A Smartphone-Based Intervention With Diaries and Therapist Feedback to Reduce Catastrophizing and Increase Functioning in Women With Chronic Widespread Pain. Part 2: 11-month Follow-up Results of a Randomized Trial

BackgroundInternet-based interventions are increasingly used to support self-management of individuals with chronic illnesses. Web-based interventions may also be effective in enhancing self-management for individuals with chronic pain, but little is known about long-term effects. Research on Web-ba...

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ग्रंथसूची विवरण
मुख्य लेखकों: Kristjánsdóttir, Ólöf Birna (लेखक), Fors, Egil A (लेखक), Eide, Erlend (लेखक), Finset, Arnstein (लेखक), Stensrud, Tonje Lauritzen (लेखक), van Dulmen, Sandra (लेखक), Wigers, Sigrid Hørven (लेखक), Eide, Hilde (लेखक)
स्वरूप: पुस्तक
प्रकाशित: JMIR Publications, 2013-03-01T00:00:00Z.
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100 1 0 |a Kristjánsdóttir, Ólöf Birna  |e author 
700 1 0 |a Fors, Egil A  |e author 
700 1 0 |a Eide, Erlend  |e author 
700 1 0 |a Finset, Arnstein  |e author 
700 1 0 |a Stensrud, Tonje Lauritzen  |e author 
700 1 0 |a van Dulmen, Sandra  |e author 
700 1 0 |a Wigers, Sigrid Hørven  |e author 
700 1 0 |a Eide, Hilde  |e author 
245 0 0 |a A Smartphone-Based Intervention With Diaries and Therapist Feedback to Reduce Catastrophizing and Increase Functioning in Women With Chronic Widespread Pain. Part 2: 11-month Follow-up Results of a Randomized Trial 
260 |b JMIR Publications,   |c 2013-03-01T00:00:00Z. 
500 |a 1438-8871 
500 |a 10.2196/jmir.2442 
520 |a BackgroundInternet-based interventions are increasingly used to support self-management of individuals with chronic illnesses. Web-based interventions may also be effective in enhancing self-management for individuals with chronic pain, but little is known about long-term effects. Research on Web-based interventions to support self-management following participation in pain management programs is limited. ObjectiveThe aim is to examine the long-term effects of a 4-week smartphone-intervention with diaries and therapist-written feedback following an inpatient chronic pain rehabilitation program, previously found to be effective at short-term and 5-month follow-ups. Methods140 women with chronic widespread pain, participating in a 4-week inpatient rehabilitation program, were randomized into two groups: with or without a smartphone intervention after the rehabilitation. The smartphone intervention consisted of one face-to-face individual session and 4 weeks of written communication via a smartphone, consisting of three diaries daily to elicit pain-related thoughts, feelings, and activities, as well as daily personalized written feedback based on cognitive behavioral principles from a therapist. Both groups were given access to an informational website to promote constructive self-management. Outcomes were measured with self-reported paper-and-pencil format questionnaires with catastrophizing as the primary outcome measure. Secondary outcomes included daily functioning and symptom levels, acceptance of pain, and emotional distress. ResultsBy the 11-month follow-up, the favorable between-group differences previously reported post-intervention and at 5-month follow-up on catastrophizing, acceptance, functioning, and symptom level were no longer evident (P>.10). However, there was more improvement in catastrophizing scores during the follow-up period in the intervention group (M=-2.36, SD 8.41) compared to the control group (M=.40, SD 7.20), P=.045. Also, per protocol within-group analysis showed a small positive effect (Cohen's d=.33) on catastrophizing in the intervention group (P=.04) and no change in the control group from the smartphone intervention baseline to 11-month follow-up. A positive effect (Cohen's d=.73) on acceptance was found within the intervention group (P<.001) but not in the control group. Small to large negative effects were found within the control group on functioning and symptom levels, emotional distress, and fatigue (P=.05) from the intervention baseline to the 11-month follow-up. ConclusionThe long-term results of this randomized trial are ambiguous. No significant between-group effect was found on the study variables at 11-month follow-up. However, the within-group analyses, comparing the baseline for the smartphone intervention to the 11-month data, indicated changes in the desired direction in catastrophizing and acceptance in the intervention group but not within the control group. This study provides modest evidence supporting the long-term effect of the intervention. Trial RegistrationClinicaltrials.gov NCT01236209; http://www.clinicaltrials.gov/ct2/show/NCT01236209 (Archived by WebCite at http://www.webcitation.org/6FF7KUXo0) 
546 |a EN 
690 |a Computer applications to medicine. Medical informatics 
690 |a R858-859.7 
690 |a Public aspects of medicine 
690 |a RA1-1270 
655 7 |a article  |2 local 
786 0 |n Journal of Medical Internet Research, Vol 15, Iss 3, p e72 (2013) 
787 0 |n http://www.jmir.org/2013/3/e72/ 
787 0 |n https://doaj.org/toc/1438-8871 
856 4 1 |u https://doaj.org/article/c165e95ae82c46a6af7e76fa25a8e2f4  |z Connect to this object online.