Effects of integrating therapeutic touch into a cognitive behavioral pain treatment program. Report of a pilot clinical trial.

The purpose of this study was to investigate the effects of offering Therapeutic Touch (TT) as an adjunct to cognitive behavioral therapy (CBT) for people with chronic pain. Patients were randomized to relaxation training (control group) or TT plus relaxation (experimental). Subsequently, all participants attended a CBT program. Preprogram and postprogram data were examined to identify patterns of change in pain intensity, self-efficacy, unitary power, disability, and perceived distress. In addition, patterns of attrition were examined. Patients in this study who were randomized to receive TT fared better in terms of enhanced self-efficacy and unitary power, as well as having lower attrition rates. Trends associated TT with less distress and disability. This pilot study suggests that offering TT as an adjunct to CBT may help to improve clinical outcomes, reduce program attrition, and promote unitary power in those who suffer with chronic pain.

Nurse-led pain management program: effect on self-efficacy, pain intensity, pain-related disability, and depressive symptoms in chronic pain patients.

Nurses routinely use a variety of nonpharmacologic and patient education interventions designed to reduce pain and promote independence. Research on group programs that combine these nursing strategies in a systematic approach provides evidence that chronic pain patients can realize an enhanced confidence in their ability to manage pain (improved self-efficacy) in addition to reductions in pain, emotional distress, and disability. The purpose of this study was to investigate the effect of participating in a nurse-led cognitive-behavioral treatment (CBT) pain management program on self-efficacy, pain intensity, pain-related disability, and depressive symptoms among patients with chronic pain. Pre- and postprogram data from 154 participants were examined to identify changes in pain intensity, self-efficacy, disability, and depressive symptoms. Mean differences, effect sizes, and 95% confidence intervals were computed for the study variables and paired t-tests were done to determine if changes were significant. Z-scores were then calculated. Pearson product moment correlations were examined to test the association between changes in self-efficacy and changes in the other variables of interest. Patients in this study reported significant improvements in all scores postprogram. Self-efficacy, pain-intensity, pain-related disability, and symptoms of depression can be changed through participation in a nurse-led outpatient CBT program. In concert with results from other research on CBT pain programs this study provides further evidence that reduction in suffering and improved sense of well-being is possible even for people who have experienced pain for many years.

From chronic pain patient to peer: benefits and risks of volunteering.

Peer volunteers have been used as cost-effective adjuncts to professional services in other settings and populations, but not a heterogeneous sample of patients with chronic pain. This study evaluated the transition from "patient" to "peer," identifying possible benefits or harm associated with volunteering. Peers provided descriptive data and questionnaires, including measures of pain, disability, self-efficacy, and depression before and after three periods: as a patient, during training, and while volunteering. Average pain intensity scores declined while participants were patients (7.1 to 4.2), rose slightly (5.8) before training, and dropped again after training and volunteering (4.3 and 3.6, respectively). A similar pattern was noted for disability. Depression scores continued to decline after initially dropping, and self-efficacy scores remained stable after the initial 40% rise as a patient. Two themes, "making a connection" and "a sense of purpose," emerged from the narrative data. Descriptive data provided further support that volunteering benefited both patients and peers. This study supports the viability of using peer volunteers for clinical or research endeavors. Improvements in pain, disability, and depression were reported immediately after training and after volunteering for several months without evidence of harm. Despite encountering challenges, the rewards of this altruistic endeavor outweighed any frustrations experienced by volunteers with chronic pain.