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Annals of Behavioral Medicine
Published in: Annals of Behavioral Medicine 3/2011

01-06-2011 | Original Article

Further Evaluation of the Motivational Model of Pain Self-Management: Coping with Chronic Pain in Multiple Sclerosis

Authors: Anna L. Kratz, Ph.D, Ivan R. Molton, Ph.D, Mark P. Jensen, Ph.D, Dawn M. Ehde, Ph.D, Warren R. Nielson, Ph.D

Published in: Annals of Behavioral Medicine | Issue 3/2011

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Abstract

Background

Growing evidence suggests that motivation to engage in pain-coping strategies is a key predictor of how well a person adjusts to pain. According to the Motivational Model of Pain Self-Management, readiness to engage in pain self-management behaviors is influenced by beliefs about the importance of the behavior (importance) and the ability to carry out the behavior (self-efficacy).

Purpose

The purpose of this study was to test the Motivational Model of Pain Self-Management for exercise and task persistence pain-coping behaviors in a sample of 114 individuals with multiple sclerosis and chronic pain.

Methods

Measures included the Multidimensional Pain Readiness to Change Questionnaire-2 and measures of importance, self-efficacy, and coping behavior duration. Tests of mediation were conducted with two path analyses, one for each coping behavior.

Results

The effects of importance and self-efficacy beliefs on coping behaviors were mediated or partially mediated by readiness to engage in those behaviors.

