Objectives-To (1) describe a behavioral intervention designed for patients with elevated pain catastrophizing who are scheduled for knee arthroplasty, and (2) use a quasi-experimental design to evaluate the potential efficacy of the intervention on pain severity, catastrophizing cognitions, and disability.Design-Quasi-experimental non-equivalent control group design with a 2 month follow-up.
Setting-Two university-based Orthopedic Surgery departments.Participants-Adults scheduled for knee replacement surgery who reported elevated levels of pain catastrophizing. Patients were recruited from two clinics and were assessed prior to surgery and 2 months following surgery.Intervention-A group of 18 patients received a psychologist directed pain coping skills training intervention comprising 8 sessions and the other group, a historical cohort of 45 patients, received usual care.Main Outcome Measures-WOMAC Pain and Disability scores as well as scores on the Pain Catastrophizing Scale.Results-Two months following surgery, the patients who received pain coping skills training reported significantly greater reductions in pain severity and catastrophizing, and greater improvements in function as compared to the usual care cohort.Conclusion-Pain catastrophizing is known to increase risk of poor outcome following knee arthroplasty. The findings provide preliminary evidence that the treatment may be highly efficacious for reducing pain, catastrophizing, and disability, in patients reporting elevated Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. The two purposes of this study were to: (1) describe a pain coping skills training intervention that our team developed specifically for a subgroup of patients scheduled for knee arthroplasty who also had high levels of pain catastrophizing, and (2) conduct a quasiexperimental study to evaluate the efficacy of this intervention on a consecutively recruited sample of patients, comparing the outcomes to a usual care cohort of patients with similarly high levels of pain catastrophizing but who did not receive pain coping skills training. Quasi-experimental studies are appropriate for use when innovative interventions are developed and compared to a reasonable control condition to obtain an initial estimate of efficacy and to determine if a randomized clinical trial is warranted. 15 Because our study was preliminary in nature, we chose not to declare a single primary outcome variable but rather to examine effects on three important outcomes: self-reported pain severity, function and pain catastrophizing. To our knowledge, this is the first ...