Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations.
Chronic pain is a debilitating condition that disrupts engagement in meaningful occupations. Self-efficacy may be a protective factor in reducing pain-related disability and promoting effective chronic pain management. After participating in the 8-week Merging Yoga and Self-Management Skills program, dyads with chronic pain reported increased self-efficacy of varying degrees. Significant improvement in self-efficacy related to physical function was reported.
Primary Author and Speaker: Charla Kinkel
Contributing Authors: Arlene Schmid, Christine A. Fruhauf, Karen Atler, and Haylee A. Candray
PURPOSE: Chronic pain is a debilitating condition that disrupts individuals' ability to perform meaningful occupations and interferes with interpersonal relationships. Self-efficacy is an essential component in adopting and maintaining healthy behaviors necessary to manage a chronic condition. Higher self-efficacy is associated with reduced pain-related disability, decreased pain severity, and improved mood. Dyadic (i.e., caregiver and care-recipient) interventions for chronic conditions may improve health outcomes for both caregiver and care-recipient. Merging Yoga and Self-Management Skills (MY-Skills) for dyads with chronic pain aims to enable participants to concurrently benefit from mind-body activity and applied skills development. However, no known studies have examined the impact of MY-Skills on self-efficacy. This study aimed to explore if participants had improved self-efficacy after completing the MY-Skills intervention.
DESIGN: In this quasi-experimental study, care dyads comprised of caregivers and care-recipients with chronic pain were recruited from local pain clinics, community centers, events, and paid advertising. For inclusion, both members of the dyad reported having musculoskeletal pain for at least three months, with one member identifying as a caregiver for the care-recipient. Participants engaged in a one-hour group self-management course followed by a one-hour group yoga session twice weekly for 8 weeks.
METHOD: Self-efficacy outcomes were assessed using the: Chronic Pain Self-Efficacy Scale with domains of pain management, physical function, and coping with symptoms; the PROMIS® Self-Efficacy for Managing Daily Activities Short Form 4a; and the PROMIS Self-Efficacy for Managing Symptoms Short Form 4a. Data were collected before and after the 8-week intervention. Data distribution was normal, and data were analyzed using a paired t-test. A post hoc exploratory analysis of separate caregiver and care-recipient outcomes was conducted using a Wilcoxon signed ranks test.
RESULTS: Eight participants completed the study (50.23 ± 14.77 avg. age, 77% female, 69% with pain for > 10 years). Participants reported increased self-efficacy across all measures and domains, with significant improvement found for self-efficacy for CPSS physical function (38.97 ± 19.45 vs. 59.10 ± 18.60, p = .004). A post hoc exploratory analysis showed increased self-efficacy across caregiver outcomes. Care-recipients reported increased self-efficacy in all areas except pain management, which significantly decreased.
CONCLUSION: MY-Skills improved self-efficacy to varying degrees for participants in aggregate. Improvements in self-efficacy related to physical function demonstrated that MY-Skills increased participants' confidence in performing everyday occupations such as running errands, doing chores, working, and socializing. Interventions like MY-Skills that improve self-efficacy may help people with chronic pain gain function, problem-solving capabilities, and coping skills. Such changes could lead to improved sense of control, reduced pain-related disability, and enhanced quality of life. Occupational therapy practitioners are well-equipped to deliver multi-faceted interventions like MY-Skills to assist clients in regaining occupational participation despite chronic pain.
References
Schmid, A. A., Fruhauf, C. A., Sharp, J. L., Van Puymbroeck, M., Bair, M. J., & Portz, J. D. (2019). Yoga for people with chronic pain in a community-based setting: A feasibility and pilot RCT. Journal of Evidence Based Integrated Medicine, 24, 1-11. https://doi.org/10.1177/2515690X19863763
Schmid, A. A., Van Puymbroeck, M., Fruhauf, C. A., Bair, M. J., & Portz, J. D. (2019). Yoga improves occupational performance, depression, and daily activities for people with chronic pain. Work, 63(2), 181-189. https://doi.org/10.3233/WOR-192919
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