Conclusions

These findings provide support for the Motivational Model of Pain Self-Management and have important implications for the development of treatments for chronic pain.
Literature
1.
Anderson DW, Ellenberg JH, Leventhal CM, et al.: Revised estimate of the prevalence of multiple sclerosis in the United States. Ann Neurol. 1992, 31:333–336.PubMedCrossRef
2.
Reingold SC: Prevalence estimates for MS in the United States and evidence of an increasing trend for women. Neurology. 2002, 59:294; author reply 294–295.
3.
O’Connor AB, Schwid SR, Herrmann DN, Markman JD, Dworkin RH: Pain associated with multiple sclerosis: Systematic review and proposed classification. Pain. 2008, 137:96–111.PubMedCrossRef
4.
Ehde DM, Osborne TL, Hanley MA, Jensen MP, Kraft GH: The scope and nature of pain in persons with multiple sclerosis. Mult Scler. 2006, 12:629–638.PubMedCrossRef
5.
Hadjimichael O, Kerns RD, Rizzo MA, Cutter G, Vollmer T: Persistent pain and uncomfortable sensations in persons with multiple sclerosis. Pain. 2007, 127:35–41.PubMedCrossRef
6.
Khan F, Pallant J: Chronic pain in multiple sclerosis: Prevalence, characteristics, and impact on quality of life in an Australian community cohort. J Pain. 2007, 8:614–623.PubMedCrossRef
7.
8.
Heckman-Stone C, Stone C: Pain management techniques used by patients with multiple sclerosis. J Pain. 2001, 2:205–208.PubMedCrossRef
9.
Archibald CJ, McGrath PJ, Ritvo PG, et al.: Pain prevalence, severity and impact in a clinic sample of multiple sclerosis patients. Pain. 1994, 58:89–93.PubMedCrossRef
10.
Bradley L: Cognitive-behavioral therapy for chronic pain. In R. Gatchel and D. C. Turk (eds), Psychological Approaches to Pain Management: A Practitioner’s Handbook. New York: Guilford, 1996.
11.
Loeser J, Turk DC: Multidisciplinary pain management. In J. Loeser, S. Batler, C. Chapman and D. C. Turk (eds), Bonica’s Management of Pain. Philadelphia: Lippincott Williams and Wilkins, 2003.
12.
Novy DM, Nelson DV, Francis DJ, Turk DC: Perspectives of chronic pain: An evaluative comparison of restrictive and comprehensive models. Psychol Bull. 1995, 118:238–247.PubMedCrossRef
13.
Hirsh AT, Kupper AE, Carter GT, Jensen MP: Psychosocial factors and adjustment to pain in individuals with postpolio syndrome. Am J Phys Med Rehabil. 2010, 89:213–224.PubMedCrossRef
14.
Raichle KA, Hanley M, Jensen MP, Cardenas DD: Cognitions, coping, and social environment predict adjustment to pain in spinal cord injury. J Pain. 2007, 8:718–729.PubMedCrossRef
15.
Osborne TL, Jensen MP, Ehde DM, Hanley MA, Kraft G: Psychosocial factors associated with pain intensity, pain-related interference, and psychological functioning in persons with multiple sclerosis and pain. Pain. 2007, 127:52–62.PubMedCrossRef
16.
Motl RW, McAuley E, Snook EM: Physical activity and multiple sclerosis: A meta-analysis. Mult Scler. 2005, 11:459–463.PubMedCrossRef
17.
Motl RW, Snook EM, McAuley E, Scott JA, Douglass ML: Correlates of physical activity among individuals with multiple sclerosis. Ann Behav Med. 2006, 32:154–161.PubMedCrossRef
18.
Barrett CL, Mann GE, Taylor PN, Strike P: A randomized trial to investigate the effects of functional electrical stimulation and therapeutic exercise on walking performance for people with multiple sclerosis. Mult Scler. 2009, 15:493–504.PubMedCrossRef
19.
Motl RW, Gosney JL: Effect of exercise training on quality of life in multiple sclerosis: A meta-analysis. Mult Scler. 2008, 14:129–135.PubMedCrossRef
20.
Snook EM, Motl RW: Effect of exercise training on walking mobility in multiple sclerosis: A meta-analysis. Neurorehabil Neural Repair. 2009, 23:108–116.PubMed
21.
Stuifbergen AK, Blozis SA, Harrison TC, Becker HA: Exercise, functional limitations, and quality of life: A longitudinal study of persons with multiple sclerosis. Arch Phys Med Rehabil. 2006, 87:935–943.PubMedCrossRef
22.
Turner AP, Kivlahan DR, Haselkorn JK: Exercise and quality of life among people with multiple sclerosis: Looking beyond physical functioning to mental health and participation in life. Arch Phys Med Rehabil. 2009, 90:420–428.PubMedCrossRef
23.
Motl RW, McAuley E: Pathways between physical activity and quality of life in adults with multiple sclerosis. Health Psychol. 2009, 28:682–689.PubMedCrossRef
24.
Motl RW, McAuley E: Longitudinal analysis of physical activity and symptoms as predictors of change in functional limitations and disability in multiple sclerosis. Rehabil Psychol. 2009, 54:204–210.PubMedCrossRef
25.
Biller N, Arnstein P, Caudill MA, Federman CW, Guberman C: Predicting completion of a cognitive-behavioral pain management program by initial measures of a chronic pain patient’ s readiness for change. Clin J Pain. 2000, 16:352–359.PubMedCrossRef
26.
Heapy A, Otis J, Marcus KS, et al.: Intersession coping skill practice mediates the relationship between readiness for self-management treatment and goal accomplishment. Pain. 2005, 118:360–368.PubMedCrossRef
