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Oguchi M, Nicholas MK, Asghari A, Sanders D, Wrigley PJ. Psychologically-based interventions for adults with chronic neuropathic pain: A scoping review. Pain Med 2024:pnae006. [PMID: 38310361 DOI: 10.1093/pm/pnae006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 12/10/2023] [Accepted: 01/25/2024] [Indexed: 02/05/2024]
Abstract
OBJECTIVE As psychologically-based interventions have been shown to have clinical utility for adults with chronic pain generally, a similar benefit might be expected in the management of chronic neuropathic pain (NeuP). However, to date this has not been established, with existing systematic reviews on this topic being hampered by the scarcity of Randomised Controlled Trials (RCTs). This review aimed to identify the type of psychologically-based interventions studied for adults with chronic NeuP. It also aimed to assess whether there are enough RCTs to justify undertaking an updated systematic review. METHODS Seven databases and two clinical trial registries were searched for NeuP and psychologically-based interventions from database inception to December 2021, and the search was updated in February 2023. The search was broadened by reviewing the reference list of included studies and contacting field experts. Predetermined study characteristics were extracted. RESULTS Of 4682 records screened, 33 (less than 1%) articles met the eligibility criteria. Four broad intervention approaches were observed, including cognitive-behavioural approaches (n = 16), mindfulness/meditation (n = 10), trauma focused therapy (n = 4), and hypnosis (n = 3). Thirteen RCTs were identified, and of these, nine retained 20 participants in each arm at post-treatment. CONCLUSIONS Cognitive Behavioural Therapy was the most common therapeutic approach identified, whereas mindfulness/meditation was the most frequently used technique. Almost half to two-thirds of the studies reported significant improvements in either pain, disability, or distress, suggesting psychologically-based interventions are potentially beneficial for adults with chronic NeuP. An updated systematic review seems warranted.
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Affiliation(s)
- M Oguchi
- Sydney Medical School-Northern, Faculty of Medicine and Health, University of Sydney, Australia, St Leonards, NSW, 2065, Australia
- Pain Management Research Institute, Kolling Institute, Northern Sydney Local Health District and the Faculty of Medicine and Health, The University of Sydney, St Leonards, NSW, 2065, Australia
- Pain Management and Research Centre, Douglas Building, Royal North Shore Hospital, St Leonards, NSW, 2065, Australia
| | - M K Nicholas
- Sydney Medical School-Northern, Faculty of Medicine and Health, University of Sydney, Australia, St Leonards, NSW, 2065, Australia
- Pain Management Research Institute, Kolling Institute, Northern Sydney Local Health District and the Faculty of Medicine and Health, The University of Sydney, St Leonards, NSW, 2065, Australia
- Pain Management and Research Centre, Douglas Building, Royal North Shore Hospital, St Leonards, NSW, 2065, Australia
| | - A Asghari
- Sydney Medical School-Northern, Faculty of Medicine and Health, University of Sydney, Australia, St Leonards, NSW, 2065, Australia
- Pain Management Research Institute, Kolling Institute, Northern Sydney Local Health District and the Faculty of Medicine and Health, The University of Sydney, St Leonards, NSW, 2065, Australia
- Pain Management and Research Centre, Douglas Building, Royal North Shore Hospital, St Leonards, NSW, 2065, Australia
| | - D Sanders
- Sydney Medical School-Northern, Faculty of Medicine and Health, University of Sydney, Australia, St Leonards, NSW, 2065, Australia
- Pain Management Research Institute, Kolling Institute, Northern Sydney Local Health District and the Faculty of Medicine and Health, The University of Sydney, St Leonards, NSW, 2065, Australia
| | - P J Wrigley
- Sydney Medical School-Northern, Faculty of Medicine and Health, University of Sydney, Australia, St Leonards, NSW, 2065, Australia
- Pain Management Research Institute, Kolling Institute, Northern Sydney Local Health District and the Faculty of Medicine and Health, The University of Sydney, St Leonards, NSW, 2065, Australia
- Pain Management and Research Centre, Douglas Building, Royal North Shore Hospital, St Leonards, NSW, 2065, Australia
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Maher CG, Han CS, Gilbert SE, Nicholas MK. A content analysis of the interventions for low back pain promoted on the websites of Australian pain clinics. Aust J Prim Health 2024; 30:PY23164. [PMID: 38373344 DOI: 10.1071/py23164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 01/29/2024] [Indexed: 02/21/2024]
Abstract
BACKGROUND The Internet is a widely used source of health information, yet the accuracy of online information can be low. This is the case for low back pain (LBP), where much of the information about LBP treatment is poor. METHODS This research conducted a content analysis to explore what pain treatments for LBP are presented to the public on websites of Australian pain clinics listed in the PainAustralia National Pain Services Directory. Websites providing information relevant to the treatment of LBP were included. Details of the treatments for LBP offered by each pain service were extracted. RESULTS In total, 173 pain services were included, with these services linking to 100 unique websites. Services were predominantly under private ownership and located in urban areas, with limited services in non-urban locations. Websites provided detail on a median of six (IQR 3-8) treatments, with detail on a higher number of treatments provided by services in the private sector. Physical, psychological and educational treatments were offered by the majority of pain services, whereas surgical and workplace-focused treatments were offered by relatively few services. Most services provided details on multidisciplinary care; however, interdisciplinary, coordinated care characterised by case-conferencing was infrequently mentioned. CONCLUSIONS Most websites provided details on treatments that were largely in-line with recommended care for LBP, but some were not, especially in private clinics. However, whether the information provided online is a true reflection of the services offered in clinics remains to be investigated.
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Affiliation(s)
- Chris G Maher
- Sydney Musculoskeletal Health, Faculty of Medicine and Health, The University of Sydney and Sydney Local Health District, Gadigal Country, Sydney, NSW, Australia
| | - Christopher S Han
- Sydney Musculoskeletal Health, Faculty of Medicine and Health, The University of Sydney and Sydney Local Health District, Gadigal Country, Sydney, NSW, Australia
| | - Stephen E Gilbert
- Sydney Musculoskeletal Health, Faculty of Medicine and Health, The University of Sydney and Sydney Local Health District, Gadigal Country, Sydney, NSW, Australia
| | - Michael K Nicholas
- Pain Education Unit, Sydney Medical School-Northern, The Kolling Institute, Faculty of Medicine and Health, The University of Sydney, Guringai and Dharug Country, Sydney, NSW, Australia
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Nicholas MK, Cardosa M, Turner J. Educational initiatives and achievements of the International Association for the Study of Pain. Pain 2023; 164:S6-S10. [PMID: 37831953 DOI: 10.1097/j.pain.0000000000003062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 08/09/2023] [Indexed: 10/15/2023]
Abstract
ABSTRACT This article summarizes the many initiatives and achievements of the International Association for the Study of Pain (IASP) in pain education worldwide since 1973. These range from major events such as the World Congress on Pain that attracts thousands of attendees to the more intimate and focused Pain Schools and Pain Camps. The article describes how education has been a key focus of IASP since its inception and how IASP has responded to its members' desire for access to the latest knowledge about pain and evidence-based pain treatments. The unique contribution of IASP to the study of pain is reflected in its consistent focus on a biopsychosocial approach to pain, the promotion of interactions between basic scientists and clinicians, as well as multidisciplinary and interdisciplinary collaborations. Details of these rich offerings can be found on the IASP web site, and this article provides a guide for those seeking to access them.
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Affiliation(s)
- Michael K Nicholas
- Pain Management Research Institute, Royal North Shore Hospital, University of Sydney, Sydney, Australia
| | | | - Judith Turner
- Department of Psychiatry & Behavioral Sciences and Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, Washington, United States
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Maher CG, Archambeau A, Buchbinder R, French SD, Morphet J, Nicholas MK, O'Sullivan P, Pirotta M, Yelland MJ, Zeller L, Marles E, Bhasale AL, Lane C. Introducing Australia's clinical care standard for low back pain 1. J Physiother 2023; 69:205-207. [PMID: 37684144 DOI: 10.1016/j.jphys.2023.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 07/10/2023] [Indexed: 09/10/2023] Open
Affiliation(s)
| | | | - Rachelle Buchbinder
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Simon D French
- Department of Chiropractic, Macquarie University, Sydney, Australia
| | - Julia Morphet
- School of Nursing and Midwifery, Monash University, Melbourne, Australia
| | | | - Peter O'Sullivan
- Pain Management Research Institute, Kolling Institute of Medical Research, University of Sydney, Sydney, Australia
| | - Marie Pirotta
- Marie Pirotta, School of Allied Health, Curtin University, Perth, Australia
| | - Michael J Yelland
- Department of General Practice, University of Melbourne, Melbourne, Australia
| | - Leo Zeller
- School of Medicine, Griffith University, Gold Coast, Australia
| | | | - Alice L Bhasale
- Royal Brisbane and Women's Hospital, Metro North Health, Brisbane, Australia
| | - Christina Lane
- Australian Commission on Safety and Quality in Health Care, Sydney, Australia
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Shaw WS, Dugan AG, McGonagle AK, Nicholas MK, Tveito TH. The Job Leeway Scale: Initial Evaluation of a Self-report Measure of Health-Related Flexibility and Latitude at Work. J Occup Rehabil 2023; 33:581-591. [PMID: 36971990 PMCID: PMC10040912 DOI: 10.1007/s10926-023-10095-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/16/2023] [Indexed: 06/18/2023]
Abstract
Purpose Evidence suggests that workers manage health-related challenges at work, in part, by using available leeway to perform work differently. The purpose of this study was to evaluate the reliability and validity of the Job Leeway Scale (JLS), a new 18-item self-report questionnaire designed to assess worker perceptions of available flexibility and latitude to manage health-related challenges at work. Methods Workers seeking assistance for workplace difficulties due to chronic medical conditions (n = 119, 83% female, median age = 49) completed the JLS along with other workplace and health measures. Construct validity was assessed using exploratory factor analysis (EFA), and concurrent validity was assessed by associations with related measures. Results Mean item scores ranged from 2.13 to 4.16 within a possible range of 0-6. The EFA supported three underlying factors: organizational leeway (9 items), task leeway (6 items), and staffing leeway (3 items). Internal consistency (alpha) ranged from 0.78 to 0.91 for subscale scores and 0.94 for the total score. The JLS showed moderate correlations with other work outcome measures including work fatigue, self-efficacy, engagement, and productivity. Conclusion The JLS is a promising new measure with initial support for its reliability and validity to assess worker beliefs of available flexibility to manage health symptoms at work, and this construct may have organizational implications for worker support and accommodation.
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Affiliation(s)
- William S Shaw
- University of Connecticut School of Medicine, Farmington, CT, USA
| | - Alicia G Dugan
- University of Connecticut School of Medicine, Farmington, CT, USA.
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Nicholas MK. Commentary on Somers et al. Behavioral cancer pain intervention dosing: results of a sequential multiple assignment randomized trial. Pain 2023; 164:1889-1890. [PMID: 37595109 DOI: 10.1097/j.pain.0000000000002916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 03/08/2023] [Indexed: 08/20/2023]
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Maher CG, Archambeau A, Buchbinder R, French SD, Morphet J, Nicholas MK, O'Sullivan P, Pirotta M, Yelland MJ, Zeller L, Saad N, Marles E, Bhasale AL, Lane C. Introducing Australia's clinical care standard for low back pain : A new clinical care standard provides evidence-based guidance to help clinicians deliver best care for people with low back pain. Chiropr Man Therap 2023; 31:17. [PMID: 37322536 DOI: 10.1186/s12998-023-00485-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023] Open
Affiliation(s)
- Christopher G Maher
- Sydney Musculoskeletal Health, University of Sydney, Sydney, NSW, Australia.
