Empowering Patients With Chronic Pain: OT & Behavior Change

This study addresses challenges faced during chronic pain occupational therapy (CPOT) in achieving successful outcomes. Specifically, the utility of the Stages of Change model in tailoring interventions to improve patient outcomes is explored. Using a quasi-experimental design, this study includes patients referred to CPOT in outpatient rehabilitation clinics. Participants are selected based on their diagnoses, including chronic pain syndrome, fibromyalgia, or chronic pain of an extremity. Data collection involves using the Pain Stages of Change Questionnaire (PSOCQ) to assess patients’ readiness for behavior change related to self-management of chronic pain. The PSOCQ identifies stage scores for Pre-Contemplation (PC), Contemplation (C), Action (A), and Maintenance (M); the highest score identifies the patient’s current stage of change. The PSOCQ is administered at three timepoints to inform the delivery of interventions by therapists. Wilcoxon signed-rank tests determine significant changes in stage scores between timepoints. Preliminary analysis demonstrates the effectiveness of tailoring interventions based on PSOCQ scores to improve patient outcomes; 100% of patients progressed to a more advanced stage. Analyses revealed significant changes in all stage scores between the initial two timepoints (n=24). Across three timepoints (n=14), significant changes in stage scores were detected within some PC comparisons, and all comparisons of A and M scores. Changes in C scores were not significant, suggesting interventions have limited impact on patients in this stage. This study highlights the potential benefits of measuring and tailoring intervention to stages of change, providing a framework to progress patients more effectively in a contemplative stage of change. Understanding and addressing readiness for behavior change prepares occupational therapists to deliver effective interventions and support sustainable improvements in self-management of chronic pain.

References

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