Health psychology : official journal of the Division of Health Psychology, American Psychological Association
-
Controlled Clinical Trial
Can we improve cognitive-behavioral therapy for chronic back pain treatment engagement and adherence? A controlled trial of tailored versus standard therapy.
This study evaluated whether tailored cognitive-behavioral therapy (TCBT) that incorporated preferences for learning specific cognitive and/or behavioral skills and used motivational enhancement strategies would improve treatment engagement and participation compared with standard CBT (SCBT). We hypothesized that participants receiving TCBT would show a lower dropout rate, attend more sessions, and report more frequent intersession pain coping skill practice than those receiving SCBT. We also hypothesized that indices of engagement and adherence would correlate with pre- to posttreatment changes in outcome factors. ⋯ Participants in this study evidenced a high degree of participation and adherence, but treatment tailored to take into account participant preferences, and that employed motivational enhancement strategies, failed to increase treatment participation over and above SCBT for chronic back pain. Evidence that participation and adherence were associated with positive outcomes supports continued clinical and research efforts focusing on these therapeutic processes.
-
Cross-sectional studies in cancer have revealed the presence of clusters of symptoms (e.g., gastrointestinal, emotional) and of patients (e.g., low or high levels of symptoms), but not much is known about their longitudinal evolution. In addition, their relationships with medical factors (e.g., cancer sites, treatments) and possible consequences (e.g., functioning) have yet to be established. This prospective study assessed the presence of clusters of patients in 828 participants scheduled to undergo surgery for cancer. ⋯ This study revealed distinct clusters of patients that varied in number during cancer treatments. Findings also identified some clusters associated with lower quality of life and functioning, which should receive more clinical attention.
-
To examine whether there are differences between non-trauma-exposed, trauma-exposed without posttraumatic stress symptoms (PSS), and trauma-exposed with PSS chronic musculoskeletal pain patients in vulnerability, protective, and pain-adjustment variables; to test the interactive relationship between PSS and the vulnerability and protective psychological variables across pain adjustment in the group of trauma-exposed-patients. ⋯ The current study supports the models of posttraumatic stress and chronic pain, such as the mutual maintenance and the shared vulnerability theories, providing an initial comprehensive framework for understanding the comorbidity of both disorders.
-
This study examined whether individual differences in loneliness and/or daily exacerbations in loneliness relate to daily pain and frequency and perception of interpersonal events among individuals with fibromyalgia (FM). ⋯ Chronic and transient episodes of loneliness are associated with more negative daily social relations and pain. However, boosts in positive events yield greater boosts in day-to-day enjoyment of social relations for lonely versus nonlonely individuals, and during loneliness episodes, a finding that can inform future interventions for individuals with chronic pain.
-
The lack of consistency between peoples' attitudes toward organ donation and organ donation registration behavior has long perplexed scholars. Ajzen and Fishbein's principle of compatibility offers a potential explanation for the attitude-behavior discrepancy. This principle states that attitudes will better predict behavior if the specificity of a measured attitude matches the specificity of the behavior under consideration. ⋯ The lack of attitude-behavior consistency in the organ donor domain can be partially explained by limited compliance with the principle of compatibility.