P06.11
Purpose: Clinical trials of various CAM therapies for chronic pain have reported inconsistent relationships between pre-treatment expectations of therapeutic benefit and treatment outcomes. As part of a study to develop and validate a questionnaire about expectations of CAM therapies for persons with chronic back pain, we interviewed people who were seeking CAM treatment for chronic low back pain. This presentation focuses on the changes over the course of treatment in the ways that patients describe their expectations and hopes about the outcomes of their treatment.
Methods: Up to three semi-structured interviews (over the course of 12 weeks) were conducted with 64 individuals seeking one of four types of CAM treatments—massage, chiropractic, acupuncture or yoga—for their chronic low back pain. Interviews were recorded, transcribed and coded using a phenomenological approach to data analysis. Here we focus our analysis on expectations and hopes related to desired outcomes of care as they vary within interviews and change over the course of treatment.
Results: Before beginning treatment, the vast majority participants voiced expectations and hopes that were focused around pain reduction. The narratives were complex, sometimes even articulating conflicting expectations in the same interview and over time. Many participants moved, as their treatment progressed, to a perspective that encompassed more aspects of their lives. They spoke of a greater acceptance of their pain as a chronic reality and reported a greater need and willingness to engage in ongoing self-care.
Conclusion: These findings suggest that one value of CAM care may be to facilitate a greater understanding that pain needs to be managed over the long term and further suggests that studies of CAM therapies should include a broader set of outcomes than the traditional condition-focused outcomes.
Contact: Karen Sherman, sherman.k@ghc.org
