A preliminary study of an online pain management programme for patients with ankylosing spondylitis

Abstract

This study was a preliminary attempt to develop and examine an online pain management programme incorporating mindfulness‐informed exercises (i.e. breathing and body scanning exercises) and CBT elements for ankylosing spondylitis patients. Thirty patients diagnosed with ankylosing spondylitis participated in a five‐week online pain management programme, which was delivered primarily through a website. The materials covered by the website included breathing and body scanning exercises, mindful walking exercise, positive thinking and management of dysfunctional thinking. Each participant received instructions and reminders from a counselling psychologist through electronic communications each week. They completed the Brief Pain Inventory, Ryff's Psychological Well‐being Scale, Pain Self‐Efficacy Questionnaire, Pain Catastrophizing Scale and Cognitive and Affective Mindfulness Scale‐Revised before and after the treatment programme. In addition, four face‐to‐face focus groups were conducted to yield supplementary qualitative findings. The overall results indicate that this online pain management programme can improve sleep quality and reduce pain interference and catastrophic responses to pain in ankylosing spondylitis patients, albeit being not very effective for mitigating the intensity of pain. Moreover, male and female patients can benefit equally from the online programme. Findings from the focus groups revealed some challenges faced by local patients when practising mindfulness‐informed exercises. Some solutions to those challenges were put forward in accordance with patients’ feedback.

Experiences of Using Digital Mindfulness-Based Interventions: Rapid Scoping Review and Thematic Synthesis

“…All studies were assessed as adequately reported (Multimedia Appendix 10 [16,34,35,47,48,[52][53][54][55][56][57][58][59][60][61][62][63][64][65][66][67][68]), including qualitative studies (8/22, 36%) and mixed methods studies or questionnaire surveys when evaluated both as a whole and with respect to qualitative data on user experience only (14/22, 64%). Overall, each study reported on the study design and questions, participant selection, data collection, and analysis.…”

“…[...] setting aside time each day for lying down and practising the exercises before sleep and even during the daytime whenever possible, no matter how short the exercise was, could help them build up their perseverance. [Author [68]] However, seeing the value of making mindfulness a habit was not enough to meet the responsibility. Participants reported needing to persist and grapple with the effortful task of making practice a scheduled activity, which involved frequent adjustments to their plans, priorities, and commitments:…”

Systematic review and narrative synthesis of the experiences of individuals with chronic pain participating in digital pain management interventions

“…The timeframe in which the studies were included ranged from 2009 to 2021. Studies encompassed both digital applications for use on smartphones/ mobile devices [ 21 , 23 – 25 ] and user-directed online modular programmes [ 9 , 20 , 22 , 26 – 29 ].…”

“…Assessment of the robustness of the theoretically informed synthesised themes was the final step used in the narrative synthesis. To reduce potential bias, the findings were reanalysed after removing those studies with a medium or low CASP quality rating [ 20 – 22 ]. This reanalysis confirmed the original synthesised themes and subthemes were robust.…”

Pain catastrophizing in rheumatic diseases: prevalence, origin, and implications

“…However, there was a slight increase in the helplessness subscale of the PCS at the 10 week follow-up, suggesting a continued need for psychological support in managing ankylosing spondylitis. Despite these psychological benefits, the overall program did not effectively reduce pain intensity [ 71 ].…”