Pain self-management in the process and outcome of multidisciplinary treatment of chronic pain: evaluation of a stage of change model.
For chronic pain patients, acceptance of a self-management approach for pain may influence success in treatment, and adopting such a perspective may be conceptualized as a stage of change model. For 65 chronic pain patients in multidisciplinary treatment programs, we examined whether pretreatment self-management stage, assessed with Pain Stage of Change Questionnaire subscales, affected improvements in outcomes, and whether changes in stage represented a therapeutic process factor. Results showed (a) low precontemplation, high contemplation, and high action attitudes at pretreatment predicted greater improvements in outcomes than the opposite pattern of attitudes; (b) pre- to midtreatment changes in precontemplation and contemplation attitudes predicted mid- to posttreatment changes in pain severity and interference, but not vice versa. Results support the usefulness of a stage model in conceptualizing patients' acquisition of a self-management approach to pain, and suggest that early-treatment progression across stages may lead to reductions in pain severity and lifestyle interference.
Finch University of Health Sciences/Chicago Medical School, North Chicago, Illinois, USA.
Beth
B
Glenn
John W
JW
Burns
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D002641:Chicago; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D009042:Motivation; D015999:Multivariate Analysis; D010043:Outcome and Process Assessment, Health Care; D010146:Pain / Q000523:psychology / Q000534:rehabilitation*; D010147:Pain Measurement; D012044:Regression Analysis; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires