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Abstract：
BACKGROUND: In Canada, adults with chronic noncancer pain face a persistent insufficiency of publicly funded resources, with the gold standard multidisciplinary pain treatment facilities unable to meet the high clinical demand. Web-based self-management programs cost-effectively increase access to pain management and can improve several aspects of physical and emotional functioning. Aiming to meet the demand for accessible, fully automated resources for individuals with chronic noncancer pain, we developed a French web- and evidence-based self-management program, Agir pour moi (APM). This program includes pain education and strategies to reduce stress, practice mindfulness, apply pacing, engage in physical activity, identify and manage thinking traps, sleep better, adapt diet, and sustain behavior change.
OBJECTIVE: This study aims to assess the APM self-management program\'s feasibility, acceptability, and preliminary effects in adults awaiting specialized services from a center of expertise in chronic pain management.
METHODS: We conducted a mixed methods study with an explanatory sequential design, including a web-based 1-arm trial and qualitative semistructured interviews. We present the results from both phases through integrative tables called joint displays.
RESULTS: Response rates were 70% (44/63) at postintervention and 56% (35/63) at 3-month follow-up among the 63 consenting participants who provided self-assessed information at baseline. In total, 46% (29/63) of the participants completed the program. We interviewed 24% (15/63) of the participants. The interview\'s first theme revolved around the overall acceptance, user-friendliness, and engaging nature of the program. The second theme emphasized the differentiation between microlevel and macrolevel engagements. The third theme delved into the diverse effects observed, potentially influenced by the macrolevel engagements. Participants highlighted the features that impacted their self-efficacy and the adoption of self-management strategies. We observed indications of improvement in self-efficacy, pain intensity, pain interference, depression, and catastrophizing. Interviewees described these and various other effects as potentially influenced by macrolevel engagement through behavioral change.
CONCLUSIONS: These findings provided preliminary evidence that the APM self-management program and research methods are feasible. However, some participants expressed the need for at least phone reminders and minimal support from a professional available to answer questions over the first few weeks of the program to engage. Recruitment strategies of a future randomized controlled trial should focus on attracting a broader representation of individuals with chronic pain in terms of gender and ethnicity.
BACKGROUND: ClinicalTrials.gov NCT05319652; https://clinicaltrials.gov/study/NCT05319652.
OBJECTIVE: This study aims to assess the APM self-management program\'s feasibility, acceptability, and preliminary effects in adults awaiting specialized services from a center of expertise in chronic pain management.
METHODS: We conducted a mixed methods study with an explanatory sequential design, including a web-based 1-arm trial and qualitative semistructured interviews. We present the results from both phases through integrative tables called joint displays.
RESULTS: Response rates were 70% (44/63) at postintervention and 56% (35/63) at 3-month follow-up among the 63 consenting participants who provided self-assessed information at baseline. In total, 46% (29/63) of the participants completed the program. We interviewed 24% (15/63) of the participants. The interview\'s first theme revolved around the overall acceptance, user-friendliness, and engaging nature of the program. The second theme emphasized the differentiation between microlevel and macrolevel engagements. The third theme delved into the diverse effects observed, potentially influenced by the macrolevel engagements. Participants highlighted the features that impacted their self-efficacy and the adoption of self-management strategies. We observed indications of improvement in self-efficacy, pain intensity, pain interference, depression, and catastrophizing. Interviewees described these and various other effects as potentially influenced by macrolevel engagement through behavioral change.
CONCLUSIONS: These findings provided preliminary evidence that the APM self-management program and research methods are feasible. However, some participants expressed the need for at least phone reminders and minimal support from a professional available to answer questions over the first few weeks of the program to engage. Recruitment strategies of a future randomized controlled trial should focus on attracting a broader representation of individuals with chronic pain in terms of gender and ethnicity.
BACKGROUND: ClinicalTrials.gov NCT05319652; https://clinicaltrials.gov/study/NCT05319652.
摘要：
背景：在加拿大，患有慢性非癌性疼痛的成年人面临着公共资助资源的持续不足，金标准的多学科疼痛治疗设施无法满足高临床需求。基于Web的自我管理计划经济有效地增加了对疼痛管理的访问，并可以改善身体和情绪功能的几个方面。旨在满足人们对无障碍的需求，为患有慢性非癌症疼痛的个人提供全自动资源，我们开发了一个基于网络和证据的法国自我管理计划，Agirpourmoi（APM）。该计划包括疼痛教育和减轻压力的策略，练习正念，应用起搏,从事体育活动，识别和管理思维陷阱，睡得更好，适应饮食，并维持行为改变。
目的：本研究旨在评估APM自我管理计划的可行性，可接受性,以及等待慢性疼痛管理专业中心提供专业服务的成年人的初步效果。
方法：我们进行了一项混合方法研究，采用解释性序贯设计，包括基于网络的单臂试验和定性半结构化访谈。我们通过称为联合显示的综合表格展示了这两个阶段的结果。
结果：在基线时提供自我评估信息的63名参与者中，干预后的反应率为70％（44/63），3个月随访时为56％（35/63）。总的来说,46％（29/63）的参与者完成了该计划。我们采访了24%(15/63)的参与者。面试的第一个主题围绕着整体接受度，用户友好性，和项目的吸引力。第二个主题强调了微观层面和宏观层面参与之间的区别。第三个主题深入研究了观察到的各种效果，可能受到宏观层面参与的影响。与会者强调了影响他们自我效能感和采用自我管理策略的特征。我们观察到自我效能改善的迹象，疼痛强度，疼痛干扰，抑郁症,和灾难。受访者将这些和各种其他影响描述为可能受到行为改变的宏观参与的影响。
结论：这些文件提供了初步证据，证明APM自我管理计划和研究方法是可行的。然而,一些参与者表示，在该计划的前几周，至少需要电话提醒和最少的专业人士支持来回答问题。未来随机对照试验的招募策略应侧重于在性别和种族方面吸引更广泛的慢性疼痛患者。
背景：ClinicalTrials.govNCT05319652;https://clinicaltrials.gov/study/NCT05319652。
目的：本研究旨在评估APM自我管理计划的可行性，可接受性,以及等待慢性疼痛管理专业中心提供专业服务的成年人的初步效果。
方法：我们进行了一项混合方法研究，采用解释性序贯设计，包括基于网络的单臂试验和定性半结构化访谈。我们通过称为联合显示的综合表格展示了这两个阶段的结果。
结果：在基线时提供自我评估信息的63名参与者中，干预后的反应率为70％（44/63），3个月随访时为56％（35/63）。总的来说,46％（29/63）的参与者完成了该计划。我们采访了24%(15/63)的参与者。面试的第一个主题围绕着整体接受度，用户友好性，和项目的吸引力。第二个主题强调了微观层面和宏观层面参与之间的区别。第三个主题深入研究了观察到的各种效果，可能受到宏观层面参与的影响。与会者强调了影响他们自我效能感和采用自我管理策略的特征。我们观察到自我效能改善的迹象，疼痛强度，疼痛干扰，抑郁症,和灾难。受访者将这些和各种其他影响描述为可能受到行为改变的宏观参与的影响。
结论：这些文件提供了初步证据，证明APM自我管理计划和研究方法是可行的。然而,一些参与者表示，在该计划的前几周，至少需要电话提醒和最少的专业人士支持来回答问题。未来随机对照试验的招募策略应侧重于在性别和种族方面吸引更广泛的慢性疼痛患者。
背景：ClinicalTrials.govNCT05319652;https://clinicaltrials.gov/study/NCT05319652。
