Exploring psychological mechanisms of clinical response to an internet-delivered psychological pain management program

European Journal of Pain : EJP
Milena GandyBlake F Dear

Abstract

The evidence for Internet-delivered pain management programs for chronic pain is growing, but there is little empirical understanding of how they effect change. Understanding mechanisms of clinical response to these programs could inform their effective development and delivery. A large sample (n = 396) from a previous randomized controlled trial of a validated internet-delivered psychological pain management program, the Pain Course, was used to examine the influence of three potential psychological mechanisms (pain acceptance, pain self-efficacy, fear of movement/re-injury) on treatment-related change in disability, depression, anxiety and average pain. Analyses involved generalized estimating equation models for clinical outcomes that adjusted for co-occurring change in psychological variables. This was paired with cross-lagged analysis to assess for evidence of causality. Analyses involved two time points, pre-treatment and post-treatment. Changes in pain-acceptance were strongly associated with changes in three (depression, anxiety and average pain) of the four clinical outcomes. Changes in self-efficacy were also strongly associated with two (anxiety and average pain) clinical outcomes. These findings suggest that partici...Continue Reading

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Citations

Oct 14, 2020·Palliative & Supportive Care·Mathew NyashanuFarai Pfende
Mar 6, 2021·Risk Management and Healthcare Policy·Dídia B CurySabrina T Reis

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