Predicting responses to self-management treatments for chronic pain: application of the pain stages of change model

Kerns, Robert D.; Rosenberg, Roberta

doi:10.1016/s0304-3959(99)00184-0

Cited by 169Musculoskeletal pain and rehabilitationBehavioral Health and InterventionsPain Management and Treatment

Predicting responses to self-management treatments for chronic pain: application of the pain stages of change model

Kerns, Robert D., Rosenberg, Roberta·2000·Pain

DOI 10.1016/s0304-3959(99)00184-0

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Abstract

Psychological treatments emphasizing a self-management approach have become commonly accepted alternatives to medical interventions for chronic pain. Unfortunately, these approaches often fail to engage a significant portion of targeted individuals and are associated with high drop-out and relapse rates. Informed by the transtheoretical model of behavior change and the cognitive behavioral perspective on chronic pain, the Pain Stages of Change Questionnaire (PSOCQ) was developed to assess readiness to adopt a self-management approach to chronic pain. Initial studies supported the reliability and validity of four distinct scales, Precontemplation, Contemplation, Action and Maintenance. The current study was designed to assess the ability of the PSOCQ to predict self-management participation and outcome. The PSOCQ and several relevant outcome measures were assessed before and after self-management treatment by 109 chronic pain patients. Profile analysis revealed that treatment completers and non-completers differed significantly across the four PSOCQ scales. Post-hoc comparisons indicated that pretreatment PSOCQ Precontemplation and Contemplation scores discriminated these two groups. Separate analyses revealed that Action and Maintenance scores increased over the course of treatment, and that changes in the PSOCQ scales were associated with improved outcomes. These findings suggest that increased commitment to a self-management approach to chronic pain may serve as a mediator…

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Preliminary support was provided for the predictive validity and utility of the PSOCQ and for the relevance of a stages of change model in addressing issues related to the self-management of chronic pain.
“Preliminary support was provided for the predictive validity and utility of the PSOCQ and for the relevance of a stages of change model in addressing issues related to the self-management of chronic pain.”
From Adjustment to Chronic Pain in Back Pain Patients Classified According to the Motivational Stages of Chronic Pain Management (2006) · cites this paper as [19]
There are significantly more pain patients with a lower educational level in the precontemplation stage, and significant differences on gender.
“showed significantly more pain patients with a lower educational level in the precontemplation stage and showed significant differences on gender as well.”
From Adjustment to Chronic Pain in Back Pain Patients Classified According to the Motivational Stages of Chronic Pain Management (2006) · cites this paper as [19]
Increases in scores on the Action and Maintenance scales of the PSOCQ occurring during treatment were significantly related to outcome.
“increases in scores on the Action and Maintenance scales of this instrument occurring during the course of treatment were significantly related to outcome.”
From Psychological aspects of persistent pain: Current state of the science (2004) · cites this paper as [54]
Patients who completed treatment scored significantly higher on the contemplation scale and significantly lower on the precontemplation scale of the PSOCQ than those who did not.
“Patients who completed treatment scored significantly higher on the contemplation scale and significantly lower on the precontemplation scale of the PSOCQ than those who did not.”
From Psychological aspects of persistent pain: Current state of the science (2004) · cites this paper as [54]
Pretreatment scores on the PSOCQ did not predict treatment outcome.
“Although pretreatment scores on the PSOCQ did not predict treatment outcome”
From Psychological aspects of persistent pain: Current state of the science (2004) · cites this paper as [54]

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Authors: Kerns, R. D., & Rosenberg, R.
Affiliations: Yale University (US)
VA Connecticut Healthcare System (US)
Corresponding author: Kerns, Robert D.
ORCID: Kerns, Robert D.
Venue: Pain
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2000-01-01
Volume: 84
Issue: 1
Pages: 49-55
ISSN: 0304-3959 (ISSN-L)
DOI: 10.1016/s0304-3959(99)00184-0
OpenAlex: W2033853365
Cited by: 168
References: 27
Citations by year: 2026: 2 · 2025: 2 · 2024: 3 · 2023: 7 · 2022: 3 · 2021: 4 · 2020: 2 · 2019: 8 · 2018: 8 · 2017: 5 · 2016: 3 · 2015: 4 · 2014: 9 · 2013: 6 · 2012: 7
FWCI: 5.61
Type: journal article
Language: en
Open access: closed
Locations: Pain (publishedVersion)
PubMed (publishedVersion)
Funders: U.S. Department of Veterans Affairs
McGill University
Topics: Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
Keywords: chronic pain, self-management, transtheoretical model, stages of change, treatment discontinuation, treatment outcome prediction, precontemplation, contemplation, treatment engagement
MeSH terms: Chronic Disease, Female, Humans, Male, Middle Aged, Pain, Pain Measurement, Surveys and Questionnaires, Self Care, Cognitive Behavioral Therapy, Pain Management

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Predicting responses to self-management treatments for chronic pain: application of the pain stages of change model

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