Brief cognitive‐behavioral audiotape interventions for cancer‐related pain

Abstract

BACKGROUND Few studies have evaluated cognitive‐behavioral interventions as an adjunct treatment for chronic cancer‐related pain. A randomized clinical trial was performed evaluating the efficacy of 3 brief cognitive‐behavioral techniques: relaxation, distraction, and positive mood interventions. METHODS Fifty‐seven patients with chronic cancer‐related pain taking opioid medications were randomly assigned to either the relaxation, distraction, positive mood, or waiting‐list control group. The patients in the 3 intervention groups received audiotapes of the cognitive‐behavioral technique and were asked to practice regularly at home. The tapes were supplemented with written instructions and follow‐up telephone calls. RESULTS Patients in the relaxation and distraction groups reported significantly reduced pain intensity immediately after listening to the tapes. The pain reduction was not maintained, however. At the 2‐week follow‐up assessment, no significant differences in pain intensity or interference were found among the treatment groups. The groups also did not differ with regard to secondary outcome measures assessing quality of life, mood, self‐efficacy, and other symptoms. The results of qualitative interviews indicated that patients often had difficulty focusing on the audiotapes and preferred their own methods of pain reduction. CONCLUSIONS Brief relaxation and distraction audiotape interventions produced immediate pain reductions but not longer‐term pain relief. Additional research with a more individualized intervention is needed to evaluate cognitive‐behavioral interventions for cancer pain control. Cancer 2006. © 2006 American Cancer Society.

Feasibility of a Patient-Controlled Cognitive-Behavioral Intervention for Pain, Fatigue, and Sleep Disturbance in Cancer

“…Such findings are not unusual with brief cognitive-behavioral interventions. Anderson et al (2006) demonstrated immediate reductions in cancer pain intensity with recorded relaxation, distraction, and positive mood strategies, but effects were not significant at a 2-week follow-up. Similarly, Berman, Iris, Bode and Dregenberg (2009) reported significant reductions in chronic non-cancer pain immediately pre- to post-treatment using web-based training in self-care pain management strategies (e.g., relaxation, positive thinking, emotional expression), but no significant differences between baseline pain intensity and a 6-week follow-up assessment.…”

“…Numerous investigators have demonstrated that strategies such as relaxation, distraction, and imagery can effectively diminish the negative physical and emotional reaction to cancer pain, as well as diminish pain intensity (Anderson et al, 2006; Kwekkeboom, Kneip & Pearson, 2003; Luebbert, Dahme, & Hasenbring, 2001; Sloman, Brown, Aldana & Chee, 1994; Syrjala, Donaldson, Davis, Kippes, & Carr, 1995). Cancer researchers have demonstrated similar findings in persons with other disease and treatment-related side effects such as nausea, vomiting, and distress (Mundy, DuHamel, & Montgomery, 2003; Redd, Montgomery, & DuHamel, 2001; Roffe, Schmidt, & Ernst, 2005).…”

Mind-Body Treatments for the Pain-Fatigue-Sleep Disturbance Symptom Cluster in Persons with Cancer

“…Samples included hospitalized patients with cancer pain, and outpatients with chronic cancer pain, and women with early stage breast cancer. Significantly greater pain relief was obtained with PMR when compared to massage, treatment-as-usual (33), positive mood manipulation, distraction, and a no treatment control condition (34). Biofeedback-assisted relaxation resulted in greater pain relief when compared to attention control (e.g., time spent with a nurse) (35).…”

Effects of self‐directed stress management training and home‐based exercise on quality of life in cancer patients receiving chemotherapy: a randomized controlled trial

“…Despite evidence of efficacy, training and resources required to provide professionally administered psychosocial interventions can be major barriers to their routine use. To address this issue, several investigators developed and evaluated self‐administered forms of stress management training for cancer patients . Of particular relevance to the current study is an intervention our team designed for chemotherapy patients .…”