Brazilian Journal of Pain
https://brjp.org.br/article/doi/10.5935/2595-0118.20220027-en
Brazilian Journal of Pain
Original Article

Brief multidisciplinary intervention for chronic pain management: pilot feasibility study

Intervenção multidisciplinar breve para manejo da dor crônica: estudo piloto de viabilidade

Yasmin Cardoso Metwaly Mohamed Ali; Áquila Lopes Gouvêa; Milena Santos de Oliveira; Sara Martini; Hazem Adel Ashmawi; Marina de Góes Salvetti

http://dx.doi.org/10.5935/2595-0118.20220027-en BrJP, vol.5, n2, p.91-95, 2022
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Abstract

BACKGROUND AND OBJECTIVES: Chronic pain has a negative impact on the quality of life of individuals and requires multidisciplinary attention. The aim of this study was to assess the feasibility of a brief multidisciplinary intervention for the management of chronic pain.

METHODS: A pilot feasibility study. The participants were individuals with chronic pain. The intervention had a psychoeducational focus and was carried out in a group for six weeks, with a two-hour weekly meeting. Participants received education on pain management, practiced stretching and relaxation techniques. The intervention was applied by two nurses, a psychologist and a physical therapist. The specific objective of this study was to assess the feasibility of the intervention through indicators of acceptability and feasibility.

RESULTS: Forty-eight people with chronic pain eligible to participate in the study were identified. Among the acceptability indicators, the acceptance rate to participate in the intervention was 52% and the retention rate among participants was 60%. The rate of adherence to the recommendations was moderate for walking (53.3%) and satisfactory for stretching (100%) and relaxation (73.3%). As for the feasibility indicators, the following aspects were considered “great”: access to the intervention site (83.3%), the intervention room (66.6%), the intervention content (86.6%) and the number of sessions (46.6%). All participants (100%) suggested increasing the number of sessions.

CONCLUSION: The brief multidisciplinary intervention for chronic pain management was considered feasible and should be tested and implemented in primary care services and outpatient services specialized in pain management.

Keywords

Chronic pain, Cognitive behavioral therapy, Feasibility studies, Health education, Pain management, Self-efficacy

Resumo

JUSTIFICATIVA E OBJETIVOS: A dor crônica provoca impacto negativo na qualidade de vida dos indivíduos e requer atenção multidisciplinar. O objetivo deste estudo foi avaliar a viabilidade de uma intervenção multidisciplinar breve para manejo da dor crônica.

MÉTODOS: Estudo clínico de viabilidade. Os participantes foram pessoas com dor crônica. A intervenção teve foco psicoeducativo e foi realizada em grupo, por seis semanas, com um encontro semanal de duas horas. Os participantes receberam educação sobre manejo da dor, praticaram alongamento e técnicas de relaxamento. A intervenção foi aplicada por duas enfermeiras, uma psicóloga e uma fisioterapeuta. O objetivo específico deste estudo foi avaliar a viabilidade da intervenção por meio de indicadores de aceitabilidade e viabilidade.

RESULTADOS: Identificaram-se 48 pessoas com dor crônica elegíveis para participar do estudo. Entre os indicadores de aceitabilidade, a taxa de aceitação para participar da intervenção foi de 52% e a taxa de retenção foi de 60%. A taxa de adesão às recomendações foi moderada para caminhada (53,3%) e satisfatória para alongamento (100%) e relaxamento (73,3%). Quanto aos indicadores de viabilidade, foram considerados “ótimos”: o acesso ao local da intervenção (83,3%), a sala da intervenção (66,6%), o conteúdo da intervenção (86,6%) e o número de sessões (46,6%). Todos os participantes (100%) sugeriram aumentar o número de sessões.

CONCLUSÃO: A intervenção multidisciplinar breve para manejo da dor crônica foi considerada viável e deve ser testada e implantada em serviços de atenção primária e serviços ambulatoriais especializados no tratamento da dor.

Palavras-chave

Autoeficácia, Dor crônica, Educação em saúde, Estudos de viabilidade, Manejo da dor, Terapia cognitivo-comportamental

References

de Moraes Vieira EB, Garcia JB, da Silva AA, Mualem Araújo RL, Jansen RC. Prevalence, characteristics, and factors associated with chronic pain with and without neuropathic characteristics in São Luís, Brazil. J Pain Symptom Manage. 2012;44(2):239-51.

Rocha JR, Karloh M, Santos AR, Sousa TR. Characterization of biopsychosocial factors of patients with chronic nonspecific low back pain. BrJP. 2021;4(4):332-8.

Raftery MN, Sarma K, Murphy AW, De La Harpe D, Normand C, McGuire B. Chronic pain in the Republic of Ireland—community prevalence, psychosocial profile and predictors of pain-related disability: results from the Prevalence, Impact and Cost of Chronic Pain (PRIME) study, Part 1. Pain. 2011;152(5):1096-103.

Nakamura M, Toyama Y, Nishiwaki Y, Ushida T. Prevalence and characteristics of chronic musculoskeletal pain in Japan: a second survey of people with or without chronic pain. J Orthop Sci. 2014;19(2):339-50.

Azevedo L, Costa-Pereira A, Mendonça L, Dias C. Epidemiology of chronic pain: a population-based nationwide study on its prevalence, characteristics and associated disability in Portugal. J Pain. 2020;13(8):773-83.

Wong WS, Fielding R. Prevalence and characteristics of chronic pain in the general population of Hong Kong. J Pain. 2011;12(2):236-45.

Grol-Prokopczyk H. undefined. Sociodemographic disparities in chronic pain, based on 12-year longitudinal data. Pain. 2017;158(2):313-222.

Vasconcelos FH, Araújo GC. Prevalence of chronic pain in Brazil: a descriptive study. BrJP. 2018;1(2):176-9.