27.
Kerns RD, Rosenberg R: Predicting responses to self-management treatments for chronic pain: application of the pain stages of change model. Pain. 2000, 84:49–55.PubMedCrossRef
28.
Williams DA: Psychological and behavioural therapies in fibromyalgia and related syndromes. Best Pract Res Clin Rheumatol. 2003, 17:649–665.PubMedCrossRef
29.
Jensen MP, Nielson WR, Kerns RD: Toward the development of a motivational model of pain self-management. J Pain. 2003, 4:477–492.PubMedCrossRef
30.
Molton IR, Jensen MP, Nielson W, Cardenas D, Ehde DM: A preliminary evaluation of the motivational model of pain self-management in persons with spinal cord injury-related pain. J Pain. 2008, 9:606–612.PubMedCrossRef
31.
Molton IR, Jensen MP, Nielson W, Cardenas D, Ehde DM. A preliminary evaluation of the motivational model of pain self-management in persons with spinal cord injury related pain. Journal of Pain. 2010, 9:606–612.
32.
Palisano R, Rosenbaum P, Walter S, et al.: Development and reliability of a system to classify gross motor function in children with cerebral palsy. Dev Med Child Neurol. 1997, 39:214–223.PubMedCrossRef
33.
Huber A, Suman AL, Rendo CA, et al.: Dimensions of “unidimensional” ratings of pain and emotions in patients with chronic musculoskeletal pain. Pain. 2007, 130:216–224.PubMedCrossRef
34.
Hoffman DL, Sadosky A, Dukes EM, Alvir J: How do changes in pain severity levels correspond to changes in health status and function in patients with painful diabetic peripheral neuropathy? Pain. 2010, 149:194–201.PubMedCrossRef
35.
Jensen MP, Smith DG, Ehde DM, Robinsin LR: Pain site and the effects of amputation pain: Further clarification of the meaning of mild, moderate, and severe pain. Pain. 2001, 91:317–322.PubMedCrossRef
36.
Serlin RC, Mendoza TR, Nakamura Y, Edwards KR, Cleeland CS: When is cancer pain mild, moderate or severe? Grading pain severity by its interference with function. Pain. 1995, 61:277–284.PubMedCrossRef
37.
Zelman DC, Hoffman DL, Seifeldin R, Dukes EM: Development of a metric for a day of manageable pain control: Derivation of pain severity cut-points for low back pain and osteoarthritis. Pain. 2003, 106:35–42.PubMedCrossRef
38.
Von Korff M, Ormel J, Keefe FJ, Dworkin SF: Grading the severity of chronic pain. Pain. 1992, 50:133–149.CrossRef
39.
Nielson WR, Jensen MP, Ehde DM, Kerns RD, Molton IR: Further development of the multidimensional pain readiness to change questionnaire: The MPRCQ2. J Pain. 2008, 9:552–565.PubMedCrossRef
40.
Jensen MP, Turner JA, Romano JM, Nielson WR: Chronic Pain Coping Inventory: Professional Manual. Lutz: Psychological Assessment Resources, 2008.
41.
Curran PJ, West SG, Finch JF: The robustness of test statistics to nonnormality and specification error in confirmatory factor analysis. Psychol Meth. 1996, 1:16–29.CrossRef
42.
Muthen LK, Muthen BO: MPlus User’s Guide. Fifth Edition. Los Angeles: Muthen & Muthen, 1998–2007.
43.
Sobel M: Asymptotic confidence intervals for indirect effects in structural equation models. Socio Meth. 1982, 13:290–312.CrossRef
44.
Bandura A: Social foundations of thought and action: A social cognitive theory. Englewood Cliffs: Prentice Hall, 1986.
45.
Janz NK, Becker MH: The Health Belief Model: A decade later. Health Educ Q. 1984, 11:1–47.PubMed
46.
Rogers R: A protection motivation theory of fear appraisals and attitude change. J Psychol. 1975, 91:93–114.CrossRef
47.
Rogers R: Cognitive and physiological processes in fear-based attitude change: A revised theory of protection motivation. In J. Cacioppo and R. Petty (eds), Social Psychophysiology: A Sourcebook. New York: Guilford, 1983, 153–176.
48.
Miller W, Rollnick S: Motivational Interviewing: Preparing People to Change. 2nd Edition. New York: Guilford, 2002.
49.
Conn VS, Hafdahl AR, Brown SA, Brown LM: Meta-analysis of patient education interventions to increase physical activity among chronically ill adults. Patient Educ Couns. 2008, 70:157–172.PubMedCrossRef
50.
Berger BA, Liang H, Hudmon KS: Evaluation of software-based telephone counseling to enhance medication persistency among patients with multiple sclerosis. J Am Pharm Assoc (2003). 2005, 45:466–472.
51.
Bombardier CH, Cunniffe M, Wadhwani R, et al.: The efficacy of telephone counseling for health promotion in people with multiple sclerosis: A randomized controlled trial. Arch Phys Med Rehabil. 2008, 89:1849–1856.PubMedCrossRef
Metadata
Title
Further Evaluation of the Motivational Model of Pain Self-Management: Coping with Chronic Pain in Multiple Sclerosis
Authors
Anna L. Kratz, Ph.D
Ivan R. Molton, Ph.D
Mark P. Jensen, Ph.D
Dawn M. Ehde, Ph.D
Warren R. Nielson, Ph.D
Publication date
01-06-2011
Publisher
Springer-Verlag
Published in
Annals of Behavioral Medicine / Issue 3/2011
Print ISSN: 0883-6612
Electronic ISSN: 1532-4796
DOI
https://doi.org/10.1007/s12160-010-9249-6

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