[Impact of a motivational intervention on coping with chronic pain: results of a controlled efficacy study].
BACKGROUND
For effective self-management of chronic pain changes of cognitive and behavioral attitudes are required. The readiness to change can be described within the framework of the transtheoretical model (TTM) and is facilitated through motivational interviewing. This prospective study evaluated the effectiveness of brief motivational interviewing by telephone for the variables self-efficacy, cognitive and behavioral coping and psychological strain through chronic pain over a period of 9 months.


METHODS
Different questionnaires, the self-efficacy expectations (ASES-D), cognitive, behavioral coping and psychological strain through chronic pain (FESV) and the German version of the pain stages of change questionnaires (PSOCQ), the FF-STABS were distributed to 147 patients at a rehabilitation clinic (indications: fibromyalgia syndrome, rheumatoid arthritis, ankylosing spondylitis). The intervention group participants received 3 telephone calls at intervals of 2 months with a follow-up time of 9 months after first study admission. At the end of the study 91 patients were enrolled for analysis (drop out rate 38%). To evaluate the effects of treatment nonparametric-analysis for longitudinal data was used.


CONCLUSIONS
The analysis showed significant positive effects in the intervention group for cognitive coping (U-value -2.423; p=0.015 group x time-effect) and for coping with emotional strains of chronic pain (subscale anxiety: U-value -2.3618; p=0.018; subscale anger: U-value 2.8638; p=0.004; group x time-effect). No significant effects were shown for self-efficacy expectations and behavioral coping with pain. Further explorative analysis of subgroups revealed slightly better treatment effects for patients with rheumatoid arthritis and ankylosing spondylitis than for those with fibromyalgia syndrome.
Rau
J
J
Zentrum für Klinische Psychologie und Rehabilitation, Universität Bremen, Grazer Str. 6, 28359 Bremen, Deutschland. jrau@uni-bremen.de
Ehlebracht-König
I
I
Petermann
F
F
D000223:Adaptation, Psychological; D000328:Adult; D001172:Arthritis, Rheumatoid / Q000523:psychology / Q000534:rehabilitation; D001521:Behavior Therapy; D002908:Chronic Disease; D015928:Cognitive Behavioral Therapy; D005260:Female; D005356:Fibromyalgia / Q000523:psychology / Q000534:rehabilitation; D006801:Humans; D055809:Illness Behavior; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010146:Pain / Q000523:psychology / Q000534:rehabilitation*; D010555:Personality Inventory; D011614:Psychotherapy, Brief; D012648:Self Care / Q000523:psychology; D020377:Self Efficacy; D013167:Spondylitis, Ankylosing / Q000523:psychology / Q000534:rehabilitation; D013689:Telephone