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Lorimer Moseley G, Leake HB, Beetsma AJ, Watson JA, Butler DS, van der Mee A, Stinson JN, Harvie D, Palermo TM, Meeus M, Ryan CG. Teaching Patients About Pain: The Emergence of Pain Science Education, its Learning Frameworks and Delivery Strategies. THE JOURNAL OF PAIN 2024; 25:104425. [PMID: 37984510 DOI: 10.1016/j.jpain.2023.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 11/07/2023] [Accepted: 11/09/2023] [Indexed: 11/22/2023]
Abstract
Since it emerged in the early 2000's, intensive education about 'how pain works', widely known as pain neuroscience education or explaining pain, has evolved into a new educational approach, with new content and new strategies. The substantial differences from the original have led the PETAL collaboration to call the current iteration 'Pain Science Education'. This review presents a brief historical context for Pain Science Education, the clinical trials, consumer perspective, and real-world clinical data that have pushed the field to update both content and method. We describe the key role of educational psychology in driving this change, the central role of constructivism, and the constructivist learning frameworks around which Pain Science Education is now planned and delivered. We integrate terminology and concepts from the learning frameworks currently being used across the PETAL collaboration in both research and practice-the Interactive, Constructive, Active, Passive framework, transformative learning theory, and dynamic model of conceptual change. We then discuss strategies that are being used to enhance learning within clinical encounters, which focus on the skill, will, and thrill of learning. Finally, we provide practical examples of these strategies so as to assist the reader to drive their own patient pain education offerings towards more effective learning. PERSPECTIVE: Rapid progress in several fields and research groups has led to the emergence 'Pain Science Education'. This PETAL review describes challenges that have spurred the field forward, the learning frameworks and educational strategies that are addressing those challenges, and some easy wins to implement and mistakes to avoid.
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Affiliation(s)
- G Lorimer Moseley
- The Pain Education Team to Advance Learning (PETAL) Collaboration; IIMPACT in Health, Allied Health and Human Performance, University of South Australia, Kaurna Country, Adelaide, Australia.
| | - Hayley B Leake
- The Pain Education Team to Advance Learning (PETAL) Collaboration; IIMPACT in Health, Allied Health and Human Performance, University of South Australia, Kaurna Country, Adelaide, Australia
| | - Anneke J Beetsma
- The Pain Education Team to Advance Learning (PETAL) Collaboration; Research group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences Groningen, the Netherlands
| | - James A Watson
- The Pain Education Team to Advance Learning (PETAL) Collaboration; Centre for Rehabilitation, School of Health and Life Sciences, Teesside University, Middlesbrough, UK; Integrated Musculoskeletal Service, Community Pain Management, North Tees and Hartlepool NHS Foundation Trust, Stockton-on-Tees, UK
| | - David S Butler
- The Pain Education Team to Advance Learning (PETAL) Collaboration; IIMPACT in Health, Allied Health and Human Performance, University of South Australia, Kaurna Country, Adelaide, Australia
| | - Annika van der Mee
- The Pain Education Team to Advance Learning (PETAL) Collaboration; Consumer Representative, Research group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences Groningen, the Netherlands
| | - Jennifer N Stinson
- The Pain Education Team to Advance Learning (PETAL) Collaboration; Child Health Evaluative Sciences, The Research Institute, The Hospital for Sick Children and Lawrence S. Bloomberg, Faculty of Nursing, The University of Toronto, Toronto, Ontario, Canada
| | - Daniel Harvie
- The Pain Education Team to Advance Learning (PETAL) Collaboration; IIMPACT in Health, Allied Health and Human Performance, University of South Australia, Kaurna Country, Adelaide, Australia
| | - Tonya M Palermo
- The Pain Education Team to Advance Learning (PETAL) Collaboration; Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, Washington
| | - Mira Meeus
- The Pain Education Team to Advance Learning (PETAL) Collaboration; MOVANT research group, Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Belgium
| | - Cormac G Ryan
- The Pain Education Team to Advance Learning (PETAL) Collaboration; Centre for Rehabilitation, School of Health and Life Sciences, Teesside University, Middlesbrough, UK
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Ryan CG, Karran EL, Wallwork SB, Pate JW, O'Keeffe M, Fullen BM, Livadas N, Jones N, Toumbourou JW, Gilchrist P, Cameron PA, Fatoye F, Ravindran D, Lorimer Moseley G. We Are All in This Together-Whole of Community Pain Science Education Campaigns to Promote Better Management of Persistent Pain. THE JOURNAL OF PAIN 2024; 25:902-917. [PMID: 37918470 DOI: 10.1016/j.jpain.2023.10.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 10/02/2023] [Accepted: 10/25/2023] [Indexed: 11/04/2023]
