Do acceptance and cognitive representations of pain predict engagement and outcome on a pain management programme?

Rankin, Hilary (2001). Do acceptance and cognitive representations of pain predict engagement and outcome on a pain management programme? PhD thesis The Open University.

DOI: https://doi.org/10.21954/ou.ro.0000e35c

Abstract

Background and aims

Pain management programmes provide effective interventions for people with chronic pain, but effects are modest, and not all participants benefit. The current study aims to investigate the role of acceptance and cognitive representations i.e. beliefs about pain, in engagement, and outcome, of this kind of intervention.

Design and participants

A quantitative design was used to investigate whether acceptance and cognitive representations of pain predict engagement and outcome of intervention, whether acceptance and cognitive representations change during intervention, and the relationship of acceptance with five dimensions of belief. Participants were 116 patients referred for assessment to a pain management programme.

Measures

Questionnaire measures of acceptance of pain, and cognitive representations of pain were used as predictor variables. Measures of distress, self-efficacy and physical function were used as outcome measures. Pain severity and waiting time were also measured as potentially confounding variables.

Results

Measures of acceptance and cognitive representations of pain did not predict who would complete the intervention. Increases in acceptance, and decreases in perceived consequences of pain, and pain identity, occurred during the intervention. Lower acceptance was related to more serious perceived consequences and greater pain identity, but not with beliefs about cause or expected duration of pain, or beliefs in control and cure.

Implications

Interventions aiming to increase acceptance by changing beliefs about perceived consequences of pain and pain identity may be useful. Further research is needed to explore the nature of acceptance, and the role of different dimensions of belief in affecting functioning, in chronic pain populations.

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