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Changes in Identification of Possible Pain Coping Strategies by People with Osteoarthritis who Complete Web-based Pain Coping Skills Training

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Abstract

Background

We previously demonstrated that automated, Web-based pain coping skills training (PCST) can reduce osteoarthritis pain. The present secondary analyses examined whether this program also changed coping strategies participants identified for use in hypothetical pain-related situations.

Method

People with hip/knee osteoarthritis (n = 107) were randomized to Web-based PCST or standard care control. At baseline and post-intervention, they reported their pain severity and impairment, then completed a task in which they described how they would cope with pain in four hypothetical pain-related situations, also reporting their perceived risk for pain and self-efficacy for managing it. We coded the generated coping strategies into counts of adaptive behavioral, maladaptive behavioral, adaptive cognitive, and discrete adaptive coping strategies (coping repertoire).

Results

Compared to the control arm, Web-based PCST decreased the number of maladaptive behavioral strategies generated (p = 0.002) while increasing the number of adaptive behavioral strategies generated (p = 0.006), likelihood of generating at least one adaptive cognitive strategy (p = 0.01), and the size of participants’ coping repertoire (p = 0.009). Several of these changes were associated with changes in pain outcomes (ps = 0.01 to 0.65). Web-based PCST also reduced perceived risk for pain in the situations (p = 0.03) and increased self-efficacy for avoiding pain in similar situations (p < 0.001).

Conclusion

Salutary changes found in this study appear to reflect intervention-concordant learning.

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Acknowledgments

This work was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), part of the National Institutes of Health (R01AR057346). The Johnston County Osteoarthritis Project, from which some participants in this trial were recruited, was supported in part by cooperative agreements S043, S1734, and S3486 from the Centers for Disease Control (CDC) and Prevention/Association of Schools of Public Health; the NIAMS Multipurpose Arthritis and Musculoskeletal Disease Center grant P60AR30701; and the NIAMS Multidisciplinary Clinical Research Center grants P60AR49465 and P60AR064166. The sponsors who provided financial support for the conduct of the research did not influence study design; collection, analysis, or interpretation of data; the writing of the report; or the decision to submit the article for publication. This study was registered at ClinicalTrials.gov (registration number: NCT01638871).

Funding

 National Institute of Arthritis and Musculoskeletal and Skin Diseases (R01AR057346).

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Authors and Affiliations

  1. Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Christine Rini

  2. Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL, USA

    Christine Rini

  3. RTI International, Berkeley, CA, USA

    Ariana W. K. Katz

  4. U.S. Government Accountability Office, Washington, DC, USA

    Ada Nwadugbo

  5. Duke University Medical Center, Durham, NC, USA

    Laura S. Porter, Tamara J. Somers & Francis J. Keefe

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  1. Christine Rini
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  2. Ariana W. K. Katz
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  3. Ada Nwadugbo
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  4. Laura S. Porter
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  6. Francis J. Keefe
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Correspondence to Christine Rini.

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Rini, C., Katz, A.W.K., Nwadugbo, A. et al. Changes in Identification of Possible Pain Coping Strategies by People with Osteoarthritis who Complete Web-based Pain Coping Skills Training. Int.J. Behav. Med. 28, 488–498 (2021). https://doi.org/10.1007/s12529-020-09938-w

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