The effects of vulnerabilities and strengths on the outcomes of a chronic pain management programme

Abstract

Chronic pain is a problem that affects around one million New Zealanders and is very difficult to treat effectively. Most pain management programmes focus on decreasing levels of treatment outcome measures (pain catastrophising, pain intensity, interference) and increasing levels of pain self-efficacy. Research shows that higher levels of vulnerabilities (depression, anxiety, stress, pessimism) can negatively impact treatment outcomes. However, research also shows that increasing levels of strengths (optimism, hope, spirituality, social support, grit) affect treatment outcomes positively. We wanted to determine if there were differences in treatment outcomes for participants with high levels of vulnerabilities or strengths. Our study looked at the relationships between treatment outcome measures, vulnerabilities, and strengths over a three-week pain management programme. Participants (N = 40) attending the ReCharge Programme at QE Health completed repeat measure scales at intake, discharge, and 12-week follow-up. We found that higher levels of depression, stress, and pessimism were associated with higher levels of pain catastrophising, pain intensity, and interference, and lower levels of pain self-efficacy. Conversely, higher levels of optimism, hope, spirituality, and grit were associated with lower levels catastrophising, intensity, and interference, and higher levels of pain self-efficacy. Anxiety and social support were not associated with any treatment outcomes. We also found that correlations of composite measures of strengths accounted for more variability in pain self-efficacy than did composite vulnerabilities. This suggests that tailored interventions, based on levels of strengths at intake, aimed at increasing levels of strengths during the ReCharge Programme could improve treatment outcome measures for clients.