Do Pain-related Beliefs Influence Adherence to Multidisciplinary Rehabilitation?

Abstract

The findings suggest that treatment adherence is determined by a combination of pain-related beliefs either supporting or inhibiting chronic pain patients' ability to adhere to treatment recommendations over time. In the studies reviewed, self-efficacy appears to be the most commonly researched predictor of treatment adherence, its effects also influencing other pain-related beliefs. More refined and standardized methodologies, consistent descriptions of pain-related beliefs, and methods of measurement will improve our understanding of adherence behaviors.

Post‐intervention treatment adherence for chronic pain patients may depend on psychological factors

“…When viewed at the bivariate level, pain self-efficacy (at pre-and post-intervention) was the only significant correlate of post-intervention treatment adherence. This finding is consistent with other research (Brus, van de Laar, Taal, Rasker, & Wiegman, 1999;Medina-Mirapeix et al, 2009;Thompson et al, 2016), which has also found a link between pain self-efficacy and post-intervention treatment adherence. Notably, the adherence and pain self-efficacy correlation was only marginally larger for post-treatment than pre-treatment self-efficacy despite observed improvements in pain self-efficacy by post-intervention.…”

“…Despite considerable exploration of the influence of psychological factors on prognosis in chronic pain contexts, few studies have explored the impact of these factors on treatment adherence, particularly in the post-treatment maintenance phase (Thompson et al, 2016). The present longitudinal study sought to remedy this by testing the predictive value of four previously identified psychological risk factors (fear-avoidance, pain self-efficacy, depression, and anxiety) for post-intervention treatment adherence following a pain management intervention.…”

“…It is reasoned that individuals who feel confident in their ability to undertake the treatment plan may be more motivated to invest time in the treatment, and may be more likely to persist in the face of setbacks or initial challenges. Recent reviews by Thompson, Broadbent, Bertino, and Staiger (2016) and Holmes, Hughes, and Morrison (2014) support the role of self-efficacy as a consistent predictor of treatment adherence. These reviews demonstrate the potential robustness of self-efficacy's effect on adherence as it was found to be a significant unique predictor of adherence across different stages of treatment.…”

“…Despite growing evidence of potential psychological factors influential to treatment adherence, several key gaps remain. First, whereas adherence during the treatment phase is a common focus in past research, adherence to post-treatment plans is less consistently evaluated (Thompson et al, 2016). While it is important to identify predictors of success during this primary treatment phase, in many instances chronic pain patients are recommended ongoing exercises post-intervention to maintain or further enhance treatment effects.…”

Influence of psychological factors on the prognosis of chronic shoulder pain: protocol for a prospective cohort study

“…In this sense, there has been a growing recognition that the degree of chronic pain is influenced by the beliefs, attitudes and expectations of individuals. [27][28][29] Given the importance of pain as a mechanism of survival, it is perhaps unsurprising that pain perception is clearly influenced by conscious and unconscious memory, cognitive and emotional functioning and contextual factors that are explicitly included in a biopsychosocial formulation of pain. 30 Inside of the biopsychosocial understanding of chronic pain, there is a growing interest, and acceptance in hypothesising that the association between physical impairment, pain intensity and pain-related disability is only moderate and that psychological factors may influence the experience of pain and its impact and hence may play a crucial role in the maintenance of pain-related problems.…”