Article

The aim of this study was to examine whether Multidimensional Pain Inventory
(MPI) subscale score changes can be used for monitoring interdisciplinary
cognitive behavioural pain rehabilitation programmes, using the Psychological
General Well-Being (PGWB) index as an independent variable of rehabilitation
outcome. Data from 434 consecutively referred patients disabled by chronic pain
were analysed. The intervention was a 4-week interdisciplinary pain
rehabilitation group programme (5 h/day), based on biopsychosocial and cognitive
behavioural principles. Mean PGWB total scores improved after rehabilitation
(P<0.0001) with clinically relevant effect sizes for patients with
'dysfunctional' and 'interpersonally distressed' MPI profiles. Substantial
correlations (r=0.7-0.3; P<0.001) were found between the changes in PGWB total
scores and four of the MPI subscale scores. These were combined into a composite
variable ['pain severity', 'interference', 'life control' (given reversed scores)
and 'affective distress'], and were labelled as the Pain Rehabilitation Index.
The subscales, 'support' and 'general activity level', were omitted, as changes
were ambiguous with respect to functioning. 'Dysfunctional' and 'interpersonally
distressed' profile patients showed a marked improvement in Pain Rehabilitation
Index after rehabilitation (effect sizes of 0.77 and 0.43; P<0.0001,
respectively). Conversely, the 'adaptive copers' may have deteriorated somewhat
(effect size -0.28; P=0.036). We propose that scores from four MPI subscales are
integrated and the difference pre-post rehabilitation is used to indicate
composite rehabilitation outcomes, making it possible to interpret all included
MPI subscales in the same direction. Psychometric evaluation of the index is
warranted.

Langue : ANGLAIS