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Title: Development of a psychologically-based treatment for chronic pain in Singapore : patient and healthcare professional inputs, theoretical model and a feasibility trial
Author: Yang, Su-Yin
ISNI:       0000 0004 5994 5754
Awarding Body: King's College London
Current Institution: King's College London (University of London)
Date of Award: 2016
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Background: Many studies in non-Asian contexts have tested psychological approaches in the treatment of chronic pain. However studies in Asia, including Singapore are few. Aims: This thesis is part of a program of research in the development of an Acceptance and Commitment Therapy (ACT)-based treatment for chronic pain, in its application within an Asian and specifically Singaporean cultural and healthcare context. Methods: Four distinct phases using a mixed-methods design approach was conducted: (a) A systematic review on the efficacy of psychological treatments for chronic pain in East and Southeast Asia (b) Assessing with semi-structured interviews, patient (N = 15) and health professional views (N = 15) on potential barriers for psychological treatment for chronic pain in Singapore, and views relevant to designing a successful ACT-based treatment for chronic pain (c) Identifying optimal delivery features in a quantitative survey developed from themes generated from the interviews, and a test of the relevance of ACT-related psychological processes in a wider patient sample (N = 200), and (d) Development and feasibility test of a culturally-adapted internet-based ACT trial (N = 33). Results: Studies included in the systematic review were few and mostly of low quality. Patients and health professionals shared many similar views on psychological treatment barriers and facilitators. Survey results showed that a focus on costs and providing proof of treatment success may increase psychological treatment uptake. The utility of psychological flexibility (PF) was found to be relevant within the sample of chronic pain patients from Singapore. High treatment satisfaction (81.8%), low dropout rates (9.1%) and significant effects on depression (0.51) and pain intensity (0.39) were demonstrated in the trial. Conclusions: A culturally-adapted ACT-based treatment examined in the healthcare context of Singapore appears feasible for future development. More effective ways to target outcomes and ACT processes are required.
Supervisor: Moss-Morris, Rona ; McCracken, Lance Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available