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The relationship between the readiness for change and clinical outcomes in response to multidisciplinary pain management.

OBJECTIVE
The pain stages of change questionnaire (PSOCQ) has been designed to assess the willingness of chronic pain patients to engage in self-management approaches. This study sought to examine the utility of the PSOCQ as a predictor of treatment completion and the relationship with treatment outcome.


DESIGN
A convenience sample, uncontrolled, pre- and post-intervention cohort design.


SETTING
Multidisciplinary pain management center.


PATIENTS
Two hundred and sixty-one participants with chronic nonmalignant pain.


INTERVENTIONS
Eight-week program of either cognitive behavioral therapy group or a functional restoration group.


OUTCOME MEASURES
Brief Pain Inventory average pain rating. The Short Form Health Survey (SF-36 version 2) mental health and physical functioning subscales as well as the PSOCQ.


RESULTS
  Results suggest that those higher on precontemplation and lower on the other scales are less likely to complete treatment. A two-way multiple analysis of variance also found that when comparing those who progress through stages with those who stagnate or regress, "progressors" show significantly more improvement in measures of mood and functionality but not pain. The treatment groups did not appear to have significantly different outcomes in terms of stage of change.


CONCLUSIONS
These findings suggest that the PSOCQ may be useful in making treatment more efficient, both by predicting who is less likely complete treatment and by providing targeted treatments according to patients' readiness to engage in self-management.