| | | | - Rachelle Buchbinder
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Simon D French
- Department of Chiropractic, Macquarie University, Sydney, NSW, Australia
| | - Julia Morphet
- School of Nursing and Midwifery, Monash University, Melbourne, VIC, Australia
- College of Emergency Nursing Australasia, Melbourne, VIC, Australia
| | - Michael K Nicholas
- Pain Management Research Institute, Kolling Institute of Medical Research, University of Sydney, Sydney, NSW, Australia
| | - Peter O'Sullivan
- School of Allied Health, Curtin University, Perth, WA, Australia
| | - Marie Pirotta
- Department of General Practice, University of Melbourne, Melbourne, VIC, Australia
| | - Michael J Yelland
- School of Medicine, Griffith University, Gold Coast, QLD, Australia
- Arana Hills Medical Centre, Brisbane, QLD, Australia
| | - Leo Zeller
- Metro North Health, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
| | - Nivene Saad
- Metro South Health, Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - Elizabeth Marles
- Australian Commission On Safety and Quality in Health Care, Sydney, NSW, Australia
| | - Alice L Bhasale
- Australian Commission On Safety and Quality in Health Care, Sydney, NSW, Australia
| | - Christina Lane
- Australian Commission On Safety and Quality in Health Care, Sydney, NSW, Australia
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Maher CG, Archambeau A, Buchbinder R, French SD, Morphet J, Nicholas MK, O'Sullivan P, Pirotta M, Yelland MJ, Zeller L, Saad N, Marles E, Bhasale AL, Lane C. Introducing Australia's clinical care standard for low back pain. ANZ J Surg 2023. [PMID: 37243309 DOI: 10.1111/ans.18517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 05/04/2023] [Indexed: 05/28/2023]
Affiliation(s)
- Christopher G Maher
- Sydney Musculoskeletal Health, University of Sydney, Sydney, New South Wales, Australia
| | | | - Rachelle Buchbinder
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Simon D French
- Department of Chiropractic, Macquarie University, Sydney, New South Wales, Australia
| | - Julia Morphet
- School of Nursing and Midwifery, Monash University, Melbourne, Victoria, Australia
- College of Emergency Nursing Australasia, Melbourne, Victoria, Australia
| | - Michael K Nicholas
- Pain Management Research Institute, Kolling Institute of Medical Research, University of Sydney, Sydney, New South Wales, Australia
| | - Peter O'Sullivan
- School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Marie Pirotta
- Department of General Practice, University of Melbourne, Melbourne, Victoria, Australia
| | - Michael J Yelland
- School of Medicine, Griffith University, Gold Coast, Queensland, Australia
- Arana Hills Medical Centre, Brisbane, Queensland, Australia
| | - Leo Zeller
- Metro North Health, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Nivene Saad
- Metro South Health, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Elizabeth Marles
- Australian Commission on Safety and Quality in Health Care, Sydney, New South Wales, Australia
| | - Alice L Bhasale
- Australian Commission on Safety and Quality in Health Care, Sydney, New South Wales, Australia
| | - Christina Lane
- Australian Commission on Safety and Quality in Health Care, Sydney, New South Wales, Australia
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Maher CG, Archambeau A, Buchbinder R, French SD, Morphet J, Nicholas MK, O'Sullivan P, Pirotta M, Yelland MJ, Zeller L, Saad N, Marles E, Bhasale AL, Lane C. Introducing Australia's clinical care standard for low back pain. Med J Aust 2023; 218:354-356. [PMID: 37120763 DOI: 10.5694/mja2.51915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 01/27/2023] [Accepted: 02/16/2023] [Indexed: 05/01/2023]
Affiliation(s)
| | | | - Rachelle Buchbinder
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC
| | - Simon D French
- Department of Chiropractic, Macquarie University, Sydney, NSW
| | - Julie Morphet
- School of Nursing and Midwifery, Monash University, Melbourne, VIC
- College of Emergency Nursing Australasia, Melbourne, VIC
| | - Michael K Nicholas
- Pain Management Research Institute, Kolling Institute of Medical Research, University of Sydney, Sydney, NSW
| | | | - Marie Pirotta
- Department of General Practice, University of Melbourne, Melbourne, VIC
| | - Michael J Yelland
- School of Medicine, Griffith University, Gold Coast, QLD
- Arana Hills Medical Centre, Brisbane, QLD
| | - Leo Zeller
- Metro North Health, Royal Brisbane and Women's Hospital, Brisbane, QLD
| | - Nivene Saad
- Metro South Health, Princess Alexandra Hospital, Brisbane, QLD
| | - Elizabeth Marles
- Australian Commission on Safety and Quality in Health Care, Sydney, NSW
| | - Alice L Bhasale
- Australian Commission on Safety and Quality in Health Care, Sydney, NSW
| | - Christina Lane
- Australian Commission on Safety and Quality in Health Care, Sydney, NSW
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Maher CG, Archambeau A, Buchbinder R, French SD, Morphet J, Nicholas MK, O'Sullivan P, Pirotta M, Yelland MJ, Zeller L, Saad N, Marles E, Bhasale AL, Lane C. Introducing Australia's clinical care standard for low back pain. J Med Imaging Radiat Oncol 2023. [PMID: 37125441 DOI: 10.1111/1754-9485.13532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 04/06/2023] [Indexed: 05/02/2023]
Affiliation(s)
- Christopher G Maher
- Sydney Musculoskeletal Health, University of Sydney, Sydney, New South Wales, Australia
| | - Aline Archambeau
- Canberra Hospital, Canberra, Australian Capital Territory, Australia
| | - Rachelle Buchbinder
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Simon D French
- Department of Chiropractic, Macquarie University, Sydney, New South Wales, Australia
| | - Julie Morphet
- School of Nursing and Midwifery, Monash University, Melbourne, Victoria, Australia
- College of Emergency Nursing Australasia, Melbourne, Victoria, Australia
| | - Michael K Nicholas
- Pain Management Research Institute, Kolling Institute of Medical Research, University of Sydney, Sydney, New South Wales, Australia
| | - Peter O'Sullivan
- School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Marie Pirotta
- Department of General Practice, University of Melbourne, Melbourne, Victoria, Australia
| | - Michael J Yelland
- School of Medicine, Griffith University, Gold Coast, Queensland, Australia
- Arana Hills Medical Centre, Brisbane, Queensland, Australia
| | - Leo Zeller
- Metro North Health, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Nivene Saad
- Metro South Health, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Elizabeth Marles
- Australian Commission on Safety and Quality in Health Care, Sydney, New South Wales, Australia
| | - Alice L Bhasale
- Australian Commission on Safety and Quality in Health Care, Sydney, New South Wales, Australia
| | - Christina Lane
- Australian Commission on Safety and Quality in Health Care, Sydney, New South Wales, Australia
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Maher CG, Archambeau A, Buchbinder R, French SD, Morphet J, Nicholas MK, O'Sullivan P, Pirotta M, Yelland MJ, Zeller L, Saad N, Marles E, Bhasale AL, Lane C. Introducing Australia's clinical care standard for low back pain. Intern Med J 2023; 53:664-667. [PMID: 37126539 DOI: 10.1111/imj.16090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 04/05/2023] [Indexed: 05/02/2023]
Affiliation(s)
- Christopher G Maher
- Sydney Musculoskeletal Health, University of Sydney, Sydney, New South Wales, Australia
| | - Aline Archambeau
- Canberra Hospital, Canberra, Australian Capital Territory, Australia
| | - Rachelle Buchbinder
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Simon D French
- Department of Chiropractic, Macquarie University, Sydney, New South Wales, Australia
| | - Julia Morphet
- School of Nursing and Midwifery, Monash University, Melbourne, Victoria, Australia
- College of Emergency Nursing Australasia, Melbourne, Victoria, Australia
| | - Michael K Nicholas
- Pain Management Research Institute, Kolling Institute of Medical Research, University of Sydney, Sydney, New South Wales, Australia
| | - Peter O'Sullivan
- School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Marie Pirotta
- Department of General Practice, University of Melbourne, Melbourne, Victoria, Australia
| | - Michael J Yelland
- School of Medicine, Griffith University, Gold Coast, Queensland, Australia
- General and Musculoskeletal Medicine Practitioner, Arana Hills Medical Centre, Brisbane, Queensland, Australia
| | - Leo Zeller
- Metro North Health, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Nivene Saad
- Metro South Health, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Elizabeth Marles
- Primary Care, Australian Commission on Safety and Quality in Health Care, Sydney, New South Wales, Australia
| | - Alice L Bhasale
- Clinical Care Standards, Australian Commission on Safety and Quality in Health Care, Sydney, New South Wales, Australia
| | - Christina Lane
- Australian Commission on Safety and Quality in Health Care, Sydney, New South Wales, Australia
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Maher CG, Archambeau A, Buchbinder R, French SD, Morphet J, Nicholas MK, O'Sullivan P, Pirotta M, Yelland MJ, Zeller L, Saad N, Marles E, Bhasale AL, Lane C. Introducing Australia's clinical care standard for low back pain. Emerg Med Australas 2023; 35:370-373. [PMID: 37120762 DOI: 10.1111/1742-6723.14218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 03/29/2023] [Indexed: 05/01/2023]
Affiliation(s)
- Christopher G Maher
- Sydney Musculoskeletal Health, University of Sydney, Sydney, New South Wales, Australia
| | - Aline Archambeau
- Emergency Department, Canberra Hospital, Canberra, Australian Capital Territory, Australia
| | - Rachelle Buchbinder
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Simon D French
- Department of Chiropractic, Macquarie University, Sydney, New South Wales, Australia
| | - Julie Morphet
- School of Nursing and Midwifery, Monash University, Melbourne, Victoria, Australia
- College of Emergency Nursing Australasia, Melbourne, Victoria, Australia
| | - Michael K Nicholas
- Pain Management Research Institute, Kolling Institute of Medical Research, University of Sydney, Sydney, New South Wales, Australia
| | - Peter O'Sullivan
- School of Allied Health, Curtin University, Perth, Western Australia, Australia
| | - Marie Pirotta
- Department of General Practice, University of Melbourne, Melbourne, Victoria, Australia
| | - Michael J Yelland
- School of Medicine, Griffith University, Gold Coast, Queensland, Australia
- Arana Hills Medical Centre, Brisbane, Queensland, Australia
| | - Leo Zeller
- Metro North Health, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Nivene Saad
- Metro South Health, Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Elizabeth Marles
- Australian Commission on Safety and Quality in Health Care, Sydney, New South Wales, Australia
| | - Alice L Bhasale
- Australian Commission on Safety and Quality in Health Care, Sydney, New South Wales, Australia
| | - Christina Lane
- Australian Commission on Safety and Quality in Health Care, Sydney, New South Wales, Australia
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Nudelman Y, Pincus T, Nicholas MK, Ben Ami N. Cross-cultural adaptation, reliability, and validity of the pain self-efficacy questionnaire - Hebrew version. Musculoskelet Sci Pract 2023; 64:102749. [PMID: 36965246 DOI: 10.1016/j.msksp.2023.102749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 03/08/2023] [Accepted: 03/14/2023] [Indexed: 03/27/2023]
Abstract
PURPOSE This study aims to translate, culturally adapt, and evaluate the psychometric properties of the Hebrew Pain Self-Efficacy Questionnaire (PSEQ). METHODS The study was designed according to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) recommendations for patient-reported outcome measurement instruments. The PSEQ was initially translated into Hebrew and cross-culturally adapted. The Hebrew version of the PSEQ (PSEQ-H) was administered to participants suffering from chronic musculoskeletal pain, along with other self-report measures of pain (NPRS, FABQ, HADS, PCS, and SF-12). Eight hypotheses on expected correlations of the PSEQ-H with other instruments were formulated a priori to assess construct validity. Structural validity was assessed using confirmatory factor analysis. Floor and ceiling effects, test-retest, and internal consistency reliability were also assessed. RESULTS The translation process retained the unidimensional model of the PSEQ. The PSEQ-H demonstrates excellent internal consistency (Cronbach's α = 0.97) and test-retest reliability (ICC = 0.88), and no significant floor and ceiling effects were observed. Construct validity was found satisfactory as 75% (six) of the analyses between the PSEQ-H and the other self-reported measures met the hypotheses. Factor analysis confirmed the single-factor structure of the questionnaire. CONCLUSIONS The PSEQ-H version was found to have excellent reliability, good construct, and structural validity, and can be used with heterogeneous chronic musculoskeletal pain populations. Future studies should test the PSEQ-H's responsiveness and psychometric properties with specific pain populations.
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Affiliation(s)
- Yaniv Nudelman
- Department of Physiotherapy, Ariel University, Ariel, Israel; Maccabi Healthcare Services, Tel-aviv, Israel.
| | - Tamar Pincus
- University of Southampton, Southampton, United Kingdom
| | - Michael K Nicholas
- Pain Management Research Institute, Sydney Medical School, The University of Sydney, Royal North Shore, Australia
| | - Noa Ben Ami
- Department of Physiotherapy, Ariel University, Ariel, Israel
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Glare PA, Costa DJ, Nicholas MK. Psychosocial characteristics of chronic pain in cancer survivors referred to an Australian multidisciplinary pain clinic. Psychooncology 2022; 31:1895-1903. [PMID: 35661330 PMCID: PMC9796565 DOI: 10.1002/pon.5975] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 05/23/2022] [Accepted: 05/25/2022] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To describe the clinical and psychosocial characteristics of chronic pain in cancer survivors referred to one Australian hospital's ambulatory pain clinic over a 7-year period (2013-19), and to compare cancer treatment-related pain with comorbid non-malignant pain. METHOD Retrospective chart review including responses to standardized self-report questionnaires (Brief Pain Inventory, Depression Anxiety Stress Scale, Pain Self-Efficacy Questionnaire, Pain Catastrophizing Scale), routinely collected in all patients referred to pain clinics at Australian and New Zealand hospitals. RESULTS Of 3510 new referrals during the study period, 267 (7.5%) had a history of cancer and 176 (5.0%) met the study's eligibility criteria. Their average age was 63 ± 13 years, with 55% female. Breast cancer survivors were commonest, followed by hematological, prostate, melanoma, and colorectal, a median of 3 years post-diagnosis. Pain was attributed to cancer treatment in 87 (49%), surgery being the commonest modality. Multimodal treatment (n = 89, 58%) was significantly commoner in the treatment-related pain group (p < 0.001). Average pain severity was moderate, as was pain-related disability and distress. Pain cognitions were often maladaptive (low pain self-efficacy, high pain catastrophizing), predicted by pre-existing anxiety and depression. Associations between pain cognitions and outcomes were medium-to-large. Differences between treatment pain and comorbid pain were small-to-medium. Their scores were similar to Australian pain clinic norms. CONCLUSION Cancer treatment causes tissue damage, but pain-related distress and disability in survivors is associated with maladaptive pain cognitions. Survivors with poor pain outcomes should be evaluated for unhelpful thoughts and beliefs especially when they have pre-existing depression or anxiety.
