Comparing the Effects of Pain Coping Interventions on Functioning and Quality of Life: A Quasi-Experiment

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Comparing the Effects of Pain Coping Interventions on Functioning and Quality of Life

A Quasi-Experiment

Abstract

Objective To determine the extent to which an intervention aimed at increasing client participation in their own care (?) improves outcomes in the treatment of recalcitrant chronic pain.

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Participants Participants have experienced a variety of other treatments without success. They are referred by physicians to the "experimental" arm (Arm I), which is funded by public insurers; or to the "control arm (Arm II), which is not. Treatment is cognitive-behavioural therapy (?) in both arms; but Arm I also involves ….. (?)

Methodology Quasi-experimental design, pre-and-post study. Referrers are blinded as to differences in intervention style. Data collection is at enrolment, at discharge, and 6 months post-discharge. Data are entered into SPSS and compared using Student=s t-test or repeated measures ANOVA as appropriate. Variables include demographics, health status (SF-1), depression level (CES-D), a variety of pain management scales, employment status.

Outcome Measures Changes in health status, in limitations and level of activity, as indicated by the short for of the Medical Outcomes Survey (SF-1). Changes in use of pain relief techniques, as indicated by the Pain Relief Log (PRL). Degree of disability, as indicated by the Pain Disability Index b(PDI). Health services utilization. All data are collected at enrolment, discharge, and 6 months post-discharge

Results N=6; 58% male; mean age 46.1. By follow-up, there was a trend toward decreased use of emergency rooms for pain management (NS) in both arms. PDI declined from 4.7 to 6. in Arm I, and from 45.8 to 44.1 in Arm II. PRL declined from 16 to 11 in Arm I, and increased from 1 to 16 in Arm II; similarly, mental component scale scores from the SF-1 improved from 0.1 to 6.4 in Arm I and declined from 8.4 to .5 in Arm II. The Sf-1's physical component scale scores improved from 8.5 to 5.0 in Arm I and from 8.5 to 1.4 in Arm II.

Conclusion These results indicate that, even though clients= pain levels do not change, their abilities to function improve more substantially in the "experimental" arm. Thus, the intervention appears to produce the desired outcomes, and may merit further study.

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