title: Nurse-led pain management program: effect on self-efficacy, pain intensity, pain-related disability, and depressive symptoms in chronic pain patients.
abstract: Nurses routinely use a variety of nonpharmacologic and patient education interventions designed to reduce pain and promote independence. Research on group programs that combine these nursing strategies in a systematic approach provides evidence that chronic pain patients can realize an enhanced confidence in their ability to manage pain (improved self-efficacy) in addition to reductions in pain, emotional distress, and disability. The purpose of this study was to investigate the effect of participating in a nurse-led cognitive-behavioral treatment (CBT) pain management program on self-efficacy, pain intensity, pain-related disability, and depressive symptoms among patients with chronic pain. Pre- and postprogram data from 154 participants were examined to identify changes in pain intensity, self-efficacy, disability, and depressive symptoms. Mean differences, effect sizes, and 95% confidence intervals were computed for the study variables and paired t-tests were done to determine if changes were significant. Z-scores were then calculated. Pearson product moment correlations were examined to test the association between changes in self-efficacy and changes in the other variables of interest. Patients in this study reported significant improvements in all scores postprogram. Self-efficacy, pain-intensity, pain-related disability, and symptoms of depression can be changed through participation in a nurse-led outpatient CBT program. In concert with results from other research on CBT pain programs this study provides further evidence that reduction in suffering and improved sense of well-being is possible even for people who have experienced pain for many years.
authors.affiliation: Graduate School of Health Studies, Simmons College, Boston, MA, USA.
authors.forename: Carol
authors.initials: C
authors.lastname: Wells-Federman
authors.forename: Paul
authors.initials: P
authors.lastname: Arnstein
authors.forename: Margaret
authors.initials: M
authors.lastname: Caudill
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D001294:Attitude to Health; D002908:Chronic Disease; D015928:Cognitive Behavioral Therapy / Q000592:standards*; D003863:Depression / Q000175:diagnosis / Q000209:etiology / Q000451:nursing* / Q000523:psychology; D006233:Persons with Disabilities / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009720:Nurse Clinicians / Q000592:standards*; D015403:Nursing Evaluation Research; D010146:Pain / Q000150:complications / Q000175:diagnosis / Q000451:nursing* / Q000523:psychology; D010147:Pain Measurement; D010353:Patient Education as Topic / Q000592:standards*; D015397:Program Evaluation; D020377:Self Efficacy