Evaluating physical functioning as part of a Cognitive Behavioural Therapy approach in treatment of people suffering from chronic pain.

AIMS AND OBJECTIVES

To evaluate physical functioning in a nurse-led integrated physiotherapy and Cognitive Behavioural Therapy (CBT) approach in treatment of people suffering from chronic pain.

BACKGROUND

Inter-professional working and physical activity supervision is described as important components of successful rehabilitation and is often included in approaches to chronic pain.

DESIGN

A quasi-experimental nonrandomised controlled design was used.

METHOD

A consecutive sample of 117 outpatients from a rehabilitation unit at a university hospital was included in this intervention study. The effects of an 8-week multidisciplinary programme, including 6 and 12 month follow-up, was examined with measures including health-related quality of life (HRQL), pain perception, pain stages of change and physical functioning. To broaden our understanding qualitative data from three physiotherapists involved were collected.

RESULTS

Improvements in physical functioning status during the programme were positively related to improvements in stages of change, pain interference (PI) and severity (PS) and HRQL. Qualitative data support these findings.

CONCLUSIONS

Findings suggest that our pain management intervention, that includes physical activity designed to help patients to live a healthier life, can have a clinically assessable impact on reducing PI and PS, improving physical functioning and HRQL.

RELEVANCE TO CLINICAL PRACTICE

Training in CBT approaches and inter-professional working in chronic pain may extend the skills of nurses and physiotherapists to improve physical functioning among a group of patients for whom traditional medicine has little to offer.