Articles: chronic-pain.
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Randomized Controlled Trial Multicenter Study Comparative Study
A qualitative analysis of a randomized controlled trial comparing a cognitive-behavioral treatment with education.
Cognitive behavioral therapy (CBT) is a widely accepted psychosocial treatment for chronic pain. However, the efficacy of CBT has not been investigated within a rural setting. Furthermore, few studies have utilized first-person accounts to qualitatively investigate the key treatment elements and processes of change underlying the well-documented quantitative improvements associated with CBT. To address these gaps, we conducted a randomized controlled trial (RCT) investigating the efficacy of group CBT compared to an active education condition (EDU) within a rural, low-literacy population. Posttreatment semistructured interviews of 28 CBT and 24 EDU treatment completers were qualitatively analyzed. Emerging themes were collated to depict a set of finalized thematic maps to visually represent the patterns inherent in the data. Patterns were separated into procedural elements and presumed change processes of treatment. Key themes, subthemes, and example extracts for CBT and EDU are presented; unique and shared aspects pertaining to the thematic maps are discussed. Results indicate that while both groups benefited from the program, the CBT group described more breadth and depth of change as compared to the EDU group. Importantly, this study identified key treatment elements and explored possible processes of change from the patients' perspective. ⋯ This qualitative article describes patient-identified key procedural elements and change process factors associated with psychosocial approaches for chronic pain management. Results may guide further adaptations to existing treatment protocols for use within unique, underserved chronic pain populations. Continued development of patient-centered approaches may help reduce health, treatment, and ethnicity disparities.
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Better understanding of how Hispanic older adults describe their chronic pain might suggest ways to support Hispanic older adults to talk about important pain information with their practitioner. The study aim was to describe how Hispanic older adults communicate pain information, including the amount of pain information and communication processes employed. A secondary analysis with a descriptive design was used. ⋯ Participants described a mean of 5.5 (SD 3.39) items of pain information. The majority stayed on topic, and one-half spoke clearly and explicitly. Hispanic older adults with osteoarthritis pain concisely describe clinically important pain information when given the opportunity to do so.
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J Pain Symptom Manage · Sep 2011
Pain-related beliefs among Chinese patients with chronic pain: the construct and concurrent predictive validity of the Chinese version of the Survey of Pain Attitudes-14 (ChSOPA-14).
Pain beliefs as indexed by the Survey of Pain Attitudes (SOPA) have been consistently shown to predict pain adjustment outcomes in Western populations. However, its utility in non-Western populations is unclear. ⋯ The findings offer preliminary evidence for the construct and concurrent predictive validity of the ChSOPA-14. This makes available a suitable instrument for chronic pain in the Chinese population and will facilitate future cross-cultural research on pain beliefs.
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Patients with chronic non-cancer pain (CNCP) are common and have a high degree of morbidity. Previous studies document clinician frustration and variability in CNCP management. We conducted this study to gather in-depth clinicians' views about factors that affect management of CNCP. ⋯ Guidelines and increased continuing medical education alone are unlikely to be the solutions to the challenges of CNCP management. Increased evidence for recommendations and resources for more comprehensive care management are needed.