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Maddock A, Blair C, Ean N, Best P. Psychological and social interventions for mental health issues and disorders in Southeast Asia: a systematic review. Int J Ment Health Syst 2021; 15:56. [PMID: 34090491 PMCID: PMC8178881 DOI: 10.1186/s13033-021-00482-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 05/25/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Mental health issues and disorders are major public health challenges, particularly in low- and middle-income countries in Southeast Asia, where chronic shortages in mental health services and human resources exist. The development of effective and accessible mental health systems in Southeast Asia will require evidence based psychological and social interventions. This systematic review provides a narrative synthesis of the evidence on the effectiveness of such interventions for mental health issues and disorders in Southeast Asia. METHODS A comprehensive literature search of 7 electronic databases (PsycINFO, Medline (Ovid), Cochrane library, EMBASE, SCOPUS, APA PsycArticles, and Social Care Online) was undertaken. RESULTS Thirty two studies employing RCT designs to evaluate the effectiveness of a range of psychological and social mental health interventions on a number of different mental health outcomes were included in this review. The disparate intervention programmes reviewed were categorised as: lay delivered, yoga, aerobic and/or meditation based, cognitive behavioural therapy oriented, eye movement desensitization and reprocessing based (EMDR), health worker delivered, and hybrid programmes. The majority of the studies included in this review were of low to moderate quality due to the variability in the quality of the study design. The highest quality, and most promising evidence came from the evaluations of lay delivered interventions. This evidence demonstrates the feasibility and potential sustainability of implementing such interventions in resource constrained contexts. CONCLUSIONS The review findings indicate that a disparate array of mental health interventions can be implemented effectively in a range of Southeast Asian mental health and health settings. There is a clear need for significantly more research however, through higher quality and larger scale RCTs before it will be known more definitively, if these interventions are effective, and for whom they are most effective in different Southeast Asian contexts.
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Affiliation(s)
- Alan Maddock
- School of Social Sciences, Education and Social Work, Queen's University Belfast, Northern Ireland, Belfast, UK.
| | - Carolyn Blair
- School of Social Sciences, Education and Social Work, Queen's University Belfast, Northern Ireland, Belfast, UK
| | - Nil Ean
- Department of Psychology, Royal University of Phnom Penh, Phnom Penh, Cambodia
| | - Paul Best
- School of Social Sciences, Education and Social Work, Queen's University Belfast, Northern Ireland, Belfast, UK
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Ikemoto T, Shiro Y, Ikemoto K, Hayashi K, Arai YC, Deie M, Beeston L, Wood B, Nicholas M. Feasibility of Imported Self-Management Program for Elderly People with Chronic Pain: A Single-Arm Confirmatory Trial. Pain Ther 2020; 9:583-599. [PMID: 32844366 PMCID: PMC7648817 DOI: 10.1007/s40122-020-00192-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Indexed: 02/08/2023] Open
Abstract
INTRODUCTION Multidisciplinary pain management programs incorporating a cognitive-behavioral therapy (CBT) approach have been reported to be helpful for elderly people with chronic pain. However, it is unclear whether the same program for elderly people with chronic pain would translate to different cultures. This study investigated whether a multidisciplinary program based on that of Nicholas et al. (Pain 154(6):824-835, 2013) in Australia would be effective for elderly people with chronic pain in Japan. METHODS Twenty-seven community-dwelling elderly people with chronic pain were enrolled to confirm changes (effect size d = 0.5) in pain disability, which were previously reported by Nicholas et al. The multidisciplinary program consisted of eight sessions (2 sessions a week for 4 weeks). Pain disability was assessed using the Pain Disability Assessment Scale (PDAS) as the primary outcome at the baseline, the beginning and the end of the program, and the 1- and 3-month (final) follow-up. We also assessed the pain severity, catastrophizing, pain self-efficacy, and physical function with the Timed Up and Go test (TUG) and the two-step test as secondary outcomes. RESULTS PDAS, pain catastrophizing, and pain self-efficacy were significantly improved immediately after the program compared with baseline, and these effects were maintained at 3-month follow-up. The effect size (d) for the PDAS score was a medium size (0.54) from baseline to 3-month follow-up. Those who showed improvements in TUG immediately after the program tended to report improved psychometric measures at 3-month follow-up. CONCLUSION These results suggest that the Japanese multidisciplinary program has a similar effect on pain disability as that reported by Nicholas et al. This finding has important implications for the development of pain services in community-dwelling elderly Japanese.
