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Title: Stakeholder analysis of outcome in chronic pain
Author: Thorne, Fiona Margaret
ISNI:       0000 0001 3532 7837
Awarding Body: University of Leeds
Current Institution: University of Leeds
Date of Award: 2007
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Determining what can be described as a 'good outcome' for people with chronic pain is problematic. It is not feasible to measure change in relation to whether individuals are within the bounds of the nonnal population as this is not possible for the majority (i.e. the pain will not cease· and return them to nonnal physical functioning). This investigation sought to derive service-user detennined criteria for the assessment of clinical significance in chronic pain. A total of 78 men and women aged 21-86 attending a local pain management out-patient clinic agreed to take part in the investigation. Participants were asked to describe an 'acceptable outcome' using common chronic pain outcome measures. Participants indicated a lower level of pain severity, impact and interference and higher level of activity as part of an acceptable outcome. Previous research has typically placed the threshold for clinically significant change at around 30%. The degree of change indicated by participants was notably higher (52.1 - 63.7%). There was considerable variation between participants. Those experiencing higher current pain intensity required a greater change in their pain experience for it to be described as an 'acceptable outcome'. For some parameters, younger age and female gender were also associated with requiring a greater degree of change. The majority of acceptable outcome ratings could be described as statistically reliable, depending on the specific pain parameter. Cut points for clinical significance were also derived for each outcome measure. Analyses revealed that a large degree of change would be required for participants to be described as experiencing a clinical significant alteration in their pain experience. Results suggest that change meeting service-user defined clinical significance criteria may be difficult to achieve in clinical practice. Suggestions for future research and possible clinical implications are discussed.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available