• Elin Dysvik, Jan Terje Kvaløy, Ragnhild Stokkeland, and Gerd Karin Natvig.
• University of Stavanger, Faculty of Social Sciences, Department of Health Studies, N-4036 Stavanger, Norway. elin.dysvik@uis.no
• Int J Nurs Stud. 2010 Jul 1;47(7):826-35.

BackgroundCognitive behavioural therapy (CBT) has been useful in the treatment of chronic pain conditions for many years. Given the increasing number of persons with chronic pain and associated psychosocial problems, the development and implementation of effective interventions based on CBT is warranted.ObjectivesThe aim of this study is to evaluate the effects of a multidisciplinary pain management programme on health-related quality of life (HRQL), as measured by the Short Form Health Survey (SF-36), pain perception as measured by the Brief Pain Inventory (BPI), and readiness-to-change as measured by the Pain Stages of Change Questionnaire (PSOCQ).DesignA pretest-post-test quasi-experimental design, with waiting list controls and baseline and post-test measures, was used.SettingThe study was conducted in the rehabilitation unit of a university hospital.ParticipantsOf 117 people suffering from chronic pain, 113 completed the 8-week multidisciplinary pain management programme. The patients were consecutive referrals. Inclusion criteria were: adults (18-67 years), pain lasting over 6 months, motivation and no ongoing litigation. Exclusion criteria were affected by major mental disorders or major medical conditions requiring treatment.MethodsThe intervention was based on a cognitive behavioural approach. Therapeutic dialogues and training, combined with physical activity, were provided to a fixed plan, including homework. The programme has several features that directly address psychosocial aspects of chronic pain. Statistical and clinical significance are considered.ResultsThe findings suggest that this programme has the potential to improve HRQL, reduce pain intensity and interference, and contribute to improvement in readiness-to-change. Statistically significant results are supplemented by results showing their clinical significance.ConclusionsImprovements in HRQL, pain-related disability, and readiness-to-change suggest that the vicious cycle of chronic pain may be alleviated by our programme. As we see it, effective treatment results are about identifying and addressing the important and changeable influences maintaining pain problems such as acceptance, understanding the mind-body connection and self-management. Although further research is needed to evaluate the effectiveness of this work, such group approaches appear to represent a feasible treatment option for many patients with chronic pain.Copyright 2009 Elsevier Ltd. All rights reserved.

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