Chronischer Schmerz und Gesellschaft

Determining the Influencing Factors on Acceptance of eHealth Pain Management Interventions Among Patients With Chronic Pain Using the Unified Theory of Acceptance and Use of Technology: Cross-sectional Study

Background

Chronic pain is a complex disease with high prevalence rates, and many individuals who are affected do not receive adequate treatment. As a complement to conventional therapies, eHealth interventions could provide many benefits to a multimodal treatment approach for patients with chronic pain, whereby future use is associated with the acceptance of these interventions.

Objective

This study aims to assess the acceptance of eHealth pain management interventions among patients with chronic pain and identify the influencing factors on acceptance. A further objective of the study is to evaluate the viability of the Unified Theory of Acceptance and Use of Technology (UTAUT) model and compare it with its extended version in terms of explained variance of acceptance.

Methods

We performed a cross-sectional web-based study. In total, 307 participants with chronic pain, as defined according to the International Association for the Study of Pain criteria, were recruited through flyers, posters, and web-based inquiries between December 2020 and July 2021. In addition to sociodemographic and medical data, the assessment included validated psychometric instruments and an extended version of the well-established UTAUT model. For statistical analyses, group comparisons and multiple hierarchical regression analyses were performed.

Results

The acceptance of eHealth pain management interventions among patients with chronic pain was overall moderate to high (mean 3.67, SD 0.89). There was significant difference in acceptance among age groups (W=9674.0; r=0.156; P=.04). Effort expectancy (β=.37; P<.001), performance expectancy (β=.33; P<.001), and social influence (β=.34; P<.001) proved to be the most important predictors of acceptance. The extended UTAUT (including the original UTAUT factors as well as sociodemographic, medical, and eHealth-related factors) model explained 66.4% of the variance in acceptance, thus supporting the viability of the model. Compared with the original UTAUT model (performance expectancy, effort expectancy, and social influence), the extended model explained significantly more variance (F_25,278=1.74; P=.02).

Conclusions

Given the association between acceptance and future use, the knowledge of the influencing factors on acceptance should be used in the development and promotion of eHealth pain management interventions. Overall, the acceptance of eHealth pain management interventions was moderate to high. In total, 8 predictors proved to be significant predictors of acceptance. The UTAUT model is a valuable instrument for determining acceptance as well as the factors that influence acceptance of eHealth pain management interventions among patients with chronic pain. The extended UTAUT model provided the greatest predictive value for acceptance.

Chronic pain as a blind spot in the diagnosis of a depressed society. On the implications of the connection between depression and chronic pain for interpretations of contemporary society

One popular description of current society is that it is a depressed society and medical evidence about depression’s prevalence may well make such an estimation plausible. However, such normative-critical assessments surrounding depression have to date usually operated with a one-sided understanding of depression. This understanding widely neglects the various ways depression manifests as well as its comorbidities. This becomes evident at the latest when considering one of depression’s most prominent and well-known comorbidities: chronic pain. Against this background, we aim in this article to substantiate our leading claim that the phenomenal interconnection between depression and chronic pain must be acknowledged in the global diagnosis of a depressive society. Thus, we argue here for a complementation of the dominant interpretation of a depressed society. This would support the overcoming of oversimplified images and estimations about depression in current society and further, help to recognize chronic pain properly on the larger scale of assessments that address society as a whole.

[Influence of the corona pandemic on pain patients : Which impacts of the pandemic on their care do patients with chronic pain experience?]

BACKGROUND

Diseases caused by the novel coronavirus (SARS-CoV-2) have led to a pandemic in a very dynamic manner. The epidemiological situation of national importance required infection control measures with the aim of reducing morbidity and mortality. An overburdening of the healthcare system should be avoided. The measures taken to combat the pandemic have had an impact on public and private life. Patients suffering from chronic pain have also been greatly affected.

QUESTION

Which impact on their care do patients with chronic pain experience?

METHOD

After multimodal inpatient treatment 70 pain patients were interviewed by telephone in a standardized fashion. They were asked about their condition as follows: did the changes due to the pandemic result in an increase in pain levels, a deterioration in mood and did the pandemic have a negative impact on the supply of pain medication?

RESULTS

Changes in the biopsychosocial area were experienced by the patients and affected their overall well-being. Chronically ill pain patients were particularly affected by the lockdown. A large number of patients associated a deterioration in mood and aggravation of the chronic pain with measures resulting from the pandemic. The mood deterioration was clearly associated (70% of respondents). An increase in pain was associated with changes caused by the pandemic in 44% of respondents. Of the patients 39% reported a deterioration of the pain management. The measures taken to combat the pandemic have had and still have an impact on the lives of chronically ill pain patients.

DISCUSSION

It is necessary to maintain the limited but still existing options of coordinated care for pain patients following a multimodal inpatient stay, even in difficult situations. The negative effects of a reduction in medical care are an argument in favor of multimodal outpatient care, especially after inpatient treatment.

Spiritual Care und chronischer Schmerz: Die Sicht von Fachpersonen. Eine qualitative Untersuchung

Chronischer Schmerz ist ein komplexes Phänomen, das alle Lebensdimensionen betrifft: die psychische, soziale und spirituelle nicht weniger als die physische. Diesem Umstand muss in der Behandlung dieser Patientengruppe Rechnung getragen werden. Wir untersuchten, an welche Voraussetzungen dafür im Deutschschweizer Raum bereits angeknüpft werden kann. An fünf Studienzentren wurden insgesamt 34 Fachpersonen in interprofessionell gemischten Fokusgruppen dazu interviewt, welche spirituellen Anliegen und Bedürfnisse von Patient/-innen mit chronischen Schmerzen sie wahrnehmen und wie diese im Behandlungsprozess berücksichtigt werden können. Eine thematische Analyse zeigte drei Kernthemen: die Relevanz spiritueller Aspekte in der multimodalen Schmerztherapie, handlungsleitende Überzeugungen und die Kompetenz zu Spiritual Care. Die Befragten waren der spirituellen Thematik gegenüber generell aufgeschlossen. Aus ihrer Sicht stellt die Integration spiritueller Anliegen und Bedürfnisse im Behandlungsprozess einen Mehrwert für die Behandlungsqualität in dieser Patientengruppe dar. Dies konsequent umzusetzen, stellt sie jedoch vor teilweise ungelöste Herausforderungen. Hier braucht es Befähigung und institutionelle Unterstützung, um Spiritual Care den entsprechenden Raum zu geben.