title: Is There a Need for Including Spiritual Care in Interdisciplinary Rehabilitation of Chronic Pain Patients? Investigating an Innovative Strategy.
abstract: OBJECTIVE
  Chronic noncancer pain influences patient's quality of life and their ability to cope. Pain relieving medication and other specific treatments commonly integrated in biopsychosocial rehabilitation demonstrate modest benefits in pain relief and improved functioning of individuals. Spiritual care, covering the fourth dimension provides insight, inspires hope and purpose, and is thought to mediate mental and physical health for patients. This study explores the need for its inclusion in interdisciplinary pain rehabilitation and describes the requirements and test environment for evaluation.
  
  
  METHODS
  Outcomes of spiritual care and interdisciplinary pain rehabilitation in follow-up studies of randomized controlled trials contained in systematic reviews were summarized. Pubmed, Cochrane, and PsycINFO were searched, citation tracking was applied, articles of follow-up studies therein were located. Literature was searched for insights pertaining to requirements for an assessment of including this fourth dimension.
  
  
  RESULTS
  No systematic reviews for spiritual care were identified. Five systematic reviews of biopsychosocial rehabilitation containing 14 studies describing long-term outcomes were retrieved. The importance of coping in maintaining long-term outcomes was empirically illustrated. The required test environment is provided by a structured multidimensional care pathway separating spirituality from well-being and mental health, with measures of treatment outcome installed enabling a comparison with benchmarks.
  
  
  CONCLUSIONS
  Active coping seems beneficial for maintaining positive long-term outcomes of interdisciplinary pain rehabilitation Spiritual care may be conducive to active coping. Further research is warranted to explore the additive value of this spiritual care in the context of a multidimensional care pathway.
authors.affiliation: Ciran Rehabilitation Centers, Venlo, the Netherlands.
authors.forename: Alexander
authors.initials: A
authors.lastname: Garschagen
authors.affiliation: Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands.
authors.forename: Monique A H
authors.initials: MA
authors.lastname: Steegers
authors.affiliation: Ciran Rehabilitation Centers, Venlo, the Netherlands.
authors.forename: Alfonsus H M M
authors.initials: AH
authors.lastname: van Bergen
authors.affiliation: Ciran Rehabilitation Centers, Venlo, the Netherlands.
authors.forename: Johannes A M
authors.initials: JA
authors.lastname: Jochijms
authors.affiliation: Ciran Rehabilitation Centers, Venlo, the Netherlands.
authors.forename: Titus L M
authors.initials: TL
authors.lastname: Skrabanja
authors.affiliation: Saw Swee Hock School of Medicine, National University of Singapore, Singapore, Singapore.
authors.forename: Hubertus J M
authors.initials: HJ
authors.lastname: Vrijhoef
authors.affiliation: Adelante, Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, the Netherlands.|Research School CAPHRI, Department of Rehabilitation Medicine, Maastricht University, Maastricht, the Netherlands.|Department of Rehabilitation Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands.
authors.forename: Rob J E M
authors.initials: RJ
authors.lastname: Smeets
authors.affiliation: Department of Anesthesiology, Pain and Palliative Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands.
authors.forename: Kris C P
authors.initials: KC
authors.lastname: Vissers
mesh_terms: D000223:Adaptation, Psychological; D059350:Chronic Pain / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D059408:Pain Management / Q000379:methods / Q000639:trends*; D010348:Patient Care Team / Q000639:trends*; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic / Q000379:methods; D026443:Spiritual Therapies / Q000379:methods / Q000639:trends*; D035703:Therapies, Investigational / Q000379:methods / Q000639:trends*; D016896:Treatment Outcome
keywords: behavioral medicine; coping behavior; interdisciplinary pain rehabilitation; mental health; multidisciplinary pain centers; pain; rehabilitation; spiritual care