scholarly journals Caregiver-guided pain coping skills training for patients with advanced cancer: Background, design, and challenges for the CaringPals study

2019 ◽  
Vol 16 (3) ◽  
pp. 263-272 ◽  
Author(s):  
Laura S Porter ◽  
Gregory Samsa ◽  
Jennifer L Steel ◽  
Laura C Hanson ◽  
Thomas W LeBlanc ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Family Caregivers ◽  
Advanced Cancer ◽  
Self Efficacy ◽  
Coping Skills ◽  
Skills Training ◽  
Training Intervention ◽  
Pain Coping ◽  
Coping Skills Training ◽  
Training Interventions

Background/Aims Pain is a major concern of patients with advanced cancer and their caregivers. There is strong evidence that pain coping skills training interventions based on cognitive-behavioral principles can reduce pain severity and pain interference. However, few such interventions have been tested for patients with advanced cancer and their family caregivers. This study aims to test the efficacy of a caregiver-guided pain coping skills training protocol on patient and caregiver outcomes. Methods A total of 214 patients age ≥18 with Stage III–Stage IV cancer and moderate to severe pain, along with their family caregivers, are being identified and randomized with a 1:1 allocation to the caregiver-guided pain coping skills training intervention or enhanced treatment-as-usual. Dyads in both conditions receive educational resources on pain management, and the caregiver-guided pain coping skills training intervention includes three weekly 60-min sessions conducted with the patient–caregiver dyad via videoconference. Measures of caregiver outcomes (self-efficacy for helping the patient manage pain, caregiver strain, caregiving satisfaction, psychological distress) and patient outcomes (self-efficacy for pain management, pain intensity and interference, psychological distress) are collected at baseline and post-intervention. Caregiver outcomes are also collected 3 and 6 months following the patient’s death. The study is enrolling patients from four tertiary care academic medical centers and one free-standing hospice and palliative care organization. The primary outcome is caregiver self-efficacy for helping the patient manage pain. Results This article describes challenges in the design and implementation of the CaringPals trial. Key issues for trial design include the identification and recruitment of patients with advanced cancer and pain, and the follow-up and collection of data from caregivers following the patient’s death. Conclusion The CaringPals trial addresses a gap in research in pain coping skills training interventions by addressing the unique needs of patients with advanced cancer and their caregivers. Findings from this study may lead to advances in the clinical care of patients with advanced cancer and pain, as well as a better understanding of the effects of training family caregivers to help patients cope with pain.

Caregiver-guided pain coping skills training for patients with advanced cancer: Results from a randomized clinical trial

2021 ◽  
pp. 026921632110042
Author(s):  
Laura S Porter ◽  
Jennifer L Steel ◽  
Diane L Fairclough ◽  
Thomas W LeBlanc ◽  
Janet Bull ◽  
...  
Keyword(s):  
Palliative Care ◽  
Psychological Distress ◽  
Family Caregivers ◽  
Advanced Cancer ◽  
Self Efficacy ◽  
Coping Skills ◽  
Skills Training ◽  
Pain Coping ◽  
Pain Education ◽  
Coping Skills Training

Background: Pain is a major concern among patients with advanced cancer and their family caregivers. Evidence suggests that pain coping skills training interventions can improve outcomes, however they have rarely been tested in this population. Aim: To test the efficacy of a caregiver-guided pain coping skills training intervention. The primary outcome was caregiver self-efficacy for helping the patient manage pain. Design: A randomized controlled trial compared the intervention to an enhanced treatment-as-usual control. Dyads in both conditions received pain education, and those in the intervention received three sessions of pain coping skills training. Caregiver outcomes (self-efficacy; caregiver strain, caregiving satisfaction, psychological distress) and patient outcomes (self-efficacy, pain intensity and interference, psychological distress) were collected at baseline and post-intervention. Setting/participants: Two hundred two patients with stage III–IV cancer and pain and their family caregivers were enrolled from four outpatient oncology clinics and a free-standing hospice/palliative care organization. Results: Compared to those in the control arm, caregivers in the intervention reported significant increases in caregiving satisfaction ( p < 0.01) and decreased anxiety ( p = 0.04). In both conditions, caregivers reported improvements in self-efficacy, and patients reported improvements in self-efficacy, pain severity and interference, and psychological distress. Conclusions: This is the first study to test a pain coping skills intervention targeted to patients and caregivers facing advanced cancer. Findings suggest that pain education provides benefits for patients and caregivers, and coping skills training may be beneficial for caregivers. Further research is needed to optimize the benefits of education and pain coping skills training for improving cancer pain outcomes. Trial registration: ClinicalTrials.gov NCT02430467, Caregiver-Guided Pain Management Training in Palliative Care