Abstract
Persistent pain is a major public health issue-estimated to affect a quarter of the world's population. Public understanding of persistent pain is based on outdated biomedical models, laden with misconceptions that are contrary to best evidence. This understanding is a barrier to effective pain management. Thus, there have been calls for public health-based interventions to address these misconceptions. Previous pain-focussed public education campaigns have targeted pain beliefs and behaviours that are thought to promote recovery, such as staying active. However, prevailing pain-related misconceptions render many of these approaches counter-intuitive, at best. Pain Science Education improves understanding of 'how pain works' and has been demonstrated to improve pain and disability outcomes. Extending Pain Science Education beyond the clinic to the wider community seems warranted. Learning from previous back pain-focussed and other public health educational campaigns could optimise the potential benefit of such a Pain Science Education campaign. Pain Science Education-grounded campaigns have been delivered in Australia and the UK and show promise, but robust evaluations are needed before any firm conclusions on their population impact can be made. Several challenges exist going forward. Not least is the need to ensure all stakeholders are involved in the development and implementation of Pain Science Education public messaging campaigns. Furthermore, it is crucial that campaigns are undertaken through a health equity lens, incorporating underrepresented communities to ensure that any intervention does not widen existing health inequalities associated with persistent pain. PERSPECTIVE: Public misconceptions about pain are a significant public health challenge and a viable intervention target to reduce the personal, social, and economic burden of persistent pain. Adaptation of Pain Science Education, which improves misconceptions in a clinical setting, into the public health setting seems a promising approach to explore.
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Affiliation(s)
- Cormac G Ryan
- Pain Education Team to Advance Learning (PETAL) Collaboration; Centre for Rehabilitation, School of Health and Life Sciences, Teesside University, UK
| | - Emma L Karran
- Pain Education Team to Advance Learning (PETAL) Collaboration; IIMPACT in Health, University of South Australia, Kaurna Country, Adelaide, Australia
| | - Sarah B Wallwork
- Pain Education Team to Advance Learning (PETAL) Collaboration; IIMPACT in Health, University of South Australia, Kaurna Country, Adelaide, Australia
| | - Joshua W Pate
- Pain Education Team to Advance Learning (PETAL) Collaboration; Graduate School of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Mary O'Keeffe
- Pain Education Team to Advance Learning (PETAL) Collaboration; Institute for Musculoskeletal Health, School of Public Health, Faculty of Medicine and Health, University of Sydney, Australia
| | - Brona M Fullen
- Pain Education Team to Advance Learning (PETAL) Collaboration; UCD School of Public Health, Physiotherapy and Sports Science, Dublin, Ireland
| | - Nick Livadas
- Pain Education Team to Advance Learning (PETAL) Collaboration; Centre for Rehabilitation, School of Health and Life Sciences, Teesside University, UK
| | - Niki Jones
- Pain Education Team to Advance Learning (PETAL) Collaboration
| | - John W Toumbourou
- Pain Education Team to Advance Learning (PETAL) Collaboration; Deakin University, School of Psychology and Centre for Social and Early Emotional Development, Geelong, Australia
| | - Peter Gilchrist
- Pain Education Team to Advance Learning (PETAL) Collaboration; The University of Adelaide Rural Clinical School, Rural Generalist Program, South Australia
| | - Paul A Cameron
- Pain Education Team to Advance Learning (PETAL) Collaboration; Fife Health & Social Care Partnership, Scotland, UK; School of Medicine, Cardiff University, UK
| | - Francis Fatoye
- Pain Education Team to Advance Learning (PETAL) Collaboration; Department of Health Professions, Faculty of Health and Education, Manchester Metropolitan University, UK; Lifestyle Disease Entity, North-West University, South Africa
| | - Deepak Ravindran
- Pain Education Team to Advance Learning (PETAL) Collaboration; Centre for Rehabilitation, School of Health and Life Sciences, Teesside University, UK; Department of Pain Medicine, Royal Berkshire NHS Foundation Trust, UK
| | - G Lorimer Moseley
- Pain Education Team to Advance Learning (PETAL) Collaboration; IIMPACT in Health, University of South Australia, Kaurna Country, Adelaide, Australia
