Do acceptance and cognitive representations of pain predict engagement and outcome on a pain management programme?.
Pain management programmes provide effective interventions for people with chronic
pain, but effects are modest, and not all participants benefit. The current study aims
to investigate the role of acceptance and cognitive representations i.e. beliefs about
pain, in engagement, and outcome, of this kind of intervention.
Design and participants
A quantitative design was used to investigate whether acceptance and cognitive
representations of pain predict engagement and outcome of intervention, whether
acceptance and cognitive representations change during intervention, and the
relationship of acceptance with five dimensions of belief. Participants were 116
patients referred for assessment to a pain management programme.
Questionnaire measures of acceptance of pain, and cognitive representations of pain
were used as predictor variables. Measures of distress, self-efficacy and physical
function were used as outcome measures. Pain severity and waiting time were also
measured as potentially confounding variables.
Measures of acceptance and cognitive representations of pain did not predict who
would complete the intervention. Increases in acceptance, and decreases in perceived
consequences of pain, and pain identity, occurred during the intervention. Lower
acceptance was related to more serious perceived consequences and greater pain
identity, but not with beliefs about cause or expected duration of pain, or beliefs in
control and cure.
Interventions aiming to increase acceptance by changing beliefs about perceived
consequences of pain and pain identity may be useful. Further research is needed to
explore the nature of acceptance, and the role of different dimensions of belief in
affecting functioning, in chronic pain populations.