ABSTRACT
BACKGROUND: Preference of types of social support may vary across recipients, and social support that is less than the amount preferred may be associated with depressed mood. PURPOSE: This study aimed to investigate the interaction effects between pain controllability and discrepancy in social support and the additive utility of discrepancy in social support over perceived social support in predicting depressed mood among patients with chronic pain. METHOD: A total of 173 patients seeking treatment at two outpatient pain management clinics in Hawaii participated. RESULTS: The results indicated that (1) patients with low pain controllability preferred significantly more social support than those with high pain controllability, for all types of social support; (2) patients preferred significantly more informational and emotional support than instrumental support for both pain controllability levels; (3) discrepancy in informational or instrumental support was not associated with depressed mood, whereas discrepancy in emotional support was significantly associated with more depressed mood for low pain controllability, but not for high pain controllability; and (4) discrepancy in emotional support added a significant increment of variance in predicting depressed mood over and above perceived emotional support, whereas discrepancy in informational or instrumental support did not. CONCLUSION: Findings suggest the relative importance of discrepancy in emotional support from a significant other, especially for patients with low pain controllability.
Subject(s)
Adaptation, Psychological , Chronic Pain/psychology , Depression/psychology , Pain Management/psychology , Social Support , Adult , Affect , Aged , Chronic Pain/complications , Depression/complications , Female , Humans , Male , Middle Aged , Pain MeasurementABSTRACT
The aim of this study was to provide a preliminary outcome evaluation of the Comprehensive Pain Program (CPP) that was developed in Hawai'i to treat chronic pain patients. The CPP is a biopsychosocial intervention designed to interrupt the pattern of social isolation and to minimize pain-related depression that contributes to reduced quality of life, poor function, and increased utilization of resources. The CPP consists of a comprehensive pre-treatment screening process and a 12-week Intensive Out patient Program (IOP). Primary elements of the IOP include group psychotherapy, acupuncture, mind/body training, and therapeutic movement, thiry-five participants from a total of five cohorts completed the IOP (i.e., three sessions a week, each lasting three hours fora 12-week period). The CPP demonstrated success in six outcome areas: 1) utilization of healthcare resources, 2) functional capacity, 3) quality of life, and 4) psychological functioning, such as somatization, depression, and anxiety Post-treatment, patients demonstrated statistically significant decreases in somatization, depression, and anxiety, and statistically significant improvement in quality of life. Patient outcomes further showed substantial improvements with regards to functional capacity, as well as significant decreases in the utilization of healthcare resources. In conclusion, the preliminary evaluation of the CPP suggests additional studies with a larger sample size and comparison groups are warranted to further evaluate critical components of the treatment regimen, clinical outcome, and cost-effectiveness.