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Pate JW, Ilhan E, Rush GQ, Kennedy DS, Verhagen A, Pacey V, Stubbs PW. Assessing the Reconceptualization of Pain in Graduate-Entry Physiotherapy Students Using the Concept of Pain Inventory for Adults: The University of Technology Sydney Physiotherapy Student Surveys Project. JOURNAL, PHYSICAL THERAPY EDUCATION 2023; 37:302-307. [PMID: 38478785 DOI: 10.1097/jte.0000000000000309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 07/19/2023] [Indexed: 06/25/2024]
Abstract
INTRODUCTION Validly and reliably assessing conceptual change is essential for evaluating the effectiveness of pain science education for physiotherapy students. We aimed to 1) evaluate concept of pain before and after a 14-week pain science education university subject, 2) assess structural validity of the Concept of Pain Inventory for Adults (COPI-Adult) in postgraduate entry-level physiotherapy students, and 3) explore possible relationships between baseline variables and baseline COPI-Adult scores. REVIEW OF LITERATURE As the COPI-Adult is a newly developed questionnaire, there is a lack of data regarding its psychometric properties. SUBJECTS Of 129 enrolled students at an Australian university, 124 (96%) and 114 (88%) completed the baseline and follow-up questionnaires, respectively. METHODS In this prospective cohort study, students who commenced the degree in 2020 or 2021 completed online questionnaires, including the COPI-Adult, at the start and end of their first semester. This semester included a 14-week pain science education subject and other physiotherapy-related subjects. Higher COPI-Adult scores (range = 0-52) indicate better alignment with contemporary pain science. We 1) compared differences in concept of pain before and after the semester, 2) performed a confirmatory factor analysis on the COPI-Adult, and 3) performed exploratory regression analyses. RESULTS Concept of Pain Inventory for Adults scores increased from baseline (median [interquartile range]: 39 [36-44]) to follow-up (48 [44-51]). The COPI-Adult retained its 1-factor structure, with acceptable internal consistency (Cronbach's alpha = 0.80). Exploratory analysis showed that previously completing a subject on pain was related to higher COPI-Adult baseline scores. Age, gender, and mental health diagnosis did not relate to baseline COPI-Adult scores. DISCUSSION AND CONCLUSION Following a 14-week pain science education subject embedded within a physiotherapy degree, students improved their concept of pain. The COPI-Adult maintains a 1-factor structure in this population. Completing a previous subject on pain was associated with higher COPI-Adult scores.
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Affiliation(s)
- Joshua W Pate
- Joshua W. Pate is a senior lecturer in physiotherapy in the Graduate School of Health at the University of Technology Sydney, PO Box 123 Broadway NSW 2007, Sydney, Australia ( ). Please address all correspondence to Joshua W. Pate
- Emre Ilhan is a lecturer in physiotherapy in the Department of Health Sciences at the Macquarie University
- Gillian Q. Rush is a PhD candidate in the Department of Anesthesiology, Perioperative, and Pain Medicine at the Stanford University School of Medicine
- David S. Kennedy is a lecturer in physiotherapy in the Graduate School of Health at the University of Technology Sydney
- Arianne Verhagen is a professor in physiotherapy in the Graduate School of Health at the University of Technology Sydney
- Verity Pacey is a A/prof in physiotherapy in the Department of Health Sciences at the Macquarie University
- Peter W. Stubbs is a senior lecturer in physiotherapy in the Graduate School of Health at the University of Technology Sydney
| | - Emre Ilhan
- Joshua W. Pate is a senior lecturer in physiotherapy in the Graduate School of Health at the University of Technology Sydney, PO Box 123 Broadway NSW 2007, Sydney, Australia ( ). Please address all correspondence to Joshua W. Pate
- Emre Ilhan is a lecturer in physiotherapy in the Department of Health Sciences at the Macquarie University
- Gillian Q. Rush is a PhD candidate in the Department of Anesthesiology, Perioperative, and Pain Medicine at the Stanford University School of Medicine
- David S. Kennedy is a lecturer in physiotherapy in the Graduate School of Health at the University of Technology Sydney
- Arianne Verhagen is a professor in physiotherapy in the Graduate School of Health at the University of Technology Sydney
- Verity Pacey is a A/prof in physiotherapy in the Department of Health Sciences at the Macquarie University
- Peter W. Stubbs is a senior lecturer in physiotherapy in the Graduate School of Health at the University of Technology Sydney
| | - Gillian Q Rush
- Joshua W. Pate is a senior lecturer in physiotherapy in the Graduate School of Health at the University of Technology Sydney, PO Box 123 Broadway NSW 2007, Sydney, Australia ( ). Please address all correspondence to Joshua W. Pate
- Emre Ilhan is a lecturer in physiotherapy in the Department of Health Sciences at the Macquarie University
- Gillian Q. Rush is a PhD candidate in the Department of Anesthesiology, Perioperative, and Pain Medicine at the Stanford University School of Medicine
