Developing a chronic pain self-management clinic at the British School of Osteopathy: Quantitative pilot study results

Abbey, H and Nanke, L (2013) Developing a chronic pain self-management clinic at the British School of Osteopathy: Quantitative pilot study results. International Journal of Osteopathic Medicine, 16. e11-e12.

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Abstract

Methods: A mixed-methods pilot study with a purposive sample of patients with pain for more than 6 months. Participants were identified by osteopaths as likely to benefit from pain management support, recruitment interviews explored scope for change and decisions about joining the course were collaborative. 2 patients decided not to join, 2 dropped out through ill-health and 15 completed the course (4 male, 11 female). Participants attended group sessions for 2 h per week for 6 weeks, facilitated by a clinical health psychologist and an osteopath. Data was collected at course start, end, and 3 month follow-up from semi-structured interviews and the Chronic Pain Acceptance (CPAQ), Chronic Pain Values Inventory (CPVI), Bournemouth (BQ) and WHO Quality of Life questionnaires. Results: 132 questionnaires were returned (73 response rate). CPAQ scores improved significantly by 3 months for Activity (Z ¼ À2.38, p ¼ 0.02) but not Willingness (Z ¼ À1.68, p ¼ 0.09). Differences between ‘importance’ and ‘success’ in CPVI Relationships scores decreased significantly (Z ¼ À2.12, p ¼ 0.03), indicating increased success living in accordance with family, friends and relationship values, but not in Agency scores for work, health and growth values (Z ¼ À1.75, p ¼ 0.08). BQ scores improved at 6 weeks but returned to previous levels by 3 months (Z ¼ À1.40, p ¼ 0.16) and Quality of Life remained stable. Individual participants with high initial BQ scores reported less fearavoidance behaviour at 3 months; those with low CPAQ scores showed higher levels of acceptance and activity; but participants with poor scores in both areas showed less overall change. Conclusions: Participants showed improvements in motivation and ability to engage in valued activities and personal relationships, but not in pain willingness, fear-avoidance or work activity. The lack of a control group and small, purposive sample mean these results should be interpreted cautiously and interview data is being analysed to explore individual experiences and outcomes. A new clinic is being developed to integrate psycho-educational material into osteopathic treatment sessions, as these results indicate that Mindfulness and Acceptance-based approaches offer promising new directions for enhancing function and agency in chronic pain patients who cannot be ‘fixed’ by manual therapy alone.

Item Type:	Article
Depositing User:	Dr Hilary Abbey
Date Deposited:	21 Dec 2020 13:01
Last Modified:	23 Sep 2021 17:40
URI:	https://hsu.repository.guildhe.ac.uk/id/eprint/133

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