A physiotherapist-delivered, combined exercise and pain coping skills training intervention for individuals with knee osteoarthritis: A pilot study

The Knee ◽  
2013 ◽  
Vol 20 (2) ◽  
pp. 106-112 ◽  
Author(s):  
Michael A. Hunt ◽  
Francis J. Keefe ◽  
Christina Bryant ◽  
Ben R. Metcalf ◽  
Yasmin Ahamed ◽  
...  
Keyword(s):  
Pilot Study ◽  
Knee Osteoarthritis ◽  
Coping Skills ◽  
Skills Training ◽  
Training Intervention ◽  
Pain Coping ◽  
Coping Skills Training ◽  
Combined Exercise

scholarly journals Moderators of Effects of Internet-Delivered Exercise and Pain Coping Skills Training for People With Knee Osteoarthritis: Exploratory Analysis of the IMPACT Randomized Controlled Trial (Preprint)

2018 ◽  
Author(s):  
Belinda J Lawford ◽  
Rana S Hinman ◽  
Jessica Kasza ◽  
Rachel Nelligan ◽  
Francis Keefe ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Self Efficacy ◽  
Rating Scale ◽  
Coping Skills ◽  
Numerical Rating Scale ◽  
Skills Training ◽  
Control Group ◽  
Pain Coping ◽  
Coping Skills Training ◽  
Numerical Rating

BACKGROUND Internet-delivered exercise, education, and pain coping skills training is effective for people with knee osteoarthritis, yet it is not clear whether this treatment is better suited to particular subgroups of patients. OBJECTIVE The aim was to explore demographic and clinical moderators of the effect of an internet-delivered intervention on changes in pain and physical function in people with knee osteoarthritis. METHODS Exploratory analysis of data from 148 people with knee osteoarthritis who participated in a randomized controlled trial comparing internet-delivered exercise, education, and pain coping skills training to internet-delivered education alone. Primary outcomes were changes in knee pain while walking (11-point Numerical Rating Scale) and physical function (Western Ontario and McMaster Universities Osteoarthritis Index function subscale) at 3 and 9 months. Separate regression models were fit with moderator variables (age, gender, expectations of outcomes, self-efficacy [pain], education, employment status, pain catastrophizing, body mass index) and study group as covariates, including an interaction between the two. RESULTS Participants in the intervention group who were currently employed had significantly greater reductions in pain at 3 months than similar participants in the control group (between-group difference: mean 2.38, 95% CI 1.52-3.23 Numerical Rating Scale units; interaction P=.02). Additionally, within the intervention group, pain at 3 months reduced by mean 0.53 (95% CI 0.28-0.78) Numerical Rating Scale units per unit increase in baseline self-efficacy for managing pain compared to mean 0.11 Numerical Rating Scale units (95% CI –0.13 to 0.35; interaction P=.02) for the control group. CONCLUSIONS People who were employed and had higher self-efficacy at baseline were more likely to experience greater improvements in pain at 3 months after an internet-delivered exercise, education, and pain coping skills training program. There was no evidence of a difference in the effect across gender, educational level, expectation of treatment outcome, or across age, body mass index, or tendency to catastrophize pain. Findings support the effectiveness of internet-delivered care for a wide range of people with knee osteoarthritis, but future confirmatory research is needed. CLINICALTRIAL Australian New Zealand Clinical Trials Registry ACTRN12614000243617; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=365812&isReview=true (Archived by WebCite at http://www.webcitation.org/6z466oTPs)

scholarly journals The influence of perioperative interventions targeting psychological distress on clinical outcome after total knee arthroplasty