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Affiliation(s)
- Tatsunori Ikemoto
- Department of Orthopaedics, Aichi Medical University, Aichi, Japan
- Pain Management Research Institute, Faculty of Medicine and Health, University of Sydney and Royal North Shore Hospital, Sydney, NSW, Australia
- Research of Pain Science, Non-Profit Organization, Nagoya, Japan
| | | | - Kayo Ikemoto
- Research of Pain Science, Non-Profit Organization, Nagoya, Japan
| | - Kazuhiro Hayashi
- Research of Pain Science, Non-Profit Organization, Nagoya, Japan
| | - Young-Chang Arai
- Research of Pain Science, Non-Profit Organization, Nagoya, Japan
| | - Masataka Deie
- Department of Orthopaedics, Aichi Medical University, Aichi, Japan
| | - Lee Beeston
- Pain Management Research Institute, Faculty of Medicine and Health, University of Sydney and Royal North Shore Hospital, Sydney, NSW, Australia
| | - Bradley Wood
- Pain Management Research Institute, Faculty of Medicine and Health, University of Sydney and Royal North Shore Hospital, Sydney, NSW, Australia
| | - Michael Nicholas
- Pain Management Research Institute, Faculty of Medicine and Health, University of Sydney and Royal North Shore Hospital, Sydney, NSW, Australia
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Hosogoshi H, Iwasa K, Fukumori T, Takagishi Y, Takebayashi Y, Adachi T, Oe Y, Tairako Y, Takao Y, Nishie H, Kanie A, Kitahara M, Enomoto K, Ishii H, Shinmei I, Horikoshi M, Shibata M. Pilot study of a basic individualized cognitive behavioral therapy program for chronic pain in Japan. Biopsychosoc Med 2020; 14:6. [PMID: 32175003 PMCID: PMC7063808 DOI: 10.1186/s13030-020-00176-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 02/28/2020] [Indexed: 12/20/2022] Open
Abstract
Background Chronic pain is a major health problem, and cognitive behavioral therapy (CBT) is its recommended treatment; however, efforts to develop CBT programs for chronic pain and assess their feasibility are remarkably delayed in Asia. Therefore, we conducted this pilot study to develop a basic individualized CBT for chronic pain (CBT-CP) and assessed its feasibility for use in Japan. Methods Our study was an open-labeled before–after trial without a control group conducted cooperatively in five Japanese tertiary care hospitals. Of 24 outpatients, 15, age 20–80, who experienced chronic pain for at least three months were eligible. They underwent an eight-session CBT-CP consisting of relaxation via a breathing method and progressive muscle relaxation, behavioral modification via activity pacing, and cognitive modification via cognitive reconstruction. The EuroQol five-dimensional questionnaire five level (EQ5D-5 L) assessment as the primary outcome and quality of life (QOL), pain severity, disability, catastrophizing, self-efficacy, and depressive symptoms as secondary outcomes were measured using self-administered questionnaires at baseline, post-treatment, and 3-month follow-up. Intention-to-treat analyses were conducted. Results Effect size for EQ5D-5 L score was medium from baseline to post-treatment (Hedge’s g = − 0.72, 90% confidence interval = − 1.38 to − 0.05) and up to the 3-month follow-up (g = − 0.60, CI = − 1.22 to 0.02). Effect sizes for mental and role/social QOL, disability, catastrophizing, self-efficacy, and depressive symptoms were medium to large, although those for pain severity and physical QOL were small. The dropout rate was acceptably low at 14%. No severe adverse events occurred. Conclusion The findings suggest that CBT-CP warrants a randomized controlled trial in Japan. Trial registration University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR), UMIN000020880. Registered on 04 February 2016.