- David S. Kennedy is a lecturer in physiotherapy in the Graduate School of Health at the University of Technology Sydney
- Arianne Verhagen is a professor in physiotherapy in the Graduate School of Health at the University of Technology Sydney
- Verity Pacey is a A/prof in physiotherapy in the Department of Health Sciences at the Macquarie University
- Peter W. Stubbs is a senior lecturer in physiotherapy in the Graduate School of Health at the University of Technology Sydney
| | - David S Kennedy
- Joshua W. Pate is a senior lecturer in physiotherapy in the Graduate School of Health at the University of Technology Sydney, PO Box 123 Broadway NSW 2007, Sydney, Australia ( ). Please address all correspondence to Joshua W. Pate
- Emre Ilhan is a lecturer in physiotherapy in the Department of Health Sciences at the Macquarie University
- Gillian Q. Rush is a PhD candidate in the Department of Anesthesiology, Perioperative, and Pain Medicine at the Stanford University School of Medicine
- David S. Kennedy is a lecturer in physiotherapy in the Graduate School of Health at the University of Technology Sydney
- Arianne Verhagen is a professor in physiotherapy in the Graduate School of Health at the University of Technology Sydney
- Verity Pacey is a A/prof in physiotherapy in the Department of Health Sciences at the Macquarie University
- Peter W. Stubbs is a senior lecturer in physiotherapy in the Graduate School of Health at the University of Technology Sydney
| | - Arianne Verhagen
- Joshua W. Pate is a senior lecturer in physiotherapy in the Graduate School of Health at the University of Technology Sydney, PO Box 123 Broadway NSW 2007, Sydney, Australia ( ). Please address all correspondence to Joshua W. Pate
- Emre Ilhan is a lecturer in physiotherapy in the Department of Health Sciences at the Macquarie University
- Gillian Q. Rush is a PhD candidate in the Department of Anesthesiology, Perioperative, and Pain Medicine at the Stanford University School of Medicine
- David S. Kennedy is a lecturer in physiotherapy in the Graduate School of Health at the University of Technology Sydney
- Arianne Verhagen is a professor in physiotherapy in the Graduate School of Health at the University of Technology Sydney
- Verity Pacey is a A/prof in physiotherapy in the Department of Health Sciences at the Macquarie University
- Peter W. Stubbs is a senior lecturer in physiotherapy in the Graduate School of Health at the University of Technology Sydney
| | - Verity Pacey
- Joshua W. Pate is a senior lecturer in physiotherapy in the Graduate School of Health at the University of Technology Sydney, PO Box 123 Broadway NSW 2007, Sydney, Australia ( ). Please address all correspondence to Joshua W. Pate
- Emre Ilhan is a lecturer in physiotherapy in the Department of Health Sciences at the Macquarie University
- Gillian Q. Rush is a PhD candidate in the Department of Anesthesiology, Perioperative, and Pain Medicine at the Stanford University School of Medicine
- David S. Kennedy is a lecturer in physiotherapy in the Graduate School of Health at the University of Technology Sydney
- Arianne Verhagen is a professor in physiotherapy in the Graduate School of Health at the University of Technology Sydney
- Verity Pacey is a A/prof in physiotherapy in the Department of Health Sciences at the Macquarie University
- Peter W. Stubbs is a senior lecturer in physiotherapy in the Graduate School of Health at the University of Technology Sydney
| | - Peter W Stubbs
- Joshua W. Pate is a senior lecturer in physiotherapy in the Graduate School of Health at the University of Technology Sydney, PO Box 123 Broadway NSW 2007, Sydney, Australia ( ). Please address all correspondence to Joshua W. Pate
- Emre Ilhan is a lecturer in physiotherapy in the Department of Health Sciences at the Macquarie University
- Gillian Q. Rush is a PhD candidate in the Department of Anesthesiology, Perioperative, and Pain Medicine at the Stanford University School of Medicine
- David S. Kennedy is a lecturer in physiotherapy in the Graduate School of Health at the University of Technology Sydney
- Arianne Verhagen is a professor in physiotherapy in the Graduate School of Health at the University of Technology Sydney
- Verity Pacey is a A/prof in physiotherapy in the Department of Health Sciences at the Macquarie University
- Peter W. Stubbs is a senior lecturer in physiotherapy in the Graduate School of Health at the University of Technology Sydney
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Mankelow J, Ravindran D, Graham A, Suri S, Pate JW, Ryan CG, Martin D. An evaluation of a one-day pain science education event in a high school setting targeting pain related beliefs, knowledge, and behavioural intentions. Musculoskelet Sci Pract 2023; 66:102818. [PMID: 37418949 DOI: 10.1016/j.msksp.2023.102818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 06/20/2023] [Accepted: 06/26/2023] [Indexed: 07/09/2023]
Abstract