2020 ◽  
Vol 40 (12) ◽  
pp. 1961-1986
Author(s):  
Juliette Caroline Sorel ◽  
Geke Marianne Overvliet ◽  
Maaike Gerarda Johanna Gademan ◽  
Chantal den Haan ◽  
Adriaan Honig ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Psychological Distress ◽  
Guided Imagery ◽  
Coping Skills ◽  
Skills Training ◽  
Pain Coping ◽  
Self Monitoring ◽  
Coping Skills Training ◽  
Total Knee

Abstract Our aim was to assess the effect of perioperative interventions targeting psychological distress on clinical outcome after total knee arthroplasty (TKA). We searched studies on the effect of perioperative interventions focused on psychological distress used in conjunction with TKA on pain, function, and quality of life (QoL) on PubMed, Embase.com, PsycINFO/OVID, CENTRAL, the Cochrane Database of Systematic Reviews, Scopus, and Web of Science. We included 40 studies (22 RCTs, ten cohort studies, and eight quasi-experimental studies) with a total of 3846 patients. We graded the quality of evidence as low for pain and function and as moderate for QoL. Patients receiving music, education, cognitive behavioural therapy, guided imagery, pain coping skills training, Reiki, occupational therapy with self-monitoring, and biofeedback-assisted progressive muscles relaxing training had lower pain scores or declined opioid prescriptions after TKA. Pain coping skills training, audio recording-guided imagery scripts, video promoting self-confidence, psychological therapies by video, Reiki, music, occupational therapy with self-monitoring, education, and psychotherapy improved postoperative functional outcome. Education through an app improved QoL after TKA. The studies in our systematic review show that perioperative interventions targeting psychological distress for patients receiving TKA seem to have a positive effect on postoperative pain, function, and QoL. RCTs with strict methodological safeguards are still needed to determine if perioperative interventions focused on psychological distress should be used in conjunction with TKA. These studies should also assess which type of intervention will be most effective in improving patient-reported outcome measures and declining opioid prescriptions.

scholarly journals A Small Randomized Controlled Pilot Trial Comparing Mobile and Traditional Pain Coping Skills Training Protocols for Cancer Patients with Pain

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Tamara J. Somers ◽  
Sarah A. Kelleher ◽  
Kelly W. Westbrook ◽  
Gretchen G. Kimmick ◽  
Rebecca A. Shelby ◽  
...  
Keyword(s):  
Pain Management ◽  
Cancer Patients ◽  
Mobile Health ◽  
Coping Skills ◽  
Pilot Trial ◽  
Skills Training ◽  
Training Intervention ◽  
Pain Coping ◽  
Coping Skills Training ◽  
Management Interventions

Psychosocial pain management interventions are efficacious for cancer pain but are underutilized. Recent advances in mobile health (mHealth) technologies provide new opportunities to decrease barriers to access psychosocial pain management interventions. The objective of this study was to gain information about the accessibility and efficacy of mobile pain coping skills training (mPCST) intervention delivered to cancer patients with pain compared to traditional in-person pain coping skills training intervention. This study randomly assigned participants (N=30) to receive either mobile health pain coping skills training intervention delivered via Skype or traditional pain coping skills training delivered face-to-face (PCST-trad). This pilot trial suggests that mPCST is feasible, presents low burden to patients, may lead to high patient engagement, and appears to be acceptable to patients. Cancer patients with pain in the mPCST group reported decreases in pain severity and physical symptoms as well as increases in self-efficacy for pain management that were comparable to changes in the PCST-trad group (p’s < 0.05). These findings suggest that mPCST, which is a highly accessible intervention, may provide benefits similar to an in-person intervention and shows promise for being feasible, acceptable, and engaging to cancer patients with pain.

Effectiveness of an Internet-Delivered Exercise and Pain-Coping Skills Training Intervention for Persons With Chronic Knee Pain

2017 ◽  
Vol 166 (7) ◽  
pp. 453 ◽  
Author(s):  
Kim L. Bennell ◽  
Rachel Nelligan ◽  
Fiona Dobson ◽  
Christine Rini ◽  
Francis Keefe ◽  
...  
Keyword(s):  
Knee Pain ◽  
Coping Skills ◽  
Skills Training ◽  
Training Intervention ◽  
Pain Coping ◽  
Coping Skills Training ◽  
Chronic Knee Pain
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