Treatment, communication, education

Presented at: EFIC Virtual Pain Education Summit

Speakers

Brona Fullen

European Pain Federation EFIC President - Associate Professor, School of Public Health, Physiotherapy and Sports Science, University College Dublin (UCD), Ireland
BIOGRAPHY
Jo Nijs

Professor at Vrije Universiteit Brussels, Belgium, Physiotherapist/Manual Therapist, University Hospital Brussels, Belgium
BIOGRAPHY
Stefan Elbers

Professor, University of Applied Sciences Utrecht, Research Group Lifestyle & Health, The Netherlands
BIOGRAPHY

Abstract

Chair: Brona Fullen, Ireland

Introduction
Brona Fullen, Ireland

Patient education
Jo Nijs, Beligum

Chronic pain the post prevalent and most costly medical problem in the Western society. It is now well-established that exercise therapy should be part of the evidence-based management for patients with chronic pain 1-5, yet clinicians struggle with implementing the evidence. Available evidence suggests that physical activity and exercise interventions have small positive effects on pain severity, physical functioning and quality of life, and cause few adverse events 6 . Still, when providing physical activity and exercise interventions to people with chronic pain, individual barriers for being physically active should be taken into account to prevent low adherence. Pain cognitions and beliefs (e.g. fear of movement 7, catastrophizing 8, hypervigilance 9, self-compassion 10 and acceptance 11) are often key determinants of certain lifestyles such as sedentary or avoidant behaviour in people with chronic pain. Patients’ beliefs about pain shape their attitudes and behaviours about how to manage their pain 12, including whether or not to be physically active. Patient education provides clinicians the possibility to address these barriers in an effective way. Indeed, pain neuroscience education allows to improve patients’ pain beliefs prior to exercise interventions, in order to allow patients to benefit much better from exercise approaches 1 . In addition, effective education is also key to address other lifestyle factors for patients with chronic pain, such as sleep, stress and diet. The lecture will explain the importance of patient education to allow patients with chronic pain to address various lifestyle factors concomitantly into an individually-tailored multimodal lifestyle intervention 13. Ultimately, this should lead to a higher clinical impact with higher effect sizes and subsequently decreasing the psychological and socio-economic burden of chronic pain in the Western world.

Motivational interviewing in relation to patient education
Jo Nijs, Belgium

Goal setting / Behavioural change
Stefan Elbers, The Netherlands

Goals are generally regarded as mental representations of desired future outcomes. They serve as reference standards for individuals to guide their behavior towards these favorable end-states 1. As such, effective goal-setting is a crucial step in the regulation of meaningful behaviors 2. Patients with chronic pain often encounter problems in their pursuit of meaningful goals. They report that pain frequently interrupts goal-directed actions, thereby continuously interfering with their daily life activities. Over time, this affects the enactment of important life roles, such as being a good parent or spouse, which negatively influences their self-image and threatens their identity 3. This presentation will include two crucial aspects of effective goal-setting within the context of chronic pain treatment. First, goals do not exist in a vacuum but are part of a motivational network that includes multiple and sometimes conflicting goals, as well as higher-order values 4. Understanding the characteristics of this network will help clinicians to better understand the perspective of patients and to help them formulate personally meaningful goals. Second, goal-directed behavior that is repetitively performed in the same context results in strong associations between that context and the behavior. Over time, perceiving the context will automatically trigger the desired behavioral response, leading to the formation of favorable habits 5. This method of automatizing goal-directed behavior is regarded as an important strategy to facilitate favorable health behaviors 6. Together, these two aspects of goal setting will help clinicians in their assessment of patient preferences to prioritize and formulate effective treatment goals.

Q&A