Randomized trial of group cognitive-behavioral therapy compared to a pain education control for low literacy rural people with chronic pain
| Autor: | Susan Gaskins, L. Charles Ward, John W. Burns, Kelly Sweeney, Melissa A. Day, Beverly E. Thorn, Regina McConley, Chalanda M Cabbil, Melissa C. Kuhajda |
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| Jazyk: | angličtina |
| Rok vydání: | 2011 |
| Předmět: |
Adult
Male Rural Population medicine.medical_specialty medicine.medical_treatment Population Psychological intervention Article law.invention Randomized controlled trial Patient Education as Topic law Medicine Humans education education.field_of_study Cognitive Behavioral Therapy business.industry Chronic pain Middle Aged medicine.disease Cognitive behavioral therapy Anesthesiology and Pain Medicine Neurology Tolerability Physical therapy Psychotherapy Group Pain catastrophizing Female Neurology (clinical) Information Literacy Analgesia Chronic Pain business Psychosocial Clinical psychology |
| Popis: | Chronic pain is a common and costly experience. Cognitive behavioral therapies (CBT) are efficacious for an array of chronic pain conditions. However, the literature is based primarily on urban (white) samples. It is unknown whether CBT works in low-socioeconomic status (SES) minority and nonminority groups. To address this question, we conducted a randomized controlled trial within a low-SES, rural chronic pain population. Specifically, we examined the feasibility, tolerability, acceptability, and efficacy of group CBT compared with a group education intervention (EDU). We hypothesized that although both interventions would elicit short- and long-term improvement across pain-related outcomes, the cognitively-focused CBT protocol would uniquely influence pain catastrophizing. Mixed design analyses of variance were conducted on the sample of eligible participants who did not commence treatment (N = 26), the intention-to-treat sample (ITT; N = 83), and the completer sample (N = 61). Factors associated with treatment completion were examined. Results indicated significantly more drop-outs occurred in CBT. ITT analyses showed that participants in both conditions reported significant improvement across pain-related outcomes, and a nonsignificant trend was found for depressed mood to improve more in CBT than EDU. Results of the completer analyses produced a similar pattern of findings; however, CBT produced greater gains on cognitive and affect variables than EDU. Treatment gains were maintained at 6-month follow-up (N = 54). Clinical significance of the findings and the number of treatment responders is reported. Overall, these findings indicate that CBT and EDU are viable treatment options in low-SES minority and nonminority groups. Further research should target disseminating and sustaining psychosocial treatment options within underserved populations. |
| Databáze: | OpenAIRE |
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