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Affiliation(s)
- Paul A. Glare
- Faculty of Medicine & HealthUniversity of SydneySydneyNew South WalesAustralia,Pain Management Research InstituteKolling InstituteSydneyNew South WalesAustralia
| | - Daniel J. Costa
- Faculty of Medicine & HealthUniversity of SydneySydneyNew South WalesAustralia,Pain Management Research InstituteKolling InstituteSydneyNew South WalesAustralia
| | - Michael K. Nicholas
- Faculty of Medicine & HealthUniversity of SydneySydneyNew South WalesAustralia,Pain Management Research InstituteKolling InstituteSydneyNew South WalesAustralia
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15
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Wilson D, Mackintosh S, Nicholas MK, Moseley GL, Costa D, Ashton-James C. Are group identity and sense of belonging relevant for group pain management programmes? An exploratory pilot study. Br J Pain 2022; 16:528-537. [PMID: 36389006 PMCID: PMC9644103 DOI: 10.1177/20494637221098941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/03/2023] Open
Abstract
Introduction Cognitive Behaviour Therapy (CBT)-based programmes for chronic pain are often conducted in groups, most likely for time and cost efficiencies. However, there has been very little investigation of the role that the group itself, and particularly the processes occurring within the group, may play in individual outcomes. The objective of this study was to explore whether social group processes were relevant to key treatment outcomes of group CBT for chronic pain. Method Data were collected from 15 groups (N = 118) undertaking a pain management programme in a tertiary setting. Intraclass correlations were computed to determine any clustering of outcomes in groups, and linear mixed modelling analysis explored pre-registered hypotheses of associations between treatment outcomes and the social group processes of Group Identification and Sense of Belonging. Results A weak association between early identification with the group and changes in pain-related disability was shown. In addition, an enhanced global Sense of Belonging was associated with increased pain self-efficacy. Conclusion These associations, in a programme that had not been designed to address group processes, suggest that their relevance is worth further investigation, particularly in group programmes that do focus on the social consequences of chronic pain. Future studies should investigate whether manipulation of social group processes within a CBT-based pain programme enhances pain-related outcomes and improves the overall well-being of people with chronic pain.
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Affiliation(s)
- Dianne Wilson
- IIMPACT in Health, Allied Health
and Human Performance, University of South
Australia, Adelaide, SA, Australia
| | - Shylie Mackintosh
- IIMPACT in Health, Allied Health
and Human Performance, University of South
Australia, Adelaide, SA, Australia
| | - Michael K Nicholas
- Pain Management Research Institute, University of Sydney, Sydney, NSW, Australia
| | - G Lorimer Moseley
- IIMPACT in Health, Allied Health
and Human Performance, University of South
Australia, Adelaide, SA, Australia
| | - Daniel Costa
- Pain Management Research Institute, University of Sydney, Sydney, NSW, Australia
| | - Claire Ashton-James
- Pain Management Research Institute, University of Sydney, Sydney, NSW, Australia
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16
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Main CJ, Shaw WS, Nicholas MK, Linton SJ. System-level efforts to address pain-related workplace challenges. Pain 2022; 163:1425-1431. [PMID: 35195550 PMCID: PMC9341230 DOI: 10.1097/j.pain.0000000000002548] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/01/2021] [Accepted: 11/08/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Chris J. Main
- Primary Care and Health Sciences, Keele University, Keele, Staffordshire, United Kingdom
| | - William S. Shaw
- Department of Medicine, University of Connecticut School of Medicine, Farmington, CT, United States
| | - Michael K. Nicholas
- Pain Management Research Institute, University of Sydney, Sydney, New South Wales, Australia
| | - Steven J. Linton
- Department of Law, Psychology, and Social Work, Orebro University, Orebro, Sweden
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17
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Shaw WS, McLellan RK, Besen E, Namazi S, Nicholas MK, Dugan AG, Tveito TH. A Worksite Self-management Program for Workers with Chronic Health Conditions Improves Worker Engagement and Retention, but not Workplace Function. J Occup Rehabil 2022; 32:77-86. [PMID: 33983524 PMCID: PMC8858918 DOI: 10.1007/s10926-021-09983-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/26/2021] [Indexed: 05/26/2023]
Abstract
Purpose An increasing number of workers in the US have chronic health conditions that limit their ability to work, and few worksite interventions have been tested to improve worker coping and problem solving at work. The purpose of this study was to evaluate a worksite-based health self-management program designed to improve workplace function among workers with chronic health conditions. Methods We conducted a randomized, controlled trial of a worksite self-management program ("Manage at Work") (clinicaltrials.gov #NCT01978392) for workers with chronic health conditions (N = 119; 82% female, ages 20-69). Most workers were recruited from the health care or light manufacturing industry sectors. Workers attended a 5-session, facilitated psychoeducational program using concepts of health self-management, self-efficacy, ergonomics, and communication. Changes on outcomes of work engagement, work limitation, job satisfaction, work fatigue, work self-efficacy, days absent, and turnover intention at 6-month follow-up were compared to wait-list controls. Results The most prevalent chronic health conditions were musculoskeletal pain, headaches, vision problems, gastrointestinal disorders, respiratory disorders, and mental health disorders. The self-management program showed greater improvement in work engagement and turnover intent at 6-month follow-up, but there was no evidence of a parallel reduction in perceived work limitation. Trends for improved outcomes of work self-efficacy, job satisfaction, and work fatigue in the intervention group did not reach statistical significance in a group x time interaction test. Conclusions Offering a worksite self-management program to workers with chronic health conditions may be a feasible and beneficial strategy to engage and retain skilled workers who are risking disability.Clinical trial registration: Clinicaltrials.gov #NCT01978392.
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Affiliation(s)
- William S. Shaw
- University of Connecticut School of Medicine, 263 Farmington Ave., Farmington, CT 06030 USA
| | - Robert K. McLellan
- Geisel School of Medicine at Dartmouth, 1 Rope Ferry Drive, Hanover, NH 03755 USA
| | - Elyssa Besen
- Liberty Mutual Insurance, 175 Berkeley Street, Boston, MA 02116 USA
| | - Sara Namazi
- University of Connecticut School of Medicine, 263 Farmington Ave., Farmington, CT 06030 USA
| | - Michael K. Nicholas
- University of Sydney at North Shore Hospital, St. Leonards, NSW 2065 Australia
| | - Alicia G. Dugan
- University of Connecticut School of Medicine, 263 Farmington Ave., Farmington, CT 06030 USA
| | - Torill H. Tveito
- University of South-Eastern Norway, Raveien 215, 3184 Borre, Norway
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18
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Abstract
BACKGROUND The early identification of factors that increase risk of poor recovery from acute low back pain (LBP) is critical to prevent the transition to chronicity. Although most studies of risk factors for poor outcome in LBP tend to investigate the condition once it is already persistent, there is evidence to suggest that this differs from risk factors measured during the early-acute stage. This study aimed to identify early risk factors for poor outcome in the short- and long-term in individuals with acute LBP, and to compare this with factors identified at 3 months in the same cohort. METHODS One hundred and thirty-three individuals were recruited within 2 weeks of an acute LBP episode and completed questionnaires related to their sociodemographic, psychological, clinical and history/treatment status at baseline and 3 months later, and their pain-level fortnightly for 12 months. RESULTS Of the 133 participants recruited, follow-up data was provided by 120 at 3 months, 97 at 6 months, 85 at 9 months and 94 at 12 months. Linear regression identified various factors at baseline (acute phase) and 3 months later that predicted short- and long-term outcome (pain level, change in pain). Key findings were that: (1) depressive symptoms at baseline most consistently predicted worse outcome; (2) psychological factors in general at 3 months were more predictive of outcome than when measured at baseline; (3) early health care utilisation predicted better outcome, whereas use of pain medication later (3 months) predicted worse outcome; and (4) sex and BMI predicted outcome inconsistently over 12-months. CONCLUSIONS The results highlight the multidimensional nature of risk factors for poor outcome in LBP and the need to consider time variation in these factors.
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Affiliation(s)
- D M Klyne
- NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - L M Hall
- NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - M K Nicholas
- Pain Management Research Institute, Royal North Shore Hospital, The University of Sydney, Sydney, Australia
| | - P W Hodges
- NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
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19
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Mittinty MM, Elliott JM, Hunter DJ, Nicholas MK, March LM, Mittinty MN. Explaining the gap in the experience of depression among arthritis patients. Clin Rheumatol 2022; 41:1227-1233. [PMID: 34993727 DOI: 10.1007/s10067-021-06010-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/25/2021] [Accepted: 12/01/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To explain the factors contributing to the gap in depression between employed arthritis patients with and without paid sick leave. METHODS Blinder-Oaxaca decomposition analysis was used to identify factors that explain the gap in the experience of depressive symptoms among arthritis patients with paid and unpaid sick leave. Data from the 2018 National Health Interview Survey, USA, was used. RESULTS A total of 7189 of the NHIS survey participants given the diagnosis of arthritis were identified, of which 39% were male and 61% were female, with mean age of 63.5 years. The decomposition findings suggest patients in the unpaid sick leave group were more likely to report depressive symptoms compared to patients with paid sick leave. The major contributors to the gap in the report of depressive symptoms are sex (female) and annual income (less than 35,000 USD). CONCLUSION Findings suggest that the absence of paid sick leave is a key determinant for experiencing depressive symptoms among individuals with arthritis. The provision of paid sick leave may reduce report of depressive symptoms among employed arthritis patients in the USA. KEY POINTS • Individuals with arthritis are consistently at greater risk of depression and unemployment as compared to individuals without arthritis. • To date greater emphasis is put on determinants of unemployment, while there is no available data on benefits associated with being employed, such as sick leave, and how it affects mental health. • Patients with unpaid sick leave appear to experience more persistent depressive symptoms than patients with access to paid sick leave. • To tackle burden of depression among arthritis patients, provision of paid sick leave may be an effective intervention.
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Affiliation(s)
- Manasi M Mittinty
- Pain Management Research Centre, Royal North Shore Hospital, The University of Sydney, PMRI, St. Leonards, Reserve Road, Sydney, NSW, 2065, Australia.
| | - James M Elliott
- Kolling Research Institute, Faculty of Medicine and Health, The University of Sydney, New South Wales, 2065, Australia
| | - David J Hunter
- Rheumatology Department, Royal North Shore Hospital and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, NSW, Sydney, 2065, Australia
| | - Michael K Nicholas
- Pain Management Research Centre, Royal North Shore Hospital, The University of Sydney, PMRI, St. Leonards, Reserve Road, Sydney, NSW, 2065, Australia
| | - Lyn M March
- Rheumatology Department, Royal North Shore Hospital and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, NSW, Sydney, 2065, Australia
| | - Murthy N Mittinty
- Better Start Group, School of Public Health, The University of Adelaide, Adelaide, SA, 5006, Australia
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20
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Nicholas MK. Commentary on Elbers et al. "Longitudinal outcome evaluations of IMPT programs". Eur J Pain 2021; 26:280-281. [PMID: 34748259 DOI: 10.1002/ejp.1888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 11/06/2021] [Indexed: 11/12/2022]
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21
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Flink IK, Reme S, Jacobsen HB, Glombiewski J, Vlaeyen JWS, Nicholas MK, Main CJ, Peters M, Williams ACDC, Schrooten MGS, Shaw W, Boersma K. Pain psychology in the 21st century: lessons learned and moving forward. Scand J Pain 2021; 20:229-238. [PMID: 32242835 DOI: 10.1515/sjpain-2019-0180] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Accepted: 02/13/2020] [Indexed: 01/10/2023]
Abstract
Background and aims In the spring of 2019, Professor Steven J. Linton, the founder of the Center for Health and Medical Psychology (CHAMP) at Örebro University, Sweden, formally retired. As a tribute to his scholarly work covering decades of influence and inspiration to the field of pain psychology, the research center organized a topical conference titled "Pain in the 21st century: Where do we come from and where are we going?", which resulted in this state-of the-art synthesis. The aim of this declaration is to highlight lessons learned but not in the least is meant to inspire and guide our continued journey forward, developing pain psychology into the 21st century. Methods Several collaborators of Professor Linton have summarized and reflected on the current state-of-the-art of pain psychology from the perspective of his input to the field, as well as on developments from the last years of advancements in pain psychology. Results The topics have been divided into six themed sections covering the fear avoidance model, transdiagnostics, secondary prevention, risk- and protective factors, communication and contextual factors. The sections cover a broad spectrum, from basic experimental studies, integrating emotion and motivational theories into current theoretical models, to applied research on the effect of early interventions as well as sophisticated emotion-focused treatment models for pain patients with concurrent emotional ill-health. Conclusions There have been major advancements within pain psychology research during the last decades, moving the field towards a more comprehensive picture, taking emotional and motivational aspects into account to understand pain sufferers. Although psychologically informed interventions in general mainly focus on the individual, it has been put forward that pain management is highly influenced by the surrounding environment, including communication with health care providers, and the occupational and social context. Implications Professor Steven J. Linton has been at the forefront of pain psychology research during the last decades, and inspired by his work this journey will continue into the 21st century, with the ultimate goal of enhancing the understanding and treatment for all people suffering from persistent and disabling pain.
