title: Integrative medicine for chronic pain: A cohort study using a process-outcome design in the context of a department for internal and integrative medicine.
abstract: BACKGROUND
  Integrative medicine inpatient treatment has been shown to improve physical and mental health in patients with internal medicine conditions. The aim of this study was to investigate the effectiveness of a 2-week integrative medicine inpatient treatment in patients with chronic pain syndromes and the association of treatment success with patient-related process variables.
  
  
  METHODS
  Inpatients with chronic pain syndromes participating in a 2-week integrative medicine inpatient program were included. Patients' pain intensity, pain disability, pain perception, quality of life, depression, and perceived stress were measured on admission, discharge, and 6 months after discharge. Likewise process variables including ability and will to change, emotional/rational disease acceptance, mindfulness, life and health satisfaction, and easiness of life were assessed.
  
  
  RESULTS
  A total of 310 inpatients (91% female, mean age 50.7 ± 12.4 year, 26.5% low back pain, and 22.9% fibromyalgia) were included. Using mixed linear models, significant improvements in pain intensity, pain disability, pain perception, quality of life, depression, and perceived stress were found (all P < 0.05). Ability to change and implementation, disease acceptance, mindfulness, life and health satisfaction, and light heartedness/easiness likewise improved (all P < 0.05). Improved outcomes were associated with increases in process variables, mainly ability to change and implementation, disease acceptance, life and health satisfaction, and light heartedness/easiness (R = 0.03-0.40).
  
  
  CONCLUSIONS
  Results of this study suggest that a 2-week integrative medicine inpatient treatment can benefit patients with chronic pain conditions. Functional improvements are associated with improved ability to change and implementation, disease acceptance, and satisfaction.
authors.affiliation: Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen Center for Integrative Medicine, Faculty of Medicine, University of Witten/Herdecke, Herdecke, Germany Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), University of Technology Sydney, Sydney, Australia.
authors.forename: Felix J
authors.initials: FJ
authors.lastname: Saha
authors.forename: Alexander
authors.initials: A
authors.lastname: Brüning
authors.forename: Cyrus
authors.initials: C
authors.lastname: Barcelona
authors.forename: Arndt
authors.initials: A
authors.lastname: Büssing
authors.forename: Jost
authors.initials: J
authors.lastname: Langhorst
authors.forename: Gustav
authors.initials: G
authors.lastname: Dobos
authors.forename: Romy
authors.initials: R
authors.lastname: Lauche
authors.forename: Holger
authors.initials: H
authors.lastname: Cramer
mesh_terms: D000328:Adult; D000368:Aged; D059350:Chronic Pain / Q000628:therapy*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D055048:Integrative Medicine; D007388:Internal Medicine; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D059408:Pain Management / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult