Predicting responses to self-management treatments for chronic pain: application of the pain stages of change model
- 1 January 2000
- journal article
- clinical trial
- Published by Wolters Kluwer Health in Pain
- Vol. 84 (1), 49-55
- https://doi.org/10.1016/s0304-3959(99)00184-0
Abstract
Psychological treatments emphasizing a self-management approach have become commonly accepted alternatives to medical interventions for chronic pain. Unfortunately, these approaches often fail to engage a significant portion of targeted individuals and are associated with high drop-out and relapse rates. Informed by the transtheoretical model of behavior change and the cognitive behavioral perspective on chronic pain, the Pain Stages of Change Questionnaire (PSOCQ) was developed to assess readiness to adopt a self-management approach to chronic pain. Initial studies supported the reliability and validity of four distinct scales, Precontemplation, Contemplation, Action and Maintenance. The current study was designed to assess the ability of the PSOCQ to predict self-management participation and outcome. The PSOCQ and several relevant outcome measures were assessed before and after self-management treatment by 109 chronic pain patients. Profile analysis revealed that treatment completers and non-completers differed significantly across the four PSOCQ scales. Post-hoc comparisons indicated that pretreatment PSOCQ Precontemplation and Contemplation scores discriminated these two groups. Separate analyses revealed that Action and Maintenance scores increased over the course of treatment, and that changes in the PSOCQ scales were associated with improved outcomes. These findings suggest that increased commitment to a self-management approach to chronic pain may serve as a mediator or moderator of successful treatment. This study supports the predictive validity and utility of the PSOCQ, as well as the relevance of the stages of change model to self-management of chronic pain.Keywords
This publication has 10 references indexed in Scilit:
- Readiness to adopt a self-management approach to chronic pain: the Pain Stages of Change Questionnaire (PSOCQ)Pain, 1997
- Behavioral medicine, clinical health psychology, and cost offset.Health Psychology, 1995
- Relationship of pain-specific beliefs to chronic pain adjustmentPain, 1994
- Factors associated with early discharge from a multidisciplinary work rehabilitation program for chronic low back painPain, 1994
- Comparison of cognitive-behavioral group treatment and an alternative non-psychological treatment for chronic low back painPain, 1992
- Neglected topics in the treatment of chronic pain patients — relapse, noncompliance, and adherence enhancementPain, 1991
- Neglected factors in chronic pain treatment outcome studies — referral patterns, failure to enter treatment, and attritionPain, 1990
- Factors for predicting premature termination from a multidisciplinary inpatient chronic pain programPain, 1989
- The West Haven-Yale Multidimensional Pain Inventory (WHYMPI)Pain, 1985
- The McGill Pain Questionnaire: Major properties and scoring methodsPain, 1975