Factors involved in patients’ perceptions of self-improvement after chronic pain treatment

Abstract

Background: Patients’ self-reported levels of improvement after having attended a chronic pain management program can provide a subjective rating of how successful they perceive they were at accomplishing their goals in the program. Past studies have demonstrated that successful patients differ from less successful ones on several cognitive–behavioral factors such as coping strategies over physical characteristics such as pain intensity. Aims: This study explored factors that determine patients’ perceptions of self-improvement after undergoing chronic pain treatment in a pain management program. Methods: Participants (n = 174) underwent a 4-week, interdisciplinary, multimodal, chronic pain management program at a hospital located in southern Ontario. Questionnaire packages that evaluate pain intensity, pain-related disability, emotional distress (e.g., depression, anxiety, catastrophizing), acceptance of pain (activity engagement and pain willingness), readiness to change, and use of adaptive or maladaptive coping strategies were completed by patients at admission and discharge. Participants were grouped into one of three categories depending on their rating of self-improvement on the Self-Evaluation Scale (SES). The groups were compared on the magnitude of change they reported on the variables mentioned above. Results: Changes in emotional distress, general health, readiness to change, activity engagement, and adaptive coping strategies (e.g., task persistence, pacing, and seeking social support) were significantly associated with differences in ratings of self-improvement. Conclusions: This study provided insight into what patients value most when rating their self-improvement, which can then be used to facilitate increased patient success and satisfaction with treatment.