Factors involved in patients’ perceptions of self-improvement after chronic pain treatment

Abstract

Background Patients’ self-reported levels of improvement after having attended a chronic pain management program can provide a subjective rating of how successful they perceive they were at accomplishing their goals in the program. Past studies have demonstrated that successful patients differ from less successful ones on several cognitive–behavioral factors such as coping strategies over physical characteristics such as pain intensity. Aims This study explored factors that determine patients’ perceptions of self-improvement after undergoing chronic pain treatment in a pain management program. Methods Participants ( n = 174) underwent a 4-week, interdisciplinary, multimodal, chronic pain management program at a hospital located in southern Ontario. Questionnaire packages that evaluate pain intensity, pain-related disability, emotional distress (e.g., depression, anxiety, catastrophizing), acceptance of pain (activity engagement and pain willingness), readiness to change, and use of adaptive or maladaptive coping strategies were completed by patients at admission and discharge. Participants were grouped into one of three categories depending on their rating of self-improvement on the Self-Evaluation Scale (SES). The groups were compared on the magnitude of change they reported on the variables mentioned above. Results Changes in emotional distress, general health, readiness to change, activity engagement, and adaptive coping strategies (e.g., task persistence, pacing, and seeking social support) were significantly associated with differences in ratings of self-improvement. Conclusions This study provided insight into what patients value most when rating their self-improvement, which can then be used to facilitate increased patient success and satisfaction with treatment.

Patient Satisfaction With Chronic Pain Management: Patient Perspectives of Improvement

“…Patients are motivated to attend pain programs after experiencing limited relief with biomedical methods (40). Results from these satisfaction questionnaires are consistent with previous findings in this program (12,25,27).…”

“…The SES is used to determine the participant’s perceived performance in the program. The SES was found to be reliable and valid in assessing goal accomplishment in a multidisciplinary chronic pain management program (12,26,27).…”

Evaluation of an interdisciplinary chronic pain program and predictors of readiness for change

“…Moreover, the sample of this study was primarily female and Caucasian, which might lead to issues with generalizability and highlight potential issues of program accessibility and barriers to participation. Though the demographics of this sample were comparable to those of similar studies in the region, 40,41 this is an important area for future research, especially in relation to publicly funded programs. Additionally, although the regression models suggest that pain-related outcomes predict the stages of change, this is simply an association and not an assumption of direction or causation.…”

Minimal clinically important difference for improvement in six-minute walk test in persons with knee osteoarthritis after total knee arthroplasty

“…Second, this could reflect the multitude of other factors that might influence an individual’s perception of change, including recall bias. In individuals with chronic pain, perception of improvement has been shown to be influenced by psychological factors, coping strategies, and general health [ 32 ]. A prior study of individuals with knee OA showed incongruence between patient perception of functional ability and performance-based measurements [ 33 ].…”