Pain self-management training increases self-efficacy, self-management behaviours and pain and depression outcomes

Teresa Damush, Kurt Kroenke, Matthew Bair, J. Wu, Wanzhu Tu, E. E. Krebs, E. Poleshuck

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Background: Self-management practices among patients with medical and psychiatric comorbidity is not well understood. We assessed the effects of a combined pharmacological and behavioural intervention on self-efficacy to manage symptoms and self-management behaviours in patients with pain and comorbid depression. Methods: Longitudinal analysis of self-management behaviours and their relationship with outcomes in a 12-month trial of 250 primary care patients with chronic musculoskeletal pain and comorbid depression. Participants were randomized to either usual care or an intervention that consisted of optimized antidepressant therapy followed by six sessions of a pain self-management (PSM) programme. Results: Participants in the intervention group significantly increased the time spent performing self-management behaviours including strengthening and stretching exercises, progressive muscle relaxation and visualization at 12 months. Moreover, intervention participants reported greater self-efficacy to manage their pain and depression. The number of pain self-management sessions received showed a dose–response relationship with improvement in both pain and depression severity. Conclusion: A combined intervention increased patient self-management behaviours and self-efficacy to manage symptoms among primary care patients with chronic musculoskeletal pain and depression. Receipt of the full dose of the entire PSM programme was related to improvements in pain interference and depression severity. What does this study add?: A nurse-led six-session PSM programme increased self-efficacy as well as specific behaviours such as strengthening and stretching exercises, progressive muscle relaxation and visualization. There was a dose–response in that attending a greater proportion of the PSM sessions led to greater improvement in both pain and depression outcomes.

Original languageEnglish (US)
Pages (from-to)1070-1078
Number of pages9
JournalEuropean Journal of Pain
Volume20
Issue number7
DOIs
StatePublished - Aug 1 2016

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Self Efficacy
Pain Management
Self Care
Depression
Pain
Autogenic Training
Musculoskeletal Pain
Chronic Pain
Primary Health Care
Exercise
Antidepressive Agents
Psychiatry
Comorbidity
Nurses
Pharmacology

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Pain self-management training increases self-efficacy, self-management behaviours and pain and depression outcomes. / Damush, Teresa; Kroenke, Kurt; Bair, Matthew; Wu, J.; Tu, Wanzhu; Krebs, E. E.; Poleshuck, E.

In: European Journal of Pain, Vol. 20, No. 7, 01.08.2016, p. 1070-1078.

Research output: Contribution to journalArticle

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