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Randomized Controlled Trial
. 2023 Jul;66(1):70-79.
doi: 10.1016/j.jpainsymman.2023.03.012. Epub 2023 Apr 6.

Effect of Pain Coping Skills Training on Pain and Pain Medication Use for Women With Breast Cancer

Hannah M Fisher  1 , Kelly A Hyland  2 , Joseph G Winger  2 , Shannon N Miller  2 , Grace H Amaden  2 , Allison K Diachina  2 , Sarah A Kelleher  2 , Tamara J Somers  2
Affiliations
Randomized Controlled Trial

Effect of Pain Coping Skills Training on Pain and Pain Medication Use for Women With Breast Cancer

Hannah M Fisher et al. J Pain Symptom Manage. 2023 Jul.

Abstract

Context: Pain is distressing for women with breast cancer. Pain medication may not provide full relief and can have negative side-effects. Cognitive-behavioral pain intervention protocols reduce pain severity and improve self-efficacy for pain management. These interventions' impact on pain medication use is less clear. Intervention length and coping skills use might play a role in pain outcomes.

Objectives: Secondary analysis to examine differences in pain severity, pain medication use, pain self-efficacy, and coping skill use after five- and one-session cognitive-behavioral pain intervention protocols. Pain self-efficacy and coping skills use were assessed as mediators of intervention effects on pain and pain medication use.

Methods: Women (N = 327) with stage I-III breast cancer were enrolled in a randomized trial comparing individually-delivered, five- and one-session pain coping skills training (PCST). Pain severity, pain medication use, pain self-efficacy, and coping skills use were assessed preintervention and five to eight weeks later (postintervention).

Results: Pain and pain medication use significantly decreased, while pain self-efficacy increased pre-post for women randomized to both conditions (P's <.05). Five-session PCST participants demonstrated less pain (P =.03) and pain medication use (P =.04), and more pain self-efficacy (P =.02) and coping skills use (P =.04) at postintervention compared to one-session PCST participants. Pain self-efficacy mediated the relationship of intervention condition with pain and pain medication use.

Conclusion: Both conditions led to improvements in pain, pain medication use, pain self-efficacy, and coping skills use, and 5-session PCST showed the greatest benefits. Brief cognitive-behavioral pain intervention improve pain outcomes, and pain self-efficacy may play a role in these effects.

Keywords: Breast cancer; coping skills use; pain coping skills; pain medication; pain self-efficacy; pain severity.

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Conflict of interest statement

Disclosures and Acknowledgment This work was supported by the National Institutes of Health [NIH/NCI R01CA202779]. The authors have no relevant financial or nonfinancial interests to disclose.

Figures

Figure 1.
Figure 1.
Pain Self-Efficacy as Mediator Note. 5-Session PCST=0 vs. 1-Session PCST=1; Solid line indicates a significant path; Dotted line indicates a non-significant path.
Figure 2.
Figure 2.
Coping Skills Use as Mediator Note. 5-Session PCST=0 vs. 1-Session PCST=1; Solid line indicates a significant path; Dotted line indicates a non-significant path.
See this image and copyright information in PMC

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