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Affiliation(s)
- Hiroki Hosogoshi
- 1Department of Sociology, Faculty of Sociology, Kansai University, 3-3-35 Yamate-cho, Suita-shi, Osaka, 564-8680 Japan.,2National Center for Cognitive Behavior Therapy and Research, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cho, Kodaira-shi, Tokyo, 187-8551 Japan
| | - Kazunori Iwasa
- 3Faculty of Education, Shujitsu University, 1-6-1 Nishigawara, Naka-ku, Okayama-shi, Okayama, 703-8516 Japan
| | - Takaki Fukumori
- 4Graduate School of Integrated Arts and Sciences, Tokushima University, 1-1 Minamijosanjima-cho, Tokushima-shi, Tokushima, 770-8502 Japan
| | - Yuriko Takagishi
- 2National Center for Cognitive Behavior Therapy and Research, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cho, Kodaira-shi, Tokyo, 187-8551 Japan.,5Department of Psychology, Surugadai University, 698 Azu, Hanno-shi, Saitama, 357-8555 Japan
| | - Yoshitake Takebayashi
- 2National Center for Cognitive Behavior Therapy and Research, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cho, Kodaira-shi, Tokyo, 187-8551 Japan.,6Department of Health Risk Communication, School of Medicine, Fukushima Medical University, 1 Hikarigaoka, Fukushima-shi, Fukushima, 960-1295 Japan
| | - Tomonori Adachi
- 7Pain Management Clinic, Shiga University of Medical Science Hospital, Seta Tsukinowa-cho, Otsu-shi, Shiga 520-2192 Japan
| | - Yuki Oe
- 2National Center for Cognitive Behavior Therapy and Research, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cho, Kodaira-shi, Tokyo, 187-8551 Japan.,8Department of Neuropsychiatry, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka-shi, Tokyo, 181-8611 Japan
| | - Yukino Tairako
- 2National Center for Cognitive Behavior Therapy and Research, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cho, Kodaira-shi, Tokyo, 187-8551 Japan.,9Department of Psychology, Meiji Gakuin University, 1-2-37 Shirokanedai, Minato-ku, Tokyo, 108-8636 Japan
| | - Yumiko Takao
- 10Department of Pain Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya-shi, Hyogo 663-8501 Japan
| | - Hiroyuki Nishie
- 11Anesthesiology and Intensive Care 2, Kawasaki Medical School, 577 Matsushima, Kurashiki-shi, Okayama, 701-0192 Japan
| | - Ayako Kanie
- 2National Center for Cognitive Behavior Therapy and Research, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cho, Kodaira-shi, Tokyo, 187-8551 Japan
| | - Masaki Kitahara
- 12Department of Anesthesiology, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama-shi, Kanagawa 232-0024 Japan
| | - Kiyoka Enomoto
- 13Graduate School of Human Sciences, Osaka University, 1-2 Yamadaoka, Suita-shi, Osaka, 565-0871 Japan
| | - Hirono Ishii
- 14Counseling Office, Japan Women's University, 1-1-1 Nishiikuta, Tama-ku, Kawasaki-shi, Kanagawa 214-8565 Japan
| | - Issei Shinmei
- 15Department of Neurology, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cho, Kodaira-shi, Tokyo, 187-8553 Japan.,TCBT Counseling Office, Cosmos Kichijoji Building 2F, 2-8-4 Kichijojihoncho, Musashino-shi, Tokyo, 180-0004 Japan
| | - Masaru Horikoshi
- 2National Center for Cognitive Behavior Therapy and Research, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi-cho, Kodaira-shi, Tokyo, 187-8551 Japan
| | - Masahiko Shibata
- 17Department of Health Science, Naragakuen University, 3-15-1 Nakatomigaoka, Nara-shi, Nara, 631-8524 Japan
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van Delden ALEQ, Band GPH, Slaets JPJ. A good beginning: study protocol for a group-randomized trial to investigate the effects of sit-to-stand desks on academic performance and sedentary time in primary education. BMC Public Health 2020; 20:70. [PMID: 31941471 PMCID: PMC6964001 DOI: 10.1186/s12889-019-8135-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 12/30/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Sedentary behavior is associated with health risks and academic under-achievement in children. Still, children spend a large part of their waking hours sitting at a desk at school. Recent short-term studies demonstrated the potential of sit-to-stand desks to reduce sitting time in primary education. The program of "A Good Beginning" was conceived to assess the long-term effects of sit-to-stand desks on sitting time in primary education, and to examine how sit-to-stand desks versus regular desks relate to academic performance, and measures of executive functioning, health and wellbeing. The present paper describes the design of this group-randomized trial, which started in 2017 and will be completed in 2019. METHODS Children of two grade-three groups (age 8-9) following regular primary education in Leiden, The Netherlands, were recruited. A coin toss determined which group is the experimental group; the other group is the control group. All children in the experimental group received sit-to-stand desks. They are invited and motivated to reduce sedentary time at school, however, it is their own choice to sit or stand. Children in the control group use regular desks. Otherwise, both groups receive regular treatment. Outcomes are assessed at baseline (T0) and at five follow-up sessions (T1-T5) alternately in winter and summer seasons over three academic years. Primary outcome measures are academic performance, and the proportion of sitting time at school, measured with a 3D accelerometer. Secondary outcome measures are a number of measures related to executive functioning (e.g., N-back task for working memory), health (e.g., height and weight for BMI), and wellbeing (e.g., KIDSCREEN-52 for Quality of Life). DISCUSSION A Good Beginning is a two-and-a-half-year research program, which aims to provide a better understanding of the long-term effects of sit-to-stand desks on sedentary time at school and the relation between sitting time reduction and academic performance, executive functioning, health and wellbeing. The findings may serve as useful information for policy making and practical decision making for school and classroom environments. TRIAL REGISTRATION The program of "A Good Beginning" is registered at the Netherlands Trial Register (NTR, https://www.trialregister.nl), number NL6166, registration date 24 November 2016.