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Affiliation(s)
- Ida K Flink
- The Center for Health and Medical Psychology (CHAMP), School of Law, Psychology and Social Work, Örebro University, Örebro, Sweden
| | - Silje Reme
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
| | - Henrik Børsting Jacobsen
- Department of Pain Management and Research, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway
| | - Julia Glombiewski
- Clinical Psychology and Psychotherapy, Faculty of Psychology, University of Koblenz Landau, Mainz, Germany
| | - Johan W S Vlaeyen
- Health Psychology Research Group, KU Leuven, Leuven, Belgium.,Experimental Health Psychology, Maastricht University, Maastricht, The Netherlands
| | - Michael K Nicholas
- Pain Management Research Institute, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia
| | - Chris J Main
- Research Institute for Primary Care Sciences, Keele University, Keele, Staffordshire, UK
| | - Madelon Peters
- Department of Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands
| | - Amanda C de C Williams
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Martien G S Schrooten
- The Center for Health and Medical Psychology (CHAMP), School of Law, Psychology and Social Work, Örebro University, Örebro, Sweden
| | - William Shaw
- Division of Occupational and Environmental Medicine, Department of Medicine, University of Connecticut Health Center, Farmington, CT, USA
| | - Katja Boersma
- The Center for Health and Medical Psychology (CHAMP), School of Law, Psychology and Social Work, Örebro University, Örebro, Sweden
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22
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Wilson D, Mackintosh S, Nicholas MK, Moseley GL, Costa DSJ, Ashton-James CE. Is the psychological composition of the therapeutic group associated with individual outcomes in group cognitive behavioural therapy for chronic pain? Br J Pain 2021; 15:69-81. [PMID: 33633854 DOI: 10.1177/2049463719895803] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
This study explored whether the psychological composition of a group, with respect to mood, catastrophising, fear of movement and pain self-efficacy characteristics at baseline, is associated with individuals' treatment outcomes following group cognitive behavioural therapy (CBT)-based programmes for chronic pain. Retrospective analyses of outcomes from two independently run CBT-based pain management programmes (Programme A: N = 317 and Programme B: N = 693) were conducted. Mixed modelling analyses did not consistently support the presence of associations between group median scores of depression, catastrophising or fear avoidance with outcomes for individuals in either programme. These results suggest that the psychological profiles of groups are not robust predictors of individual outcomes in CBT groups for chronic pain. By implication, efforts made to consider group composition with respect to psychological attributes may be unnecessary.
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Affiliation(s)
- Dianne Wilson
- University of South Australia, Adelaide, SA, Australia
| | | | - Michael K Nicholas
- Pain Management Research Institute, University of Sydney, Sydney, NSW, Australia
| | - G Lorimer Moseley
- University of South Australia, Adelaide, SA, Australia.,Neuroscience Research Australia, Sydney, NSW, Australia
| | - Daniel S J Costa
- Pain Management Research Institute, University of Sydney, Sydney, NSW, Australia
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23
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Sharpe L, Jones E, Ashton‐James CE, Nicholas MK, Refshauge K. Necessary components of psychological treatment in pain management programs: A Delphi study. Eur J Pain 2020; 24:1160-1168. [DOI: 10.1002/ejp.1561] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 03/02/2020] [Accepted: 03/07/2020] [Indexed: 11/09/2022]
Affiliation(s)
- Louise Sharpe
- The School of Psychology University of Sydney Sydney NSW Australia
| | - Emma Jones
- The School of Psychology University of Sydney Sydney NSW Australia
| | | | - Michael K. Nicholas
- Pain Management Research Institute The University of Sydney Sydney NSW Australia
| | - Kathryn Refshauge
- Faculty of Health Sciences The University of Sydney Sydney NSW Australia
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24
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Nicholas MK, Costa DSJ, Linton SJ, Main CJ, Shaw WS, Pearce G, Gleeson M, Pinto RZ, Blyth FM, McAuley JH, Smeets RJEM, McGarity A. Implementation of Early Intervention Protocol in Australia for 'High Risk' Injured Workers is Associated with Fewer Lost Work Days Over 2 Years Than Usual (Stepped) Care. J Occup Rehabil 2020; 30:93-104. [PMID: 31346923 DOI: 10.1007/s10926-019-09849-y] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Purpose To evaluate whether a protocol for early intervention addressing the psychosocial risk factors for delayed return to work in workers with soft tissue injuries would achieve better long-term outcomes than usual (stepped) care. Methods The study used a controlled, non-randomised prospective design to compare two case management approaches. For the intervention condition, workers screened within 1-3 weeks of injury as being at high risk of delayed returned to work by the Örebro Musculoskeletal Pain Screening Questionnaire-short version (ÖMPSQ-SF) were offered psychological assessment and a comprehensive protocol to address the identified obstacles for return to work. Similarly identified injured workers in the control condition were managed under usual (stepped) care arrangements. Results At 2-year follow-up, the mean lost work days for the Intervention group was less than half that of the usual care group, their claim costs were 30% lower, as was the growth trajectory of their costs after 11 months. Conclusions The findings supported the hypothesis that brief psychological risk factor screening, combined with a protocol for active collaboration between key stakeholders to address identified psychological and workplace factors for delayed return to work, can achieve better return on investment than usual (stepped) care.
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Affiliation(s)
- M K Nicholas
- Sydney Medical School - Northern, University of Sydney & Royal North Shore Hospital, St Leonards, NSW, Australia.
| | - D S J Costa
- Sydney Medical School - Northern, University of Sydney & Royal North Shore Hospital, St Leonards, NSW, Australia
| | - S J Linton
- Center for Health And Medical Psychology, Department of Law, Psychology, and Social Work, Örebro University, Örebro, Sweden
| | - C J Main
- Arthritis Care UK Primary Care Centre, Keele University, Keele, North Staffordshire, UK
| | - W S Shaw
- University of Massachusetts Medical School, Worcester, MA, USA
| | - G Pearce
- Sydney Medical School - Northern, University of Sydney & Royal North Shore Hospital, St Leonards, NSW, Australia
| | - M Gleeson
- Sydney Medical School - Northern, University of Sydney & Royal North Shore Hospital, St Leonards, NSW, Australia
| | - R Z Pinto
- Sydney Medical School - Northern, University of Sydney & Royal North Shore Hospital, St Leonards, NSW, Australia
| | - F M Blyth
- School of Public Health, Concord Clinical School, University of Sydney, Sydney, NSW, Australia
| | - J H McAuley
- Neuroscience Research Australia and School of Medical Sciences, University of NSW, Sydney, NSW, Australia
| | - R J E M Smeets
- Department of Rehabilitation Medicine, Caphri, Maastricht University, Maastricht, The Netherlands
- CIR Revalidatie, Eindhoven, The Netherlands
| | - A McGarity
- Injury Management Health & Safety Branch, NSW Fire and Safety, Sydney, Australia
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25
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Nicholas MK, Costa DSJ, Linton SJ, Main CJ, Shaw WS, Pearce G, Gleeson M, Pinto RZ, Blyth FM, McAuley JH, Smeets RJEM, McGarity A. Correction to: Implementation of Early Intervention Protocol in Australia for 'High Risk' Injured Workers is Associated with Fewer Lost Work Days Over 2 Years Than Usual (Stepped) Care. J Occup Rehabil 2019; 29:671. [PMID: 31414346 DOI: 10.1007/s10926-019-09855-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The original version of this article unfortunately contained a spelling error in one of the co-authors's names. The family name of the co-author was incorrectly displayed as "James McCauley" instead of "James McAuley. The original article has been corrected.
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Affiliation(s)
- M K Nicholas
- Sydney Medical School - Northern, University of Sydney & Royal North Shore Hospital, St Leonards, NSW, Australia.
| | - D S J Costa
- Sydney Medical School - Northern, University of Sydney & Royal North Shore Hospital, St Leonards, NSW, Australia
| | - S J Linton
- Center for Health And Medical Psychology, Department of Law, Psychology, and Social Work, Örebro University, Örebro, Sweden
| | - C J Main
- Arthritis Care UK Primary Care Centre, Keele University, Keele, North Staffordshire, UK
| | - W S Shaw
- University of Massachusetts Medical School, Worcester, MA, USA
| | - G Pearce
- Sydney Medical School - Northern, University of Sydney & Royal North Shore Hospital, St Leonards, NSW, Australia
| | - M Gleeson
- Sydney Medical School - Northern, University of Sydney & Royal North Shore Hospital, St Leonards, NSW, Australia
| | - R Z Pinto
- Sydney Medical School - Northern, University of Sydney & Royal North Shore Hospital, St Leonards, NSW, Australia
| | - F M Blyth
- School of Public Health, Concord Clinical School, University of Sydney, Sydney, NSW, Australia
| | - J H McAuley
- Neuroscience Research Australia and School of Medical Sciences, University of NSW, Sydney, NSW, Australia
| | - R J E M Smeets
- Department of Rehabilitation Medicine, Caphri, Maastricht University, Maastricht, The Netherlands
- CIR Revalidatie, Eindhoven, The Netherlands
| | - A McGarity
- Injury Management Health & Safety Branch, NSW Fire and Safety, Sydney, Australia
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26
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Traeger AC, Lee H, Hübscher M, Skinner IW, Moseley GL, Nicholas MK, Henschke N, Refshauge KM, Blyth FM, Main CJ, Hush JM, Lo S, McAuley JH. Effect of Intensive Patient Education vs Placebo Patient Education on Outcomes in Patients With Acute Low Back Pain: A Randomized Clinical Trial. JAMA Neurol 2019; 76:161-169. [PMID: 30398542 DOI: 10.1001/jamaneurol.2018.3376] [Citation(s) in RCA: 81] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Importance Many patients with acute low back pain do not recover with basic first-line care (advice, reassurance, and simple analgesia, if necessary). It is unclear whether intensive patient education improves clinical outcomes for those patients already receiving first-line care. Objective To determine the effectiveness of intensive patient education for patients with acute low back pain. Design, Setting, and Participants This randomized, placebo-controlled clinical trial recruited patients from general practices, physiotherapy clinics, and a research center in Sydney, Australia, between September 10, 2013, and December 2, 2015. Trial follow-up was completed in December 17, 2016. Primary care practitioners invited 618 patients presenting with acute low back pain to participate. Researchers excluded 416 potential participants. All of the 202 eligible participants had low back pain of fewer than 6 weeks' duration and a high risk of developing chronic low back pain according to Predicting the Inception of Chronic Pain (PICKUP) Tool, a validated prognostic model. Participants were randomized in a 1:1 ratio to either patient education or placebo patient education. Interventions All participants received recommended first-line care for acute low back pain from their usual practitioner. Participants received additional 2 × 1-hour sessions of patient education (information on pain and biopsychosocial contributors plus self-management techniques, such as remaining active and pacing) or placebo patient education (active listening, without information or advice). Main Outcomes and Measures The primary outcome was pain intensity (11-point numeric rating scale) at 3 months. Secondary outcomes included disability (24-point Roland Morris Disability Questionnaire) at 1 week, and at 3, 6, and 12 months. Results Of 202 participants randomized for the trial, the mean (SD) age of participants was 45 (14.5) years and 103 (51.0%) were female. Retention rates were greater than 90% at all time points. Intensive patient education was not more effective than placebo patient education at reducing pain intensity (3-month mean [SD] pain intensity: 2.1 [2.4] vs 2.4 [2.2]; mean difference at 3 months, -0.3 [95% CI, -1.0 to 0.3]). There was a small effect of intensive patient education on the secondary outcome of disability at 1 week (mean difference, -1.6 points on a 24-point scale [95% CI, -3.1 to -0.1]) and 3 months (mean difference, -1.7 points, [95% CI, -3.2 to -0.2]) but not at 6 or 12 months. Conclusions and Relevance Adding 2 hours of patient education to recommended first-line care for patients with acute low back pain did not improve pain outcomes. Clinical guideline recommendations to provide complex and intensive support to high-risk patients with acute low back pain may have been premature. Trial Registration Australian Clinical Trial Registration Number: 12612001180808.
