title: A behavioral medicine intervention for older women living alone with chronic pain - a feasibility study.
abstract: BACKGROUND
  To be an older woman, live alone, have chronic pain, and be dependent on support are all factors that may have an impact on daily life. One way to promote ability in everyday activities in people with pain-related conditions is to use individualized, integrated behavioral medicine in physical therapy interventions. How this kind of intervention works for older women living alone at home, with chronic pain, and dependent on formal care to manage their everyday lives has not been studied. The aim was to explore the feasibility of a study and to evaluate an individually tailored integrated behavioral medicine in physical therapy intervention for the target group of women.
  
  
  METHODS
  The study was a 12-week randomized trial with two-group design. Primary effect outcomes were pain-related disability and morale. Secondary effect outcomes focused on pain-related beliefs, self-efficacy for exercise, concerns of falling, physical activity, and physical performance.
  
  
  RESULTS
  In total, 23 women agreed to participate in the study and 16 women completed the intervention. The results showed that the behavioral medicine in physical therapy intervention was feasible. No effects were seen on the primary effect outcomes. The experimental intervention seemed to improve the level of physical activity and self-efficacy for exercise. Some of the participants in both groups perceived that they could manage their everyday life in a better way after participation in the study.
  
  
  CONCLUSIONS
  Results from this study are encouraging, but the study procedure and interventions have to be refined and tested in a larger feasibility study to be able to evaluate the effects of these kinds of interventions on pain-related disability, pain-related beliefs, self-efficacy in everyday activities, and morale in the target group. Further research is also needed to refine and evaluate effects from individualized reminder routines, support to collect self-report data, safety procedures for balance training, and training of personnel to enhance self-efficacy.
authors.affiliation: Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge, Sweden ; School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna, Vasteras, Sweden.
authors.forename: Sara
authors.initials: S
authors.lastname: Cederbom
authors.affiliation: School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna, Vasteras, Sweden ; Research and Development Unit, Jakobsbergs Hospital, Stockholm County Council, Järfälla, Sweden.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Rydwik
authors.affiliation: School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna, Vasteras, Sweden.
authors.forename: Anne
authors.initials: A
authors.lastname: Söderlund
authors.affiliation: School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna, Vasteras, Sweden.
authors.forename: Eva
authors.initials: E
authors.lastname: Denison
authors.affiliation: Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge, Sweden.
authors.forename: Kerstin
authors.initials: K
authors.lastname: Frändin
authors.affiliation: School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna, Vasteras, Sweden.
authors.forename: Petra
authors.initials: P
authors.lastname: von Heideken Wågert
mesh_terms: D000203:Activities of Daily Living; D000369:Aged, 80 and over; D001521:Behavior Therapy; D059350:Chronic Pain / Q000523:psychology* / Q000534:rehabilitation*; D004185:Disability Evaluation; D005240:Feasibility Studies; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D009013:Morale; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D010349:Patient Compliance; D010809:Physical Fitness; D026741:Physical Therapy Modalities; D020377:Self Efficacy; D013548:Sweden; D016896:Treatment Outcome
keywords: biopsychosocial model; community-dwelling; elderly; exercise intervention; female; physical therapy