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Affiliation(s)
- A Lex E Q van Delden
- Leyden Academy on Vitality and Ageing, Leiden, The Netherlands.
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands.
| | - Guido P H Band
- Cognitive Psychology Unit, Institute of Psychology, Leiden University, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition (LIBC), Leiden, The Netherlands
| | - Joris P J Slaets
- Leyden Academy on Vitality and Ageing, Leiden, The Netherlands
- Center for Geriatric Medicine, University Medical Center Groningen, Groningen, The Netherlands
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Bellido-Vallejo JC, Pancorbo-Hidalgo PL. Psychometric Evaluation of the Nursing Outcome "Pain: Adverse Psychological Response" in Patients With Chronic Pain. Int J Nurs Knowl 2019; 31:164-172. [PMID: 31743614 DOI: 10.1111/2047-3095.12267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 08/04/2019] [Accepted: 10/12/2019] [Indexed: 11/27/2022]
Abstract
PURPOSE To culturally adapt into Spanish and validate the outcome "Pain: Adverse psychological response" (code 1306) in patients with chronic pain. METHODS A three-stage study was conducted: (a) translation and cultural adaptation, (b) content validation, and (c) clinical validation. FINDINGS The Spanish version of the outcome "Pain: Adverse psychological response" has high content validity ( 0.91). Fourteen indicators were organized into two factors. This version offers good reliability in both inter-observer agreement (kappa = 0.72) and internal consistency (alpha = 0.89). CONCLUSIONS The Spanish adaptation of "Pain: Adverse psychological response" is a reliable and valid instrument for the measurement of emotional aspects of chronic pain. IMPLICATIONS FOR NURSING PRACTICE The Spanish adaptation of this outcome offers nurses a set of structured indicators to measure the adverse emotional impact of chronic pain.
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Adachi T, Sunohara M, Enomoto K, Sasaki K, Sakaue G, Fujita Y, Mizuno Y, Okamoto Y, Miki K, Yukioka M, Nitta K, Iwashita N, Kitagawa H, Shibata M, Sasaki J, Jensen MP, Fukui S. Japanese cross-cultural validation study of the Pain Stage of Change Questionnaire. Pain Rep 2019; 4:e711. [PMID: 31041416 PMCID: PMC6455691 DOI: 10.1097/pr9.0000000000000711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 12/11/2018] [Accepted: 12/16/2018] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Although evidence supports efficacy of treatments that enhance self-management of chronic pain, the efficacy of these treatments has been hypothesized to be influenced by patient readiness for self-management. The Pain Stage of Change Questionnaire (PSOCQ) is a reliable and valid measure of patient readiness to self-manage pain. However, there is not yet a Japanese version of the PSOCQ (PSOCQ-J), which limits our ability to evaluate the role of readiness for pain self-management in function and treatment response in Japanese patients with chronic pain. OBJECTIVE Here, we sought to develop the PSOCQ-J and evaluate its psychometric properties. METHODS We recruited 201 patients with chronic pain. The study participants were asked to complete the PSOCQ-J and other measures assessing pain severity, pain interference, catastrophizing, self-efficacy, and pain coping strategies. RESULTS The results supported a 4-factor structure of the PSOCQ-J. We also found good to excellent internal consistencies and good test-retest reliabilities for the 4 scales. The Precontemplation scale had weak to moderate positive correlations with measures of pain-related dysfunction and maladaptive coping. The Action and Maintenance scales had weak to moderate positive correlations with measures of self-efficacy and adaptive coping. The Contemplation scale had weak positive correlations with measures of pain interference and both adaptive and maladaptive coping. CONCLUSIONS The PSOCQ-J demonstrated adequate psychometric properties in a sample of Japanese patients with chronic pain. This measure can be used to evaluate the role that readiness to self-manage pain may play in adjustment to chronic pain in Japanese pain populations.