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Affiliation(s)
- Adrian C Traeger
- Neuroscience Research Australia, Sydney, New South Wales, Australia.,Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Hopin Lee
- Neuroscience Research Australia, Sydney, New South Wales, Australia.,Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
| | - Markus Hübscher
- Neuroscience Research Australia, Sydney, New South Wales, Australia
| | - Ian W Skinner
- Neuroscience Research Australia, Sydney, New South Wales, Australia.,Graduate School of Health, University of Technology, Sydney, New South Wales, Australia
| | - G Lorimer Moseley
- Neuroscience Research Australia, Sydney, New South Wales, Australia.,Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia, Australia
| | - Michael K Nicholas
- University of Sydney at Royal North Shore Hospital, Pain Management Research Institute, Sydney, New South Wales, Australia
| | - Nicholas Henschke
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Kathryn M Refshauge
- Faculty of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Fiona M Blyth
- Centre for Education and Research on Ageing, The University of Sydney, Sydney, New South Wales, Australia
| | - Chris J Main
- Arthritis Care UK National Primary Care Centre, Keele University, North Staffordshire, United Kingdom
| | - Julia M Hush
- Department of Health Professions, Macquarie University, Sydney, New South Wales, Australia
| | - Serigne Lo
- Melanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia.,Institute for Research and Medical Consultations, University of Dammam, Dammam, Kingdom of Saudi Arabia
| | - James H McAuley
- Neuroscience Research Australia, Sydney, New South Wales, Australia.,Exercise Physiology, School of Medical Sciences, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
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Nicholas MK, Costa DSJ, Linton SJ, Main CJ, Shaw WS, Pearce R, Gleeson M, Pinto RZ, Blyth FM, McCauley JH, Maher CG, Smeets RJEM, McGarity A. Predicting Return to Work in a Heterogeneous Sample of Recently Injured Workers Using the Brief ÖMPSQ-SF. J Occup Rehabil 2019; 29:295-302. [PMID: 29796980 DOI: 10.1007/s10926-018-9784-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Purpose (1) to examine the ability of the Örebro Musculoskeletal Pain Screening Questionnaire-short version (ÖMPSQ-SF) to predict time to return to pre-injury work duties (PID) following a work-related soft tissue injury (regardless of body location); and (2) to examine the appropriateness of 50/100 as a suitable cut-off score for case identification. Methods Injured workers (IW) from six public hospitals in Sydney, Australia, who had taken medically-sanctioned time off work due to their injury, were recruited by insurance case managers within 5-15 days of their injury. Eligible participants (N = 213 in total) were administered the ÖMPSQ-SF over the telephone by the case manager. For objective (1) Cox proportional hazards regression analysis was used to predict days to return to PID using the ÖMPSQ-SF. For objective (2) receiver operator characteristic (ROC) analysis was used to determine the ÖMPSQ-SF total score that optimises sensitivity and specificity in detecting whether or not participants had returned to PID within 2-7 weeks. Results The total ÖMPSQ-SF score significantly predicted number of days to return to PID, such that for every 1-point increase in the total ÖMPSQ-SF score the predicted chance of returning to work reduced by 4% (i.e., hazard ratio = 0.96), p < 0.001. Sensitivity and specificity for the ROC analysis comparing ÖMPSQ-SF total score to return to PID within 2-7 weeks suggested 48 as the optimal cut off (sensitivity = 0.65, specificity = 0.79). Conclusion The results provide strong support for the use of the ÖMPSQ-SF in an applied setting for identifying those IW likely to have delayed RTW when administered within 15 days of the injury. While a score of 48/100 was the optimal cut point for sensitivity and specificity, pragmatically, 50/100 should be acceptable as a cut-off in future studies of this type.
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Affiliation(s)
- M K Nicholas
- Sydney Medical School - Northern, University of Sydney & Royal North Shore Hospital, St Leonards, NSW, Australia.
| | - D S J Costa
- Sydney Medical School - Northern, University of Sydney & Royal North Shore Hospital, St Leonards, NSW, Australia
| | - S J Linton
- Department of Law, Psychology, and Social Work, Center for Health and Medical Psychology, Örebro University, Örebro, Sweden
| | - C J Main
- Arthritis Care UK Primary Care Centre, Keele University, North Staffordshire, UK
| | - W S Shaw
- University of Connecticut Health Center, Farmington, CT, USA
| | - R Pearce
- Sydney Medical School - Northern, University of Sydney & Royal North Shore Hospital, St Leonards, NSW, Australia
| | - M Gleeson
- Sydney Medical School - Northern, University of Sydney & Royal North Shore Hospital, St Leonards, NSW, Australia
| | - R Z Pinto
- Sydney Medical School - Northern, University of Sydney & Royal North Shore Hospital, St Leonards, NSW, Australia
| | - F M Blyth
- School of Public Health, Concord Clinical School, University of Sydney, Sydney, NSW, Australia
| | - J H McCauley
- Neuroscience Research Australia and School of Medical Sciences, University of NSW, Sydney, NSW, Australia
| | - C G Maher
- The George Institute, Sydney Medical School, University of Sydney, Sydney, Australia
| | - R J E M Smeets
- Knowledge Centre Rehabilitation Foundation Limburg, Hoensbroek, The Netherlands
- Department of Rehabilitation Medicine, Caphri, Maastricht University, Maastricht, The Netherlands
| | - A McGarity
- Injury Management, Health & Safety Branch, NSW Fire and Safety, Sydney, Australia
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Stevens ML, Lin CWC, van der Ploeg HP, De Sousa M, Castle J, Nicholas MK, Maher CG. Feasibility, Validity, and Responsiveness of Self-Report and Objective Measures of Physical Activity in Patients With Chronic Pain. PM R 2019; 11:858-867. [PMID: 30609195 DOI: 10.1002/pmrj.12058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 11/22/2018] [Indexed: 11/08/2022]
Abstract
BACKGROUND Accurate tools for measuring physical activity are important for monitoring patients with chronic pain. However, these tools have not been properly validated in this population. OBJECTIVE To determine the suitability of two physical activity measures for use in chronic pain populations. DESIGN Longitudinal observational study. SETTING Pain Management and Research Centre. PARTICIPANTS Sixty-four patients presenting to the Pain Management and Research Centre with chronic pain. METHODS Participants underwent a 3-week pain management program that included cognitive behavioral strategies, education, and multiple exercises sessions per day. Physical activity was measured by the Active Australia Survey and the Actigraph GT3X at the start and end of the program. Feasibility of the physical activity measures was assessed. Criterion validity and responsiveness between the measures was compared. Correlation of physical activity with self-rated global rating of change (GROC) scales in health were calculated. MAIN OUTCOME MEASUREMENTS Minutes per day spent in low, moderate, and vigorous physical activity; global rating of change. RESULTS Fifty-two percent (n = 33) and 78% (n = 50) of participants had valid Actigraph and Active Australia data, respectively, for both time points. For criterion validity and responsiveness correlations varied (rho = -.12-.52). All correlations between physical activity measures and GROC were small or negligible (rho ≤ .18). CONCLUSION Feasibility of the Actigraph was poor compared to the Active Australia Survey. The criterion validity and responsiveness of the Active Australia Survey to the Actigraph was inconsistent and the relationship of both these measures to clinical outcomes was poor. However, limitations due to missing data mean that further research is required. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Matthew L Stevens
- Musculoskeletal Health Sydney, School of Public Health, University of Sydney, Sydney, Australia
| | - Chung-Wei C Lin
- Musculoskeletal Health Sydney, School of Public Health, University of Sydney, Sydney, Australia
| | - Hidde P van der Ploeg
- Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.,Sydney School of Public Health, University of Sydney, Sydney, Australia
| | - Maria De Sousa
- Pain Management Research Institute, University of Sydney at the Royal North Shore Hospital, Sydney, Australia
| | - Jessica Castle
- Pain Management Research Institute, University of Sydney at the Royal North Shore Hospital, Sydney, Australia
| | - Michael K Nicholas
- Pain Management Research Institute, University of Sydney at the Royal North Shore Hospital, Sydney, Australia
| | - Chris G Maher
- Musculoskeletal Health Sydney, School of Public Health, University of Sydney, Sydney, Australia
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Oliveira CB, Franco MR, Maher CG, Tiedemann A, Silva FG, Damato TM, Nicholas MK, Christofaro DGD, Pinto RZ. The efficacy of a multimodal physical activity intervention with supervised exercises, health coaching and an activity monitor on physical activity levels of patients with chronic, nonspecific low back pain (Physical Activity for Back Pain (PAyBACK) trial): study protocol for a randomised controlled trial. Trials 2018; 19:40. [PMID: 29334992 PMCID: PMC5769445 DOI: 10.1186/s13063-017-2436-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Accepted: 12/29/2017] [Indexed: 12/15/2022] Open
Abstract
Background Physical activity plays an important role in the management of chronic low back pain (LBP). Engaging in an active lifestyle is associated with a better prognosis. Nevertheless, there is evidence to suggest that patients with chronic LBP are less likely to meet recommended physical activity levels. Furthermore, while exercise therapy has been endorsed by recent clinical practice guidelines, evidence from systematic reviews suggests that its effect on pain and disability are at best moderate and not sustained over time. A limitation of current exercises programmes for chronic LBP is that these programmes are not designed to change patients’ behaviour toward an active lifestyle. Therefore, we will investigate the short- and long-term efficacy of a multimodal intervention, consisting of supervised exercises, health coaching and use of an activity monitor (i.e. Fitbit Flex) compared to supervised exercises plus sham coaching and a sham activity monitor on physical activity levels, pain intensity and disability, in patients with chronic, nonspecific LBP. Methods This study will be a two-group, single-blind, randomised controlled trial. One hundred and sixty adults with chronic, nonspecific LBP will be recruited. Participants allocated to both groups will receive a group exercise programme. In addition, the intervention group will receive health coaching sessions (i.e. assisting the participants to achieve their physical activity goals) and an activity monitor (i.e. Fitbit Flex). The participants allocated to the control group will receive sham health coaching (i.e. encouraged to talk about their LBP or other problems, but without any therapeutic advice from the physiotherapist) and a sham activity monitor. Outcome measures will be assessed at baseline and at 3, 6 and 12 months post randomisation. The primary outcomes will be physical activity, measured objectively with an accelerometer, as well as pain intensity and disability at 3 months post randomisation. Secondary outcomes will be physical activity, pain intensity and disability at 6 and 12 months post randomisation as well as other self-report measures of physical activity and sedentary behaviour, depression, quality of life, pain self-efficacy and weight-related outcomes at 3, 6, and 12 months post randomisation. Discussion This study is significant as it will be the first study to investigate whether a multimodal intervention designed to increase physical activity levels reduces pain and disability, and increases physical activity levels compared to a control intervention in patients with chronic LBP. Trial registration ClinicalTrials.gov, ID: NCT03200509. Registered on 28 June 2017. Electronic supplementary material The online version of this article 10.1186/s13063-017-2436-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Crystian B Oliveira
- Department of Physical Therapy, Faculty of Science and Technology, Sao Paulo State University (UNESP), Presidente Prudente, SP, Brazil
| | - Márcia R Franco
- Department of Physical Therapy, Faculty of Science and Technology, Sao Paulo State University (UNESP), Presidente Prudente, SP, Brazil
| | - Chris G Maher
- School of Public Health, Sydney Medical School, University of Sydney, Sydney, NSW, Australia.,Institute for Musculoskeletal Health, Sydney Local Health District, Sydney, NSW, Australia
| | - Anne Tiedemann
- School of Public Health, Sydney Medical School, University of Sydney, Sydney, NSW, Australia.,Institute for Musculoskeletal Health, Sydney Local Health District, Sydney, NSW, Australia
| | - Fernanda G Silva
- Department of Physical Therapy, Faculty of Science and Technology, Sao Paulo State University (UNESP), Presidente Prudente, SP, Brazil
| | - Tatiana M Damato
- Department of Physical Therapy, Faculty of Science and Technology, Sao Paulo State University (UNESP), Presidente Prudente, SP, Brazil
| | - Michael K Nicholas
- Pain Management Research Institute, University of Sydney at Royal North Shore Hospital, Sydney, NSW, Australia
| | - Diego G D Christofaro
- Departament of Physical Education, Faculty of Science and Technology, Sao Paulo State University (UNESP), Presidente Prudente, SP, Brazil
| | - Rafael Z Pinto
- Department of Physical Therapy, Faculty of Science and Technology, Sao Paulo State University (UNESP), Presidente Prudente, SP, Brazil. .,Departament of Physical Therapy, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.
