Abstract
BackgroundChronic pain is a substantial burden on the Australian healthcare system with an estimated 19.2% of Australians experiencing chronic pain. Knowledge of the neurophysiology and multidimensional aspects of pain is imperative to ensure health professionals apply a biopsychosocial approach to pain. Questionnaires may be used to assess learner changes in neurophysiology knowledge and beliefs and attitudes towards pain after education interventions.The aim of this study was to evaluate changes in pain neurophysiology knowledge, beliefs and attitudes following a 12 week clinically-focused pain module in year 3 osteopathy students as measured by the Neurophysiology of Pain (NPQ) Questionnaire and Health Care Providers Pain and Impairment Relationship scale (HC-PAIRS).MethodsA pre-post design was utilised. Learners completed a demographic information survey pre-module, and completed the NPQ & HC-PAIRS prior to undertaking, and after completing, a twelve week clinically-focused pain module.ResultsLearners (n = 55) completed the NPQ & HC-PAIRS at both time points. The median NPQ score was significantly increased with a large effect size (p < 0.001, z = − 5.71, r = 0.78) following the completion of the module. In contrast, the HC-PAIRS total score was significantly increased after the completion of the module (p < 0.01, z = − 6.95, r = 0.91) suggesting an increase in negative pain attitudes and beliefs. Results indicate that a clinically-focused pain module can increase pain neurophysiology knowledge. However the HC-PAIRS results suggest an increase in negative pain attitudes and beliefs. The HC-PAIRS questionnaire was developed for use with chronic low back pain attitudes & beliefs in practitioners, rather than pre-clinical students. Students were provided with general principles of pain management, rather than condition specific pain management. This study is the first comparing pain neurophysiology knowledge and changes in attitudes and beliefs towards pain pre-post a clinically-focused pain module using the NPQ & HC-PAIRS.ConclusionsThere was a significant improvement in NPQ score after the 12 week clinically-focused pain module. The HC-PAIRS result was paradoxical and may reflect issues with the module design or the measurement tool. The module duration is longer than that reported in the literature and demonstrates effectiveness in increasing pain neurophysiology knowledge.
Highlights
Chronic pain is a substantial burden on the Australian healthcare system with an estimated 19.2% of Australians experiencing chronic pain
Matched pre-post Neurophysiology of Pain Questionnaire (NPQ) and HC-PAIRS data were available for fifty-five (n = 55) of these participants
The median NPQ score increased from pre- (10/19 correct answers) to post-intervention (14/19 correct answers) with a large effect size (p < 0.001, z = − 5.71, r = 0.78)
Summary
Chronic pain is a substantial burden on the Australian healthcare system with an estimated 19.2% of Australians experiencing chronic pain. The prevalence of chronic pain supports the need to develop an understanding of the multidimensional nature of pain so as to provide targeted care for the individual patient. Developing this understanding in health profession pre-registration training is important as it may assist in reducing the perception of pain as a structural and/or biomechanical issue [2], encourage guidelines adherence [3] and improve provision of information and advice to patients with respect to pain [4, 5]. The IASP has designated 2018 as the Global Year for Excellence in Pain Education [6] This group suggests it is essential that health professionals undertake comprehensive pain education to ensure they are able to develop an appropriate biopsychosocial management approach tailored to the individual patient. Evaluating acquisition and application of pain knowledge and evolution of attitudes and beliefs towards appropriate pain management is a critical component of assessing efficacy of pain curricula
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