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Smartphone Intervention Helps Women with Chronic Pain

02 Sep

Investigators from Akershus University College of Applied Sciences in Oslo, Norway, conducted a randomized clinical trial to study the efficacy of a 4-week smartphone-delivered intervention on catastrophizing and other indicators of distress in women suffering from chronic pain, following their 4-week inpatient rehabilitation stay.
 
A total of 140 women with chronic widespread pain, who participated in a 4-week inpatient rehabilitation program, were randomized into 2 groups: with or without a smartphone intervention following their rehabilitation stay.
 
The smartphone intervention consisted of one face-to-face session and 4 weeks of written communication via a smartphone. Participants received 3 smartphone diary entries daily to support their awareness of and reflection on pain-related thoughts, feelings, and activities.

The registered diaries were immediately available to a therapist who submitted personalized written feedback daily, based on cognitive behavioral principles.

Both groups were given access to a non-interactive website after discharge to promote constructive self-management.
 
Outcomes were measured with self-reported questionnaires. The primary outcome measure of catastrophizing was determined using the pain catastrophizing scale (score range 0-52). Secondary outcomes included acceptance of pain, emotional distress, functioning, and symptom levels.

Of the 140 participants, 112 completed the study: 48 in the intervention group and 64 in the control group.
Immediately after the intervention period, the intervention group reported less catastrophizing (mean 9.20, SD 5.85) than the control group (mean 15.71, SD 9.11, P<.001), yielding a large effect size (Cohen's d=0.87) for study completers.
 
At 5-month follow-up, the between-group effect sizes remained moderate for catastrophizing (Cohen's d=0.74, P=.003), acceptance of pain (Cohen's d=0.54, P=.02), and functioning and symptom levels (Cohen's d=0.75, P=.001).

The results suggest that a smartphone-delivered intervention with diaries and personalized feedback can reduce catastrophizing and prevent increases in functional impairment and symptom levels in women with chronic widespread pain following inpatient rehabilitation.

Citation: 
Kristjánsdóttir OB, Fors EA, Eide E, Finset A, Stensrud TL, van Dulmen S, Wigers SH, Eide H. A smartphone-based intervention with diaries and therapist-feedback to reduce catastrophizing and increase functioning in women with chronic widespread pain: randomized controlled trial. Journal of Medical Internet Research. 2013 Jan 7; 15 (1):e5. doi: 10.2196/jmir.2249. This email address is being protected from spambots. You need JavaScript enabled to view it.

Belleruth Naparstek

Psychotherapist, author and guided imagery pioneer Belleruth Naparstek is the creator of the popular Health Journeys guided imagery audio series. Her latest book on imagery and posttraumatic stress, Invisible Heroes: Survivors of Trauma and How They Heal (Bantam Dell), won the Spirituality & Health Top 50 Books Award