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Affiliation(s)
- Tomonori Adachi
- Pain Management Clinic, Shiga University of Medical Science Hospital, Otsu, Shiga, Japan
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
- Japan Society for the Promotion of Science, Chiyoda, Tokyo, Japan
| | - Momoka Sunohara
- Department of Psychology, Concordia University, Montreal, QC, Canada
| | - Kiyoka Enomoto
- Pain Management Clinic, Shiga University of Medical Science Hospital, Otsu, Shiga, Japan
- Center for Pain Management, Osaka University Medical Hospital, Suita, Osaka, Japan
| | | | | | - Yoshitsugu Fujita
- Department of Orthopedic Surgery, Japanese Red Cross Otsu Shiga Hospital, Otsu, Shiga, Japan
| | - Yasuyuki Mizuno
- Department of Psychosomatic and General Internal Medicine, Kansai Medical University, Hirakata, Osaka, Japan
| | - Yoshiaki Okamoto
- Department of Pharmacy, Ashiya Municipal Hospital, Ashiya, Hyogo, Japan
| | - Kenji Miki
- Faculty of Health Science, Osaka Yukioka College of Health Science, Ibaraki, Osaka, Japan
- Center for Pain Management, Hayaishi Hospital, Osaka, Osaka, Japan
- Department of Rheumatology, Yukioka Hospital, Osaka, Osaka, Japan
| | - Masao Yukioka
- Department of Rheumatology, Yukioka Hospital, Osaka, Osaka, Japan
| | | | - Narihito Iwashita
- Pain Management Clinic, Shiga University of Medical Science Hospital, Otsu, Shiga, Japan
- Department of Anesthesiology, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Hirotoshi Kitagawa
- Department of Anesthesiology, Shiga University of Medical Science, Otsu, Shiga, Japan
| | - Masahiko Shibata
- Center for Pain Management, Osaka University Medical Hospital, Suita, Osaka, Japan
- Department of Health Science, Naragakuen University, Nara, Japan
| | - Jun Sasaki
- Department of Human Sciences, Graduate School of Human Sciences, Osaka University, Suita, Osaka, Japan
| | - Mark P. Jensen
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
| | - Sei Fukui
- Pain Management Clinic, Shiga University of Medical Science Hospital, Otsu, Shiga, Japan
- Department of Anesthesiology, Shiga University of Medical Science, Otsu, Shiga, Japan
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Yang SY, McCracken LM, Moss-Morris R. Psychological Treatment Needs for Chronic Pain in Singapore and the Relevance of the Psychological Flexibility Model. PAIN MEDICINE 2018; 18:1679-1694. [PMID: 27492743 DOI: 10.1093/pm/pnw175] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objective The goals of the present study were (a) to assess the psychological treatment needs and treatment delivery preferences in people attending services or contacting a hospital website for chronic pain in Singapore, and (b) to explore potential relevance of the psychological flexibility (PF) model for this group by investigating associations between PF and pain-related outcomes. Design and Setting This was a cross-sectional questionnaire study of people with chronic pain in Singapore. Subjects Current users of treatment services at a tertiary pain management clinic (PMC), users of pain treatment services elsewhere, and non-treatment users. Methods Participants were either recruited face-to-face at a pain clinic or via an online portal. All participants completed a questionnaire, including a survey of treatment barriers and needs, treatment delivery preferences for chronic pain, and standardized measures of PF, pain interference, emotional functioning, and health care use. Results A total of 200 participants completed the study. Cost of treatment was identified as a main deterrent, while proof of treatment success was identified as a main facilitator for treatment uptake. A majority of participants (88.5%) indicated a preference for face-to-face treatment. In multiple regression analyses, after controlling for relevant demographic variables and pain intensity, PF explained 14% of the variance for pain interference and impact of depressive symptoms and 22% of the variance for depressive symptoms. Conclusion A focus on meeting patients' needs at low cost, and providing proof of treatment success may increase psychological treatment uptake. Increasing PF for pain in people from Singapore may also contribute to better patient functioning.
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Affiliation(s)
- Su-Yin Yang
- King's College London, Health Psychology Section, Psychology Department, London, United Kingdom.,Pain Management Clinic, Orthopaedic Surgery Department, Tan Tock Seng Hospital, Singapore
| | - Lance M McCracken
- King's College London, Health Psychology Section, Psychology Department, London, United Kingdom
| | - Rona Moss-Morris
- King's College London, Health Psychology Section, Psychology Department, London, United Kingdom
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