Division of Physical Therapy, Shenandoah University, Winchester, VA USA.
Physiother Theory Pract. 2023 Sep 2;39(9):1938-1951. doi: 10.1080/09593985.2022.2060884. Epub 2022 Apr 6.
Chronic pain and pain catastrophization are growing problems across the United States, within the Hispanic-American population. Pain neuroscience education (PNE) changes pain knowledge and beliefs in many populations, but its impact on reconceptualization in people of Hispanic-American origin is unknown.
Explore the changes in pain knowledge in Hispanic-American individuals and the process involved in reconceptualization following a PNE lecture.
Eight Hispanic-American adults participated in a mixed-methods exploratory study. The Revised Neurophysiology of Pain Questionnaire (R-NPQ) was completed before, immediately after, and eight months after an adapted PNE lecture. A focus group involving four participants discussed the impact of PNE. Transcripts were translated and theme coded, and a concept map was developed by consensus.
R-NPQ scores improved from 25.3% to 43.5% post-lecture, and the number of unsure responses decreased from 41.5% to 18.4%. At eight months, R-NPQ scores remained stable (44.2%) but unsure responses increased (28.9%). Themes that contributed to the process of change included cognitive dissonance, relevance of instruction, idea exchange through peer interaction, reflection, confidence, changed behaviors, and educational utility.
While small improvements in knowledge and perception of pain appeared to occur with the PNE, knowledge remained low. Consideration of adult learning principles such as applicability, peer-interaction, the confrontation of beliefs, and reflection throughout PNE may enhance its impact. Future investigation should explore the efficacy of this intervention, when compared or combined with other techniques in the treatment of Hispanic-Americans experiencing persistent pain.
慢性疼痛和疼痛灾难化在美国、西班牙裔美国人中是一个日益严重的问题。疼痛神经科学教育(PNE)改变了许多人群对疼痛的知识和信念,但它对西班牙裔美国人起源的重新概念化的影响尚不清楚。
探索 PNE 讲座后西班牙裔美国人个体的疼痛知识变化以及重新概念化的过程。
8 名西班牙裔成年人参与了一项混合方法的探索性研究。在接受改编后的 PNE 讲座之前、之后立即以及 8 个月后,参与者完成了修订后的疼痛神经生理学问卷(R-NPQ)。一个由 4 名参与者组成的焦点小组讨论了 PNE 的影响。翻译并对转录本进行主题编码,并通过共识开发概念图。
R-NPQ 分数从讲座后从 25.3%提高到 43.5%,不确定的回答从 41.5%减少到 18.4%。8 个月后,R-NPQ 分数保持稳定(44.2%),但不确定的回答增加(28.9%)。促进变化过程的主题包括认知失调、教学相关性、通过同伴互动进行思想交流、反思、信心、行为改变和教育效用。
虽然 PNE 似乎使知识和对疼痛的感知有了微小的改善,但知识仍然很低。在 PNE 过程中考虑成人学习原则,如适用性、同伴互动、信念的挑战和反思,可能会增强其效果。未来的研究应该探讨这种干预在治疗经历持续性疼痛的西班牙裔美国人时的疗效,以及与其他技术的比较或结合。