BACKGROUND Persistent pain is a common condition affecting one in four UK adults. Public understanding of pain is limited. Delivering pain education within schools may improve public understanding in the longer term. OBJECTIVE To evaluate the impact of a one-day Pain Science Education (PSE) event on sixth form/high school students' pain beliefs, knowledge and behavioural intention. METHODS Exploratory, single-site, mixed-methods, single-arm study involving secondary school students ≥16 years old attending a one-day PSE event. Outcome measures included the Pain Beliefs Questionnaire (PBQ), Concepts of Pain Inventory (COPI-ADULT), a vignette to assess pain behaviours; and thematic analysis of semi-structured interviews. RESULTS Ninety (mean age 16.5 years, 74% female) of the 114 attendees, agreed to participate in the evaluation. PBQ scores improved on the Organic beliefs subscale [mean difference -5.9 (95% CI -6.8, -5.0), P < 0.01] and Psychosocial Beliefs subscale [1.6 (1.0, 2.2) P < 0.01]. The COPI-Adult revealed an improvement [7.1 (6.0-8.1) points, P < 0.01] between baseline and post intervention. Pain behavioural intentions improved post education for work, exercise, and bed rest related activities (p < 0.05). Thematic analysis of interviews (n = 3) identified increased awareness of chronic pain and its underpinning biology, beliefs that pain education should be widely available, and that pain management should be holistic. CONCLUSIONS A one-day PSE public health event can improve pain beliefs, knowledge and behavioural intentions in high school students and increase openness to holistic management. Future controlled studies are needed to confirm these results and investigate potential long-term impacts.
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Affiliation(s)
- J Mankelow
- Centre for Rehabilitation, School of Health and Life Sciences, Teesside University, UK; Pain Education Team Aspiring Better Learning (PETAL), Australia; Pain Education Team Aspiring Better Learning (PETAL), UK.
| | - D Ravindran
- Centre for Rehabilitation, School of Health and Life Sciences, Teesside University, UK; Royal Berkshire NHS Foundation Trust, UK; Pain Education Team Aspiring Better Learning (PETAL), Australia; Pain Education Team Aspiring Better Learning (PETAL), UK
| | - A Graham
- Centre for Rehabilitation, School of Health and Life Sciences, Teesside University, UK
| | - S Suri
- Centre for Rehabilitation, School of Health and Life Sciences, Teesside University, UK; NIHR Applied Research Collaboration for the North East and North Cumbria, Newcastle Upon Tyne, England, UK
| | - J W Pate
- Graduate School of Health, University of Technology Sydney, Sydney, New South Wales, Australia; Pain Education Team Aspiring Better Learning (PETAL), Australia; Pain Education Team Aspiring Better Learning (PETAL), UK
| | - C G Ryan
- Centre for Rehabilitation, School of Health and Life Sciences, Teesside University, UK; Pain Education Team Aspiring Better Learning (PETAL), Australia; Pain Education Team Aspiring Better Learning (PETAL), UK
| | - D Martin
- Centre for Rehabilitation, School of Health and Life Sciences, Teesside University, UK; NIHR Applied Research Collaboration for the North East and North Cumbria, Newcastle Upon Tyne, England, UK; Graduate School of Health, University of Technology Sydney, Sydney, New South Wales, Australia
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Exploration and Analysis of the Educational Management of University Students in the Context of Environmental Constraints. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2022; 2022:8112175. [PMID: 36034625 PMCID: PMC9410807 DOI: 10.1155/2022/8112175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 07/06/2022] [Indexed: 11/17/2022]
Abstract
In order to solve the problem of the educational management of university students in the context of environmental constraints, a method based on the exploration and analysis of the educational management of university students in the context of environmental constraints was proposed. The method was combined with practical thinking, by which big data analysis strategies were introduced and the evaluation index system in the educational management of university students was explored. With the help of empirical testing, it was verified that whether the on-campus information system can bring benefits to the educational management of university students. At the same time, the method of summary analysis was used, with the training set parameters 8000 and the testing set parameters 4000. The data within the information management system were elaborated by the way of formula to ensure the stable operation of the new management system and avoid mistakes in the educational management work of university students. It aimed at increasing the application of teaching staff with high comprehensive quality ability to ensure that it had strong comprehensive benefits. And then the exploration and analysis of the educational management of university students was completed under the background of environmental constraints.
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