• Robert Knoerl, Debra L Barton, Janean E Holden, John C Krauss, Beth LaVasseur, and SmithEllen M LEMLAssociate Professor, University of Michigan School of Nursing, Ann Arbor, MI, Email: ellenls@umich.edu..
• Post-Doctoral Research Fellow, Phyllis F. Cantor, Center for Research in Nursing and Patient Care Services, Dana-Farber Cancer, Institute, 450 Brookline Avenue, LW 517, Boston, MA 02215, Email: Robert_knoerl@DFCI.Harvard.edu.
• Can Oncol Nurs J. 2018 Jan 1; 28 (3): 178-183.

PurposePreliminary evidence suggests that a self-guided cognitive and behaviourally-based pain management intervention (PROSPECT) is effective for chronic painful chemotherapy-induced peripheral neuropathy (CIPN), but its mechanism of action is unknown. The purpose of this secondary analysis was to explore if changes in anxiety, depression, sleep-related impairment, or fatigue mediated improvements in worst pain following PROSPECT in individuals with chronic painful CIPN.MethodsSixty participants were randomized to receive self-guided cognitive behavioural pain management (access for eight weeks) or treatment as usual. A seven-day worst CIPN pain diary and the PROMIS measures of anxiety, depression, fatigue, and sleep-related impairment were administered pre/posttest (eight-weeks). Causal mediation analysis was used to quantify mediators of worst pain improvement.ResultsNone of the hypothesized mediators had a statistically significant effect on worst pain (n=38).ImplicationsFurther research is needed to identify potential mediators of pain intensity that can be targeted by specific cognitive behavioural strategies to improve painful CIPN severity.

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