Salvetti MG, Cobelo A, Vernalha PM, Vianna CI, Canarezi LC, Calegare RG. Effects of a psychoeducational program for chronic pain management. Rev Lat Am Enfermagem. 2012;20(5):896-902.

Nash V, Ponto J, Townsend C, Nelson P, Bretz MN. Cognitive behavioral therapy, self-efficacy, and depression in persons with chronic pain. Pain Manag Nurs. 2020;14(4):236-43.

Kawi J. Chronic low back pain patients’ perceptions on self-management, self-management support, and functional ability. Pain Manag Nurs. 2020;15(1):258-64.

Manias E, Gibson SJ, Finch S. Testing an educational nursing intervention for pain assessment and management in older people. Pain Med. 2020;12(8):1199-215.

Prevost V, Delorme C, Grach M-C, Le Chvetzoff G, Hureau M. Therapeutic education in improving cancer pain management: a synthesis of available studies. Am J Hosp Palliat Care. 2020;33(6):599-612.

Mehlsen M, Heegaard L, Counseling L. A prospective evaluation of the chronic pain Self-Management Programme in a Danish population of chronic pain patients. Patient Educ Cous. 2015;98(5):677-80.

Salvetti MG, Pimenta CAM. Dor crônica e a crença de auto-eficácia. Rev Esc Enferm USP. 2020;41(1):135-40.

Salvetti MG, Pimenta CAM, Lage L V, Oliveira Junior JO, Rocha JO. Auto-eficácia e sintomas depressivos em doentes com dor crônica. Rev Psiq Clin. 2020;34(3):111-7.

Martinez-Calderon J, Meeus M, Struyf F, Luque-Suarez A. The role of self-efficacy in pain intensity, function, psychological factors, health behaviors, and quality of life in people with rheumatoid arthritis: A systematic review. Physiotherapy Theory and Practice. 2020;36:21-37.

Martinez-Calderon J, Zamora-Campos C, Navarro-Ledesma S, Luque-Suarez A. The role of self-efficacy on the prognosis of chronic musculoskeletal pain: a systematic review. J Pain. 2018;19(1):10-34.

Gagnon CM, Scholten P, Atchison J. Multidimensional patient impression of change following interdisciplinary pain management. Pain Pract. 2018;18(8):997-1010.

Davin S, Lapin B, Mijatovic D, Fox R, Benzel E. Comparative effectiveness of an interdisciplinary pain program for chronic low back pain, compared to physical therapy alone. Spine. 2019;44(24):1715-22.

Casey MB, Cotter N, Kelly C, Mc Elchar L, Dunne C, Neary R. Exercise and acceptance and commitment therapy for chronic pain: a case series with one-year follow-up. Musculoskeletal Care. 2020;18(1):64-73.

Dysvik E, Kvaløy JT, Natvig GK. The effectiveness of an improved multidisciplinary pain management programme: A 6- and 12-month follow-up study. J Adv Nurs. 2012;68(5):1061-72.

Moraes EB, Martins Júnior FF, Silva LB, Garcia JBS, Mattos-Pimenta CA. Autoeficácia e medo da dor ao movimento na lombalgia crônica: uma intervenção desenvolvida por enfermeiras. Rev Gaúcha Enferm. 2021;42.

Eldridge SM, Chan CL, Campbell MJ, Bond CM, Hopewell S, Thabane L, Lancaster GA. CONSORT 2010 statement: extension to randomised pilot and feasibility trials. BMJ. 2016:355.

Sidani S, Braden CJ. Nursing and health interventions: design, evaluation, and implementation. 2021.

Hawker GA, Mian S, Kendzerska T, French M. Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale. SF. Arthritis Care Res. 2011;63(^sSusppl 11):S.240-52.

Bandura A. Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev. 1977;84(2):191-215.

Azzi RG, Bandura A, Polydoro SA. Teoria social cognitiva. 2006.

Souza MS, Hortense P, Napoleão AA, Stefane T. Autoeficácia, intensidade de dor e qualidade de vida em indivíduos com dor crônica. Rev Eletronica Enferm. 2020;18:20160331.

Carvalho RC, Maglioni CB, Machado GB, Araújo JE. Prevalence and characteristics of chronic pain in Brazil: a national internet-based survey study. BrJP. 2020;1(4):331-8.

Joypaul S, Kelly F, McMillan SS, King MA. Multi-disciplinary interventions for chronic pain involving education: a systematic review. PLoS One. 2019.

Gordon DB, Watt-Watson J, Reports BB. Interprofessional pain education—with, from, and about competent, collaborative practice teams to transform pain care. Pain. 2019;3(3):1-6.

Suri K, Pandey M. Effect of Jacobson Progressive Muscle Relaxation (JPMR) on psychopathological problems in chronic non-malignant pain patients. Indian J Heal Wellbeing. 2018;9(4):630-3.

Louw A, Zimney K, Puentedura EL, Diener I. The efficacy of pain neuroscience education on musculoskeletal pain: a systematic review of the literature. Artic Physiother Theory Pract. 2020;32(5):332-55.

Thorn B, Campbell L, Van Dyke BP. Literacy-adapted cognitive behavioral therapy versus education for chronic pain at low-income clinics: a randomized controlled trial. Ann Intern Med. 2020;168(7):471-80.

Dias VP, Silveira DT, Witt RR. Educação em Saúde: o trabalho de grupos em atenção primária. Rev APS. 2009;12(2):221-7.

Cervera DPP, Pereira BDM, Goulart BF. Educação em saúde: percepção dos enfermeiros da atenção básica em Uberaba (MG). Ciên Saúde Coletiva. 2011;16(Suppl 1):1547-54.

Submitted date:
05/19/2021

Accepted date:
05/09/2022

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