Effects of a patient-centered program including the cumulative-complexity model in women with chronic pelvic pain: a randomized controlled trial

Abstract

ObjectivesTo evaluate the effects of a patient-centered intervention including the cumulative-complexity model on quality of life related to health, coping behaviors, pain, self-perceived occupational performance and activity levels. Study designRandomized controlled trial. Forty-four women with a clinical diagnosis of chronic pelvic pain were randomized into two groups. Patients in the experimental group (n = 22) were included in a patient-centered intervention that involved relevant activities proposed by participants. Patients in the control group (n = 22) received a leaflet with information about chronic pelvic pain, physical activity, fear of movement, false beliefs, active lifestyle and behavioral advice. Main outcome measuresThe primary outcome measures were health-related quality of life assessed with the EuroQol-5D and coping behavior using the Coping Strategies Questionnaires. Secondary outcomes included severity of pain using a Visual Analogue Scale, self-perception of occupational performance using the Canadian Occupational Performance Measure and physical activity levels assessed by the International Physical Activity Questionnaire. ResultsAn analysis of variance with repeated measures showed, in the experimental group compared with the control group, significantly greater improvement from baseline to post-intervention in health-related quality of life (EuroQol-5D Visual Analog Scale values of 70.06 ± 16.44 vs. 57.38 ± 16.40, p = 0.026) and coping behavior (adaptive coping 113.00 ± 31.89 vs. 83.24 ± 16.69, p = 0.002). Pain, self-perception of performance and physical activity levels also significantly improved. ConclusionsA patient-centered intervention considering the workload of patients and their capacity for performing health behaviors provides benefits regarding quality of life and coping behavior. Additionally, pain, self-perceived performance of relevant tasks and physical activity levels improved.