title: Health-related quality of life improvements among women with chronic pain: comparison of two multidisciplinary interventions.
abstract: OBJECTIVE
  To measure the effect of 4 weeks traditional multidisciplinary pain management program (TMP) versus neuroscience education and mindfulness-based cognitive therapy (NEM) on quality of life (HRQL) among women with chronic pain.
  
  
  METHODS
  This observational longitudinal cohort study conducted in an Icelandic rehabilitation centre included 122 women who received TMP, 90 receiving NEM, and 57 waiting list controls. Pain intensity (visual analogue scale) and HRQL (Icelandic Quality of Life scale) were measured before and after interventions. ANOVA and linear regression were used for comparisons.
  
  
  RESULTS
  Compared with controls we observed statistically significant changes in pain intensity (p < 0.001) and HRQL (p < 0.001) among women receiving both interventions, while NEM participants reported significant improvements in sleep (8.0 versus 4.4 in TMP; p = 0.008). Head to head comparison between study groups revealed that pain intensity improved more among TMP participants (21.8 versus 17.2 mm; p = 0.013 adjusted). Women with low HRQL at baseline improved more than those with higher HRQL (mean TMP = 13.4; NEM = 12.9 if HRQL ≤ 35 versus mean TMP = 6.6 and NEM = 7.8 if HQRL > 35).
  
  
  CONCLUSIONS
  Our non-randomized study suggests that both NEM and TMP programs improve pain and HRQL among women with chronic pain. Sleep quality showed more improvements in NEM while pain intensity in TMP. Longer-term follow-ups are needed to address whether improvements sustain.
  
  
  CONCLUSIONS
  Chronic pain is a debilitating condition affecting quality of life and restricting societal participation. Intensive multidisciplinary bio-psycho-social rehabilitation is essential for this patient group. This study shows improvement in health-related quality of life and pain intensity following such rehabilitation. Emphasizing mindfulness based cognitive therapy and neuroscience patient education improves sleep to more extend than more traditional approach.
authors.affiliation: a Department of Physical Therapy , and.|b Centre of Public Health Sciences, Faculty of Medicine, University of Iceland , Reykjavík , Iceland .
authors.forename: Sigrún Vala
authors.initials: SV
authors.lastname: Björnsdóttir
authors.affiliation: c HNLFI Rehabilitation Clinic , Hveragerði , Iceland .
authors.forename: Margrét
authors.initials: M
authors.lastname: Arnljótsdóttir
authors.affiliation: b Centre of Public Health Sciences, Faculty of Medicine, University of Iceland , Reykjavík , Iceland .
authors.forename: Gunnar
authors.initials: G
authors.lastname: Tómasson
authors.affiliation: c HNLFI Rehabilitation Clinic , Hveragerði , Iceland .|d Department of Orthopaedic Surgery, Akademiska , University Hospital Uppsala , Sweden , and.
authors.forename: Jan
authors.initials: J
authors.lastname: Triebel
authors.affiliation: b Centre of Public Health Sciences, Faculty of Medicine, University of Iceland , Reykjavík , Iceland .|e Department of Epidemiology , Harvard School of Public Health , Boston , MA , USA.
authors.forename: Unnur Anna
authors.initials: UA
authors.lastname: Valdimarsdóttir
mesh_terms: D059350:Chronic Pain / Q000150:complications / Q000175:diagnosis / Q000523:psychology / Q000534:rehabilitation; D003131:Combined Modality Therapy / Q000379:methods; D004035:Diet Therapy / Q000379:methods*; D020920:Dyssomnias / Q000209:etiology / Q000628:therapy; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D007055:Iceland; D008137:Longitudinal Studies; D008875:Middle Aged; D064866:Mindfulness / Q000379:methods*; D059408:Pain Management / Q000379:methods; D010147:Pain Measurement; D010348:Patient Care Team / Q000458:organization & administration*; D010353:Patient Education as Topic / Q000379:methods; D011788:Quality of Life; D016896:Treatment Outcome
keywords: Chronic pain; health-related quality of life; mindfulness; multidisciplinary rehabilitation; neuroscience patient education