Personality Does Not Predict Treatment Preference, Treatment Experience Does: A Study of Four Complementary Pain Treatments

Abstract

The aim of the present study was to determine the extent to which personality and treatment experience affect patients’ appraisals of 4 complementary treatments for chronic pain. Patients and Methods: A total of 232 chronic pain patients (164 females, 68 males, average age 56.6 years) visiting a spa clinic in Austria returned a questionnaire on patient characteristics and personality (autonomy, depressiveness, assertiveness, selfcontrol) as well as attitudes towards (i.e. appealing, effective, pleasant) and experience of the treatments. Results were analysed by use of linear regression analysis and confidence intervals. Results: Although all treatments were appraised positively, the passive treatments (thermal water tub baths, classical massage) were favoured more than the active treatments (relaxation training or exercise therapy). Treatment appraisal was not predicted by any of the personality traits but to a large extent by treatment experience. Relaxing, not unpleasant treatments were the most highly esteemed treatments. How strenuous or tiring a treatment was only had a minor effect on its appraisal. Conclusions: Neither do dependent, passive patients prefer passive treatments, nor do conscientious patients prefer active treatments. Instead, the appraisal of treatments that induce specific somatosensory sensations is largely determined by treatment experiences, i.e. what the treatment feels like. Despite the popularity of CAM which encompasses many experientially intensive treatments, treatment experience has to date been a neglected topic of treatment research.

The Treatment Experience Questionnaire: Development and Validation of a Questionnaire Assessing the Individual's Emotional, Perceptual, and Cognitive Reactions to Alternative, Physical, and Dental Treatments

“…Patients' appraisal of treatment is positively associated with treatment-related mood, somatosensory intensity, and positive bodily sensations. This latter finding replicates and extends previous results, as not only ‘feeling good' during the treatment but also the (felt) intensity of the treatment contribute to treatment liking [19]. Negative bodily sensations were correlated with mood and tension in the expected direction, and to a greater extent than positive bodily sensations.…”

“…Treatment appraisal encompasses both items related to treatment liking and items related to treatment efficacy. Although theoretically ‘liking' and ‘perceiving to be effective' are 2 different facets, individuals obviously do not make this distinction, favoring effective treatments and regarding favorable treatments as effective, as has been previously observed [19]. …”

“…Knowledge of the type and extent of discomfort may be relevant for improving treatment administration, patient preparation, as well as treatment adherence. Thirdly, treatment experience has been shown to affect treatment preference and satisfaction [19,20]. A more detailed knowledge of the facets of treatment experience affecting treatment preference and treatment satisfaction may again help to improve treatments or to optimize the patient-treatment match.…”

“…A third aspect is treatment appraisal which represents the overall cognitive evaluation of the treatment. What a patient thinks about a treatment has been found to be associated with the emotional aspects of treatment experience and may affect treatment outcome by way of the placebo effect [19,32]. Part B of the TEQ was designed to assess these 3 somatosensory and cognitive aspects of treatment experience.…”

Why consumers maintain complementary and alternative medicine use: A qualitative study

“…41 A few crosssectional quantitative studies suggest differences between new and established CAM users, 42;43 those with high and low commitment to CAM, 44;45 and between those who rely on CAM and those who use it alongside conventional medicine. 14 Adherence to CAM might be associated with patients' experiences of a therapy, 46 and their perceptions of their practitioner 47 and illness. 48 Men with prostate cancer were more likely to stop using CAM when a high degree of effort was required to maintain use.…”