Patient’s perception of change following an interdisciplinary pain management program

      We assessed 118 chronic pain patients’ perceptions of change at the competition of a functional restoration program using a new questionnaire consisting of patient-centered outcomes. The patients participated in either an intensive (5 days per week, up to 4 weeks) or a modified (1-2 half days per week, up to 5 weeks) outpatient program depending upon initial assessment needs. Treatment programs included individual and group sessions with pain psychology, physical and occupational therapy, biofeedback/relaxation training, and medical management. Patients also participated in nursing lectures, vocational lectures, and movement-based classes including Feldenkrais. Outcome measures included the Center for Epidemiological Studies Depression Scale short form (CESD-10), Pain Anxiety Symptom Scale short version (PASS-20), Chronic Pain Acceptance Questionnaire (CPAQ), Coping Strategies Questionnaire-Revised (CSQ-R), and an adaptation to the Patient’s Global Impression of Change (domains included: overall… status, pain, sleep, mood, physical functioning, ability to cope with pain, ability to manage pain flare-ups, and the overall efficacy of medication). Patient’s impressions of change were rated on a scale from 1 (Very Much Improved) to 7 (Very Much Worse). Mean ratings showed that patients considered the program effective. Domains perceived to be most improved were “overall status”, “overall mood,” and “overall ability to cope with pain” (M=1.94, SD=0.74; M=1.98, SD=0.80; M=1.91, SD=0.75, respectively). Furthermore, the patient’s impressions of change on all domains correlated significantly with change scores on the CESD-10 (r’s 0.21 – 0.38, P’s < .05) and all but one domain (overall efficacy of medication) significantly correlated with change scores on the PASS-20, CPAQ, and CSQ-R (r’s 0.20 – 0.45, P’s < .05). Thus, there was support to show that the patient’s perceptions of change adequately represented changes on a number of program outcomes.