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Karayannis NV, Jull GA, Nicholas MK, Hodges PW. Psychological Features and Their Relationship to Movement-Based Subgroups in People Living With Low Back Pain. Arch Phys Med Rehabil 2018; 99:121-128. [DOI: 10.1016/j.apmr.2017.08.493] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 08/25/2017] [Indexed: 11/26/2022]
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31
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Main CJ, Nicholas MK, Shaw WS, Tetrick LE, Ehrhart MG, Pransky G. Erratum to: Implementation Science and Employer Disability Practices: Embedding Implementation Factors in Research Designs. J Occup Rehabil 2017; 27:477. [PMID: 28853049 PMCID: PMC6828363 DOI: 10.1007/s10926-017-9725-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- Chris J Main
- Arthritis Care UK Primary Care Center, Keele University, North Staffordshire, UK
| | - Michael K Nicholas
- Pain Management Research Institute, Sydney Medical School - Northern, Royal North Shore Hospital, St. Leonards, NSW, 2065, Australia.
| | - William S Shaw
- Liberty Mutual Research Institute for Safety, Hopkinton, MA, USA
- University of Massachusetts Medical School, Worcester, MA, USA
| | | | | | - Glenn Pransky
- Liberty Mutual Research Institute for Safety, Hopkinton, MA, USA
- University of Massachusetts Medical School, Worcester, MA, USA
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Elbers NA, Chase R, Craig A, Guy L, Harris IA, Middleton JW, Nicholas MK, Rebbeck T, Walsh J, Willcock S, Lockwood K, Cameron ID. Health care professionals' attitudes towards evidence-based medicine in the workers' compensation setting: a cohort study. BMC Med Inform Decis Mak 2017; 17:64. [PMID: 28532470 PMCID: PMC5440905 DOI: 10.1186/s12911-017-0460-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Accepted: 05/11/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Problems may arise during the approval process of treatment after a compensable work injury, which include excess paperwork, delays in approving services, disputes, and allegations of over-servicing. This is perceived as undesirable for injured people, health care professionals and claims managers, and costly to the health care system, compensation system, workplaces and society. Introducing an Evidence Based Medicine (EBM) decision tool in the workers' compensation system could provide a partial solution, by reducing uncertainty about effective treatment. The aim of this study was to investigate attitudes of health care professionals (HCP) to the potential implementation of an EBM tool in the workers' compensation setting. METHODS The study has a mixed methods design. The quantitative study consisted of an online questionnaire asking about self-reported knowledge, attitudes and behaviour to EBM in general. The qualitative study consisted of interviews about an EBM tool being applied in the workers' compensation process. Participants were health care practitioners from different clinical specialties. They were recruited through the investigators' clinical networks and the workers' compensation government regulator's website. RESULTS Participants completing the questionnaire (n = 231) indicated they were knowledgeable about the evidence-base in their field, but perceived some difficulties when applying EBM. General practitioners reported having the greatest obstacles to applying EBM. Participants who were interviewed (n = 15) perceived that an EBM tool in the workers' compensation setting could potentially have some advantages, such as reducing inappropriate treatment, or over-servicing, and providing guidance for clinicians. However, participants expressed substantial concerns that the EBM tool would not adequately reflect the impact of psychosocial factors on recovery. They also highlighted a lack of timeliness in decision making and proper assessment, particularly in pain management. CONCLUSIONS Overall, HCP are supportive of EBM, but have strong concerns about implementation of EBM based decision making in the workers' compensation setting. The participants felt that an EBM tool should not be applied rigidly and should take into account clinical judgement and patient variability and preferences. In general, the treatment approval process in the workers' compensation insurance system is a sensitive area, in which the interaction between HCP and claims managers can be improved.
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Affiliation(s)
- Nieke A. Elbers
- Sydney Medical School Northern, University of Sydney; Northern Sydney Local Health District, St Leonards, Australia
| | - Robin Chase
- Tyrrell Consulting, Adelaide, South Australia Australia
| | - Ashley Craig
- Sydney Medical School Northern, University of Sydney; Northern Sydney Local Health District, St Leonards, Australia
| | - Lyn Guy
- School of Health Sciences, University of Newcastle, Newcastle, Australia
| | - Ian A. Harris
- Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, UNSW, Sydney, Australia
| | - James W. Middleton
- Sydney Medical School Northern, University of Sydney; Northern Sydney Local Health District, St Leonards, Australia
| | - Michael K. Nicholas
- Sydney Medical School Northern, University of Sydney; Northern Sydney Local Health District, St Leonards, Australia
| | - Trudy Rebbeck
- Sydney Medical School Northern, University of Sydney; Northern Sydney Local Health District, St Leonards, Australia
- Discipline of Physiotherapy, Faculty of Health Sciences, University of Sydney, Sydney, Australia
| | - John Walsh
- Sydney Medical School Northern, University of Sydney; Northern Sydney Local Health District, St Leonards, Australia
| | - Simon Willcock
- Macquarie University Hospital and Health Sciences Centre, Sydney, Australia
| | - Keri Lockwood
- Sydney Medical School Northern, University of Sydney; Northern Sydney Local Health District, St Leonards, Australia
| | - Ian D Cameron
- Sydney Medical School Northern, University of Sydney; Northern Sydney Local Health District, St Leonards, Australia
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Traeger AC, Skinner IW, Hübscher M, Lee H, Moseley GL, Nicholas MK, Henschke N, Refshauge KM, Blyth FM, Main CJ, Hush JM, Pearce G, Lo S, McAuley JH. A randomized, placebo-controlled trial of patient education for acute low back pain (PREVENT Trial): statistical analysis plan. Braz J Phys Ther 2017; 21:219-223. [PMID: 28545779 PMCID: PMC5537460 DOI: 10.1016/j.bjpt.2017.04.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 01/23/2017] [Accepted: 01/23/2017] [Indexed: 12/19/2022] Open
Abstract
Patient education is recommended in the primary care management of acute low back pain. The PREVENT Trial is the first placebo-controlled randomized trial to evaluate the efficacy of patient education. Statistical analysis plans increase the transparency around how researchers plan to estimate and interpret treatment effects from randomized trials. This protocol describes the pre-specified principles, methods, and procedures to be adhered to in the statistical analysis of the PREVENT trial data.
Background Statistical analysis plans increase the transparency of decisions made in the analysis of clinical trial results. The purpose of this paper is to detail the planned analyses for the PREVENT trial, a randomized, placebo-controlled trial of patient education for acute low back pain. Results We report the pre-specified principles, methods, and procedures to be adhered to in the main analysis of the PREVENT trial data. The primary outcome analysis will be based on Mixed Models for Repeated Measures (MMRM), which can test treatment effects at specific time points, and the assumptions of this analysis are outlined. We also outline the treatment of secondary outcomes and planned sensitivity analyses. We provide decisions regarding the treatment of missing data, handling of descriptive and process measure data, and blinded review procedures. Conclusions Making public the pre-specified statistical analysis plan for the PREVENT trial minimizes the potential for bias in the analysis of trial data, and in the interpretation and reporting of trial results. Trial registration ACTRN12612001180808 (https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12612001180808)
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Affiliation(s)
- Adrian C Traeger
- Prince of Wales Clinical School, University of New South Wales, Sydney, New South Wales, Australia; Neuroscience Research Australia, Sydney, New South Wales, Australia.
| | - Ian W Skinner
- Prince of Wales Clinical School, University of New South Wales, Sydney, New South Wales, Australia; Neuroscience Research Australia, Sydney, New South Wales, Australia
| | - Markus Hübscher
- Prince of Wales Clinical School, University of New South Wales, Sydney, New South Wales, Australia; Neuroscience Research Australia, Sydney, New South Wales, Australia
| | - Hopin Lee
- Prince of Wales Clinical School, University of New South Wales, Sydney, New South Wales, Australia; Neuroscience Research Australia, Sydney, New South Wales, Australia
| | - G Lorimer Moseley
- Neuroscience Research Australia, Sydney, New South Wales, Australia; Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia, Australia
| | - Michael K Nicholas
- Pain Management Research Institute, University of Sydney at Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Nicholas Henschke
- Institute of Public Health, University of Heidelberg, Heidelberg, Germany
| | - Kathryn M Refshauge
- Faculty of Health Sciences, University of Sydney, Sydney, New South Wales, Australia
| | - Fiona M Blyth
- Centre for Education and Research on Ageing, University of Sydney, Sydney, New South Wales, Australia
| | - Chris J Main
- Arthritis Care UK National Primary Care Centre, Keele University, North Staffordshire, UK
| | - Julia M Hush
- Department of Health Professions, Macquarie University, Sydney, New South Wales, Australia
| | - Garry Pearce
- Department of Rehabilitation Medicine, Greenwich Hospital, Sydney, New South Wales, Australia
| | - Serigne Lo
- Melanoma Institute Australia, Sydney, New South Wales, Australia
| | - James H McAuley
- Prince of Wales Clinical School, University of New South Wales, Sydney, New South Wales, Australia; Neuroscience Research Australia, Sydney, New South Wales, Australia
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Costa DS, Asghari A, Nicholas MK. Item response theory analysis of the Pain Self-Efficacy Questionnaire. Scand J Pain 2017; 14:113-117. [DOI: 10.1016/j.sjpain.2016.08.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 08/01/2016] [Accepted: 08/02/2016] [Indexed: 10/21/2022]
Abstract
Abstract
Background and aims
The Pain Self-Efficacy Questionnaire (PSEQ) is a 10-item instrument designed to assess the extent to which a person in pain believes s/he is able to accomplish various activities despite their pain. There is strong evidence for the validity and reliability of both the full-length PSEQ and a 2-item version. The purpose of this study is to further examine the properties of the PSEQ using an item response theory (IRT) approach.
Methods
We used the two-parameter graded response model to examine the category probability curves, and location and discrimination parameters of the 10 PSEQ items. In item response theory, responses to a set of items are assumed to be probabilistically determined by a latent (unobserved) variable. In the graded-response model specifically, item response threshold (the value of the latent variable for which adjacent response categories are equally likely) and discrimination parameters are estimated for each item. Participants were 1511 mixed, chronic pain patients attending for initial assessment at a tertiary pain management centre.
Results
All items except item 7 (‘I can cope with my pain without medication’) performed well in IRT analysis, and the category probability curves suggested that participants used the 7-point response scale consistently. Items 6 (‘I can still do many of the things I enjoy doing, such as hobbies or leisure activity, despite pain’), 8 (‘I can still accomplish most of my goals in life, despite the pain’) and 9 (‘I can live a normal lifestyle, despite the pain’) captured higher levels of the latent variable with greater precision.
Conclusions
The results from this IRT analysis add to the body of evidence based on classical test theory illustrating the strong psychometric properties of the PSEQ. Despite the relatively poor performance of Item 7, its clinical utility warrants its retention in the questionnaire.
Implications
The strong psychometric properties of the PSEQ support its use as an effective tool for assessing self-efficacy in people with pain.
