposure. However, amongst populations such as chronic pain patients, it’s not unusual to experience symptoms of their condition or medication which could have a confounding influence on cybersickness symptom reporting. Therefore, in population groups where illness and medication use is common, assuming baseline is not necessarily desirable. This study aimed to investigate cybersickness baseline recordings amongst a chronic pain population, and highlights how deviations from an assumed baseline may incorrectly infer adverse effects arising from VR exposure. A repeated measures study design was used, in which twelve participants were assessed pre and post VR exposure via SSQ. Significant differences were found between actual and assumed pre-exposure baseline scores. Furthermore, we found significant differences between actual and assumed increases in cybersickness scores from baseline to post exposure. This study highlights that clinical sub-populations cannot be assumed to have a zero baseline SSQ score, and this should be taken into consideration when evaluating the usability of VR systems or interventions for participants from different demographics.

Pain Influences Several Levels of Attention

2005 ◽  
Vol 16 (4) ◽  
pp. 235-242 ◽  
Author(s):  
Astrid von Bueren Jarchow ◽  
Bogdan P. Radanov ◽  
Lutz Jäncke
Keyword(s):  
Chronic Pain ◽  
Divided Attention ◽  
Covert Attention ◽  
Attention Task ◽  
Attentional Deficits ◽  
Control Subjects ◽  
Chronic Pain Patients ◽  
Divided Attention Task ◽  
Pain Stimuli ◽  
Pain Patients

Abstract: The aim of the present study was to examine to what extent chronic pain has an impact on various attentional processes. To measure these attention processes a set of experimental standard tests of the “Testbatterie zur Aufmerksamkeitsprüfung” (TAP), a neuropsychological battery testing different levels of attention, were used: alertness, divided attention, covert attention, vigilance, visual search, and Go-NoGo tasks. 24 chronic outpatients and 24 well-matched healthy control subjects were tested. The control subjects were matched for age, gender, and education. The group of chronic pain patients exhibited marked deficiencies in all attentional functions except for the divided attention task. Thus, the data supports the notion that chronic pain negatively influences attention because pain patients` attention is strongly captivated by the internal pain stimuli. Only the more demanding divided attention task has the capability to distract the focus of attention to the pain stimuli. Therefore, the pain patients are capable of performing within normal limits. Based on these findings chronic pain patients' attentional deficits should be appropriately evaluated and considered for insurance and work related matters. The effect of a successful distraction away from the pain in the divided attention task can also open new therapeutic aspects.

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