Empowering Patients: A Multicomponent Workshop Improves Self-Management and Quality of Life in Chronic Pain

赋能患者:多组分工作坊改善慢性疼痛患者的自我管理和生活质量

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Abstract

BACKGROUND: Chronic pain is a prevalent and disabling condition, affecting 20-30% of the global population, which requires multidisciplinary approaches integrating non-pharmacological therapies and promoting patient engagement in self-management. OBJECTIVE: To describe the structure, content, outcomes, and lessons learned from multicomponent workshops for chronic non-cancer pain using non-pharmacological therapies. METHODS: A quasi-experimental before-after study was conducted in patients attending a chronic pain workshop at San Juan de Dios Hospital (Bormujos, Seville, Spain) between November 2021 and May 2024, with a 3-month follow-up, Validated scales and an ad hoc patient survey were administered at baseline, immediately post-workshop, and at 3-month follow-up. Furthermore, comparative analysis was conducted 4 months before and after the intervention for emergency visits and consultations, medication consumption, and employment status. Analyses employed Chi-square or Fisher's exact tests (categorical variables); student's t-tests or Mann-Whitney U (between-group); paired t-tests or Wilcoxon (within-group pre-post); and effect sizes (Cohen's d, Rosenthal's r). Significance was set at p < 0.05. RESULTS: 197 patients completed the workshop; 178 (90.4%) were women, mean age: 55.0; 114 (57.9%) had fibromyalgia. Reductions were observed in: pain (scale 0-10) (baseline: 7.0; end of workshop: 5.0; 3 months: 5.0; p < 0.001); anxiety (13.0; 9.0; 11.0; p < 0.001); and depression (11.4; 7.2; 6.8; p < 0.001) (scales 0-21). Increases were noted in: well-being (scale 0-10) (4.0; 6.0; 5.0; p < 0.001); quality of life (scale 0-1) (0.399; 0.581; 0.556; p < 0.001); health status (scale 0-100) (40.0; 60.0; 60.0; p < 0.001); self-esteem (scale 9-36) (23.5; 27.1; 26.6; p < 0.001); and resilience (scale 6-30) (17.0; 18.0; 18.0; p = 0.002, p < 0.001). PROMs were completed by 189 patients at the end of the workshop and 110 at 3 months: pain decreased (end of workshop: 76.7%; 3 months: 80.7%); medication decreased (80.5%; 78.1%); and habits improved (87.2%; 87.6%). 40 patients (37.4%) reduced emergency visits and scheduled consultations. Overall satisfaction: 9.7. CONCLUSIONS: The workshop enhanced patients' self-management and produced improvements in pain, quality of life, emotional well-being, and self-esteem, with effects maintained at 3 months.

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