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Affiliation(s)
- Daniel S.J. Costa
- Pain Management Research Institute , University of Sydney at Royal North Shore Hospital , Sydney , Australia
- Sydney Medical School , University of Sydney , Sydney , Australia
| | - Ali Asghari
- Pain Management Research Institute , University of Sydney at Royal North Shore Hospital , Sydney , Australia
- School of Psychology , University of Shahed , Tehran , Iran
| | - Michael K. Nicholas
- Pain Management Research Institute , University of Sydney at Royal North Shore Hospital , Sydney , Australia
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Shaw WS, Main CJ, Pransky G, Nicholas MK, Anema JR, Linton SJ. Employer Policies and Practices to Manage and Prevent Disability: Foreword to the Special Issue. J Occup Rehabil 2016; 26:394-398. [PMID: 27562584 PMCID: PMC5104772 DOI: 10.1007/s10926-016-9658-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Purpose Employer policies and practices have been shown to impact workplace disability, but research in this area has waned in recent years despite an aging workforce, a growing prevalence of chronic health conditions, and a larger proportion of working-age adults on permanent work disability in many jurisdictions. The purpose of this article is to describe the background rationale and methodology for an invited conference designed to improve research of employer strategies to curtail work disability. Methods A multidisciplinary team of 26 international researchers with published research in employer-based disability management or related fields were invited to attend a 3-day conference in Hopkinton, Massachusetts, USA. The overall goal was to review the status of current research of workplace disability management and prevention, examine its relevance for employer decision-making, compare conceptual frameworks or theoretical perspectives, and recommend future research directions. Working groups were organized and draft manuscripts were prepared in advance. Conference activities included working group presentations and critiques, discussions with a panel of industry consultants and advisors, group interaction and debate, generation of final recommendations, and manuscript revision. Results/Conclusion Six principal domains were established with respect to future research: (a) further elucidation of the key workplace factors that buffer the disabling effects of injury and illness; (b) more innovative and feasible options for workplace intervention; (c) measurement of workplace-relevant disability outcomes; (d) a stronger theoretical framework for understanding the factors behind employer uptake and implementation; (e) a focus on special clinical populations and occupations where disability risk is most troubling; and (f) better representation of workers and employers that reflect the diverse and changing nature of work. Final comments and recommendations of the working groups are presented in the following six articles in this special issue of the Journal of Occupational Rehabilitation. Conference attendees recommended changes in methodology, collaboration strategies, and theoretical perspectives to improve the practical and scientific impact of future research of employer practices.
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Affiliation(s)
- William S Shaw
- Liberty Mutual Research Institute for Safety, 71 Frankland Road, Hopkinton, MA, 01748, USA.
- University of Massachusetts Medical School, Worcester, MA, USA.
| | - Chris J Main
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care Sciences and Health Sciences, Keele University, Keele, Staffordshire, UK
| | - Glenn Pransky
- Liberty Mutual Research Institute for Safety, 71 Frankland Road, Hopkinton, MA, 01748, USA
- University of Massachusetts Medical School, Worcester, MA, USA
| | - Michael K Nicholas
- Pain Management Research Institute, University of Sydney at Royal North Shore Hospital, Sydney, Australia
| | - Johannes R Anema
- EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Steven J Linton
- CHAMP, School of Law, Psychology and Social Work, Örebro University, Örebro, Sweden
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Main CJ, Nicholas MK, Shaw WS, Tetrick LE, Ehrhart MG, Pransky G. Implementation Science and Employer Disability Practices: Embedding Implementation Factors in Research Designs. J Occup Rehabil 2016; 26:448-464. [PMID: 27796914 PMCID: PMC5104783 DOI: 10.1007/s10926-016-9677-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Purpose For work disability research to have an impact on employer policies and practices it is important for such research to acknowledge and incorporate relevant aspects of the workplace. The goal of this article is to summarize recent theoretical and methodological advances in the field of Implementation Science, relate these to research of employer disability management practices, and recommend future research priorities. Methods The authors participated in a year-long collaboration culminating in an invited 3-day conference, "Improving Research of Employer Practices to Prevent Disability", held October 14-16, 2015, in Hopkinton, MA, USA. The collaboration included a topical review of the literature, group conference calls to identify key areas and challenges, drafting of initial documents, review of industry publications, and a conference presentation that included feedback from peer researchers and a question/answer session with a special panel of knowledge experts with direct employer experience. Results A 4-phase implementation model including both outer and inner contexts was adopted as the most appropriate conceptual framework, and aligned well with the set of process evaluation factors described in both the work disability prevention literature and the grey literature. Innovative interventions involving disability risk screening and psychologically-based interventions have been slow to gain traction among employers and insurers. Research recommendations to address this are : (1) to assess organizational culture and readiness for change in addition to individual factors; (2) to conduct process evaluations alongside controlled trials; (3) to analyze decision-making factors among stakeholders; and (4 ) to solicit input from employers and insurers during early phases of study design. Conclusions Future research interventions involving workplace support and involvement to prevent disability may be more feasible for implementation if organizational decision-making factors are imbedded in research designs and interventions are developed to take account of these influences.
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Affiliation(s)
- Chris J Main
- Arthritis Care UK Primary Care Center, Keele University, North Staffordshire, UK
| | - Michael K Nicholas
- Pain Management Research Institute, Sydney Medical School - Northern, Royal North Shore Hospital, St. Leonards, NSW, 2065, Australia.
| | - William S Shaw
- Liberty Mutual Research Institute for Safety, Hopkinton, MA, USA
- University of Massachusetts Medical School, Worcester, MA, USA
| | | | | | - Glenn Pransky
- Liberty Mutual Research Institute for Safety, Hopkinton, MA, USA
- University of Massachusetts Medical School, Worcester, MA, USA
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Bennell KL, Ahamed Y, Jull G, Bryant C, Hunt MA, Forbes AB, Kasza J, Akram M, Metcalf B, Harris A, Egerton T, Kenardy JA, Nicholas MK, Keefe FJ. Physical Therapist-Delivered Pain Coping Skills Training and Exercise for Knee Osteoarthritis: Randomized Controlled Trial. Arthritis Care Res (Hoboken) 2016; 68:590-602. [DOI: 10.1002/acr.22744] [Citation(s) in RCA: 97] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Revised: 09/15/2015] [Accepted: 09/22/2015] [Indexed: 01/22/2023]
Affiliation(s)
| | - Yasmin Ahamed
- University of Melbourne; Melbourne Victoria Australia
| | | | - Christina Bryant
- University of Melbourne and Royal Women's Hospital; Melbourne Victoria Australia
| | - Michael A. Hunt
- University of British Columbia; Vancouver British Columbia Canada
| | | | | | | | - Ben Metcalf
- University of Melbourne; Melbourne Victoria Australia
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Wilson D, Mackintosh S, Nicholas MK, Moseley GL. Harnessing group composition-related effects in pain management programs: a review and recommendations. Pain Manag 2016; 6:161-73. [PMID: 27008418 DOI: 10.2217/pmt.15.66] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Cognitive-behavioral therapy, an effective management strategy for chronic pain, is frequently conducted in groups. Although clinicians often report 'knowing when a group will go well or badly', investigations of the effect that group composition might have on outcomes is lacking. Conceptual models, explanatory theories and experiments have been developed in fields of psychotherapy, organizational, social and educational psychology, but there has been no attempt to take on this issue in our field. The current hypothesis-generating review synthesizes these substantial bodies of literature to identify common themes across fields and integrate them with current concepts of cognitive-behavioral therapy-based pain management. We present a putative conceptual model with testable hypotheses relating to features of each group as a whole, the individuals in that group and the group's leader.
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Affiliation(s)
- Dianne Wilson
- The Sansom Institute for Health Research, University of South Australia, School of Health Sciences, City East Campus, GPO Box 2471, Adelaide, SA 5001, Australia
| | - Shylie Mackintosh
- The Sansom Institute for Health Research, University of South Australia, School of Health Sciences, City East Campus, GPO Box 2471, Adelaide, SA 5001, Australia
| | - Michael K Nicholas
- Pain Management Research Institute, University of Sydney, St Leonards, New South Wales 2065, Australia
| | - G Lorimer Moseley
- The Sansom Institute for Health Research, University of South Australia, School of Health Sciences, City East Campus, GPO Box 2471, Adelaide, SA 5001, Australia
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Wood BM, Nicholas MK, Blyth F, Asghari A, Gibson S. The mediating role of catastrophizing in the relationship between pain intensity and depressed mood in older adults with persistent pain: A longitudinal analysis. Scand J Pain 2016; 11:157-162. [PMID: 28850461 DOI: 10.1016/j.sjpain.2015.12.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Revised: 12/18/2015] [Accepted: 12/20/2015] [Indexed: 11/18/2022]
Abstract
BACKGROUND AND AIMS Depression is common in older adults with persistent pain. Cognitive-behavioural models of pain propose that the relationship between pain and depression is influenced or mediated by interpretations of events (cognitions), rather than by the event itself. Almost exclusively, the evidence for this position has come from studies of people aged less than 65 years. The role of cognitions in the pain experience of older adults has been unclear due to the limited and conflicting evidence available. The aim of our study was to examine the role of catastrophizing in mediating the relationship between pain intensity and depressed mood in older adults with persistent pain using reliable and valid measures for this population. METHODS In a two-wave longitudinal design, a sample of 141 patients (89 women, 52 men) 65 years and over with persistent pain participating in an evaluation of a pain self-management programme completed questionnaires measuring usual level of pain intensity (NRS), depressed mood (DASS-21) and the catastrophizing factors of magnification and helplessness (PRSS) at the beginning of the programme and 6 months later. Demographic data and pain history were collected by self-completion questionnaires, which were mailed to patients prior to participating in the programme and returned by post. RESULTS Change scores for usual level of pain intensity (NRS), depressed mood (DASS-21) and the magnification and helplessness factors on the PRSS-Catastrophizing were calculated by subtracting the scores at 6 months after completion of the study (Time 2) from the scores at the beginning of the study (Time 1). In the longitudinal analyses of mediation, using a series of regression analyses, change scores for both factors (magnification, helplessness) of the measure of catastrophizing (PRSS) totally and significantly mediated the relationship between change scores for pain intensity and depressed mood. The significant relative magnitude of beta between pain intensity and depression reduced from 0.22 to 0.13 and became non-significant after introducing magnification as a mediating variable, whilst the significant relative magnitude of beta reduced from 0.22 to 0.12 and also became non-significant after introducing helplessness as a mediating variable. CONCLUSIONS These results support a cognitive-behavioural model and highlight the importance of cognitive factors, in this case catastrophizing, in the relationship between pain intensity and depressed mood in older adults with persistent pain. IMPLICATIONS These findings also have important clinical implications for the treatment of older adults with persistent pain. They highlight the importance of targeting interventions to reduce the influence of catastrophizing as a prerequisite for reducing depressive symptoms in this growing population.
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Affiliation(s)
- Bradley M Wood
- Pain Management Research Institute, University of Sydney at Royal North Shore Hospital, Sydney, Australia.
| | - Michael K Nicholas
- Pain Management Research Institute, University of Sydney at Royal North Shore Hospital, Sydney, Australia
| | - Fiona Blyth
- Pain Management Research Institute, University of Sydney at Royal North Shore Hospital, Sydney, Australia; School of Public Health, University of Sydney, Sydney, Australia
| | - Ali Asghari
- Pain Management Research Institute, University of Sydney at Royal North Shore Hospital, Sydney, Australia; School of Psychology, Shahed University, Tehran, Iran
| | - Stephen Gibson
- National Ageing Research Institute, Royal Melbourne Hospital, VIC, Australia; Caulfield Pain Management and Research Centre, Caulfield, VIC, Australia
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Abstract
It has long been recognized that in the management of chronic illnesses generally, medical care alone is unlikely to be sufficient without the active contribution of the patient. This perspective has also been enunciated in numerous guidelines for the management of chronic pain. However, in the case of chronic pain at least, the nature and role of self-management have been poorly defined and, as a result, poorly understood and researched. This review considers the nature of self-management strategies for chronic pain, evidence of their effectiveness and ways in which self-management can be facilitated for those in chronic pain. A research and training agenda is proposed for where this work could go next.
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Affiliation(s)
- Michael K Nicholas
- Pain Management Research Institute, Sydney Medical School-Northern, Royal North Shore Hospital, St Leonards, NSW 2065, Australia
| | - Fiona M Blyth
- Concord Clinical School, Sydney Medical School, Concord Repatriation General Hospital, Hospital Road, Concord, NSW 2139, Australia
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Abstract
There are neurobiological, cognitive and conditioning processes involved in placebo mechanismsMechanisms research has demonstrated that there is not one placebo effect, but manyPlacebo effects are an inherent element in routine clinical practiceModulation of placebo mechanisms in routine practice could provide an opportunity for improving clinical care.
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Affiliation(s)
- Damien G Finniss
- Pain Management and Research Institute University of Sydney and Royal North Shore Hospital Pacific Hwy, St Leonards, 2065, Sydney, NSW Australia
| | - Michael K Nicholas
- Pain Management and Research Institute University of Sydney and Royal North Shore Hospital Pacific Hwy, St Leonards, 2065, Sydney, NSW Australia
| | - Fabrizio Benedetti
- Department of Neuroscience Clinical and Applied Physiology Program University of Turin Medical School Turin, Italy
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Nicholas MK, McGuire BE, Asghari A. A 2-Item Short Form of the Pain Self-Efficacy Questionnaire: Development and Psychometric Evaluation of PSEQ-2. The Journal of Pain 2015; 16:153-63. [DOI: 10.1016/j.jpain.2014.11.002] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Revised: 10/23/2014] [Accepted: 11/03/2014] [Indexed: 10/24/2022]
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Lukas RV, Mata-Machado NA, Nicholas MK, Salgia R, Antic T, Villaflor VM. Leptomeningeal carcinomatosis in esophageal cancer: a case series and systematic review of the literature. Dis Esophagus 2014; 28:772-81. [PMID: 25142531 DOI: 10.1111/dote.12276] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The aim of this study was to more clearly define the clinical course of leptomeningeal carcinomatosis due to esophageal cancer. A single institution retrospective case series was conducted. Additionally, a systematic review of the literature was performed. We present a large case series (n = 7) of leptomeningeal carcinomatosis due to esophageal cancer. Our case series and systematic review of the literature report similar findings. In our series, we report a predominance of male patients (86%) with adenocarcinoma histology (77%). Variable onset of leptomeningeal involvement of esophageal cancer in relation to the original diagnosis of the primary disease (5 months to 3 years and 11 weeks) was noted. Disease progresses quickly and overall survival is poor, measured in weeks (2.5-16 weeks) from the diagnosis of leptomeningeal involvement. Four of our patients initiated whole-brain radiation therapy with only two completing the course prior to clinical deterioration. Our patient with the longest survival (16 weeks) received intrathecal topotecan and oral temozolomide. Leptomeningeal carcinomatosis secondary to esophageal cancer has a poor prognosis. A clearly beneficial treatment modality is lacking.
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Affiliation(s)
- R V Lukas
- Department of Neurology, University of Chicago, Chicago, Illinois, USA
| | - N A Mata-Machado
- Department of Pediatric Neurology, Loyola University, Chicago, Illinois, USA
| | - M K Nicholas
- Department of Neurology, University of Chicago, Chicago, Illinois, USA.,Department of Surgery-Section of Neurosurgery, University of Chicago, Chicago, Illinois, USA.,Department of Radiation and Cellular Oncology, University of Chicago, Chicago, Illinois, USA
| | - R Salgia
- Department of Medicine-Section of Hematology & Oncology, University of Chicago, Chicago, Illinois, USA
| | - T Antic
- Department of Pathology, University of Chicago, Chicago, Illinois, USA
| | - V M Villaflor
- Department of Medicine-Section of Hematology & Oncology, University of Chicago, Chicago, Illinois, USA
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Nicholas MK. Expanding access to effective psychologically based treatments: training nurse practitioners yields dividends. Pain 2014; 155:1679-1680. [PMID: 25003252 DOI: 10.1016/j.pain.2014.06.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Accepted: 06/26/2014] [Indexed: 11/18/2022]
Affiliation(s)
- Michael K Nicholas
- Pain Management Research Institute, University of Sydney & Royal North Shore Hospital, Sydney 2065, Australia
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Affiliation(s)
- Michael K Nicholas
- Pain Management Research Institute, University of Sydney at Royal North Shore Hospital, Sydney, Australia
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Traeger AC, Moseley GL, Hübscher M, Lee H, Skinner IW, Nicholas MK, Henschke N, Refshauge KM, Blyth FM, Main CJ, Hush JM, Pearce G, McAuley JH. Pain education to prevent chronic low back pain: a study protocol for a randomised controlled trial. BMJ Open 2014; 4:e005505. [PMID: 24889854 PMCID: PMC4054624 DOI: 10.1136/bmjopen-2014-005505] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION Low back pain (LBP) is the leading cause of disability worldwide. Of those patients who present to primary care with acute LBP, 40% continue to report symptoms 3 months later and develop chronic LBP. Although it is possible to identify these patients early, effective interventions to improve their outcomes are not available. This double-blind (participant/outcome assessor) randomised controlled trial will investigate the efficacy of a brief educational approach to prevent chronic LBP in 'at-risk' individuals. METHODS/ANALYSIS Participants will be recruited from primary care practices in the Sydney metropolitan area. To be eligible for inclusion participants will be aged 18-75 years, with acute LBP (<4 weeks' duration) preceded by at least a 1 month pain-free period and at-risk of developing chronic LBP. Potential participants with chronic spinal pain and those with suspected serious spinal pathology will be excluded. Eligible participants who agree to take part will be randomly allocated to receive 2×1 h sessions of pain biology education or 2×1 h sessions of sham education from a specially trained study physiotherapist. The study requires 101 participants per group to detect a 1-point difference in pain intensity 3 months after pain onset. Secondary outcomes include the incidence of chronic LBP, disability, pain intensity, depression, healthcare utilisation, pain attitudes and beliefs, global recovery and recurrence and are measured at 1 week post-intervention, and at 3, 6 and 12 months post LBP onset. ETHICS/DISSEMINATION Ethical approval was obtained from the University of New South Wales Human Ethics Committee in June 2013 (ref number HC12664). Outcomes will be disseminated through publication in peer-reviewed journals and presentations at international conference meetings. TRIAL REGISTRATION NUMBER https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12612001180808.
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Affiliation(s)
- Adrian C Traeger
- School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia Neuroscience Research Australia, Sydney, New South Wales, Australia
| | - G Lorimer Moseley
- Neuroscience Research Australia, Sydney, New South Wales, Australia Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia, Australia
| | - Markus Hübscher
- Neuroscience Research Australia, Sydney, New South Wales, Australia
| | - Hopin Lee
- School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia Neuroscience Research Australia, Sydney, New South Wales, Australia
| | - Ian W Skinner
- School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia Neuroscience Research Australia, Sydney, New South Wales, Australia
| | - Michael K Nicholas
- Pain Management Research Institute, University of Sydney at Royal North Shore Hospital, Sydney, New South Wales, Australia
| | - Nicholas Henschke
- Institute of Public Health, University of Heidelberg, Heidelberg, Germany
| | - Kathryn M Refshauge
- Faculty of Health Sciences, University of Sydney, Sydney, New South Wales, Australia
| | - Fiona M Blyth
- Centre for Education and Research on Ageing, University of Sydney, Sydney, New South Wales, Australia
| | - Chris J Main
- Arthritis Care UK National Primary Care Centre, Keele University, North Staffordshire, UK
| | - Julia M Hush
- Department of Health Professions, Macquarie University, Sydney, New South Wales, Australia
| | - Garry Pearce
- Department of Rehabilitation Medicine, Greenwich Hospital, Sydney, New South Wales, Australia
| | - James H McAuley
- School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia Neuroscience Research Australia, Sydney, New South Wales, Australia
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Akhter R, Benson J, Svensson P, Nicholas MK, Peck CC, Murray GM. Experimental Jaw Muscle Pain Increases Pain Scores and Jaw Movement Variability in Higher Pain Catastrophizers. J Oral Facial Pain Headache 2014; 28:191-204. [DOI: 10.11607/ofph.1211] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Shaw WS, Besen E, Pransky G, Boot CRL, Nicholas MK, McLellan RK, Tveito TH. Manage at work: a randomized, controlled trial of a self-management group intervention to overcome workplace challenges associated with chronic physical health conditions. BMC Public Health 2014; 14:515. [PMID: 24885844 PMCID: PMC4051380 DOI: 10.1186/1471-2458-14-515] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Accepted: 05/23/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The percentage of older and chronically ill workers is increasing rapidly in the US and in many other countries, but few interventions are available to help employees overcome the workplace challenges of chronic pain and other physical health conditions. While most workers are eligible for job accommodation and disability compensation benefits, other workplace strategies might improve individual-level coping and problem solving to prevent work disability. In this study, we hypothesize that an employer-sponsored group intervention program employing self-management principles may improve worker engagement and reduce functional limitation associated with chronic disorders. METHODS In a randomized controlled trial (RCT), workers participating in an employer-sponsored self-management group intervention will be compared with a no-treatment (wait list) control condition. Volunteer employees (n = 300) will be recruited from five participating employers and randomly assigned to intervention or control. Participants in the intervention arm will attend facilitated group workshop sessions at work (10 hours total) to explore methods for improving comfort, adjusting work habits, communicating needs effectively, applying systematic problem solving, and dealing with negative thoughts and emotions about work. Work engagement and work limitation are the principal outcomes. Secondary outcomes include fatigue, job satisfaction, self-efficacy, turnover intention, sickness absence, and health care utilization. Measurements will be taken at baseline, 6-, and 12-month follow-up. A process evaluation will be performed alongside the randomized trial. DISCUSSION This study will be most relevant for organizations and occupational settings where some degree of job flexibility, leeway, and decision-making autonomy can be afforded to affected workers. The study design will provide initial assessment of a novel workplace approach and to understand factors affecting its feasibility and effectiveness. TRIAL REGISTRATION Clinicaltrials.gov: NCT01978392 (Issued November 6, 2013).
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Affiliation(s)
- William S Shaw
- Liberty Mutual Research Institute for Safety, 71 Frankland Rd,, Hopkinton, MA 01748, USA.
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Nicholas MK, Asghari A, Sharpe L, Brnabic A, Wood BM, Overton S, Tonkin L, de Sousa M, Finniss D, Beeston L, Sutherland A, Corbett M, Brooker C. Cognitive exposure versus avoidance in patients with chronic pain: adherence matters. Eur J Pain 2013; 18:424-37. [PMID: 23939595 DOI: 10.1002/j.1532-2149.2013.00383.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2013] [Indexed: 11/11/2022]
Abstract
BACKGROUND Behavioural exposure methods can reduce pain-avoidance behaviours, but outcomes vary. One possible explanation is that patients employ cognitive (experiential) avoidance during behavioural exposure. If so, reducing cognitive avoidance during behavioural exposure should help. One option is interoceptive exposure (IE), which involves sustained exposure (via attention) to pain sensations. In order to test if IE could improve outcomes from behavioural exposure, this study with mixed chronic pain patients compared outcomes from a cognitive behavioural therapy (CBT) pain management programme incorporating either IE or distraction from pain. METHODS One hundred forty chronic pain patients were randomly assigned to CBT + IE or CBT + distraction. Outcome measures included pain, disability, depression and medication. Measures reflecting degree of threat of pain were also employed (catastrophizing, fear-avoidance, pain self-efficacy and pain acceptance). An intention-to-treat approach, using mixed-effects model repeated measures, as well as conventional inferential statistical tests, effect sizes and reliable change indices were employed to evaluate the outcomes up to 1-year post-treatment. RESULTS Significant improvements were achieved by both treatment conditions on all outcome measures and on measures reflecting the threatening nature of pain, with no differences between treatment conditions. CONCLUSIONS The addition of IE to behavioural exposure did not improve outcomes. However, higher adherence to either attentional strategy was associated with larger effect sizes on all measures, suggesting factors shared by the two treatments could have contributed to the outcomes. Taken as a whole, the results suggest that increasing adherence to treatment strategies, possibly by motivational measures, would improve the overall outcomes of these interventions.
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Affiliation(s)
- M K Nicholas
- Pain Management Research Institute, University of Sydney at Royal North Shore Hospital, Australia
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Hunt MA, Keefe FJ, Bryant C, Metcalf BR, Ahamed Y, Nicholas MK, Bennell KL. A physiotherapist-delivered, combined exercise and pain coping skills training intervention for individuals with knee osteoarthritis: a pilot study. Knee 2013; 20:106-12. [PMID: 22921688 DOI: 10.1016/j.knee.2012.07.008] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2011] [Revised: 07/05/2012] [Accepted: 07/16/2012] [Indexed: 02/02/2023]
Abstract
BACKGROUND Osteoarthritis (OA) of the knee is associated with a number of physical and psychological impairments. Unfortunately, very few treatment strategies are capable of addressing both types of impairments concurrently. We performed a pilot, randomized controlled, proof of principle trial investigating the feasibility and effects of an intervention combining physical exercise and pain coping skills training (PCST). METHODS Twenty patients with a clinical and radiographical diagnosis of tibiofemoral OA were randomized to receive either 10 weeks of physiotherapist supervised exercises (lower limb strengthening and walking) combined with non-directive counseling (NDC) or the same exercise program delivered concurrently with PCST. Primary outcomes included self-reported pain and pain coping, while secondary outcomes included self efficacy and self-reported physical function. RESULTS Ten participants were randomized to each group and both groups exhibited significant improvements in isometric knee strength, self-reported knee pain and physical function, self efficacy for control of pain management and other arthritis symptoms. Only those in the exercise + PCST group reported statistically significant improvements in pain control coping and rational thinking. No between-group differences existed in any outcome (0.07 < p < 0.98). Based on our findings, 63 participants per group would be needed for future large-scale studies using similar outcome measures and design. CONCLUSIONS Our study showed that an intervention that combines exercise and PCST within the same treatment session and delivered by specially-trained physiotherapists is feasible and can improve both physical and psychological outcomes in individuals with knee OA. LEVEL OF EVIDENCE Level II Clinical Trials Registry number: ACTRN12609000623291.
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Affiliation(s)
- Michael A Hunt
- Department of Physical Therapy, University of British Columbia, Vancouver, Canada.
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